Maybe, although the OP does say “How could something as fundamental as protein deficiency not be a standard, ordinary thing we test for?”, so it sounded like it hadn’t been tested at all.
But yeah now you’ve made me want to criticize the whole idea of normal ranges! One time I had a vitamin D deficiency that had me extremely ill for three months and even bedridden for part of that time, but clinically it was only mildly out of range, and the doctor just told me “Your vitamin D level is a bit low” – which I feel didn’t sufficiently suggest that it might be the root cause of the debilitating illness I had gone to him about. In general Elizabeth and others have made me think that reference ranges are a lot more nonsense than they seem, and that they like all things in medicine are more likely to apply to ~tall white men, so I as a non-tall non-white non-man should be skeptical and pay more attention to things that are at the extremes of the reference range, even if they’re not ‘clinically significant’.
(That rant was not directed at you tbc, I just wanted to rant it, thanks)
I had a blood test once as a part of a regular checkup, and I suspected that some symptoms I have might be caused by iron deficiency. But the doctor looked at the results and said “nope, all values are within the norm”.
I told him my hypothesis, and he showed me the scale for iron, with the interval of “healthy”, and he showed me that my results were exactly one pixel above the minimum. Which means healthy, yay! Because it would be a deficiency only if it was at least one pixel below the minimum.
(Then I took supplements anyway and felt better. Of course, chances are it was just a placebo effect.)
I happen to be a tall white man, but I wish doctors distinguished between “normal” and “technically still normal” values. Damn, I am not asking whether I am eligible for disability. I am merely curious about whether there is some trivial action I could take that has a potential to make me feel significantly better.
(Not in USA, btw. Just saying, because the article mentions USA.)
This is why we need a healthcare system in which people can get regular checkups. They should have an extensive medical history on you, that way their comparisons take into account what is “normal for you” and not just whether you’re “normal amongst the population”, since the latter may not even be relevant.
Most of the problem with the reference ranges is that they are usually just intended to reflect what 95% of the reference population will have. That’s much easier to measure than the range which indicates good health.
There isn’t much incentive for any authority to establish guidelines for healthy ranges. So too many people end up equating “normal” results with good results, because normal is what gets quantified, and is usually what is reported on test results.
As a tall white man myself, I’d say that I have one value that’s been somewhat out of range on every bloodwork panel I’ve had in a decade, and no doctor I’ve asked has cared.
I’ve also found that I benefit from more of some vitamins than the ranges suggest I should need, so even for someone like me there’s a lot of individual variation.
Summary: I think you’re right, but the ranges are even more nonsensical than that.
It would be unsurprising if the albumin level turned out to be low, if the A/G ratio was slightly off despite the normal-looking total protein values, etc.
As SirTruffleberry said, this situation would be a place where having long-term trends could help.
It is also possible that his lab values fell just barely within the normal ranges.
Maybe, although the OP does say “How could something as fundamental as protein deficiency not be a standard, ordinary thing we test for?”, so it sounded like it hadn’t been tested at all.
But yeah now you’ve made me want to criticize the whole idea of normal ranges! One time I had a vitamin D deficiency that had me extremely ill for three months and even bedridden for part of that time, but clinically it was only mildly out of range, and the doctor just told me “Your vitamin D level is a bit low” – which I feel didn’t sufficiently suggest that it might be the root cause of the debilitating illness I had gone to him about. In general Elizabeth and others have made me think that reference ranges are a lot more nonsense than they seem, and that they like all things in medicine are more likely to apply to ~tall white men, so I as a non-tall non-white non-man should be skeptical and pay more attention to things that are at the extremes of the reference range, even if they’re not ‘clinically significant’.
(That rant was not directed at you tbc, I just wanted to rant it, thanks)
I had a blood test once as a part of a regular checkup, and I suspected that some symptoms I have might be caused by iron deficiency. But the doctor looked at the results and said “nope, all values are within the norm”.
I told him my hypothesis, and he showed me the scale for iron, with the interval of “healthy”, and he showed me that my results were exactly one pixel above the minimum. Which means healthy, yay! Because it would be a deficiency only if it was at least one pixel below the minimum.
(Then I took supplements anyway and felt better. Of course, chances are it was just a placebo effect.)
I happen to be a tall white man, but I wish doctors distinguished between “normal” and “technically still normal” values. Damn, I am not asking whether I am eligible for disability. I am merely curious about whether there is some trivial action I could take that has a potential to make me feel significantly better.
(Not in USA, btw. Just saying, because the article mentions USA.)
This is why we need a healthcare system in which people can get regular checkups. They should have an extensive medical history on you, that way their comparisons take into account what is “normal for you” and not just whether you’re “normal amongst the population”, since the latter may not even be relevant.
Most of the problem with the reference ranges is that they are usually just intended to reflect what 95% of the reference population will have. That’s much easier to measure than the range which indicates good health.
There isn’t much incentive for any authority to establish guidelines for healthy ranges. So too many people end up equating “normal” results with good results, because normal is what gets quantified, and is usually what is reported on test results.
As a tall white man myself, I’d say that I have one value that’s been somewhat out of range on every bloodwork panel I’ve had in a decade, and no doctor I’ve asked has cared.
I’ve also found that I benefit from more of some vitamins than the ranges suggest I should need, so even for someone like me there’s a lot of individual variation.
Summary: I think you’re right, but the ranges are even more nonsensical than that.
In a later comment, the original poster said that the Total Protein seemed fine. Unfortunately, https://www.ajkd.org/article/S0272-6386(99)70278-7/fulltext suggests that the person looking at the labs would have to know that they ought to look closely at the albumin level, specifically. It wouldn’t be the first time that ”Reality has a surprising amount of detail” where overlooking 1 thing is enough to get into trouble.
It would be unsurprising if the albumin level turned out to be low, if the A/G ratio was slightly off despite the normal-looking total protein values, etc.
As SirTruffleberry said, this situation would be a place where having long-term trends could help.