Metabolic Tests

Metabolic Discovery Comprehensive Panel

This thorough set of tests helps assess your metabolism. Are you storing too much fat and sugar or perhaps too little? Are you insulin resistant with subsequent inflammation? You can run this panel to discover whether your diet, fitness and nutritional habits are providing you the metabolic health and longevity you deserve. Don’t settle for one-size-fits-all health advice.

Preparation: Fast for 10-16 hours, overnight. Drink enough water and take your prescribed medications. No coffee or vigorous exercise on the morning of the blood draw.

CONTAINS ALL OF THE TESTS IN THE Metabolic Discovery Panel

• CBC (includes Differential and Platelets)
• Comprehensive Metabolic Panel (CMP)
• Ferritin
• Hemoglobin A1c with eAG
• Insulin
• Lipid Panel with Ratios
• Vitamin B12 (Cobalamin)
• Vitamin D, 25-Hydroxy, Total, Immunoassay

PLUS

• Adiponectin 
• Iron and Total Iron Binding Capacity (TIBC)
• Leptin
• T3, Free
• T4, Free
• TSH

Identifying patients who have metabolic syndrome and who are thus at higher risk of diabetes, coronary heart disease or stroke. Identifying patients who are insulin resistant (fasting insulin at or above the 75th percentile) and who are thus at higher risk of diabetes, coronary heart disease, stroke, or liver disease. Monitoring of risk factors and insulin levels after life style change, medication use, or both.

The adiponectin ELISA assay quantitatively measures human adiponectin in serum. It has been shown that decreased expression of adiponectin correlates with insulin resistance. Adiponectin appears to be a potent insulin enhancer linking adipose tissue and whole body glucose metabolism.

Description: An Albumin test is a blood test used to screen for a diagnose kidney disease, liver disorders, and evaluate a patient’s nutritional status.

Also Known As: ALB Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is an Albumin test ordered?

A panel of tests is commonly ordered as part of a health check, including an albumin test.

If a person exhibits any of the following signs of a liver problem, an albumin test may be requested along with other tests:

• skin or eyes turning yellow
• weakness, exhaustion
• Unaccounted-for weight loss
• reduced appetite
• edema and/or pain in the abdomen
• Dark feces and pale urine
• Itching

When someone exhibits the following nephrotic syndrome symptoms, for example:

• Swelling or puffiness, especially in the face, wrists, abdomen, thighs, or ankles, or around the eyes
• Foamy, bloody, or coffee-colored urine
• a reduction in the urine's volume
• problems urinating, such as a burning sensation or an unusual discharge, or a change in frequency, particularly at night
• discomfort in the middle of the back, below the ribs, and next to the kidneys
• elevated blood pressure

An albumin test may also be requested by a medical professional to assess or track a patient's nutritional condition. A reduction in albumin, however, needs to be carefully examined because, in addition to starvation, albumin concentrations respond to a number of other diseases.

What does an Albumin blood test check for?

The liver produces a protein called albumin. It has numerous roles and makes up roughly 60% of the blood's overall protein content. The amount of albumin in the blood is determined by this test.

Albumin nourishes tissues, transports hormones, vitamins, medicines, and chemicals like calcium throughout the body, and prevents fluid from seeping out of blood vessels. When factors affect the liver's ability to produce albumin, increase protein breakdown, increase protein loss through the kidneys, and/or increase plasma volume, albumin levels may decline to a greater or lower extent.

Low blood albumin can result from two key factors, including:

• Severe liver disease: Since the liver produces albumin, its level may drop with loss of liver function; however, this is usually only the case in cases of severe liver illness.
• Kidney disease: One of the kidneys' numerous jobs is to preserve plasma proteins like albumin so that they don't pass through the urine production process with other waste materials. High levels of albumin are found in the blood, and when the kidneys are working well, very little albumin is excreted in the urine. However, the ability to preserve albumin and other proteins starts to deteriorate if a person's kidneys become harmed or ill. Chronic disorders like diabetes and hypertension are prone to this. Extremely large amounts of albumin are lost through the kidneys in nephrotic syndrome.

Lab tests often ordered with an Albumin test:

• Hepatic Function Panel
• Comprehensive Metabolic Panel
• Urine Albumin
• Urinalysis
• Total Protein
• Creatinine
• Blood Urea Nitrogen (BUN)
• Renal Panel

Conditions where an Albumin test is recommended:

• Liver Disease
• Kidney Disease
• Malnutrition
• Proteinuria

How does my health care provider use an Albumin test?

An albumin test is widely used to assess a person's general health state since it is typically included in the panels of tests run as part of a health check, such as a thorough metabolic panel.

Albumin may also be used in a variety of situations to aid in the diagnosis of disease, to track changes in health status due to therapy or disease progression, and as a screen that may suggest the need for other types of testing because it can be low in a range of diseases and disorders.

The liver produces albumin, a protein that nourishes cells, prevents fluid from seeping out of blood vessels, carries hormones, vitamins, medications, and other chemicals like calcium throughout the body.

A creatinine, blood urea nitrogen, or renal panel may be ordered in addition to an albumin test to assess liver function or in conjunction with one of these tests to assess kidney function. Additionally, albumin can be requested to assess a person's nutritional status.

What do my Albumin test results mean?

The results of an albumin test are assessed in conjunction with those from other tests carried out concurrently, such as those in a comprehensive metabolic panel or during follow-up.

A low albumin level could be a red flag and a sign that more research may be necessary. A low albumin level could indicate a short-term issue that will go away on its own or it could indicate an acute or chronic disease that calls for medical attention.

When conditions affect albumin production, increase protein breakdown, increase protein loss, and/or expand plasma volume, albumin levels may decline to a greater or lower extent. Additional testing may be carried out to look into a low result, depending on the patient's medical history, signs and symptoms, and physical examination.

Low albumin levels may signal liver illness. To pinpoint precisely which sort of liver illness may be present, liver enzyme tests or a liver panel may be prescribed. However, until the disease has progressed to an advanced degree, a person with liver disease may have normal or nearly normal albumin levels. For instance, albumin is frequently low in cirrhotic individuals while albumin is typically normal in most chronic liver illnesses that have not progressed to cirrhosis.

Low albumin levels can be a sign of illnesses where the kidneys are unable to stop albumin from leaking into the urine and being lost. In this situation, tests for creatinine, BUN, or a renal panel may be requested, along with measurements of the albumin or protein levels in the urine.

Inflammation, shock, and starvation are among conditions that can cause low albumin levels. They may exhibit symptoms of diseases like Crohn's disease or celiac disease, which affect how well the body absorbs and digests protein, as well as circumstances where significant amounts of protein are wasted from the intestines.

A low albumin level can also occur in a number of different illnesses, including:

• Infections
• Burns
• Surgery
• chronic disease
• Cancer
• Diabetes
• Hypothyroidism
• the cancer syndrome
• Plasma volume enlargement brought on by congestive heart failure and occasionally pregnancy
• Dehydration can cause high albumin levels, albeit this condition is not routinely tracked or detected by the test.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: An Alkaline Phosphatase test or ALP is a blood test that is used to screen for and monitor liver disease, bone disorders, and gallbladder disease.

Also Known As: ALP Test, Alk Phos Test, Alkp Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Alkaline Phosphatase test ordered?

An ALP test may be requested as a standard laboratory test, frequently in conjunction with a liver panel of further assays. When a person exhibits signs of a liver or bone issue, it is frequently requested in conjunction with a number of additional tests.

What does an Alkaline Phosphatase test check for?

An enzyme called alkaline phosphatase is present in many bodily tissues. The cells that make up bone and the liver have the highest quantities of ALP. Liver illness or bone diseases are the most frequent causes of high blood levels of ALP. The blood's concentration of ALP is determined by this test.

ALP is located in the liver on the margins of cells that converge to form bile ducts, which are minuscule tubes that transport bile from the liver to the bowels, where it is required to aid in the digestion of dietary fat. Osteoblasts, specialized cells involved in bone production, are responsible for producing ALP in bone. Isoenzymes, which are produced in unique forms by each type of tissue, are ALP.

For instance, when one or more bile ducts are obstructed, ALP blood levels may significantly rise. Gallbladder inflammation or gallstones may be the cause of this. Blood ALP levels rise slightly more subtly in cirrhosis, liver cancer, hepatitis, and when liver-toxic medications are used.

Increased ALP levels can result from any condition that promotes excessive bone growth, including bone diseases like Paget's disease. Because their bones are still growing, children and adolescents often have higher blood ALP levels. Because of this, the ALP test needs to be interpreted differently for children and adults.

It is feasible to distinguish between the various ALP forms generated by various bodily tissues. A test may be run to identify which isoenzyme is elevated in the blood if it is unclear from clinical signs and symptoms whether the cause of a high ALP test result is liver or bone illness.

Lab tests often ordered with an Alkaline Phosphatase test:

• AST
• ALT
• GGT
• Bilirubin
• Comprehensive Metabolic Panel
• Hepatic Function Panel
• Alkaline Phosphatase Isoenzymes

Conditions where an Alkaline Phosphatase test is recommended:

• Lier Disease
• Hepatitis
• Cirrhosis
• Jaundice
• Osteoporosis
• Paget’s Disease
• Vitamin D Deficiency

How does my health care provider use an Alkaline Phosphatase test?

Using the alkaline phosphatase test, liver disease and bone diseases can be found.

Damaged liver cells produce more ALP into the blood under situations that harm the liver. Because ALP levels are particularly high at the margins of the cells that unite to form bile ducts, this test is frequently used to identify obstructed bile ducts. Blood levels of ALP are frequently high when one or more of them are blocked, such as by a tumor.

ALP levels in the blood can be impacted by any illness or disease that hinders bone development or increases bone cell activity. For instance, an ALP test may be used to identify tumors that have metastasized to the bones or to identify Paget's disease, a condition that results in deformed bones. This examination could occasionally be used to track the progress of patients being treated for Paget's disease or other bone disorders such vitamin D insufficiency.

Tests for the ALP isoenzyme may be performed to identify the cause if ALP readings are elevated but it is unclear whether this is related to liver or bone illness. To distinguish between liver and bone illness, one may additionally perform a GGT test and/or a test for 5'-nucleotidase. The levels of GGT and 5'-nucleotidase are elevated in liver illness but not in disorders of the bones.

What do my Alkaline Phosphatase test results mean?

High ALP typically indicates the presence of a disease that increases bone cell activity or liver damage.

The liver is typically where the elevated ALP is coming from if other liver tests, such as bilirubin, aspartate aminotransferase, or alanine aminotransferase, are also high. The high ALP is probably the result of liver illness if GGT or 5-nucleotidase levels are also elevated. If one of these two tests comes out normal, a bone issue is probably to blame for the high ALP. The ALP is typically coming from bone if calcium and/or phosphorus readings are abnormal.

A test for ALP isoenzymes may be required to differentiate between bone and liver ALP if it is unclear from signs and symptoms or other regular testing whether the high ALP is from the liver or bone.

ALP test findings are typically analyzed alongside those of other liver disease testing. ALP is commonly significantly less increased than AST and ALT in several types of liver illness, such as hepatitis. ALP and bilirubin may increase substantially higher than AST or ALT when the bile ducts are obstructed. ALP levels in liver cancer may also be higher.

ALP may be elevated in some bone illnesses, such as Paget's disease, which causes enlarged and misshapen bones, or in some cancers that extend to the bone.

ALP levels will eventually drop or return to normal if Paget's disease is successfully treated in a patient. ALP levels should fall if someone with liver or bone cancer responds to therapy.

Other illnesses include Hodgkin's lymphoma, congestive heart failure, ulcerative colitis, and specific bacterial infections can cause moderately high ALP.

ALP levels may briefly drop after cardiac bypass surgery or blood transfusions. Levels may drop as a result of a zinc deficiency. Hypophosphatasia, a rare genetic bone metabolism condition, can result in extremely low levels of ALP that persist for a long time. Wilson disease, protein insufficiency, and malnutrition are further potential reasons of low ALP.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: An Alanine Aminotransferase Test is a blood test that is used to screen for and diagnose liver disease.

Also Known As: Alanine Aminotransferase Test, Alanine Transaminase Test, GPT Test, SGPT Test, Serum Glutamic Pyruvic Transaminase Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is an Alanine Transaminase test ordered?

When a person undergoes a standard health examination, ALT may be ordered as part of a full metabolic panel.

When a person has signs and symptoms of a liver problem, a healthcare provider will usually prescribe an ALT test.

Because many people with minor liver damage have no signs or symptoms, ALT may be ordered alone or in combination with other tests for persons who are at an elevated risk for liver disease. With modest liver injury, ALT levels will rise even if there are no other symptoms.

ALT may be ordered on a frequent basis during the course of treatment to establish whether the medication is effective when it is used to monitor the treatment of persons with liver disease.

What does an Alanine Transaminase blood test check for?

Alanine aminotransferase is an enzyme found mostly in liver and kidney cells. It's also found in much lesser concentrations in the heart and muscles. This test determines the amount of ALT in your blood.

The enzyme ALT converts alanine, a protein amino acid, into pyruvate, an important intermediary in cellular energy production. ALT levels in the blood are low in healthy people. ALT is released into the bloodstream when the liver is injured, frequently before more evident indications of liver injury, such as jaundice, appear. As a result, ALT is a useful test for detecting liver disease early on.

The liver is a critical organ positioned directly behind the rib cage on the upper right side of the abdomen. It is engaged in a variety of vital bodily functions. The liver aids in the digestion of nutrients, creates bile to aid in fat digestion, produces a variety of essential proteins such as blood clotting factors and albumin, and breaks down potentially hazardous compounds into safe substances that the body may utilize or discard.

Damage to liver cells can be caused by a variety of factors, resulting in an elevation in ALT. The test is most useful for detecting damage caused by hepatitis or medications or other toxins that are harmful to the liver.

As part of a liver panel, ALT is frequently tested alongside aspartate aminotransferase, another liver enzyme. When the liver is injured, both ALT and AST levels rise, albeit ALT is more specific for the liver and may be the only one to rise in some circumstances. An AST/ALT ratio can be used to help distinguish between different types of liver injury and their severity, as well as to distinguish liver injury from heart or muscle damage.

Lab tests often ordered with an Alanine Transaminase test:

• AST
• ALP
• GGT
• Bilirubin
• Liver Panel
• Comprehensive Metabolic Panel
• Albumin
• Total Protein
• Prothrombin Time
• Hepatitis Panel General

Conditions where a an Alanine Transaminase test is recommended:

• Liver Disease
• Hepatitis
• Jaundice
• Cirrhosis
• Alcoholism
• Wilson Disease
• Hemochromatosis

How does my health care provider use an Alanine Transaminase test?

The alanine aminotransferase test is commonly used to diagnose liver damage. It's frequently ordered as part of a liver panel or complete metabolic panel with aspartate aminotransferase to screen for and/or diagnose liver disease.

ALT is an enzyme found mostly in liver and kidney cells. ALT is released into the bloodstream when the liver is injured. As a result, ALT is a useful test for detecting liver disease early on.

Although ALT is more specific to the liver than AST, they are both considered to be two of the most significant tests for detecting liver impairment. When AST is directly compared to ALT, an AST/ALT ratio is calculated. This ratio can assist distinguish between different types of liver disease and identify cardiac or muscle harm.

To assess which type of liver illness is present, ALT values are frequently matched to the results of other tests such as alkaline phosphatase, total protein, and bilirubin.

ALT is frequently requested to monitor the therapy of people with liver disease to evaluate if it is effective, and it can be ordered alone or in combination with other tests.

What do my ALT test results mean?

A low ALT level in the blood is normal and anticipated. The most prevalent cause of ALT levels that are higher than normal is liver disease.

Acute hepatitis and viral infections are the most common causes of very elevated ALT values. ALT levels are normally elevated for 1-2 months after acute hepatitis, but they might take up to 3-6 months to return to normal. ALT levels may also be significantly raised as a result of exposure to liver-toxic medications or other chemicals, or in situations that produce reduced blood flow (ischemia) to the liver.

In chronic hepatitis, ALT levels are frequently less than four times normal. Because ALT levels in this scenario regularly fluctuate between normal and slightly elevated, the test may be ordered frequently to observe if a trend emerges. Other reasons of mild ALT elevations include bile duct obstruction, cirrhosis, heart damage, alcohol addiction, and liver cancers.

ALT is frequently used in conjunction with an AST test or as part of a liver panel. See the Liver Panel article for more information on ALT values in relation to other liver tests.

The ALT level is usually greater than the AST level in most forms of liver disorders, and the AST/ALT ratio is low. There are a few exceptions: in alcoholic hepatitis, cirrhosis, and heart or muscle injury, the AST/ALT ratio is frequently more than 1, and it may be greater than 1 for a day or two after the onset of acute hepatitis.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: An Aspartate Aminotransferase Test is a blood test that is used to screen for and diagnose liver disease.

Also Known As: Aspartate Aminotransferase Test, Serum Glutamic-Oxaloacetic Transaminase Test, SGOT Test Transaminase, Serum AST Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is an Aspartate Aminotransferase test ordered?

When someone undergoes a standard health examination, an AST test may be requested as part of a full metabolic panel.

When a person exhibits indications and symptoms of a liver problem, an AST test may be ordered along with numerous other tests.

Because many persons with minor liver damage have no signs or symptoms, AST may be ordered alone or in combination with other tests for people who are at an elevated risk for liver disease.

When AST is used to evaluate the effectiveness of treatment for people with liver disease, it may be ordered on a frequent basis during the course of treatment.

What does an Aspartate Aminotransferase blood test check for?

Aspartate aminotransferase is an enzyme found in cells all over the body, but especially in the heart and liver, as well as the kidneys and muscles to a lesser amount. AST levels in the blood are typically low in healthy people. AST is released into the bloodstream when liver or muscle cells are damaged. As a result, AST can be used to detect or monitor liver disease.

The liver is a critical organ found directly behind the rib cage in the upper right side of the abdomen. It is engaged in a variety of vital bodily functions. The liver aids in the digestion of nutrients, creates bile to aid in fat digestion, manufactures numerous vital proteins such as blood clotting factors, and breaks down potentially hazardous compounds into safe substances that the body may utilize or expel.

A variety of disorders can harm liver cells and cause AST levels to rise. The test is most effective in detecting liver damage caused by hepatitis, liver-toxic medications, cirrhosis, or alcoholism. AST, on the other hand, is not particular to the liver and can be elevated in diseases affecting other organs.

Alanine aminotransferase testing is frequently combined with an AST test. When the liver is injured, both of these enzymes become high in the bloodstream. A computed AST/ALT ratio can help distinguish between different types of liver injury and determine whether elevated levels are due to something else, such as a heart or muscle injury.

Lab tests often ordered with an Aspartate Aminotransferase test:

• GGT
• ALT
• ALP
• Bilirubin
• Hepatic Function Panel
• Comprehensive Metabolic Panel (CMP)
• Albumin
• Total Protein

Conditions where an Aspartate Aminotransferase test is recommended:

• Liver Disease
• Hepatitis
• Jaundice
• Alcoholism
• Cirrhosis
• Wilson Disease
• Hemochromatosis

How does my health care provider use an Aspartate Aminotransferase test?

The aspartate aminotransferase blood test is commonly used to identify liver disease. It is frequently ordered in conjunction with alanine aminotransferase, another liver enzyme, or as part of a liver panel or comprehensive metabolic panel to screen for and/or diagnose liver problems.

Although ALT is more specific for the liver than AST and is more usually elevated than AST, both are regarded to be two of the most significant tests for detecting liver impairment. When AST is directly compared to ALT, an AST/ALT ratio is calculated. This ratio can be used to differentiate between different types of liver disease and hepatic harm from heart or muscle damage.

To assess which type of liver illness is present, AST levels are frequently compared to the results of other tests such as alkaline phosphatase, total protein, and bilirubin.

AST is frequently evaluated to monitor the treatment of people with liver disease, and it can be ordered alone or in combination with other tests.

AST is sometimes used to monitor persons who are receiving potentially hazardous drugs for the liver. If the person's AST levels rise, he or she may be moved to another medicine.

What do my AST test results mean?

Low AST levels in the blood are typical and anticipated.

Acute hepatitis and viral infections are the most common causes of very high AST values. AST values are normally elevated for 1-2 months after acute hepatitis, but they might take up to 3-6 months to recover to normal. AST levels can also be significantly high as a result of exposure to liver-toxic medications or other chemicals, as well as situations that produce reduced blood supply to the liver.

AST values are usually lower in chronic hepatitis, generally less than 4 times normal, and are more likely to be normal than ALT levels. With chronic hepatitis, AST levels typically fluctuate between normal and slightly elevated, so the test may be ordered repeatedly to detect the pattern. Other illnesses of the liver, particularly when the bile ducts are clogged, as well as cirrhosis and certain malignancies of the liver, can cause moderate increases. AST can also rise after a heart attack or a muscular damage, although to a far higher extent than ALT.

The AST test is frequently done in conjunction with the ALT test or as part of a liver panel. See the Liver Panel article for more information on AST values in relation to other liver tests.

The ALT level is usually greater than the AST level in most kinds of liver disease, and the AST/ALT ratio is low. There are a few exceptions: in alcoholic hepatitis, cirrhosis, hepatitis C virus-related chronic liver disease, and the first day or two of acute hepatitis or injury from bile duct obstruction, the AST/ALT ratio is frequently elevated. AST levels are generally substantially higher than ALT after cardiac or muscle injury, and they tend to stay higher than ALT for longer than they do after liver injury.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Description: A Basic Metabolic Panel is a blood test used to screen for, diagnose, and monitor a variety of conditions and diseases such as diabetes and kidney disease.  

Also Known As: BMP, Chemistry Panel, Chemistry Screen, Chem 7, Chem 11, BMP Test, SMA 7, SMAC7, Basic Metabolic Test, Chem Test, Chem Panel Test 

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred. 

Average Processing Time: 1 to 2 days

When is a Basic Metabolic Panel test ordered?  

A BMP may be requested as part of a standard physical examination. 

The panel is frequently ordered in hospital emergency rooms because its components provide vital information regarding a person's renal state, electrolyte and acid/base balance, blood glucose, and calcium levels. Significant changes in these test results can suggest serious issues such as renal failure, insulin shock or diabetic coma, respiratory distress, or abnormalities in heart rhythm. 

What does a Basic Metabolic Panel blood test check for? 

The basic metabolic panel (BMP) is a 9-test panel that provides essential information to a health practitioner about a person's current metabolic status, including kidney health, blood glucose level, electrolyte and acid/base balance. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the BMP test: 

• Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

• Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. Calcium is also used for blood clot formation and the formation and maintenance of bones and teeth. 

• Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

• Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

• Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

• Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

• Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

• Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

• Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood Urea Nitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Basic Metabolic Panel test: 

• Complete Blood Count with Differential and Platelets
• Hemoglobin A1c
• Iron and Total Iron Binding Capacity
• Lipid Panel
• Insulin
• Vitamin B12 and Folate
• C-Reactive Protein

Conditions where a Basic Metabolic Panel test is recommended: 

• Diabetes 
• Kidney Disease 
• Liver Disease 

Commonly Asked Questions: 

How does my health care provider use a Basic Metabolic Panel test? 

The basic metabolic panel (BMP) is used to evaluate a person's kidney function, electrolyte, acid/base balance, and blood glucose level, all of which are linked to their metabolism. It can also be used to keep track of hospitalized patients and persons with known illnesses like hypertension and hypokalemia. 

If a health practitioner wants to track two or more separate BMP components, the full BMP might be ordered because it contains more information. Alternatively, when monitoring, the healthcare provider may order specific tests, such as a follow-up glucose, potassium, or calcium test, or an electrolyte panel to track sodium, potassium, chloride, and CO2. If a doctor needs further information, he or she can request a comprehensive metabolic panel (CMP), which is a collection of 21 tests that includes the BMP. 

What do my Basic Metabolic Panel results mean? 

The results of the tests included in the BMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. 

Out-of-range results on any of the BMP's tests can be caused by a number of things, including kidney failure, breathing issues, and diabetes-related consequences. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

The results of the BMP components can be influenced by a range of prescription and over-the-counter medicines. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide them with a thorough medical history because many other circumstances can influence how your results are interpreted. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79. 

See individual analytes

Measurement of the levels of bilirubin is used in the diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gall bladder obstruction. The assessment of direct bilirubin is helpful in the differentiation of hepatic disorders. The increase in total bilirubin associated with obstructive jaundice is primarily due to the direct (conjugated) fraction. Both direct and indirect bilirubin are increased in the serum with hepatitis.

Description: Bilirubin Fractionated is a blood test that is used to screen for or monitor liver disorders, hemolytic anemia, and neonatal jaundice.

Also Known As: Total Bilirubin Test, TBIL Test, Neonatal Bilirubin Test, Direct Bilirubin Test, Conjugated Bilirubin Test, Indirect Bilirubin Test, Unconjugated Bilirubin Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Bilirubin, Fractionated test ordered?

When someone shows evidence of abnormal liver function, a doctor will usually request a bilirubin test along with other laboratory tests. A bilirubin test may be ordered when a patient:

• Evidence of jaundice is visible.
• Has a history of excessive alcohol consumption
• Has a possible drug toxicity
• Has been exposed to viruses that cause hepatitis

Other signs and symptoms to look out for include:

• Urine with a dark amber tint.
• Nausea/vomiting
• Swelling and/or pain in the abdomen
• Fatigue and malaise which are common symptoms of chronic liver disease.

In babies with jaundice, measuring and monitoring bilirubin is considered routine medical therapy.

When someone is suspected of hemolytic anemia as a cause of anemia, bilirubin tests may be ordered. In this instance, it's frequently ordered in conjunction with other hemolysis-related tests such a complete blood count, reticulocyte count, haptoglobin, and LDH.

What does a Bilirubin, Fractionated blood test check for?

Bilirubin is an orange-yellow pigment that is largely formed as a byproduct of heme degradation. Heme is a component of hemoglobin, a red blood cell protein. Bilirubin is eventually digested by the liver, which allows it to be excreted from the body. This test assesses a person's liver function or aids in the diagnosis of anemias caused by RBC destruction by measuring the quantity of bilirubin in their blood.

After roughly 120 days in circulation, RBCs generally disintegrate. Heme is transformed to bilirubin as it is released from hemoglobin. Unconjugated bilirubin is another name for this type of bilirubin. Proteins transport unconjugated bilirubin to the liver, where sugars are linked to bilirubin to produce conjugated bilirubin. Conjugated bilirubin enters the bile and travels from the liver to the small intestines, where bacteria break it down further before it is excreted in the stool. As a result, bilirubin breakdown products give stool its distinctive brown hue.

A normal, healthy human produces a tiny quantity of bilirubin each day. The majority of bilirubin comes from damaged or degraded RBCs, with the rest coming from bone marrow or the liver. Small amounts of unconjugated bilirubin are normally discharged into the bloodstream, but there is almost no conjugated bilirubin. Laboratory tests can measure or estimate both types, and a total bilirubin result can be presented as well.

A person may appear jaundiced, with yellowing of the skin and/or whites of the eyes, if the bilirubin level in their blood rises. The pattern of bilirubin test results can provide information to the health care provider about the ailment that may be present. When there is an exceptional quantity of RBC destruction or when the liver is unable to handle bilirubin, unconjugated bilirubin levels may rise. Conversely, conjugated bilirubin levels can rise when the liver can process bilirubin but not transmit the conjugated bilirubin to the bile for elimination; this is most commonly caused by acute hepatitis or bile duct blockage.

In the first few days after birth, increased total and unconjugated bilirubin levels are fairly common in infants. This condition is known as "physiologic jaundice of the newborn," and it develops when the liver of a newborn is not yet mature enough to handle bilirubin. Physiologic jaundice in newborns usually goes away after a few days. RBCs may be damaged in newborn hemolytic illness due to blood incompatibility between the infant and the mother; in these circumstances, treatment may be necessary since large amounts of unconjugated bilirubin might harm the newborn's brain.

Increased total and conjugated bilirubin levels in infants can be caused by biliary atresia, an uncommon but life-threatening congenital disease. To avoid catastrophic liver damage that may necessitate liver transplantation during the first few years of life, this problem must be rapidly recognized and treated, usually with surgery. Despite early surgical therapy, some children may require liver transplants.

Lab tests often ordered with a Bilirubin, Fractionated test:

• CMP
• ALT
• ALP
• AST
• Hepatitis A
• Hepatitis B
• Hepatitis C
• Complete Blood Count (CBC)
• Urinalysis
• GGT
• Reticulocyte Count

Conditions where a Bilirubin, Fractionated test is recommended:

• Jaundice
• Liver Disease
• Hepatitis
• Alcoholism
• Hemolytic Anemia

Commonly Asked Questions:

How does my health care provider use a Bilirubin, Fractionated test?

A bilirubin test is used to detect an abnormally high quantity of the substance in the blood. It can be used to figure out what's causing your jaundice and/or diagnose illnesses like liver disease, hemolytic anemia, and bile duct blockage.

Bilirubin is an orange-yellow pigment that is largely formed as a byproduct of heme degradation. Heme is a component of hemoglobin, a red blood cell protein. Bilirubin is eventually digested by the liver, which allows it to be excreted from the body. An increased blood level can be caused by any disorder that speeds up the breakdown of RBCs or impairs the processing and elimination of bilirubin.

Laboratory testing can measure or estimate two types of bilirubin:

Unconjugated bilirubin—unconjugated bilirubin is formed when heme is released from hemoglobin. Proteins transport it to the liver. Small levels of the substance may be found in the blood.

Sugars are attached to bilirubin in the liver, resulting in conjugated bilirubin. It enters the bile and travels from the liver to the small intestines before being excreted in the feces. In normal circumstances, there is no conjugated bilirubin in the blood.

A chemical test is usually done to determine the total bilirubin level first. If the total bilirubin level rises, a second chemical test can be used to detect water-soluble forms of bilirubin, known as "direct" bilirubin. The amount of conjugated bilirubin present can be estimated using the direct bilirubin test. The "indirect" amount of unconjugated bilirubin can be estimated by subtracting the direct bilirubin level from the total bilirubin level. The pattern of bilirubin test results can provide information to the healthcare professional about the ailment that may be present.

Bilirubin is measured in adults and older children to:

• Diagnose and/or monitor liver and bile duct disorders.
• Evaluate patients with hemolytic anemia
• Distinguish between the causes of jaundice in babies.

Only unconjugated bilirubin is raised in both physiologic jaundice and hemolytic illness of the infant.

Damage to the newborn's liver from neonatal hepatitis and biliary atresia will also raise conjugated bilirubin concentrations, which is generally the first indication that one of these less common disorders is present.

Because excessive unconjugated bilirubin harms growing brain cells, it is critical to detect and treat an increased amount of bilirubin in a newborn. Mental retardation, learning and developmental impairments, hearing loss, eye movement disorders, and mortality are all possible outcomes of this damage.

What do my bilirubin test results mean?

In adults and children, increased total bilirubin, primarily unconjugated bilirubin, could be caused by:

• Hemolytic or pernicious anemia are two types of anemia.
• Reaction to a transfusion
• Cirrhosis
• Gilbert syndrome

When conjugated bilirubin levels are higher than unconjugated bilirubin levels, there is usually a problem with bilirubin removal by the liver cells. This can be caused by a variety of factors, including:

• Hepatitis caused by a virus
• Reactions to drugs
• Alcoholic hepatitis

When the bile ducts are blocked, conjugated bilirubin is raised more than unconjugated bilirubin. This can happen, for example, when:

• In the bile ducts, there are gallstones.
• Damaging of the bile ducts due to tumors

Increased bilirubin levels can also be caused by rare hereditary illnesses that involve aberrant bilirubin metabolism, such as Rotor, Dubin-Johnson, and Crigler-Najjar syndromes.

Low bilirubin levels are usually not a cause for worry and are not monitored.

A newborn's high bilirubin level may be transient and diminish within a few days to two weeks. However, if the bilirubin level exceeds a crucial threshold or rises rapidly, the cause must be investigated so that appropriate treatment can be started. Increased bilirubin levels can be caused by the rapid breakdown of red blood cells as a result of:

• Incompatibility of the mother's blood type with that of her child
• Infections that are present at birth
• oxygen deficiency
• Liver disease

Only unconjugated bilirubin is elevated in most of these disorders. In the rare disorders of biliary atresia and newborn hepatitis, increased conjugated bilirubin is found. To avoid liver damage, biliary atresia necessitates surgical surgery.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Measurement of the levels of bilirubin is used in the diagnosis and treatment of liver, hemolytic, hematologic, and metabolic disorders, including hepatitis and gallbladder obstructive disease.

Description: A Calcium test is a blood test that is used to screen for, diagnose, and monitor a wide range of medical conditions.

Also Known As: Ca Test, Serum Calcium Test, Calcium Blood Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

Average Processing Time: 1 to 2 days

When is a Calcium test ordered?

A blood calcium test is frequently requested during a general medical evaluation. It's usually part of the comprehensive metabolic panel or the basic metabolic panel, two sets of tests that can be done during an initial evaluation or as part of a routine medical checks.

Many people do not experience symptoms of high or low calcium until their levels are dangerously high or low.

When a person has certain types of cancer, kidney illness, or has had a kidney transplant, calcium monitoring may be required. When someone is being treated for abnormal calcium levels, monitoring may be required to determine the effectiveness of medications such as calcium or vitamin D supplements.

What does a Calcium blood test check for?

Calcium is one of the most plentiful and vital minerals in the human body. It is required for cell signaling as well as the proper operation of muscles, nerves, and the heart. Calcium is essential for blood clotting as well as bone growth, density, and maintenance. This test determines how much calcium is present in the blood.

Calcium is found complexed in the bones for 99 percent of the time, while the remaining 1% circulates in the blood. Calcium levels are closely monitored; if too little is absorbed or consumed, or if too much is lost through the kidney or stomach, calcium is removed from bone to keep blood concentrations stable. Approximately half of the calcium in the blood is metabolically active and "free." The other half is "bound" to albumin, with a minor proportion complexed to anions like phosphate, and both of these forms are metabolically inactive.

Blood calcium can be measured using two different tests. The free and bound forms of calcium are measured in the total calcium test. Only the free, physiologically active form of calcium is measured in the ionized calcium test.

Lab tests often ordered with a Calcium test:

• Phosphorus
• Vitamin D
• Magnesium
• PTH
• Albumin
• Basic Metabolic Panel (BMP)
• Comprehensive Metabolic Panel (CMP)

Conditions where a Calcium test is recommended:

• Kidney Disease
• Thyroid Disease
• Alcoholism
• Malnutrition
• Parathyroid Diseases
• Breast Cancer
• Multiple Myeloma

How does my health care provider use a Calcium test?

A blood calcium test is used to screen for, diagnose, and monitor a variety of bone, heart, nerve, kidney, and tooth disorders. If a person has signs of a parathyroid disease, malabsorption, or an overactive thyroid, the test may be ordered.

A total calcium level is frequently checked as part of a standard health check. It's part of the comprehensive metabolic panel and the basic metabolic panel, which are both collections of tests used to diagnose or monitor a range of ailments.

When a total calcium result is abnormal, it is interpreted as a sign of an underlying disease. Additional tests to assess ionized calcium, urine calcium, phosphorus, magnesium, vitamin D, parathyroid hormone, and PTH-related peptide are frequently performed to assist determine the underlying problem. PTH and vitamin D are in charge of keeping calcium levels in the blood within a narrow range of values.

Measuring calcium and PTH combined can assist identify whether the parathyroid glands are functioning normally if the calcium is abnormal. Testing for vitamin D, phosphorus, and/or magnesium can assist evaluate whether the kidneys are excreting the right amount of calcium, and measuring urine calcium can help detect whether additional deficits or excesses exist. The balance of these many compounds is frequently just as critical as their concentrations.

The total calcium test is the most common test used to determine calcium status. Because the balance between free and bound calcium is usually constant and predictable, it is a reliable reflection of the quantity of free calcium present in the blood in most cases. However, the balance between bound and free calcium is altered in some persons, and total calcium is not a good indicator of calcium status. Ionized calcium measurement may be required in certain cases. Critically sick patients, those receiving blood transfusions or intravenous fluids, patients undergoing major surgery, and persons with blood protein disorders such low albumin are all candidates for ionized calcium testing.

What do my Calcium test results mean?

The amount of calcium circulating in the blood is not the same as the amount of calcium in the bones.

A feedback loop including PTH and vitamin D regulates and stabilizes calcium uptake, utilization, and excretion. Conditions and disorders that disturb calcium control can induce abnormal acute or chronic calcium elevations or declines, resulting in hypercalcemia or hypocalcemia symptoms.

Total calcium is usually tested instead of ionized calcium since it is easier to do and requires no additional treatment of the blood sample. Because the free and bound forms of calcium make up about half of the total, total calcium is usually a decent depiction of free calcium. Because nearly half of the calcium in blood is bonded to protein, high or low protein levels might alter total calcium test findings. In these circumstances, an ionized calcium test is more appropriate for measuring free calcium.

A normal total or ionized calcium test, when combined with other normal laboratory findings, indicates that a person's calcium metabolism is normal and blood levels are properly managed.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Clinical Significance
Micronutrient, Calcium - Serum calcium is involved in the regulation of neuromuscular and enzyme activity, bone metabolism and blood coagulation. Calcium blood levels are controlled by a complex interaction of parathyroid hormone, vitamin D, calcitonin and adrenal cortical steroids. Calcium measurements are useful in the diagnosis of parathyroid disease, some bone disorders and chronic renal disease. A low level of calcium may result in tetany.

Patients must be 18 years of age or greater.

Reference Range(s) (mg/dL)
                        Male                  Female
18-19 years     8.9-10.4    8.9-10.4
20-49 years     8.6-10.3    8.6-10.2
>49 years        8.6-10.3    8.6-10.4
Reference range not available for individuals <18 years for this micronutrient test.

Clinical Significance
Micronutrients, Heavy Metals Panel, Blood

Patients must be 18 years of age or greater.

Includes

• Micronutrient, Arsenic, Blood
• Micronutrient, Cadmium, Blood
• Micronutrient, Cobalt, Blood
• Micronutrient, Lead, Blood
• Micronutrient, Mercury, Blood

Measurements are used in the diagnosis and treatment of numerous potentially serious disorders associated with changes in body acid-base balance.

Carnitine, LC/MS/MS Includes: Carnitine, Total; Carnitine, Free; Carnitine, Esters; Esterified/Free Ratio

 

Clinical Significance

Serum carnitine analysis is useful in the diagnosis and monitoring of patients with carnitine deficiency (either primary or secondary). Primary carnitine deficiency is an autosomal recessively inherited genetic condition that affects carnitine uptake by cells and tissues through a defect in the plasma membrane carnitine transporter. Secondary carnitine deficiency can be seen in some disease states or in patients on carnitine-poor diets, but is also seen in a number of metabolic disorders. In these disorders, carnitine complexes with the accumulated substrate of the blocked metabolic step, and the resulting acylcarnitine ester is excreted in the urine, leading to a depletion of carnitine in the patient

Serum chloride is the major extracellular anion and counter-balances the major cation, sodium, maintaining electrical neutrality of the body fluids. Two thirds of the total anion concentration in extracellular fluids is chloride and it is significantly involved in maintaining proper hydration and osmotic pressure. Movement of chloride ions across the red blood cell membrane is essential for the transport of biocarbonate ions in response to changing concentrations of carbon dioxide. Chloride measurements are used in the diagnosis and treatment of electrolyte and metabolic disorders such as cystic fibrosis and diabetic acidosis.

Clinical Significance

Urine chloride excretion approximates the dietary intake. The chloride content of most foods parallel that of sodium. An increase in urine chloride may result from water deficient dehydration, diabetic acidosis, Addison's disease, and salt-losing renal disease. Decreased urine levels are seen in congestive heart failure, severe diaphoresis and in hypochloremic metabolic alkalosis due to prolonged vomiting.

NTx is useful to assess bone resorption in patients with metabolic bone disease and monitor therapy to slow or halt osteoporotic bone loss. A decline of 30% or more of NTx over a six-month period suggests effective therapy.

NTx is useful to assess bone resorption in patients with metabolic bone disease. The test is also useful in monitoring therapy to slow or halt osteoporotic bone loss. A decline of 30% or more of NTx over a six-month period suggests effective therapy.

CTx is useful to assess bone resorption in patients with metabolic bone disease. The test is also useful in monitoring therapy to slow or halt osteoporotic bone loss.

Description: A Comprehensive Metabolic Panel or CMP is a blood test that is a combination of a Basic Metabolic Panel, a Liver Panel, and electrolyte panel, and is used to screen for, diagnose, and monitor a variety of conditions and diseases such as liver disease, diabetes, and kidney disease. 

Also Known As: CMP, Chem, Chem-14, Chem-12, Chem-21, Chemistry Panel, Chem Panel, Chem Screen, Chemistry Screen, SMA 12, SMA 20, SMA 21, SMAC, Chem test

Collection Method: Blood Draw 

Specimen Type: Serum 

Test Preparation: 9-12 hours fasting is preferred.

Average Processing Time: 1 to 2 days 

When is a Comprehensive Metabolic Panel test ordered:  

A CMP is frequently requested as part of a lab test for a medical evaluation or yearly physical. A CMP test consists of many different tests that give healthcare providers a range of information about your health, including liver and kidney function, electrolyte balance, and blood sugar levels. To confirm or rule out a suspected diagnosis, abnormal test results are frequently followed up with other tests that provide a more in depth or targeted analysis of key areas that need investigating. 

What does a Comprehensive Metabolic Panel blood test check for? 

The complete metabolic panel (CMP) is a set of 20 tests that provides critical information to a healthcare professional about a person's current metabolic status, check for liver or kidney disease, electrolyte and acid/base balance, and blood glucose and blood protein levels. Abnormal results, particularly when they are combined, can suggest a problem that needs to be addressed. 

The following tests are included in the CMP: 

• Albumin: this is a measure of Albumin levels in your blood. Albumin is a protein made by the liver that is responsible for many vital roles including transporting nutrients throughout the body and preventing fluid from leaking out of blood vessels. 

• Albumin/Globulin Ratio: this is a ratio between your total Albumin and Globulin  

• Alkaline Phosphatase: this is a measure of Alkaline phosphatase or ALP in your blood. Alkaline phosphatase is a protein found in all body tissues, however the ALP found in blood comes from the liver and bones. Elevated levels are often associated with liver damage, gallbladder disease, or bone disorder. 

• Alt: this is a measure of Alanine transaminase or ALT in your blood. Alanine Aminotransferase is an enzyme found in the highest amounts in the liver with small amounts in the heart and muscles. Elevated levels are often associated with liver damage. 

• AST: this is a measure of Aspartate Aminotransferase or AST. Aspartate Aminotransferase is an enzyme found mostly in the heart and liver, with smaller amounts in the kidney and muscles. Elevated levels are often associated with liver damage. 

• Bilirubin, Total: this is a measure of bilirubin in your blood. Bilirubin is an orange-yellowish waste product produced from the breakdown of heme which is a component of hemoglobin found in red blood cells. The liver is responsible for removal of bilirubin from the body. 

• Bun/Creatinine Ratio: this is a ratio between your Urea Nitrogen (BUN) result and Creatinine result.  

• Calcium: this is a measurement of calcium in your blood. Calcium is the most abundant and one of the most important minerals in the body as it essential for proper nerve, muscle, and heart function. 

• Calcium: is used for blood clot formation and the formation and maintenance of bones and teeth. 

• Carbon Dioxide: this is a measure of carbon dioxide in your blood. Carbon dioxide is a negatively charged electrolyte that works with other electrolytes such as chloride, potassium, and sodium to regulate the body’s acid-base balance and fluid levels.  

• Chloride: this is a measure of Chloride in your blood. Chloride is a negatively charged electrolyte that works with other electrolytes such as potassium and sodium to regulate the body’s acid-base balance and fluid levels. 

• Creatinine: this is a measure of Creatinine levels in your blood. Creatinine is created from the breakdown of creatine in your muscles and is removed from your body by the kidneys. Elevated creatinine levels are often associated with kidney damage. 

• Egfr African American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Egfr Non-Afr. American: this is a measure of how well your kidneys are functioning. Glomeruli are tiny filters in your kidneys that filter out waste products from your blood for removal while retaining important substances such as nutrients and blood cells. 

• Globulin: this is a measure of all blood proteins in your blood that are not albumin. 

• Glucose: this is a measure of glucose in your blood. Glucose is created from the breakdown of carbohydrates during digestion and is the body’s primary source of energy. 

• Potassium: this is a measure of Potassium in your blood. Potassium is an electrolyte that plays a vital role in cell metabolism, nerve and muscle function, and transport of nutrients into cells and removal of wastes products out of cells. 

• Protein, Total: this is a measure of total protein levels in your blood. 
  Sodium: this is a measure of Sodium in your blood. Sodium is an electrolyte that plays a vital role in nerve and muscle function. 

• Sodium: this is a measure of sodium in your blood's serum. Sodium is a vital mineral for nerve and muscle cell function.

• Urea Nitrogen (Bun): this is a measure of Urea Nitrogen in your blood, also known as Blood UreaNitrogen (BUN). Urea is a waste product created in the liver when proteins are broken down into amino acids. Elevated levels are often associated with kidney damage. 

Lab tests often ordered with a Comprehensive Metabolic Panel test: 

• Complete Blood Count with Differential and Platelets
• Iron and Total Iron Binding Capacity
• Lipid Panel
• Vitamin B12 and Folate
• Prothrombin with INR and Partial Thromboplastin Times
• Sed Rate (ESR)
• C-Reactive Protein

Conditions where a Comprehensive Metabolic Panel test is recommended: 

• Diabetes
• Kidney Disease
• Liver Disease
• Hypertension

Commonly Asked Questions: 

How does my health care provider use a Comprehensive Metabolic Panel test? 

The comprehensive metabolic panel (CMP) is a broad screening tool for assessing organ function and detecting diseases like diabetes, liver disease, and kidney disease. The CMP test may also be requested to monitor known disorders such as hypertension and to check for any renal or liver-related side effects in persons taking specific drugs. If a health practitioner wants to follow two or more separate CMP components, the full CMP might be ordered because it contains more information. 

What do my Comprehensive Metabolic Panel test results mean? 

The results of the tests included in the CMP are usually analyzed together to look for patterns. A single abnormal test result may indicate something different than a series of abnormal test findings. A high result on one of the liver enzyme tests, for example, is not the same as a high result on several liver enzyme tests. 

Several sets of CMPs, frequently performed on various days, may be examined to gain insights into the underlying disease and response to treatment, especially in hospitalized patients. 

Out-of-range findings for any of the CMP tests can be caused by a variety of illnesses, including kidney failure, breathing issues, and diabetes-related complications, to name a few. If any of the results are abnormal, one or more follow-up tests are usually ordered to help determine the reason and/or establish a diagnosis. 

Is there anything else I should know? 

A wide range of prescription and over-the-counter medications can have an impact on the results of the CMP's components. Any medications you're taking should be disclosed to your healthcare professional. Similarly, it is critical to provide a thorough history because many other circumstances can influence how your results are interpreted. 

What's the difference between the CMP and the BMP tests, and why would my doctor choose one over the other? 

The CMP consists of 14 tests, while the basic metabolic panel (BMP) is a subset of those with eight tests. The liver (ALP, ALT, AST, and bilirubin) and protein (albumin and total protein) tests are not included. If a healthcare provider wants a more thorough picture of a person's organ function or to check for specific illnesses like diabetes or liver or kidney disease, he or she may prescribe a CMP rather than a BMP. 

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

Please note the following regarding BUN/Creatinine ratio: 

The lab does not report the calculation for the BUN/Creatinine Ratio unless one or both biomarkers’ results fall out of the published range. 

If you still wish to see the value, it's easy to calculate. Simply take your Urea Nitrogen (BUN) result and divide it by your Creatinine result.  

As an example, if your Urea Nitrogen result is 11 and your Creatinine result is 0.86, then you would divide 11 by 0.86 and get a BUN/Creatinine Ratio result of 12.79.