Doctors in Bahrain are urging both healthcare professionals and patients to take persistent symptoms seriously, rather than dismissing them simply because blood test results appear ‘normal’.
While laboratory investigations are essential tools in modern medicine, medics stress they should support clinical decision-making, not replace it, as results alone cannot capture the full picture of a patient’s health or account for subtle symptoms that may indicate early-stage or developing conditions.
“Unfortunately, over-reliance on test results can lead to missed diagnoses and delayed treatment,” University Medical Centre at King Abdullah Medical City senior paediatric consultant Professor Mohammed Elbeltagi told the GDN. “Many medical conditions develop gradually, meaning routine laboratory tests often detect problems only at their most advanced stage.
“This misses crucial opportunities for early intervention and prevention of long-term harm.”
One of the most common misconceptions, Dr Elbeltagi noted, is the belief that a normal haemoglobin level indicates healthy iron stores. “A normal haemoglobin level only rules out iron deficiency anaemia; it does not exclude iron deficiency itself,” he said.
“Iron deficiency is widespread in Bahrain, particularly among children and adolescents, women of childbearing age, pregnant women and individuals with poor dietary intake or chronic illness.”
Even in the absence of anaemia, iron deficiency can still cause symptoms such as poor concentration, learning difficulties, memory problems, irritability, anxiety and recurrent infections.
Proper diagnosis often requires more than a single test.
Dr Elbeltagi also highlighted how normal blood test results can be misleading when diagnosing diabetes, particularly type 2, which affects around 15 per cent of Bahrain’s population.
“Many patients are reassured when told their fasting blood sugar is normal. However, a result within range does not necessarily mean optimal metabolism,” he said, adding that type 2 diabetes does not begin with elevated blood sugar, but develops over several years.
“It starts with insulin resistance, a silent phase in which the body’s cells fail to respond properly to insulin. This progresses through compensated hyperinsulinemia, where the pancreas produces too much insulin to maintain normal glucose levels, followed by prediabetes with mildly-elevated glucose levels.”
Type 2 diabetes is the final and most visible stage.
He stressed that avoiding missed diagnoses requires a thorough medical assessment, beginning with careful listening to the patient.
“Doctors should take a detailed medical history, order targeted investigations and interpret results within the full clinical context,” he said.
He also encouraged patients to take an active role in their care by asking whether more specific tests may be needed.
Meanwhile, KIMSHEALTH Medical Centre Muharraq obstetric and gynaecologist specialist Dr Shaista Sariwal, pointed out that with advances in medicine and the availability of medical testing packages, many patients now order their own tests.
“They may assume everything is fine simply because the results fall within the normal range, but every patient is different,” she explained.
Dr Sariwal gave the example of thyroid function tests, particularly thyroid-stimulating hormone (TSH) levels, a hormone test that assesses how well a thyroid gland is functioning.
“I see patients dealing with infertility who think their results are normal when, in fact, slightly elevated levels can be affecting their fertility. For instance, a TSH result of 3.5uIU/ml, which is within reference ranges, can indicate the thyroid isn’t producing enough hormone. Ideally, levels should be around 2.5IU/ml to 3IU/ml for optimal function.”
“In such cases, we usually prescribe medication for about a month and then repeat the test to monitor the patient’s progress.”
Other tests carried out to properly assess thyroid function include Free T4 (Free Thyroxine), which measures the amount of active thyroid hormone circulating in the blood and Free T3 (Free Triiodothyronine), which measures the active form of thyroid hormone at the tissue level.
Thyroid antibodies can also be tested if autoimmune diseases are suspected. Overall, she explained that even when patients check their own test results, they may not have the full picture. It is still crucial to discuss the findings with a doctor, especially if the results are borderline.
The GDN previously reported that the rise of AI tools is also complicating medical care, with more patients arriving at clinics armed with self-diagnoses from online sources.
Physicians say this trend often creates confusion and requires additional time to correct misconceptions, taking focus away from addressing the patient’s actual condition.
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