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CMP: Comprehensive Metabolic Panel (16 Essential Tests)

The Comprehensive Metabolic Panel includes 16 essential tests that are typically requested by your doctor as part of a routine check-up or annual physical. This panel gives you or your doctor a clearer picture of your overall health.

Note: This panel requires fasting. Do not eat for 10-12 hours before taking the panel to ensure its accuracy.

Sodium (Na) Potassium (K), Chloride (C) and Carbon Dioxide (CO2) – When tested, irregular values in these “electrolytes” can indicate trouble with your body’s salt/water or acid/base balance. Dehydration, vomiting, medications and kidney problems can cause these health issues.

Albumin (Alb), Alkaline Phosphatase (ALP), Bilirubin (Bil)-Direct and Total, Aspartate Transaminase (AST); and Alanine Transaminase (ALT) – These are proteins and enzymes found in the blood. Abnormal levels of any of these tests can indicate liver damage or liver disease.

Blood Urea Nitrogen (BUN), Calcium (Ca), Creatinine (Cr), Phosporus and Glucose Testing – These tests check for a range of problems that affect the kidneys, including kidney disease. These also measure the waste in the blood that may affect kidney filtration.

Why Do I Need It?:

This is one of the most common blood tests available and it gives you a tremendous amount of information about your health. And of course, it’s at a great value! Note: This panel requires fasting. Do not eat for 10-12 hours before taking the panel to ensure its accuracy.

Normal ranges: can depend on your gender and age. Below are the normal ranges for a healthy adult.

Albumin3.5 – 5.0 gm/dL
Alkaline Phosphatase50 – 160 units/L
ABilirubin Directup to 0.4 mg/dL
Bilirubin Totalp to 1.0 mg/dL
BUN– 18 mg/dL
Calcium8.5 – 10.5 mg/dL
Carbon Dioxide20-29 mEq/L
Chloride98 – 106 mEq/L
Creatinine0.6 – 1.2 mg/dL
Glucose70-110 mg/dL
Potassium3.5 – 5.0 mEq/L
Total Protein6.0 – 8.4 gm/dL
ALT1 – 21 units/L
AST– 27 units/L
Sodium135 – 145 mEq/L
Phosphorus3.0 – 4.5 mg/dL

High Results Indicate::
ALBUMIN: Elevated levels of albumin could indicate dehydration.

ALKALINE PHOSPHATASE: Elevated levels could indicate bone growth or disease, liver disease, leukemia or malignancies in the bone or liver.

BILIRUBIN DIRECT: Elevated levels could indicate hepatitis, cirrhosis, neoplasm or biliary disease.

BILIRUBIN TOTAL: Elevated levels could indicate hepatitis, cirrhosis, neoplasm, alcoholism, hemolytic disease, biliary obstruction or anorexia.

BUN: Elevated levels can indicate impaired kidney function.

CALCIUM: Elevated levels can indicate dehydration, hyperparathyroidism, kidney disease, bone cancer or high Vitamin D, Vitamin A or Calcium intake.

CARBON DIOXIDE: Elevated levels can indicate chronic obstructive pulmonary disease, emphysema, or pneumonia.

CHLORIDE: Elevated levels of chloride can indicate dehydration, high sodium or kidney disease.

CREATININE: Elevated levels can indicate kidney damage or infection, prostate disease or urinary tract obstruction.

GLUCOSE: Elevated levels could indicate hyperglycemia or diabetes.

POTASSIUM: Elevated levels could indicate excessive potassium intake, hyperkalemia or kidney failure or damage.

TOTAL PROTEIN: Elevated levels could indicate dehydration or high levels of albumin and/or globulin.

ALT: Elevated levels could indicate liver disease, hepatocyte injury, hepatitis, drug therapy or biliary disease.

AST: Elevated levels could indicate alcoholism, cirrhosis, hepatitis, drug therapy or biliary disease.

SODIUM: Elevated levels of sodium could indicate hypernatremia or dehydration.

PHOSPHORUS: Elevated levels could indicate hypoparathyroidism or diabetic ketoacidosis.

Low Results Indicate::
ALBUMIN: Low levels of albumin could indicate liver disease, nephrotic syndrome, heart failure or low intake or absorption of protein.

ALKALINE PHOSPHATASE: Low levels could indicate a zinc deficiency, hypothyroidism, Vitamin C or B6 deficiency, excessive Vitamin D intake or malnutrition.

BILIRUBIN DIRECT: Low levels are generally not a concern and are not monitored.

BILIRUBIN TOTAL: Low levels are generally not a concern and are not monitored.

BUN: Low levels are generally not a concern and are not monitored.

CALCIUM: Low levels can indicate parathyroid gland problems and intestinal absorption problems.

CARBON DIOXIDE: Low levels can indicate cirrhosis or liver failure.

CHLORIDE: Low levels of chloride can indicate low sodium, emphysema or chronic lung disease.

CREATININE: Low levels are usually not a concern, but may be caused by decreased muscle mass or pregnancy.

GLUCOSE: Low levels could indicate hypoglycemia.

POTASSIUM: Low levels of potassium could indicate hypokalemia, dehydration or acetaminophen overdose.

TOTAL PROTEIN: Low total protein levels can indicate a liver or kidney disorder.

ALT: Low levels are generally not a concern and are not monitored.

AST: Low levels could indicate uremia, Vitamin B6 deficiency or drug therapy.

SODIUM: Low levels could indicate hyponatremia, fluid retention or too much water intake.

PHOSPHORUS: Low levels of phosphorus could indicate hypercalcemia, overuse of diuretics, hypothyroidism or chronic antacid use.

Comprehensive Metabolic Panel

Total Protein is a measure of available building blocks for many compounds in the body. Protein are used to form enzymes, hormones, antibodies and many structural components like muscle tissue. The main proteins in the blood are albumin and globulin. Increases are seen in liver disorders, alcoholism, and chronic infections and inflammation. Decreases are noted in malabsorption, colitis, and poor nutrition.

Albumin is a primary protein in the blood and is made from amino acids in the liver and is also available from the diet, especially from eggs. It helps with the immune system, maintains proper fluid balance in the tissues and plays a role in nutrient transport and waste removal. Increases are seen in kidney disorders and dehydration. Decreases are noted in decreased immune function and edema.

Globulin is the other primary protein and has important functions in immune response. Among its other jobs are carrying hormones and lipids. Compounds known as imunoglobulins, like IgA, IgG and IgE are highly important for various immune issues like allergies and infections in the mucus linings of the body. Increases are seen in chronic infection and during recovery from acute infections, as well as in Rheumatoid arthritis, lupus, and in some cases when stomach acids are deficient. Decreases are primarily found in patients with compromised immunity and in cases of poor nutrition or malabsorption.

BUN - Blood Urea Nitrogen is an end product of protein breakdown. It’s produced mainly in the liver and is eliminated by the kidneys. Increases can be caused by excessive protein consumption, inadequate water consumption and kidney disorders. Decreases are related to poor diet, liver problems, excessive water consumption and malabsorption.

Uric Acid is an end product of a protein digestion, mainly a type of protein called purine. Some foods that are high in purine are organ meats, spinach, mushrooms, yeast and asparagus. It also comes from the breakdown of purine proteins in the nucleus of cells. Increases occur when the kidneys can’t eliminate properly or with gouty arthritis, alcoholism and high protein diets. Decreases are primarily associated with low protein diet or malabsorption.

Glucose is sugar that is used by the cells to provide energy. It is the only type of fuel that can be used by the brain and nervous system, whereas other tissues can also burn fats for energy. Glucose comes from the digestion of carbohydrates and may also be stored as glycogen for later use. It is primarily kept in balance by 2 hormones made in the pancreas – insulin and glucagon, although the liver, adrenal and thyroid glands are also involved. Increased values are related to diabetes, stress, Syndrome X and diet. Decreased values can reflect hypoglycemia and result from overproduction of insulin, alcoholism and liver disorders.

SGOT (also called AST) is an enzyme found mainly in the liver, heart, muscle and gonads. It functions in conversion of cholesterol to hormones and in the synthesis of several acids formed from the breakdown of proteins and fats. Increases are seen in congestive heart disease, heart attack, liver disease and alcoholism. Decreases are seen in gonadal dysfunction and vitamin B-6 deficiency.

SGPT (also called ALT) is an enzyme found primarily in the liver where it is produced when fatty membranes release stored food substances. It is released when cells die and is used to measure liver damage and other cellular damage. Increases are seen in liver disorders, alcoholism, vitamin A deficiency and heart attack. Decreases are seen in congested liver with poor release of stored nutrients.

GGT is another enzyme found primarily in the liver that is responsible for transporting amino acids and proteins into cells. Increases are seen in obstruction of the bile duct, liver damage and alcohol use, especially chronic. Decreases are seen when the liver is congested and in hypothyroid conditions.

Calcium is a principle component of the bones and teeth with 99% of the body’s calcium found in these structures. The other 1% is very important to processes like blood clotting, nerve and muscle function, and various enzyme activities. Increases are seen in disorders involving the parathyroid and thyroid glands, excess intake of vitamin D, and in conditions related to much acid in the body. Decreases are seen in parathyroid dysfunction, vitamin D deficiency, magnesium deficiency and numerous other conditions.

Iron is an important part of hemoglobin the red blood cells, carrying oxygen to all cells of the body. It also provides information on how the liver and spleen are functioning. Increases are indicative of some types of anemia where adequate co-factors are deficient leaving unbound iron that can cause free radicals. Decreases are seen in iron deficiency anemia, fatigue and bleeding in the G.I. tract.

Potassium is an electrolyte related to fluid balance and is used mainly inside the body’s cells. It is necessary for proper function of the heart and muscles. Increases are seen with excessive destruction of cells, underactive adrenal glands and kidney disease. Decreases are mainly seen in diarrhea, diuretic use, nutritional deficiency and overactive adrenal glands.

Sodium is also an electrolyte. A low level of blood sodium means you have hyponatremia, which is usually due to too much sodium loss, too much water intake or retention, or to fluid accumulation in the body (edema). Low sodium may be due to dehydration or a disease process.

Bilirubin (Total Bilirubin) comes from the normal breakdown of red blood cells. This breakdown is done by the spleen, which produces indirect bilirubin, and the liver, which produces direct bilirubin. The combination of these two forms is called total bilirubin. Increases are seen in liver and spleen dysfunction. Decreases are found in iron deficiency anemia and also a type of spleen dysfunction.

Carbon Dioxide (CO2) is actually the total of bicarbonate and carbon dioxide. These two substances are in a dynamic equilibrium and help maintain the balance of acid and base in the body. The test also reflects the ability of the lungs to exchange oxygen for the carbon dioxide gas. Increases indicate more alkaline blood condition and in the extreme, metabolic alkalosis. Decreases show more acidity in the blood and in the extreme metabolic acidosis. Chloride is another electrolyte involved in maintaining proper fluid balance and pH balance. It is also part of the stomach’s hydrochloric acid that digests protein and levels are also influenced by kidney function. Increases are seen when too much acid is in the system, in dehydration, and with swelling caused by too much fluid inside the cells. Decreases are seen in excessive sweating, stomach acid deficiency and edema.

Creatinine is a waste product of muscle activity and levels are related to a person’s muscle mass and how much exercise and strenuous activity they perform. Increases can also be related to inadequate kidney function. Deceases may be due to lack of muscle mass or degeneration