Understanding Abnormal Blood Test Results
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Anxiety is normal — and expected. Feeling worried about a blood test result, no matter how minor, is a completely human response. Your GP’s first role is always to comfort and to inform you honestly.
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Your lifestyle shows up in your results. Diet, alcohol, supplements, and over-exercising can all skew your numbers — and many abnormalities are fully reversible once habits improve.
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True red flags are usually spotted clinically first. Doctors identify urgent concerns through examination and history before ordering tests. Never rely on self-diagnosis — see your GP promptly if something feels wrong.
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Your Family Physician is your best first call. They know your history, can arrange further investigations, and co-ordinate specialist referrals — acting as the central conductor of your healthcare.
Few things unsettle a person quite like receiving a blood test result flagged in red. Whether it is a number sitting slightly outside the reference range or an unfamiliar term printed on a pathology report, the immediate response for many patients is anxiety — sometimes even before they have spoken to their doctor.
It is a deeply human reaction, and according to an experienced Family Physician and General Practitioner (GP), it is one that deserves to be met with genuine care, patience, and clarity.
In this article, a Dr Leong Choon Kit shares his perspective on the blood tests they encounter most often, how they approach difficult conversations with patients, what truly constitutes a red flag, and what patients can do when they find themselves staring at a result they do not understand.
The Tests We Interpret Every Day — And the Anxiety They Bring
In a busy general practice, blood tests span a wide spectrum. From routine health screenings for otherwise healthy patients, to monitoring of chronic conditions such as diabetes mellitus, hypertension, and high cholesterol — the GP is the first port of call for interpreting these results.
Beyond chronic disease management, common investigations include full blood counts for unexplained fevers such as dengue, urine microscopy and culture, and rapid antigen tests for respiratory infections including influenza and COVID-19.
What might surprise many patients, however, is just how universal the anxiety surrounding these tests truly is. As Dr Leong explains:
“My personal experience is that there is no test that patients are not anxious about. Even something as simple as an ART swab test for influenza and COVID, or a dengue antigen test, can be highly worrying to a patient.”
This extends even to something as seemingly routine as a blood pressure reading. Some patients hope that a worrying result is simply a mistake, while simultaneously knowing deep down that they are unwell.
For those newly diagnosed with a condition, denial is common. For those already living with a chronic illness, the concern shifts to whether they are managing it adequately.
The doctor’s philosophy is straightforward: “In short, anxious about any test is human. As doctors, especially GPs and Family Physicians, our job is to comfort always.” This ethos underpins every aspect of how they communicate results — and it is a principle worth remembering.
The Art of Delivering Difficult News
One of the most nuanced challenges a GP faces is explaining to a patient why an abnormal result might be nothing to worry about — or conversely, why something that seems minor actually warrants prompt attention. Getting this balance right requires both clinical judgement and considerable emotional intelligence.
Comfort Without False Reassurance
Dr Leong is deliberate in their approach. His personal preference is always to make the patient comfortable when reviewing any results — but never at the cost of honesty. “I have also learnt never to sugar coat the diagnosis and the results. We should be as upfront as possible,” they say. “Having said that, we must always be mindful of the anxiety caused.”
In practice, this translates to a deliberate slowness: speaking at a measured pace, pausing often to allow the patient to absorb information, ask questions, and respond.
Body language matters enormously — an open, unhurried posture signals that this is a space for dialogue, not just a one-way delivery of information. Tissue paper, Dr Leong notes matter-of-factly, is always within reach.
Preparing Patients Before They Arrive
The consideration extends beyond the consultation itself. When reminding patients of appointments where significant results will be discussed, Dr Leong often suggests they bring a family member or loved one with them. This practice, Dr Leong notes, is deeply embedded in the social fabric of Asian societies like Singapore, where family plays a central role in health decisions.
Practical scheduling matters too. Dr Leong is careful to allocate additional time for review appointments when results are involved, ensuring there is no rush — and if a result warrants closer monitoring, an earlier follow-up is arranged. These seemingly small adjustments can make an enormous difference to how patients experience and process difficult news.
Recognising True Red Flags: When to Seek Urgent Help
Not all abnormal results are created equal. Understanding which findings demand immediate attention — and which can be safely monitored over time — is a skill built through years of clinical training and experience. For GPs, this process begins well before a single test is ordered.
Clinical Instinct Comes First
“As a clinician, our antennae for red flags derive mostly from our history taking and physical examination,” the doctor explains. Blood tests and other investigations are largely confirmatory — they are used to verify a suspicion already formed through a careful patient interview and physical assessment. If red flags are identified before testing even begins, the appropriate response is escalation to an Emergency Department, where specialists can conduct the relevant investigations promptly.
But what happens when there is no obvious clinical concern, yet something still gives the doctor pause?
This is where experience and professional instinct come into their own. Dr Leong gives a telling example: left-sided chest pain. Even when nothing alarming is found on examination, they will still order an ECG and blood tests to measure cardiac markers. “Left-sided chest pain is usually cardiac in origin unless proven otherwise,” they state plainly.
Acting Urgently When It Matters
For time-sensitive investigations such as cardiac markers, Dr Leong orders tests urgently and typically receives results within eight to twelve hours. This swift turnaround allows them to act quickly if a serious condition is identified — or to provide meaningful reassurance if the results are clear.
The message for patients is clear: if you are experiencing symptoms that concern you — particularly chest pain, sudden shortness of breath, or other acute presentations — do not wait and hope for the best.
Seek medical attention promptly. Your GP is equipped to triage your situation and direct you to the right level of care.
How Lifestyle Shapes Your Blood Test Results
For many Singaporeans, the connection between daily habits and blood test results is not always obvious — yet it is profound. Diet, exercise, stress, and supplementation all leave measurable traces in the body’s biochemistry, and Dr Leong has seen these patterns play out countless times in clinical practice.
The Liver Tells the Story of What You Eat and Drink
Raised liver enzymes are among the most common lifestyle-related abnormalities Dr Leong encounters. The culprits are varied: excessive carbohydrate and oily food intake, alcohol consumption, herbal supplements, and over-the-counter vitamins can all push liver enzyme levels above the normal range.
The reassuring news is that these elevations are often reversible. “The level will return to normal after some weeks if the patient improves on the lifestyle, diet and exercise,” Dr Leong notes, adding that patients are also advised to stop herbs, supplements, and alcohol while liver enzymes are being monitored.
Extreme dieting is another area of concern. While the ketogenic diet has gained considerable popularity as a weight-loss strategy, the doctor cautions against its unchecked adoption. By substituting carbohydrates with large amounts of fat, some patients have experienced liver and kidney damage.
“We have also seen patients suffering from liver and kidney damages from adopting these extreme diets,” Dr Leong says — a sobering reminder that trendy dietary approaches are not without risk.
Over-Exercise and the Kidneys: A Cautionary Tale
Physical fitness is, of course, generally beneficial — but exercise taken to extremes can have serious consequences. Dr Leong highlights a phenomenon that has become increasingly prevalent among younger, health-conscious Singaporeans: rhabdomyolysis. This condition, in which muscle tissue breaks down due to intense physical exertion, causes a sudden spike in creatinine levels that can damage the kidneys.
High-intensity interval training, spin cycling, and other demanding workout formats are commonly associated with this risk. While most people who exercise vigorously will never develop rhabdomyolysis, those who dramatically increase their training intensity — particularly without adequate hydration — are most vulnerable.
If you notice dark-coloured urine, severe muscle pain, or significant weakness after an intense session, this warrants prompt medical evaluation.
What to Do When You See an Abnormal Result
Perhaps the most practically useful advice in the entire conversation is also the simplest. When asked what a patient should do when they first encounter an abnormal result, Dr Leong’s answer is unequivocal:
“My best advice for facing any abnormal results is always to discuss with one’s enrolled Family Physician who knows you well.”
This is not a platitude. A Family Physician who has followed your health journey over time brings an invaluable depth of context to any new result. They understand your baseline, your history, your lifestyle, and your risk factors — meaning they are far better placed to interpret a result than any generic online search or anonymous health forum.
The GP as Conductor of Your Healthcare
Dr Leong uses a beautifully apt metaphor to describe the role of a Family Physician in managing complex health situations: they are like a conductor in an orchestra.
Beyond treating immediate concerns and arranging repeat testing, the GP can order more definitive investigations and co-ordinate referrals to the most appropriate specialists — ensuring that all parts of a patient’s care are working in harmony rather than in isolation.
This co-ordinating function is especially important when multiple organ systems are involved, or when a patient’s results paint a complicated picture. Rather than bouncing between specialists without a central guiding hand, patients benefit enormously from having a trusted GP who can synthesise information from multiple sources and chart a coherent path forward.
Managing your health proactively with an enrolled GP can also unlock government support — find out more in our guide on understanding the Healthier SG scheme and its benefits.
The Human Side of the Laboratory Report
Blood tests are powerful tools, but they are not the whole story. They are data points that must be interpreted within the context of a living, breathing person — someone with a history, habits, fears, and family circumstances that cannot be captured in a reference range printed on a page.
What emerges from this conversation is a portrait of general practice medicine at its best: careful, compassionate, and contextual. A good GP does not just read numbers — they listen, observe, and think. They make space for the anxiety that is an entirely natural part of receiving a result you do not fully understand. And they take the time, as this doctor puts it, never to rush.
For patients navigating the sometimes bewildering world of pathology results, the takeaway is both straightforward and reassuring: you do not have to face abnormal results alone. With the right GP by your side — one who knows your history and takes the time to explain, not just inform — even the most unsettling result can become the beginning of a constructive conversation rather than a source of unmanaged fear.
FAQ – Understanding Abnormal Blood Test Results
1) Should I be worried if my blood test result is flagged as abnormal?
Not necessarily. Many abnormal results are minor, temporary, or directly linked to lifestyle factors such as diet, exercise, or supplements. The most important step is to discuss the result with your GP, who can interpret it within the full context of your health history.
2) What blood tests do GPs most commonly interpret?
GPs routinely review screening tests for healthy patients, chronic disease markers (such as cholesterol, blood glucose, and blood pressure readings), full blood counts for unexplained fevers, urine tests, and rapid antigen tests for respiratory infections like COVID-19 and influenza.
3) What are genuine red flags in a blood test result?
Red flags are most often identified through your doctor’s physical examination and medical history before any test is even ordered. One example is left-sided chest pain, which is treated as cardiac in origin until proven otherwise — prompting urgent ECG and cardiac marker testing with results typically returned within eight to twelve hours.
4) Can my diet or exercise habits affect my blood test results?
Absolutely. Eating excessive carbohydrates or oily foods, drinking alcohol, taking herbal supplements, and even extreme diets like keto can raise liver enzymes. High-intensity exercise can trigger rhabdomyolysis — a muscle breakdown process that spikes creatinine and may harm the kidneys. Many of these changes normalise once lifestyle habits improve.
5) What should I do when I first receive an abnormal result?
The best first step is to speak with your enrolled Family Physician. They can arrange retesting, order further investigations if needed, and refer you to the right specialists — acting as the central co-ordinator of your care.
1) In your experience, what are the most common abnormal blood test results you see in Singapore patients, and which ones cause the most anxiety?
As a Family Physician / General Practitioners, the common tests we interpret are those from screening tests for healthy ones and those for chronic diseases such as diabetes mellitus, hypertension and high cholesterol, various tests related to acute conditions such as ART swab tests for respiratory infections, full blood count when we see unknown causes of fever like dengue, and urine microscopy and culture and sensitivity.
My personal experience is that there is no tests that patients are not anxious about. Even as simple as a ART Swab tests for influenza and Covid, or a dengue antigen test can be highly worrying to a patient. Often they hope that the tests are wrong, but yet they know that they are unwell and unlikely that the results are accurate.
Even something as simple as measuring their blood pressure can cause much anxiety among some patients. For the newly diagnosed ones, they may be in denial. For those already diagnosed, they are worried about the control of their blood pressure. In short, anxious about any tests is human. As doctors, especially GP / FP, our job is to comfort always.
2) How do you explain to patients when an abnormal result is likely benign vs. something that needs urgent follow-up?
My personal preference is always to make the patient comfortable when reviewing any results.
I have also learnt never to sugar coat the diagnosis and the results. We should be as upfront as possible.
Having said that, we must always be mindful of the anxiety caused. So, I tend to speak slowly, pause often for questions and responses. My body language must always be one that is open for discussion and care. I also will get ready for tissue papers if it is required. At times, when reminding the patient of their medical appointment, we would suggest that they be accompanied by their loved ones and family members. This is a common practice in the Asian society like Singapore.
Finally, I will remind myself not to rush through the results, factor more time for review when setting appointment as well as setting an earlier appointment for review.
3) What are the key red flags in blood test results that mean a patient should seek immediate medical attention?
As a clinician, our antennae for red flags derive mostly from our history taking and physical examination.
Often blood tests, urine tests and other scans are to use to confirm our suspicions. And if red flags were noted before the tests, we would have escalated to the Emergency Department at the hospitals and let the physicians there conduct the relevant tests.
At times, we may also find nothing clinically but our clinical minds have some concerns, we will conduct tests to verify. For instance, in a case of left sided chest pain. If we find nothing alarming, we will usually still conduct some tests and not write the pain off. Left sided chest pain is usually cardiac in origin unless proven otherwise.
At our clinics, we may run a ECG to look at the electric waves changes if any. We will also take some blood for testing cardiac markers. For these sent out tests, we will order it urgently and will usually get the results within eight to twelve hours.
4) How do common lifestyle factors in Singapore (diet, stress, exercise) affect blood test results like cholesterol, liver enzymes, or glucose?
Excellent question. Many lifestyle decisions alter our body function presented as abnormalities in the blood tests. The example you cited is very common. For those who over eat carbohydrate and oily food, invariably their liver enzymes will be raised. The level will return to normal after some weeks if the patient improves on the lifetstyle, diet and exercise.
Often herbs, supplements and alcohol also raise the liver enzymes. So, the patients are also advised to stop these.
Some people may attempt to lose weight using the keto diet regime. They substitute the carbohydrates they eat with fat. We have also seen patients suffering from liver and kidney damages from adopting these extreme diets.
Another organ is the kidney. Many younger people like to over exercise and participate in high intensity sports and also spin cycle, and their muscle breaks down causing a process called rhabdomyolysis. The sudden increase in creatinine will harm the kidneys.
5) What safe next steps do you recommend when a patient first sees an abnormal result (e.g., retesting, lifestyle changes, specialist referral)?
My best advice for facing any abnormal results is always to discuss with one’s enrolled Family Physician who knows you well.
A Family Physician would be able to draft out a plan to tackle the issues at hand.
Besides treating and retesting, he or she may also order more definitive investigations. He or she may also co-manage the problems with the most appropriate specialists, much like a conductor in an orchestra.
Medically Reviewed
About the Experts
Reviewer
Dr Leong Choon Kit
MBBS, M.Med (Public Health), GDFM, MCFP(S), FCFP(S), FAMS (Family Medicine) — Adjunct Assistant Professor, Duke-NUS & NUS
Dr Leong Choon Kit is a family physician and public health advocate with extensive experience in primary care, public policy, and vaccination initiatives. He leads Tampines Family Medicine Clinic and the Class Primary Care Network, and co-authored Singapore's Adult Vaccination Guidelines. An Adjunct Assistant Professor at both Duke-NUS Medical School and NUS, he has spent over a decade mentoring pre-medical students across all three local medical schools and is deeply committed to nurturing the next generation of doctors.
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Timothy Leong
Writer, Content Editor & Marketing Specialist — MMC
Timothy Leong is the writer, content editor, and marketing specialist at MMC. With experience in writing and creating websites for local businesses, he makes sure that everything online runs smoothly.
