Globulins…ever thought much about them?  Me neither really unless they were clearly below range which made me consider immune impairment but recently Dr. Michael Hayter, who I am co-presenting the Diagnostics Master Class (Health Masters Live) with, inspired me to take a closer look!  Globulins are typically reported in your patients’ E/LFTs or standard chemistry and they refer to a big group of molecules including CRP, transferrin, lipoproteins and yes all the immunoglobulins/antibodies.

While most pathology companies’ adult reference range is ~20-40 g/L Michael made the point to be alert to a pattern of results in the 30s, as this may be indicative of some immune activation.

 This made a lot of sense to me and I realise can be a very helpful tool when we are faced with patients where the the cause of their disease remains elusive.  I experience this often – people present without a firm diagnosis (often in spite of significant medical investigation) and I am wondering if say there is an immune/autoimmune component to their unusual symptom picture.  So from now on watch those globulins and if you see them  sitting in the mid or upper 30s on more than one occasion – consider other appropriate immune investigations such as a CRP and immunoglobulin panel etc. to further nut out the drivers of the pathology.