@Peyt the Alpha-1 test was a blood test so assuming that means it is a serum test. No?
This excerpt explains how my deficiency was stumbled upon as it was a Protein Electrophoresis panel that I had...
"Protein electrophoresis is a test that evaluates many different proteins in the blood. Sometimes the test will detect a deficiency in AAT unexpectedly, when it is done for a different purpose. In those cases, follow-up testing for AAT may confirm a deficiency of the protein, even if there are no
signs or
symptoms of disease."
After I saw that my level of Alpha-1 was on the lower side I found that indeed my 23andme DNA testing shows that I am "PiSZ" so I only produce roughly 40% of normal amount of Alpha-1.
"AAT is an
acute phase reactant. This means that it will be elevated in
acute and
chronic inflammatory conditions, infections, and with some cancers. Increased levels of AAT may also be seen with oral contraceptive use,
pregnancy, and stress. These temporary or chronic AAT increases may cause levels to appear normal in people with mild to moderate AAT deficiency."
https://labtestsonline.org/understanding/analytes/alpha1-antitrypsin/tab/test/