In my last post, I looked at the Lipid Panel results from my recent blood analysis. Today, I’ll look at the Comprehensive Metabolic Panel (CMP) portion of the results. This CMP is also commonly referred to as a Chemistry Panel or SMA 12/20.
This panel gives you important information about the current status of your kidneys and liver as well as electrolyte and acid/base balance and levels of blood glucose and blood proteins. The results of this panel can be used to evaluate organ function and check for conditions such as diabetes, liver disease and kidney disease. With a family history of some of these conditions, I think that an annual CMP is probably a good idea for me.
As I mentioned in my last post, I am not a doctor. The thoughts that I will share on my results are based on my own research and may not be the same as what your doctor would recommend. Always consult with a trusted medical professional when it comes to your health.
First on the results were the Electrolytes, so I’ll start there. Electrolytes are minerals found naturally in the body, such as potassium, calcium, sodium, and magnesium. Electrolytes are needed to keep the body’s balance of fluids at the proper level and to maintain normal functions, such as heart rhythm, muscle contraction, and brain function.
Sodium – 138 mmol/L
Blood sodium testing is used to detect abnormal concentrations of sodium (both high and low). The recommended range is between 136 and 145 mmol/L, so I’m within range. Sodium is both an electrolyte and mineral. It helps keep the water (the amount of fluid inside and outside the body’s cells) and electrolyte balance of the body. Sodium is also important in how nerves and muscles work. Sodium levels in the body are partly controlled by a hormone called aldosterone, which is made by the adrenal glands. Aldosterone levels tell the kidneys when to hold sodium in the body instead of passing it in the urine. Small amounts of sodium are also lost through the skin when you sweat. It is possible to have low sodium levels following physical activity, but for blood taken under non-extreme conditions, a low level of blond sodium is usually due to a condition such as Addison’s disease, diarrhea, diuretic administration, or kidney disease. A high blood sodium level is almost always due to dehydration. This occurs when the body contains too little water for the amount of sodium. The sodium levels become abnormally high when water loss exceeds sodium loss.
Potassium – 4.6 mmol/L
Normal range is between 3.4 and 5.4 mmol/L. Potassium helps keep the water and electrolyte balance of the body and is important in how nerves and muscles work. Potassium levels often change with sodium levels. When sodium levels go up, potassium goes down, and visa versa. Potassium levels can be affected by how the kidneys are working, the blood pH, the amount of potassium you eat (found in potatoes, bananas, squash, scallops) and hormone levels in the body. A common cause of high levels of Potassium is kidney disease. Low levels can be attributed to diarrhea or dehydration.
Chloride – 101 mmol/L
Normal range is between 98 and 107 mmol/L. Most of the Chloride in the body comes from the salt that you eat. It is absorbed by your intestines when you digest food. Excess chloride leaves the body through urine. Low levels of blood chloride can be caused by low blood sodium, congestive heart failure, chronic lung diseases and loss of acid from the body. High levels usually indicate dehydration, but can also be caused by Cushing syndrome or kidney disease.
CO2 – 28 mmol/L
Normal range is between 22 and 30 mmol/L. In the body, most of the CO2 is in the form of a substance called bicarbonate (HCO3-). Therefore, the CO2 blood test is really a measure of your blood bicarbonate level. When bicarbonate levels are higher or lower than normal, it suggests that the body is having trouble maintaining its acid-base balance or that you have upset your electrolyte balance, perhaps by losing or retaining fluid. Both of these imbalances may be due to a wide range of dysfunctions. Low levels can be a warning sign for Addison’s disease, diabetic ketoacidosis or Kidney disease. High levels can be cuased by Cushing syndrome, Conn syndrome or lung diseases.
That’s it for the electrolytes, so let’s move on to proteins. Proteins are large, complicated molecules that are vital to the function of all cells and tissues. They are made in many places throughout your body and circulate in the blood. Proteins take a variety of forms — such as albumin, antibodies and enzymes — and have many different functions in the body. They help fight diseases, regulate body functions, build muscles and transport drugs and other substances throughout the body. So they are like little bad-ass worker molecules.
Certain proteins in the blood may be elevated as your body fights an infection or some other inflammation. People with certain bone marrow diseases, such as multiple myeloma, may have high blood protein levels before they show any other symptoms.
Total Proteins – 7.4 g/dL
Normal range is 6.3 to 8.2 g/dL. Total protein measurements can reflect nutritional status and may be used to screen for and help diagnose kidney disease or liver disease. If total protein is abnormal, further testing must be performed to identify which specific protein is abnormally low or high so that a specific diagnosis can be made. A low total protein level can suggest a liver disorder, a kidney disorder, or a disorder in which protein is not digested or absorbed properly. Low levels may be seen in severe malnutrition and with conditions that cause malabsorption, such as celiac disease or inflammatory bowel disease (IBD). I talked about blood proteins quite a bit in my posts on gluten. A high total protein level may be seen with chronic inflammation or infections such as viral hepatitis or HIV. It also may be associated with bone marrow disorders such as multiple myeloma. It’s worth mentioning that a high-protein diet doesn’t cause high blood protein. High blood protein is not a specific disease or condition in itself.
My report shows total protein, albumin, globulins, and the calculated ratio of albumin to globulins, termed the A/G ratio. Normally, there is a little more albumin than globulins, giving a normal A/G ratio of slightly over 1. Because disease states affect the relative amounts of albumin and globulin, the A/G ratio may provide a clue as to the cause of the change in protein levels.
Albumin – 4.7 g/dL
Globulin – 2.7 g/dL
A/G Ratio – 1.7
A low A/G ratio (under 1.1) may reflect overproduction of globulins, such as seen in autoimmune diseases, or underproduction of albumin, such as may occur with cirrhosis, or selective loss of albumin from the circulation, as may occur with kidney disease. A high A/G ratio (over 2.5) suggests underproduction of immunoglobulins as may be seen in some genetic deficiencies and in some leukemias.
The Liver Panel is used to screen for, detect, evaluate, and monitor acute and chronic liver inflammation (hepatitis), liver disease and/or damage. The liver serves several important functions in the body, including changing nutrients into energy for the body and breaking down toxic substances. The liver panel consists of four tests.
Bilirubin (Total) – 0.7 mg/dL
Normal Range is between 0.2 and 1.3 mg/dL. Bilirubin is a brownish yellow substance found in bile (helps digest food). It is produced when the liver breaks down old red blood cells. When bilirubin levels are high, the skin and whites of the eyes may appear yellow (jaundice). Jaundice may be caused by liver disease (hepatitis), blood disorders (hemolytic anemia), or blockage of the tubes (bile ducts) that allow bile to pass from the liver to the small intestine. Low levels of bilirubin are not generally a concern and are not monitored.
AST (aspartate aminotransferase) – 26 U/L
Normal range is between 15 and 46 U/L. An AST test measures the amount of this enzyme in the blood. AST is normally found in red blood cells, liver, heart, muscle tissue, pancreas, and kidneys. When body tissue or an organ such as the heart or liver is diseased or damaged, additional AST is released into the bloodstream. Very high levels of AST (more than 10 times normal) are usually due to acute hepatitis, sometimes due to a viral infection. Low levels of AST are not a concern. The AST test is usually done at the same time as a test for alanine aminotransferase, or ALT.
ALT (alanine aminotransferase) – 23 U/L
Normal range is between 13 and 69 U/L. As with the AST test, ALT is used to dentify liver disease, especially cirrhosis and hepatitis caused by alcohol, drugs, or viruses. AST and ALT are considered to be two of the most important tests to detect liver injury, although ALT is more specific to the liver than is AST. In most types of liver diseases, the ALT level is higher than AST, and the AST/ALT ratio will be low (less than 1).
ALP (alkaline phosphatase) – 36 U/L
Normal range is between 38 and 126 U/L. The liver makes more ALP than the other organs or the bones. ALP helps break down proteins in the body and exists in different forms, depending on where it originates. Some conditions cause large amounts of ALP in the blood. These conditions include rapid bone growth (during puberty), bone disease (such as Paget’s disease or cancer that has spread to the bones), a disease that affects how much calcium is in the blood (hyperparathyroidism), vitamin D deficiency, or damaged liver cells. A deficiency in zinc may cause low ALP levels. Malnutrition or protein deficiency as well as Wilson disease could also be possible causes for lowered ALP. It may also be caused by celiac disease or a deficiency in vitamins and minerals. My level of ALP was slightly below the normal range, but my protein levels are normal, so I’m not concerned. It’s something that I will be sure to keep an eye on in the future.
Next I’ll move on to the Kidney tests. Kidney’s not only remove waste products and excess fluid from the body, they regulate of the body’s salt, potassium and acid content. The kidneys also produce hormones that affect the function of other organs. So needless to say, these little bean-shaped dudes are very important.
BUN (Blood Urea Nitrogen) – 16 mg/dL
Normal range is between 7 and 20 mg/dL. The BUN test is primarily used, along with the creatinine test, to evaluate kidney function in a wide range of circumstances, to help diagnose kidney disease, and to monitor people with acute or chronic kidney dysfunction or failure. If your kidneys are not able to remove urea from the blood normally, your BUN level rises. Heart failure, dehydration, or a diet high in protein can also make your BUN level higher. Liver disease or damage can lower your BUN level. BUN levels can increase with the amount of protein in the diet. High-protein diets may cause abnormally high BUN levels while very low-protein diets can cause an abnormally low BUN.
Creatinine – 1.0 mg/dL
Normal range is 0.7 to 1.5 mg/dL. Creatinine is a waste product formed by the breakdown of a substance (creatine) important for converting food into energy (metabolism). The creatinine is filtered out of the blood by the kidneys and then passed out of the body in urine. If the kidneys are damaged and can’t function normally, the amount of creatinine in the urine decreases while the amount of creatinine in the blood increases. Low blood levels of creatinine are not common, but they are also not usually a cause for concern. They can be seen with conditions that result in decreased muscle mass. Blood urea nitrogen (BUN) and creatinine tests can be used together to find the BUN-to-creatinine ratio (BUN:creatinine). A BUN-to-creatinine ratio can be used to check for problems, such as dehydration, that may cause abnormal BUN and creatinine levels. My ratio was 16.0 – the normal range is between 10 and 20.
eGFR (estimated Glomerular Filtration Rate) – >60
The final kidney test is the eGRF. A normal eGFR is 60 or more. A low eGFR number may suggest kidney disease. All my results told me was that mine was greater than 60…so I’ll take it.
There are only three other tests that fall under the Comprehensive Metabolic Panel, glucose, calcium and Vitamin D.
Glucose – 89 mg/dL
Normal range is 74-106 mg/dL. A blood glucose test measures the amount of a type of sugar, called glucose, in your blood. Glucose comes from carbohydrate foods. Insulin is a hormone that helps your body’s cells use the glucose. Insulin is produced in the pancreas and released into the blood when the amount of glucose in the blood rises. Normally, your blood glucose levels increase slightly after you eat. This increase causes your pancreas to release insulin so that your blood glucose levels do not get too high. Blood glucose levels that remain high over time can damage your eyes, kidneys, nerves, and blood vessels. There are several different types of blood glucose tests, but the one I had done was a Fasting Blood Glucose (FBG). It measures blood glucose after you have not eaten for at least 8 hours. It is often the first test done to check for prediabetes and diabetes. Anything over 126 mg/dL on this FBG test would indicate diabetes. With a family history if diabetes, this is a number that I will be sure to keep a close eye on as well.
Calcium – 9.4 mg/dL
Normal range is 8.4 to 10.2 mg/dL. Calcium is the most common mineral in the body and one of the most important. The body needs it to build and fix bones and teeth, help nerves work, make muscles squeeze together, help blood clot, and help the heart to work. Almost all of the calcium in the body is stored in bone. Blood calcium levels do not indicate levels of bone calcium but rather how much calcium is circulating in the blood. Normally the level of calcium in the blood is carefully controlled. When blood calcium levels get low (hypocalcemia), the bones release calcium to bring it back to a good blood level. When blood calcium levels get high (hypercalcemia), the extra calcium is stored in the bones or passed out of the body in urine and stool. It is important to get the right amount of calcium in your food because the body loses calcium every day. Foods rich in calcium include dairy products (milk, cheese), eggs, fish, green vegetables, and fruit. Most people who have low or high levels of calcium do not have any symptoms. Calcium levels need to be very high or low to cause symptoms. Some causes of high levels of calcium are hyperthyroidism, sarcoidosis, excess Vitamin D, HIV/AIDS and cancer. Low levels can be caused by liver disease, renal failure or malnutrition.
Vitamin D 25 Hydroxy – 41.1 ng/mL
Normal range is >= 32 ng/mL. The 25-hydroxy vitamin D test is the most accurate way to measure how much vitamin D is in your body. In the kidney, 25-hydroxy vitamin D changes into an active form of the vitamin. The active form of vitamin D helps control calcium and phosphate levels in the body. Lower-than-normal levels can be due to a vitamin D deficiency, which can result from lack of exposure to sunlight (especially this time of year), lack of enough vitamin D in the diet, liver and kidney diseases, and/or poor food absorption. If you don’t spend much time in the sun or always are careful to cover your skin (sunscreen inhibits vitamin D production), you should look into taking a vitamin D supplement. I personally take, and would recommend Vitamin Code RAW D3 from Garden of Life.
So that’s it. I shared my blood lab results on here to both help you understand your own results and to show how eating healthy and exercising can result in your body functioning as it is supposed to. In no way am I trying to “toot my own horn” by posting my numbers. I just hope that someone that is struggling with any of the diseases or symptoms that come along with unhealthy levels of the tests outlined above will strive to make improvements in their lifestyle to ensure a longer, more fulfilling life! The human body is amazing, and given the chance, it can and will heal itself.
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