When Your Client's Numbers Are High: How to Respond Without Fear or Shame

A client shares a high A1c, cholesterol result, or blood pressure reading. Your response can help them feel supported and take an appropriate next step, without turning a number into a judgment or stepping outside your role.

You already bring valuable skills to this moment: listening, building trust, and helping people follow through on goals that matter to them. A concerning result calls for those skills, along with a clear boundary: your role is to support, not diagnose or interpret lab results.

Start by staying calm

A client may arrive worried, embarrassed, or unsure what the result means. They may also be bracing for criticism. A steady, non-alarmist response helps keep the conversation open.

Try:

“Thank you for telling me. I can understand why this might feel concerning. What has your healthcare provider said about it so far?”

That response acknowledges the person without labeling the result. Avoid saying “That’s really bad,” guessing at a diagnosis, or reassuring them that everything is fine. You may not have the clinical context to know what the result means, and an overly strong reaction can increase fear rather than support action.

A result needs to be reviewed in context by an appropriate healthcare professional. The client’s history, the specific test, and any symptoms may all matter. Your job is not to fill in those clinical details. It is to help the client connect with the right care and identify what support would be useful in your coaching role.

Celebrate the fact that they tested and shared

It may seem like a small detail, but testing and sharing the result are meaningful steps. A client could have avoided the appointment, put off opening a portal message, or kept the news to themselves. Acknowledge what they did without praising or criticizing the number itself.

You might say:

“I’m glad you got checked and that you felt comfortable sharing this with me.”

Or:

“You took a useful step by getting the test. Let’s make sure you have support for the next one.”

This helps separate health information from personal worth. A number is not a grade, a character assessment, or proof that someone has failed. Shame is not a reliable behavior-change tool. Judgment can make it harder for a person to talk openly about barriers or ask for help.

Ask curious questions, not a string of instructions

When you’re concerned, it’s natural to want to move straight into advice. But a lecture can leave the client feeling managed rather than heard. Begin with open questions, then listen for what they understand, what matters to them, and what they’re ready to do.

Questions may include:

• “What did your provider tell you about the result?”
• “What feels most important to you right now?”
• “What questions do you want answered?”
• “What might make it difficult to follow up?”
• “Would it help to think through how you’ll contact your provider?”

Ask permission before offering general information or brainstorming. If the client hasn’t yet spoken to a provider, keep the next step clear: encourage them to contact the clinician who ordered the test or their primary-care provider. Don’t interpret the number for them or suggest that a lifestyle change can replace medical follow-up.

Make the referral clear and respectful

Vague language like “You should probably get that checked” can leave a client unsure what to do. A direct, supportive referral makes the boundary, and the next step, easier to understand.

For example:

“I can’t diagnose or interpret this result, but it’s important to review it with a healthcare professional. Please contact the clinician who ordered the test and ask what follow-up they recommend. I can help you prepare questions or plan how to make that call.”

If the client has already received guidance, ask what support they want with following the plan. With the client’s permission, you may be able to coordinate with their care team, depending on your role and workplace policies.

Some situations call for urgent action. For blood pressure above 180/120 mm Hg, the American Heart Association advises waiting at least one minute and checking again. If the reading remains that high, the person should contact a healthcare professional immediately. If it is accompanied by symptoms such as chest pain, shortness of breath, weakness or numbness, vision changes, or difficulty speaking, call emergency services. Follow your organization’s emergency procedures; don’t try to manage a medical emergency as a coach. See the American Heart Association’s guidance on high blood pressure.

For A1c or cholesterol results, encourage the client to ask their provider what the result means for them and what follow-up is appropriate. The CDC’s overview of diabetes testing explains A1c testing and its role in clinical assessment. Share educational resources only within your scope, and don’t use a threshold or a single flagged result to diagnose.

Focus on what coaching can influence

Medical care belongs with qualified healthcare professionals. Coaching can still offer meaningful support alongside that care. Once the client has a follow-up plan, or while they are arranging one, you can help them explore practical, self-directed changes that fit their goals and circumstances.

Depending on your training and scope, that might include:

• Habits: What small, realistic routine would the client like to work on?
• Stress and sleep: What patterns are affecting their energy, recovery, or capacity to follow through?
• Follow-through: Would a reminder, appointment plan, or list of questions make it easier to contact their provider?
• Barriers: Are time, cost, caregiving, food access, transportation, or competing demands getting in the way?
• Support: Who or what could help the client take the next step?

Ask what feels manageable instead of prescribing a plan. One possible question is, “What’s one step you feel ready to take this week?” The answer may be making a medical appointment, tracking a routine the client wants to understand, or choosing a small habit to practice. The client, not the coach, sets the priority.

For health and wellness coaches, the NBHWC Scope of Practice is a useful reference for distinguishing coaching support from diagnosis, interpretation of medical data, and treatment. Always follow your own credentials, applicable laws, employer policies, and any care-team agreements.

A short response you can adapt

When you need simple language in the moment, try:

“Thank you for sharing this with me. I’m not able to interpret or diagnose lab results, and this deserves review with your healthcare provider. What have they advised so far? I can help you prepare questions, plan your follow-up, and work on habits that fit your goals and their guidance.”

This keeps the conversation calm, makes the referral explicit, and brings the focus back to support you can provide.

Keep the boundary, and the relationship

You don’t need to solve the medical question to be helpful. You can acknowledge the client’s concern, avoid shame, encourage timely clinical follow-up, and help them identify a realistic next step. That combination respects both the client’s experience and your professional role.

If you want a deeper resource for navigating these conversations, Nicole’s companion guide, “What to Do When Your Numbers Are High,” is available in her Thinkific shop.

Ladimax University’s professional continuing education course also explores scope-appropriate coaching approaches for midlife metabolic health. It is continuing education, not clinical training or a scope expansion.