Your blood tests may say everything is “normal,” but your body might be telling a very different story. Persistent symptoms – fatigue, pain, discomfort, or anything that feels out of the ordinary – shouldn’t be brushed aside simply because lab results fall within range. When concerns are dismissed on the basis of normal reports alone, it can be a red flag, because you are often the first to notice when something isn’t right. Listening to those signals and pushing for deeper evaluation can be crucial, especially when early signs of illness don’t always show up on standard tests.
Dr Karan Rajan is challenging the common assumption that normal lab results automatically mean you’re in the clear. In an Instagram video shared on April 2, the surgeon explains that blood tests are only one piece of the puzzle, and that symptoms still need careful evaluation – even when labs appear normal. He also emphasises that some of the most serious chronic conditions often don’t show up in routine test results at all.
Blood tests are “snapshots”
According to Dr Rajan, it’s entirely possible for someone to have perfectly normal blood test results and still experience persistent, recurring symptoms. That’s because blood tests don’t always tell the whole story – on their own, they may neither definitively rule out a condition nor confirm a diagnosis. As the surgeon explains, they function more like “snapshots” of your health at a given moment, which can overlook patterns and trajectories developing over time.
He explains, “For example, your HbA1c, which is a marker of long-term blood sugar control, could be 40 millimoles per mole, which is considered normal. But maybe last year it was 35 and the year before that 30. Your absolute number could be normal, but your trajectory could be concerning and it could signal that maybe you’re headed towards a disease process. Blood tests without context are often very limited.”
Some conditions don’t show up on blood tests
Dr Rajan also points out that some conditions simply don’t show up on standard blood tests. In many cases, diagnoses rely not just on lab values but on a careful evaluation of symptoms, medical history, and clinical presentation.
He explains, “But there’s also many conditions that just don’t show up in bloods. Endometriosis, fibromyalgia, many chronic pain conditions, early cancers, POTS. These are often clinical diagnoses based on symptoms, not just a lab value. There’s something that doctors learn in medical school, but we quickly forget: When a measure becomes a target, it ceases to be a good measure.”
How to deal with a situation like this?
You know your body better than anyone – not your doctor, not the lab report. So if your test results come back normal but something still feels off, or your symptoms persist, it’s important to trust that instinct. Here’s what Dr Rajan recommends you ask your doctor, so you can advocate for yourself with clarity and confidence.
- “I understand that my blood tests are normal, but I have all these symptoms. What conditions could present this way even with normal labs?”
- “I know my test is normal today, but can I see my results from the last few visits? I want to understand if there’s a trend over time.”
- “Are there any specialist blood tests that may be worth checking that could help?”
- “Is there any value in imaging or referral to a specialist?”
The surgeon also recommends coming prepared with documentation – a detailed symptom diary, noting triggers, timelines, and patterns – to give your doctor a clearer picture of what you’re experiencing.
This isn’t to suggest that blood tests don’t matter, but rather to recognise that they are only one piece of a much larger puzzle. As Dr Rajan points out, some of the most debilitating chronic conditions can still present with completely normal blood test results.
