@nsnipes11 , I'm going to take a crack at just listing the reference ranges with footnotes for the online sources for the immunoglobulin and kidney test results that you mentioned. I can't do much interpretation, not being qualified to do so. I hope it will help, though.

You wrote: "... immunofixation shows IgG monoclonal protein with lambda light chain." I'm listing the values you then reported with a reference (normal) range for each one.

The caveat is that different labs may use varying ranges for the same tests, depending on their processes. I think that the immunoglobulin values are probably (?) pretty standard, but I'm not sure about glucose, creatinine, and other blood values. I think that different labs might vary more on those. Anyway:

"< " means "less than".
">" means "greater than".

M-SPIKE
- M-spike = 1.5 mg/dL
--- Mayo Labs ref : IgG < 3 mg/dL may be consistent with MGUS or a number of other monoclonal gammopathies. *
--- IgG > 3 mg/dL is consistent with multiple myeloma. *

So your M-spike is square in the middle of the reference range for MGUS.

IMMUNOGLOBULIN G
- IgG = 1,819 mg/dL
--- Mayo Labs (normal) ref range: at age > or =18 years: 767-1,590 mg/dL *
--- --- So you have somewhat higher IGg than Mayo Labs' reference range. Other labs may state this range somewhat higher or lower. Problem is, I can't figure out what a "concerning" high level might be, as opposed to "slightly high". And the IgG level can go up for reasons other than MGUS, like a recent infection, autoimmune problems, and others.

KAPPA/LAMBDA RATIO
- K/L Ratio = 0.39
--- Mayo Labs ref range: 0.26-1.65 *

LAMBDA FLC
- Lambda FLC = 27.00 mg/dL
--- Mayo Labs ref range: 0.57-2.63 mg/dL *

KAPPA FLC
- Kappa FLC = 10.53 mg/dL, calculated below
--- --- kappa / .39 = 27.00
--- --- 10.53 / .39 = 27.00
--- --- kappa = 10.53
--- Mayo Labs ref range: 0.33-1.94 mg/dL *

The kappa/lambda RATIO is within the normal range, but the kappa and lambda measures are each above the normal range. It's my (limited) understanding that a variety of factors can cause both types of free light chains to increase at the same time, including the kidneys having trouble clearing them*, or your body making more in the first place, which can happen with infections, inflammation, or some autoimmune diseases*. Or both.

Since kidney health may impact free light chain values in blood, I'll include those values, too.

CREATININE
- Creatinine = 1.1 mg/dL
--- Normal, female (American Kidney Fund): 0.6 - 1.1 mg/dL

eGFR
- eGFR = 53
--- Average, age 70+: 75

According to the National Kidney Fund and a few other places I spotted, the creatinine result is within normal range for a female, though at the top, and the eGFR is kinda lower than normal. But eGFR scores decline over our lifetime, so at close to 80, this score may be low, but not extremely so. I don't know. That'll be a question for a doctor, maybe in relation to previous eGFR results.

Which leads to this: You, as an insured patient and heck! a human being! deserve professional answers to your health questions. All of them. I can understand the doctor getting sidetracked in an appointment, but I can't quite grant your healthcare team that tolerance for not answering your Portal questions. If it were me, I think I'd politely repeat the message every three days until someone answered. Or find a doctor who is responsive, maybe even someone in the same practice. My neuropathy problem alone is forcing me to pound some doors.

Best wishes! ❤️
Nancy

REFERENCES

* IgG reference range: https://www.mayocliniclabs.com/test-catalog/overview/8156#Clinical-and-Interpretive
* IgG ranges for MGUS/MM: https://www.mayocliniclabs.com/test-catalog/overview/609783#Clinical-and-Interpretive
* K/L ratio, lambda, kappa ranges: https://www.mayocliniclabs.com/api/sitecore/TestCatalog/DownloadTestCatalog?testId=609782
* Both lambda and kappa have raised levels: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253807/
* Creatinine: https://www.kidneyfund.org/all-about-kidneys/tests/serum-creatinine-test
* eGFR: https://www.kidney.org/atoz/content/gfr