4 min readNew DelhiApr 6, 2026 05:00 PM IST
For many people, a ‘normal’ blood test result brings a sense of relief, often signalling that nothing serious is wrong. But what happens when symptoms persist despite those reassuring numbers? In a recent Instagram video, content creator and UK-based surgeon Dr Karan Rajan emphasised that it’s entirely possible to experience ongoing symptoms even when routine tests appear normal. As he puts it, blood tests often act as “snapshots” of health at a single point in time, which means they may miss gradual changes or underlying trends.
Explaining this further, he said, “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.”
He also highlighted that certain conditions may not show up in routine blood work at all, making symptom evaluation and clinical judgement equally important. “But there are also many conditions that just don’t show up in bloods. Endometriosis, fibromyalgia, many chronic pain conditions, early cancers, and 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.”
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
To help patients navigate such situations, Dr Rajan encouraged active participation in one’s own healthcare. He suggests asking questions like, “I understand that my blood tests are normal, but I have all these symptoms. What conditions could present this way even with normal labs?” and “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.”
He also recommended exploring whether “there are any specialist blood tests that may be worth checking” and if “there is any value in imaging or referral to a specialist.” Keeping a detailed symptom diary, noting patterns and triggers, can also provide valuable insights during consultations.
But why do normal blood test results sometimes fail to capture underlying health issues?
Dr Palleti Siva Karthik Reddy, MBBS, MD general medicine, FAIG, consultant physician at Elite Care Clinic, tells indianexpress.com, “Normal blood test results do not always equate to optimal health. Most lab parameters are designed to detect advanced or clinically significant abnormalities, not early or functional changes in the body.”
Many conditions, Dr Reddy says, including hormonal imbalances, autoimmune disorders, and early-stage deficiencies, may not immediately show up on standard blood panels. It is also important to understand that reference ranges are based on population averages, not individual baselines, so a value within range may still be suboptimal for a specific person.
How important is tracking symptom patterns and trends over time?
Tracking symptoms over time is critical because many conditions evolve gradually and may only become apparent through patterns rather than isolated events.
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“Consistent documentation helps bridge the gap between subjective experience and clinical evidence. Individuals can maintain a simple health log noting symptoms, duration, triggers, diet, sleep, and stress levels. Even basic tracking over a few weeks can provide valuable insights that support more accurate and timely diagnosis,” concludes Dr Reddy.
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
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