VII.2.2. THE TOTAL PROTEINS – VALUES CONSIDERED TO BE NORMAL AND VALUES THAT WE PROPOSE TO BE ADOPTED AS NORMAL
Let us now turn our attention to TP values that are considered to be normal both in medical literature, but especially in laboratory test reports: these are the specialist’s “instrument” for diagnosis and treatment.
To date, medical studies and medical laboratories do not agree regarding the lower and upper limits of the quantitative values of TP that are considered to be normal values (n.v.). It would be unproductive to quote the large number of medical studies that include references regarding the normal quantity of proteins in blood plasma. These are usually recorded between 6 and 8 g/dL, with variations “going” up to 8,7 g/dL or even more. The normal average TP is almost unanimously accepted to be 7,5 g/dL. We tend to find similar variations in laboratory reports from both Romania and other countries.
In this paper we will present the quantitative value of TP for each clinical case but also the lower-upper reference values – n.v. – noted by the laboratories which issued the medical reports. The conclusive results of our observations show thatthe values considered to be normal are not in accordance with reality. The reality regarding TP determined value is that in a good state of health, they should fit within the n.v. noted by the laboratory. There isone condition attached to this: the lower-upper limits of n.v. of TP should be set forth in a way that excludes the disease. However, in the majority of cases, the quantitative value of the TP fits within the limits of n.v., even under the conditions of a severe disease.
In my doctoral thesis in medical sciences, I have issued a first warning signal regarding the inconsistency between the presence of disease (dysproteinaemia), the value of TP and n.v. limits. By analysing 1200 clinical cases of autoimmune diseases, we have come to the conclusion that the average value of TP in these diseases was 8,37 g/dL. But if we admit that the quantitative normal values of the TP are between 6 and 8,7 g/dL, the conclusion would be that the subjects that have autoimmune diseases do not show quantitative dysproteinaemias. In reality, the autoimmune diseases are dysproteinaemias whose characteristics are the quantitative decrease of ALB and the quantitative increase of GL, especially that of gamma globulin, which is a sign of the quantitative increase of immunoglobulins (autoantibodies), but also of some positive acute-phase proteins. One of the conclusions that we came to is that it is necessary to adopt other lower-upper reference ranges for normal values of TP, both in medical literature but especially within laboratories. Out of 1200 subjects suffering from autoimmune diseases that formed part of our study and whose determined TP values were compared against values considered to be normal by the laboratories (n.v.=6,6-8,7 g/dL):
- 84 subjects (7%) show hyperproteinaemia, having TP over the upper limit of the n.v.:>(8,71 g/dL);
- 1008 subjects (84%) show physiological proteinaemia, with TP within the n.v. (6,6 – 8,7 g/dL);
- 108 subjects (9%) show hypoproteinaemia, with TP under the lower limit of n.v. : < 6,6 g/dL).
Therefore, if we admit the reference range of TP of 6,6 – 8,7 g/dL as realistic, it would mean that from the 1200 subjects with diagnosed autoimmune diseases, only 16% show quantitative dysproteinaemias. However, specialists know that the main characteristic of autoimmune disease is dysproteinaemia.
Faced with this situation, we looked for those TP lower-upper laboratory references which the least cases of diseases are diagnosed. We classified the 1200 subjects in three groups, according to the TP value of their laboratory report:
- TP > 7,50 g/dL………………............854 subjects
- TP < 7 g/dL ……………….............240 subjects
- TP between 7 g/dL and 7,50 g/dL........106 subjects (out of which 16 subjects have TP between 7,20-7,40g/dL)
Based on this clinical research, we propose that the normal values of TP that should be adopted are between 7 g/dL and 7,50 g/dL: only 106 from the 1200 studied subjects fall into this category. Consequently, the 7,50 g/dL value cannot be the average of the normal values of TP, but can be considered the upper limit (maximum) of laboratory references. As we can see, the fewest cases of autoimmune diseases (16 subjects (1,33%) out of 1200) fall into the PT limits of 7,20 - 7,40 g/dL. We could say that these last values are an ideal quantitative and qualitative (structural) proteinaemia.
As we will see later, an interesting fact to note is that the evolution of the quantitative values of the TP that we mentioned above relates not only to autoimmune diseases or to the diseases that became autoimmune by their chronic course, but also to a wide range of other diseases.
As we will see from the analysis of the clinical cases that we will present, the further the TP value decreases below 7 g/dL or the more it increases above 7,50 g/dL, the greater the effect on a patient’s health. When an author of medical literature, a clinician or a medical laboratory identify a healthy individual whose TP value approaches or exceeds 8 g/dL, mountaineers will be climbing Everest through equatorial jungles and the Hawaiians will be eating seal fat on bread inside their igloos built on Hawaii beaches! This statement might seem out of place, and indeed it is, in a study that claims to be scientific. However, its role is only to draw the attention to the values taught in school or taken mechanically from laboratory reports that seem to be caught in a time warp.
Consequently, we will maintain the suggestion that normal values (lower-upper) of the laboratory references for TP should be the ones that we determined:
TP as n.v = 7 g/dL – 7,50 g/dL.
The clinical cases that we are about to present, contain the TP values measured by a large number of laboratories, and will substantiate our proposal.