@dazlin, those values do look good. For comparison, my kappa/lambda ratio is 5.64, bone marrow was 5% abnormal kappa plasma cells, no M-spike because I'm kappa-only. So I'm kind of in your neighborhood and have been trying to read about those kinds of values.

You might want to get the 24-hour UPEP/IFE (Bence Jones) test along the way, but it sounds like you've had good monitoring.

I personally feel like there are things related to MGUS that create inflammation (or respond with inflammation) and produce fatigue, where you feel like you're getting the flu a lot of the time. So I went looking for references to MGUS + inflammation. Here are a couple of chunks:

"Concerning inflammation, 14 cytokines were equally increased in MGUS and MM compared to healthy subjects. MM diverged from MGUS by greater concentrations of IL-11, RANTES, hepatocyte growth factor (HGF), and stroma cell-derived factor 1 alpha (SDF-1-α). MGUS and MM subjects exhibiting hyposialylated pc IgGs had considerably greater concentrations of IL-6, IL-17, IL-33, TGF-β1, HGF, and tumor necrosis factor-α compared to subjects with hypersialylated pc IgGs." (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600674/)

So basically it's saying that people with both MGUS and MM can have notable levels of inflammation.

And this chunk, which is just about MM, but explains cytokines a little:

"When functioning normally, cytokines protect a person’s body, but when cancer is present, cytokines can actually cause cancer cells to grow and spread to other parts of the body. The resulting fatigue from cytokine release is similar to that which people feel when fighting off a virus. With myeloma, the fatigue is more persistent and lasts much longer."

(When they say "cancer", they mean MM, of course.)

At least we know we're not alone!