Hm, so, I definitely agree about having very little faith in the modern medical system’s ability to figure out most problems. I have a lot of experience with this myself and it’s rough — I’m sorry it was bad for you and I’m glad you got better!
However, I’m pretty surprised that your protein levels were never tested! When I go to a doctor in America and tell them that some new thing is mysteriously wrong with me, their first recourse is pretty much always to order blood tests, and consequently I have had my blood protein levels checked six times in the past five years as part of a standard hepatic function panel. I’m not super familiar with the medical field, but from Googling it looks like if you had a protein deficiency, that test would turn it up.
I guess maybe because of the symptoms you were presenting with, no one felt the need to check your liver function? But if that’s the case I’m confused why they do it to me all the time, since one of my main problems is mysterious musculoskeletal pain. Hm.
Funny you should mention this; it made me check my records. It turns out that none of the doctors actually requested bloodwork. However, I do have my own bloodwork, which I do every 4-6 months on my own. Looking through that, what I see for heptatic protein level is 7.2+-0.2 for the past two and a half years.
This includes my most recent test, where I had been taking massive amounts of protein for months. So whatever that test is measuring, it doesn’t actually seem related to the amount of protein the body has available or needs.
ChatGPT explanation of what hepatic protein level measures:
Hepatic (liver) proteins refer to a group of proteins that are synthesized in the liver. Blood tests can be used to determine the level of these proteins in the bloodstream, providing insight into liver function and overall health.
Albumin: Albumin is a protein produced by the liver, and it makes up about half of the protein in your blood. It has many vital functions, including preventing fluid leakage from blood vessels, transporting substances around the body (like hormones, vitamins, and medications), and supporting tissue growth and healing. A blood test can determine albumin levels in your body. Lower than normal albumin levels can indicate liver disease, among other conditions.
Total Protein: This test measures the total amount of two classes of proteins found in the blood: albumin and globulin. Proteins are important building blocks of all cells and tissues; they are necessary for body growth and health. This test can help diagnose nutritional problems, kidney disease, liver disease, and many other medical conditions.
Globulins: This is a group of proteins in your blood. They are made in your liver by your immune system. Globulins play an essential role in liver function, blood clotting, and fighting infection. There are different types of globulins, and some tests might assess the different globulins separately, like alpha-1, alpha-2, beta, and gamma globulins.
Liver enzyme tests: These include aspartate aminotransferase (AST) and alanine aminotransferase (ALT) tests, which measure enzymes the liver releases in response to damage or disease. Although these aren’t proteins, they often get tested alongside hepatic proteins to provide a more complete picture of liver health.
Prothrombin time (PT) and International Normalized Ratio (INR): The liver also produces proteins involved in blood clotting. A PT test measures how long it takes for your blood to clot. An INR is a standardized way for laboratories to report PT results. Abnormally long clotting times may suggest a problem with these proteins and liver function.
Abnormal results of these tests may indicate a potential problem with the liver, but they do not necessarily specify the exact nature of the problem. Additional diagnostic tests may be required to identify the specific cause of abnormal hepatic protein levels.
It’s a test for liver function.
Do you have any data in your blood tests for any amino acids?
Our body doesn’t need any proteins, it needs amino acids and proteins are a way to ingest amino acids.
ChatGPT suggests:
To determine if you’re getting enough of each essential amino acid, a healthcare provider might be able to order a plasma amino acid test, which measures the levels of amino acids in your blood. However, these tests are not routinely used in healthy people, and there’s some debate over how accurately they reflect long-term dietary intake.
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.
Hm, so, I definitely agree about having very little faith in the modern medical system’s ability to figure out most problems. I have a lot of experience with this myself and it’s rough — I’m sorry it was bad for you and I’m glad you got better!
However, I’m pretty surprised that your protein levels were never tested! When I go to a doctor in America and tell them that some new thing is mysteriously wrong with me, their first recourse is pretty much always to order blood tests, and consequently I have had my blood protein levels checked six times in the past five years as part of a standard hepatic function panel. I’m not super familiar with the medical field, but from Googling it looks like if you had a protein deficiency, that test would turn it up.
I guess maybe because of the symptoms you were presenting with, no one felt the need to check your liver function? But if that’s the case I’m confused why they do it to me all the time, since one of my main problems is mysterious musculoskeletal pain. Hm.
Funny you should mention this; it made me check my records. It turns out that none of the doctors actually requested bloodwork. However, I do have my own bloodwork, which I do every 4-6 months on my own. Looking through that, what I see for heptatic protein level is 7.2+-0.2 for the past two and a half years.
This includes my most recent test, where I had been taking massive amounts of protein for months. So whatever that test is measuring, it doesn’t actually seem related to the amount of protein the body has available or needs.
ChatGPT explanation of what hepatic protein level measures:
It’s a test for liver function.
Do you have any data in your blood tests for any amino acids?
Our body doesn’t need any proteins, it needs amino acids and proteins are a way to ingest amino acids.
ChatGPT suggests:
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.