Comprehensive Metabolic Panel (CMP) : Everything You Need to Know
Table of Contents
What is a Comprehensive Metabolic Panel?
A comprehensive metabolic panel (also known as a CMP blood test, comp metabolic panel, or CMP lab test) is a laboratory test that measures 14 different substances in a person’s blood.
A CMP blood test provides important information about your body's chemical balance and metabolism – the process of how the body uses food and energy. We’ll get into specific detail about the comp metabolic panel in a minute, but the important takeaway is this:
Abnormal levels of any of the substances we’ll be getting into, or in some cases, a combination of abnormalities can be a sign of a serious health problem.
Why Should You Get a CMP Lab Test?
The disease process can be very long. Therefore, even though your body may be heading down the road to serious heart disease, you may not notice symptoms for many months and often many years. And it’s not just for heart disease, as few diseases show up at your doorstep waving a big banner that reads: Welcome to Kidney Disease.
That’s just not how the human body works. Just think about the word, disease, or dis-ease, meaning a body, not at ease. Your body can be in a state of dis-ease for as long as 10 or 20 years and then (not so) suddenly, you’ve got a serious problem on your hands. And one that may be nearly impossible to reverse.
The last thing you want is to find out about disease by experiencing physical signs and symptoms or by a physical diagnosis. By then, it could be too late. And I don’t mean to sound like an alarmist; this is just how the human body works.
For this reason, a comp metabolic panel is usually done as part of a larger routine checkup, and often when a healthcare provider thinks a patient may have kidney or liver disease. But as you now know, by the time those suspicions can be seen and felt physically, you’re already well into the disease process.
What is a CMP Blood Test Used For?
A CMP lab test is used to evaluate several body processes and functions, including:
- Liver and kidney health
- Blood sugar levels
- Blood protein levels
- Acid and base balance
- Fluid and electrolyte balance
- Metabolism
- Side effects of some medications
A comprehensive metabolic panel, meaning all the tests you’ll see below, can be taken from just one blood sample. However, a CMP metabolic panel can also include a urine test and a thyroid test, as the point of the test is to get a comprehensive view of a person’s complete physical function.
Now let’s look at what each test in the comprehensive metabolic panel measures and what those high or low numbers mean for you. However, it should be noted that we won’t get into specific numbers as these will often have no meaning for all but experienced healthcare professionals.
Comprehensive Metabolic Panel Results
Glucose (fasting or non-fasting)
What it is: Sugar in the blood
What a low number means for you: Hypoglycemia, liver disease, adrenal insufficiency, excess insulin
What a high number means for you: Hyperglycemia, certain types of diabetes, prediabetes, pancreatitis, hyperthyroidism
Sodium (Na)
What it is: An electrolyte which keeps your body in balance
What a low number means for you: Use of diuretics, diarrhea, adrenal insufficiency
What a high number means for you: Kidney dysfunction, dehydration, Cushing's syndrome
Potassium (K)
What it is: An electrolyte and mineral
What a low number means for you: Use of diuretics or corticosteroids (such as prednisone or cortisone
What a high number means for you: Acute or chronic kidney failure, Addison's disease, diabetes, dehydration
Chloride (Cl)
What it is: An electrolyte
What a low number means for you: Emphysema, chronic lung disease
What a high number means for you: Dehydration, Cushing's syndrome, kidney disease
Carbon dioxide (bicarbonate) (CO2)
What it is: Gaseous waste product from metabolism
What a low number means for you: Kidney disease, certain toxic exposures, severe infection
What a high number means for you: Lung diseases, including COPD
BUN (blood urea nitrogen)
What it is: A waste product formed in the liver and carried to the kidneys, filtered out of blood, and excreted through urine
What a low number means for you: Malnutrition
What a high number means for you: Liver or kidney disease, heart failure
Creatinine
What it is: A chemical waste produced by muscle metabolism
What a low number means for you: Low muscle mass, malnutrition
What a high number means for you: Chronic or temporary decrease in kidney function
BUN/creatinine ratio
What it is: The ratio between BUN and creatinine
What a low number means for you: Malnutrition
What a high number means for you: Blood in bowels, kidney obstruction, dehydration
Calcium (Ca)
What it is: A mineral stored in the hard part of bones
What a low number means for you: Calcium, magnesium, or Vitamin D deficiency; malnutrition; pancreatitis; neurological disorders
What a high number means for you: Kidney disease, hyperparathyroidism, cancer, excess vitamin D intake
Magnesium (Mg)
What it is: An electrolyte
What a low number means for you: Diabetes, high blood calcium levels, kidney disease, pancreatitis, hypoparathyroidism
What a high number means for you: Dehydration, Addison's disease, hyperparathyroidism, hypothyroidism, kidney failure
Protein (total)
What it is: Chains of amino acids essential for the growth and repair of cells
What a low number means for you: Malnutrition, liver disease, kidney disease
What a high number means for you: Liver disease, kidney disease, dehydration, multiple myeloma, WM
Albumin
What it is: Protein that keeps fluid from leaking out of blood vessels and that
nourishes tissues and transports nutrients through the body
What a low number means for you: Malnutrition, liver disease, kidney disease
What a high number means for you: Dehydration
Globulin
What it is: Alpha, beta, and gamma proteins; some are produced by the liver and
others by the immune system
What a low number means for you: Malnutrition, liver disease, kidney disease
What a high number means for you: Multiple myeloma, WM, leukemia, rheumatoid arthritis, lupus, and other autoimmune diseases
Albumin/globulin ratio
What it is: The ratio between albumin and globulin
What a low number means for you: Multiple myeloma, WM, autoimmune diseases, liver disease, kidney disease
What a high number means for you: Certain genetic conditions, some leukemias, liver dysfunction, hypogammaglobulinemia
Bilirubin (direct or total)
What it is: A pigment in the bile, a digestive fluid produced by the liver
What a low number means for you: Generally not a concern
What a high number means for you: Liver disease, bile duct disorder, red cell destruction
Alkaline phosphatase (ALP)
What it is: Enzyme found in the liver and bones
What a low number means for you: Malnutrition
What a high number means for you: Paget's disease or certain cancers that spread to bone, bile duct obstruction, liver cancer
Alanine amino-transferase (ALT)
What it is: Enzyme found mostly in the liver
What a low number means for you: Generally not a concern
What a high number means for you: Certain toxins such as excess acetaminophen or alcohol, hepatitis
Aspartate amino-transferase (AST)
What it is: Enzyme found in liver, muscle, and other tissues
What a low number means for you: Generally not a concern
What a high number means for you: Excess acetaminophen, hepatitis muscle injury
Glomerular filtration rate (GFR)
What it is: Checks how well the kidneys are working by estimating how much blood passes through the glomeruli (filters) of the kidneys each minute. It is calculated with a formula.
What a low number means for you: Chronic kidney disease or kidney failure; GFR decreases progressively with age
What a high number means for you: Generally not a concern
If you’ve been tested recently and you’re wondering about the base level measurements for all the tests outlined above, check out this table: (link to table) These measurements are only for the U.S. or in other words, non-metric.
CMP Blood Test Measurements in More Detail
- Serum glucose is used to diagnose diabetes. If your glucose measurement is 126 on a fasting blood draw (blood drawn first thing in the morning after an overnight fast), then you have diabetes, assuming another test confirms the diagnosis.
- Uric acid measurement is how gout is diagnosed.
- The BUN (Blood Urea Nitrogen) is often at abnormal levels in people with kidney disease, dehydration, and heart failure, malnutrition, and liver disease.
- Serum creatinine is used to measure kidney function.
- The BUN to creatinine ratio provides information on possible causes of kidney dysfunction, heart failure, dehydration, or decreased kidney blood flow.
- Serum sodium can be increased in people suffering from dehydration and decreased in diarrhetic therapy and the syndrome of inappropriate antidiuretic hormone (SIADH).
- Serum potassium can be increased in adrenal insufficiency and acute renal failure, as well as with an inappropriate combination of medicines. Potassium could be decreased in primary aldosteronism, diuretic therapy, and renal tubular acidosis.
- Serum chloride can be increased in people suffering from dehydration and renal tubular acidosis, and it can be decreased in congestive heart failure and primary aldosteronism.
- Carbon dioxide can be increased in primary pulmonary disease, such as severe COPD and in primary aldosteronism. It can be decreased in metabolic acidoses, such as with diabetic ketoacidosis.
- Serum calcium can be increased in an endocrine disease known as primary hyperthyroidism. It can also be increased in malignancy. However, most of the time, when a person has a sudden rise in serum calcium, it's simply due to hyperparathyroidism, which can be treated. However, you can also have decreased serum calcium in hypoparathyroidism and vitamin D deficiency.
- Serum phosphorus can be increased in acute or chronic renal failure and decreased in malabsorption and vitamin D deficiency.
- Total serum protein can be increased in multiple myeloma and sarcoidosis, and it can be decreased in chronic glomerulonephritis – a type of chronic renal disease.
- Serum albumin can be decreased in liver disease, cirrhosis, and nephrotic syndrome.
- Total globulin and albumin to globulin ratio can be increased or decreased due to several causes.
- Total bilirubin can be increased in hepatitis, hemolytic anemia, and in bile duct blocks, either within the liver or within the bile duct that drains the gallbladder and the liver.
- Direct bilirubin is increased in the same things as total bilirubin, but the ratio of direct to total gives us further information on the causes. For instance, one of the most common causes of a mildly elevated total bilirubin found on a routine CMP blood test is a syndrome called Gilbert's disease.
- Alkaline phosphatase can be increased in bone disease and liver disease and decreased in malnutrition and celiac disease.
- AST, ALT, and GGT are often called liver enzyme tests. However, they don't measure liver function, but rather give evidence of liver damage. They can also be elevated when there is damage to other parts of the body. They can be increased in liver disease, muscle disease, pancreatitis. And the GGT can be a sensitive indicator of alcoholism.
We did say this article would be everything you needed to know, however, let us repeat the main takeaway: You have to be tested regularly to catch any of these diseases before they become an uncorrectable problem. And thanks to our modern world where we all have more access to these tests, you don’t even need to see a doctor.
Check out Discounted Labs Comprehensive Metabolic Panel today. It includes 14 of the most important tests we outlined above. The CMP blood test functions as a checkup for kidney function, liver function, and electrolyte and fluid balance.
Don’t put off these tests any longer. The information you get back may mean the difference between great health and poor health. There’s no room for regret when it comes to your health.