Diagnosis

MGUS is usually detected during blood tests for another condition, such as a certain nerve disorder (peripheral neuropathy). The blood tests can show abnormal proteins as well as unusual amounts of normal proteins.

If your doctor detects monoclonal gammopathy, further testing may be recommended to determine which M protein your body is making and how much is being made.

To rule out other causes of elevated protein levels, your doctor might recommend:

  • Additional blood tests. Tests to count the blood cells in your blood (complete blood count), to look for a decline in kidney function (serum creatinine test) and to determine the amount of calcium in your blood (serum calcium test) can help rule out conditions such as multiple myeloma.
  • Urine tests. These tests can determine if abnormal protein is being released into your urine, and assess any resulting kidney damage. You'll likely need to collect your urine for 24 hours.
  • Imaging tests. If you are experiencing bone pain, your doctor might recommend an MRI or CT-positron emission tomography (PET) scan. The images can help your doctor find bone abnormalities related to MGUS.
  • Bone marrow test. A hollow needle removes a portion of your bone marrow from the back of one of your hipbones. The bone marrow is analyzed to determine its percentage of plasma cells. Bone marrow testing is generally done only when you're at risk of developing a more serious disease or if you have unexplained anemia, kidney failure, bone lesions or high calcium levels.

Treatment

MGUS doesn't require treatment. But your doctor is likely to recommend periodic checkups to monitor your health, probably starting six months after your diagnosis.

Watchful waiting

If you are at high risk of developing a more-serious condition, your doctor may recommend more frequent checkups so that any progression can be diagnosed and treatment started as soon as possible.

Your doctor is likely to watch for the development of signs and symptoms including:

  • Pain
  • Fatigue or weakness
  • Unintentional weight loss
  • Fever or night sweats
  • Headache, dizziness, nerve pain, or changes in vision or hearing
  • Bleeding
  • Anemia or other blood abnormalities
  • Swollen lymph nodes, liver or spleen
  • Heart and kidney problems

Medications

If you have osteoporosis, your doctor might recommend a medication (bisphosphonate) to increase bone density. Examples include alendronate (Binosto, Fosamax), risedronate (Actonel, Atelvia), ibandronate (Boniva) and zoledronic acid (Reclast, Zometa).

Coping and support

You can't control whether MGUS will lead to something more serious. But you can control many aspects of your health. Try to:

  • Stick to your checkup schedule. Diagnosing a serious condition, such as cancer, in the early stages may improve your treatment outcomes.
  • Follow a healthy lifestyle. You can reduce your risk of developing conditions unrelated to MGUS by eating a variety of fruits and vegetables, getting enough exercise and sleep, and reducing stress.

Preparing for your appointment

You may be referred to a doctor who specializes in blood disorders (hematologist).

It's a good idea to be well-prepared for your appointment. Here's some information to help you get ready, and what to expect from your doctor.

What you can do

  • List any symptoms you're experiencing, including those that may seem unrelated to the reason you scheduled the appointment.
  • List key personal information, including any major stresses or recent life changes.
  • List all medications, vitamins or supplements you take, including doses.
  • Ask a family member or friend to come with you. Sometimes it can be difficult to remember all of the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • List questions to ask your doctor.

For MGUS, some basic questions to ask your doctor include:

  • What kinds of tests do I need?
  • Do these tests require any special preparation?
  • How frequently do I need to schedule follow-up visits and testing?
  • Do you recommend any treatment or lifestyle changes?
  • I have other health conditions. How can I best manage these conditions together?

Don't hesitate to ask other questions you have.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, including:

  • Do you have any numbness or tingling in your hands and feet?
  • Do you have osteoporosis?
  • Do you have a family history of MGUS?
  • Have you ever had a blood clot?
  • Have you ever experienced a broken bone?
  • Have you ever had cancer?