Common is not the same as Normal

May 13, 2013

Day 23-- By Dr. Meghan Walker ND

What do menstrual cramps, hot flashes, one bowel movement every three days and heartburn have in common? They are all symptoms we would classify as common, but none of them are normal. We have grown up in a culture where we pop an anti-inflammatory to manage pain and an antacid to cope with post-consumptive heartburn. We do it over and over again, rarely stopping to ask, does this happen to everyone? I spend my days talking to people about their health. We examine the big things that brought them through the door, but we dedicate an equal amount of time to checking-in on the small stuff. Bowel habits, menstrual cramps, pain during intercourse, we discuss it all. Remarkable in this investigation is not that we have the opportunity to discuss these matters, it is the amazement on people’s faces when they realize that their weekly headaches, post-nasal drip or joint pain are a common, but not necessarily “normal” part of our physiological experience.


Acknowledging these common symptoms does not negate the notion that the range of normal for a population can be varied, or that it is in fact expected that we will oscillate in and out of a state “ideal” health. It is the chronic presence of “common” symptoms that I am attempting to honour. Appropriate medical evaluations will help to elucidate when, as clinicians, we are seeing a variation of normal or just de-prioritizing something that is common.


The danger in mistaking common for normal is not usually that there is something larger lurking below the surface (although this can be the case); it is the fact that someone is missing out on the opportunity to operate at his or her highest potential. I frequently create an association for my patients between the concept of an oil light and symptoms. When an oil light begins to flash on the dashboard of your car you are faced with several options. You can ignore it and drive a little further, cover it with tape, disconnect the cables all together or maybe you can try adding some oil at your next stop. It is rare that when an oil light comes on that you would assume that it is just a normal occurrence. Without the simplistic insight of a dashboard, the human body has different mechanism of communicating when it requires attention. Your symptoms become your oil light.


My story, like so many of my patient’s started with my own incapacity to differentiate common from normal. My symptoms were relatively innocuous. Gas, bloating, looser bowel movements – everyone had those. I was also plagued with unrelenting leg cramps. For years I would massage my legs to keep them from cramping up while I slept and sat through classes. These are normal symptoms I was told and thesn began to tell myself.  It was not until someone challenged me to try a gluten-free diet that I realized that what I thought was normal for everyone, was really just common for me. Unsatisfied with simply the anecdotal removal of my favourite grains, I decided to follow through by seeing a gastroenterologist. Several tests and biopsies later there was a diagnosis, I had celiac disease. My common, seemingly normal symptoms were in fact my dashboard, politely trying to get me to pull over and seek assistance. The importance of my story was not that I had an odd presentation of celiac disease; it is in recognizing the value in acknowledging the common symptoms we all carry around. In hindsight, my mother was horrified to learn of my diagnosis. As a kid she used to feed me bread or pasta as comfort foods when I was particularly distressed, at night, because of those ‘common’, but pesky growing pains in my legs.


Taking control of one’s health means eating well, exercising and sleeping sufficiently, but it also means listening to what your body is whispering. Start to ask yourself, whether the common heartburn, cramping or headache are in fact your oil light, politely seeking attention.


5 common, but not necessarily normal symptoms:


  1. Constipation: Despite what anyone tells you, 1-2 bowel movements per week is not normal. Aim for 1 per day, at most every other day. Lack of fiber, dehydration and food sensitivities are commonly implicated in chronic constipation.
  2. Heartburn: We all have it on occasion, but it doesn’t mean it should be happening. Adjustments to diet including the amount of water you consume while eating can make a significant difference. Frequent reliance on antacids aren’t fixing the problem, they are simply placing tape on the oil light
  3. Menstrual cramps: For many of us, menstrual cramps have become synonymous with womanhood. While they may be indicative of something deeper, pre-menstrual cramping is something frequently improved with simple lifestyle adjustments, for some, the removal of dairy is particularly effective.
  4. Eczema in children: As clinicians, we see this all the time.  Mild eczema in children can frequently be eliminated without the need for corticosteroids by adjusting your little person’s diet. Consider the eczema an early oil light signal.
  5. Insomnia: Insomnia is frequently a symptom of something else, not necessarily an endpoint on it’s own. Speak to your clinician about possible causes, including your need to create an effective stress management plan.
The Integrative Health Institute is located downtown Toronto at the corner of King and Sherbourne St. Check out more from Dr. Walker at her blog,

Photo Credit: Madilyn Peiper via Compfight

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