People often first notice AapoAI amyloidosis through slowly progressive problems like numbness or tingling in the feet and hands, fatigue, or unexplained weight loss, sometimes paired with swelling in the legs from kidney involvement. For many, the first signs of AapoAI amyloidosis are abnormal urine tests showing protein (proteinuria), declining kidney function, or an enlarged liver found during a check-up, even before symptoms feel severe. In families with a known APOA1 gene change, how AapoAI amyloidosis is first noticed may be earlier through genetic testing or targeted monitoring after mild symptoms appear.