Have you ever had a blood test result come back with something labelled “abnormal”?
For many people, that single word is enough to trigger concern. Even in the absence of symptoms, seeing unfamiliar medical terms or unexpected findings in a report can quickly lead to anxious thoughts about underlying disease.
But the truth is, not everything that appears abnormal in a laboratory report indicates something dangerous.
One example that is often misunderstood is Southeast Asian Ovalocytosis (SAO). While the name may sound technical and unfamiliar, SAO is not a disease. It is a genetic variation that affects the shape of red blood cells, and it is relatively common among populations in Southeast Asia, including Malaysia.
In individuals with SAO, red blood cells tend to be more oval in shape and slightly more rigid than usual. This change is caused by a variation in a key protein on the surface of the red blood cell, which plays an important role in maintaining its structure and flexibility. The condition can be detected through routine blood tests or by examining blood cells under a microscope, where these oval-shaped cells become apparent.
While this explanation may sound clinical, what matters more is how it affects the individual. In most cases, it does not.
People with SAO typically do not experience symptoms. They are not unusually tired, they are not pale, and they do not suffer from anaemia. In fact, many only discover they have this condition incidentally during routine health screenings or tests conducted for unrelated reasons.
Interestingly, SAO is believed to have existed in human populations for generations, particularly in regions where malaria was once widespread. There is evidence to suggest that this variation may offer some degree of protection against malaria infection. In that sense, what appears unusual in a lab report may actually reflect a form of biological adaptation shaped by the environment over time.
That said, the picture can become more complex when SAO coexists with other conditions. For instance, if an individual also has iron deficiency or inherited blood disorders such as thalassaemia, they may develop symptoms of anaemia, including fatigue, dizziness or pallor. In such cases, it is important to recognise that these symptoms are usually driven by the accompanying condition, rather than SAO itself.
Because SAO is inherited, it can be passed from parent to child. If one parent carries the trait, there is roughly a 50 per cent chance that each child will inherit it. In most instances, this does not lead to health problems. However, if both parents are carriers, there is a smaller risk that the child may inherit a more severe form, which could require closer medical monitoring from an early stage.
All of this raises a practical question: what should you do if your blood test report contains something labelled as abnormal?
The first step is to recognise that laboratory results are only one part of a much larger picture. Numbers and terminology need to be interpreted alongside clinical findings, medical history, and how you actually feel. On their own, they rarely tell the full story.
The next step is to have a proper conversation with your doctor. Beyond explaining the terminology, a good discussion can help clarify whether a finding has real clinical significance or is simply a benign variation that does not require treatment.
In many cases, the anxiety does not come from the condition itself, but from encountering unfamiliar information without context. Medical language can be intimidating, especially when presented without explanation, even when the underlying issue is harmless.
SAO offers a useful reminder that not every difference in the human body is a problem waiting to be fixed. Some are simply variations that have long existed quietly without affecting daily life.
With better understanding, we can approach our health with a little more calm and a little less fear, especially when faced with words like “abnormal” that may not mean what we think they do.
The author is a consultant haematopathologist at Hospital Sultan Zainal Abidin, Kuala Terengganu.
The views expressed here are the personal opinion of the writer and do not represent that of Twentytwo13.
