Patient: Is it possible that I have all those symptoms and my labs are all normal?
Doctor: Yes. It is possible. Very possible sometimes.

 

Sometimes patients will wonder how come they have too many symptoms like diffuse body aches or aches all over for example while  their labs tests are all normal. Their common belief here is that for any symptom in the body, there has to be some lab test that will be abnormal and that will help in the diagnosis of the cause of that symptom. 

 

In fact, this belief is not true at all. It is one of the many misconceptions that patients about how doctors diagnose diseases. It is one reason why  some patients will volunteer to do lab tests on their own before they see the doctor and in many instances, those labs are unneeded or irrelevant to the diagnosis. It is also the reason why some patients will insist that the doctor order extra labs for them to relieve the anxiety they have about their symptoms.

 

Here are the correct medical facts:

Not all the medical conditions that can cause symptoms of diffuse body aches or aches all over will be associated with abnormal blood tests. Some diseases will  have abnormal lab tests like autoimmune rheumatic diseases and like infections for example. Other diseases, no matter how troublesome the symptoms of the aches can be, will show completely normal blood lab tests. Examples here include osteoarthritis of the joints, hypermobility of the ligaments of joints, functional or psychological causes of symptoms, fibromyalgia and aches that are associated with excessive exertion and overuse of the joints and muscles of the body.

 

Having said that, you probably know now why doctors will sometimes, after having listened to the your symptoms,  request some blood tests and at other times they will request none. The point here is that most of the process of diagnosis happens while the doctor is listening to the patient, after which he might order some confirmatory investigations where needed. If the doctor did not suspect any of the medical problems that would cause abnormal blood tests, there would be no point in ordering any.

 

So the conclusion here:
One: You can have symptoms like diffuse body aches or aches all over but your blood tests can still be all normal sometimes.

Two: Diagnosis is all about history that doctors take from patients and not about labs that patients do

Three: It is not advisable to volunteer by doing extra lab tests on your own before you see the doctor

Four: Always remember that the diagnosis is for the doctor and the education is for the patient; anything that is related to diagnosing the medical problem that is causing your symptoms is the doctor's job. But once the doctor has diagnosed your medical problem, you are entitled to know exactly what your diagnosis is, on what basis the doctor reached this diagnosis and the role of the labs, if any, in your diagnosis.

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This post was prepared and published by  Dr. Hatem Eleishi. Dr. Hatem Eleishi is a professor of rheumatology at Cairo university (Egypt) and is especially dedicated to supporting arthritis patients with online educational videos and articles about arthritis causes and treatment. He also runs a rheumatology clinic in Cairo and a center for online medical consultations that, in addition to providing online rheumatology consultations, also provides online medical consultations in several different medical specialties by expert consultants from Egypt, Canada and the United States.

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