Understanding Your CMP

This week we are talking about your CMP a.k.a Comprehensive Metabolic Panel. These are the labs that your doctor orders when you get lab work. This set of labs measures 14 different components and we are breaking them down for you.

If you have questions, or topics that you want to hear about, head over to our Instagrams https://www.instagram.com/bayleethedietitian/ or https://www.instagram.com/brianna.dietitian/ and send us a DM! You can also follow the podcast https://www.instagram.com/mocktailminutes/

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Just Ingredients 

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Transcript

Brianna: 0:23

Hello everyone. Welcome back to this week's episode of Mocktail Minutes. This is Bailey

Baylee: 0:29

and this is Brianna.

Brianna: 0:31

this week I am drinking, I think it's, is it called Poppy Punch or Punch Pop or something? It's the poppy drink in the white can. It's like the punch flavor, something like that. It's really good. It tastes like, would say high C. I think it's good. I enjoy Mm,

Baylee: 0:47

Yeah, I'm doing the, I finally got my just ingredients in, they were actually in last week. They were just in my mailbox and I haven't

Brianna: 0:53

Oh, perfect.

Baylee: 0:54

But I'm doing the guava mango. I really like it, but it's a really subtle, I feel like it's a subtle flavor, so you can't add it to a Stanley. I mean, you can, but it doesn't taste like much.

Brianna: 1:03

Yeah,

Baylee: 1:04

it makes me get'em in faster. So.

Brianna: 1:06

Yes. This week we are talking about understanding your CMP. So this is what is typically ordered when you like go to your doctor's office, probably like your routine labs. It's gonna be a CMP stands for a comprehensive metabolic panel and it measures 14 different. Like biomarkers that are looking at your electrolytes, your kidney function, your liver function, blood sugar and even like protein status and nutrition. So it's kind of just like a quick little snapshot as to how well your body is maintaining balance. Our body really likes balance, it likes routine, it likes consistency. So this is a good place to start.

Baylee: 1:49

Yeah. And this is, this is what, when your doctor runs blood work, like Bailey said, this is what they're ordering. So there's 14 different components to the CMP. So the first one is glucose. So typically you're fasting, and so it should be a fasting glucose. Optimal would be under 90. And if you don't know glucose is your primary source of energy. So elevated levels may indicate diabetes, especially if you're fasting and you haven't eaten. You know, in theory your blood sugar should be low. I will say this is one I try not to, I try to tell people, don't fully panic on.'cause I feel like a lot impacts your fasting glucose. Like how long you've been awake, were you stressed, getting out the door, like all those things. So. Just a fasting glucose alone isn't enough to be like, oh, something's really wrong. I would say, unless it's like over one 10, then I'm like, okay, there's probably something going on. But if it's like 95, I'm like, eh, not optimal, but

Brianna: 2:46

where, yes, I think a CGM can kind of be helpful sometimes because it's giving you more consistent information, like you're getting a couple days, like 15 days rather than just, here's what happened today. I, fun fact, every time I wear a CGM and my lab work, so I'm always in the normal range. But I am above optimal. A lot of it I need to do, like I've done a lot better at managing my stress, but then life is happening right now, and so I need to really prioritize that more. And then I also know from my HTMA test that my potassium. I don't have, I'm like, I'm deficient in potassium. So that is what else I'm focusing on, because that's gonna also affect your glucose. So this is where the lab test is like, it's telling us what's happening right now, and this is why I like to have, okay, labs are great, but also like the HTMA to take it a step further. And I said, this is just kind of like beginning steps. Let's, let's do a little bit of a check-in to see what's going on here. So yeah, weird glucose.

Baylee: 3:49

The next ones are gonna be like two, three, and four are gonna be your electrolytes, so this is gonna be sodium, potassium chloride, disclaimer. Your serum electrolytes are different than the hair tissue mineral analysis. So if you've like, no, my potassium's totally fine. I got my blood work, I'm in range, completely different than what it's doing in your cells. So sodium optimal is gonna be 1 38 to 1 42, and this is helping to maintain fluid, balance and nerve function. So too high of sodium can mean or dehydrated. Or that you have high salt intake or that you're stressed, low could mean over hydrated or adrenal insufficiency. And then really what you want to do is pay attention to what forms of sodium you're getting and how much, and then your balance of potassium with it.

Brianna: 4:39

and I would say it really does give a good insight as to, okay, what are the adrenals doing? And just, just that snapshot of hydration because I can, I mean, sometimes we have normal sodium, but when we take a deeper look, it's like, oh, we actually, we need to replenish that a little bit more and. Help your adrenals function a little bit better.

Baylee: 5:00

Yeah. That's your energy, you know?

Brianna: 5:02

And then your potassium, potassium, optimal levels are 4.4 to 4.7. So these, this is important for a muscle contraction and your heart rhythm. Potassium is always a funny one because I guess it's not technically funny, but as a dietician, this is the one that everyone's like, this is how you can kill people as a dietician, is overload on potassium through like an IV or something like food. You're not gonna do that. But like when we're thinking what we're putting in IVs or like tube feeds, potassium is definitely something we wanna consider as a dietician because it does affect your heart's rhythm. But if it's too high, this could be meaning, okay, do we have some kidney issues? Are we supplementing too much? Or if it's low, is this just due to not enough potassium rich foods? Are we on some diuretics or like vomiting that's gonna lower your potassium? So. Low intake is very actually common because it's found a lot in fruits and vegetables and just typical American diet. We're not great at fruits and vegetables all the time.

Baylee: 6:06

yeah. This is why if you have high blood pressure, doctors are like, decrease your sodium. They're missing out the part of increase your potassium, but it's easier to tell people, Hey, don't eat as much salt. And instead of like, Hey, we're trying to eat more fruits and vegetables, like people are just, it's hard to get them to eat fruits and vegetables. So you want a ratio. And then you have chloride. So chloride works with sodium to maintain that fluid balance and that acid base status, which sounds complicated, but basically we just, it's another electrolyte that we need. To maintain proper intra intracellular hydration.

Brianna: 6:42

Next one, carbon dioxide. So optimal, we wanna see this. 23 to 30. And this is also gonna reflect that acid-based balance so low could be an indication of like metabolic acidosis. So this could be related to like uncontrolled diabetes or again, kidney issues

Baylee: 7:00

Mm-hmm.

Brianna: 7:01

if it's high. This could be metabolic alkalosis acid-based balance here. So this could be like vomiting or using diuretics. Acid based shifts can be influenced by the diet. So thinking like high protein, low vegetable diets versus like alkaline foods. Now you don't have to necessarily fall like an acid diet or like an alkaline diet. I mean, I've seen those kind of pop up to be trendy. You don't have to do this, like your body is pretty good at regulating. If you're having trouble keeping this balance, that's when you wanna look deeper and see. Okay. Is there some minerals I need to replenish? What adjustments can I make to my diet? Start there.

Baylee: 7:44

Yeah. It's gonna be like. Either really, really high doses of something or really, really low. I didn't say intake or doses, I should say intake. If it was really easy to manipulate your carbon dioxide with just the foods that you're eating, everyone would be dead. Okay? So drinking your alkaline water is not really gonna do much for you. In the grand scheme of things, it's all about balance. And then obviously like. Metabolic health. Six and seven is gonna be your BUN and your creatinine. So this is really looking at your kidney function. So BUN stands for blood, urine, nitrogen. And so this is basically the breakdown product of protein. So this is where everyone seems to think, oh my gosh, if I eat a high protein diet, I'm killing my kidneys. That's old thinking that's not true. But a high BUN could be. Too high a protein intake or dehydration. I see that the most. Whenever anyone does it, I'm like, you're probably dehydrated. Especially'cause you're fasting. When you take these labs, you wake up like dehydrated a wee bit. So of course it's probably gonna be higher. But dehydration, high protein intake, intake or kidney dysfunction, and then low would be poor protein intake or liver disease. And then creatinine,

Brianna: 9:03

Not to be confused with creatine,

Baylee: 9:05

it is not creatine. Just so everybody knows it is not the same, so don't worry about that. But this is a byproduct of muscle metabolism that is filtered by the kidneys. This is why it's very important if you have kidney disease, that you're not rapidly losing weight because your kidneys have to filter out those byproducts. So high could mean kidney dysfunction. Again, your kidneys are just having a hard time filtering things. High muscle mass, high protein low would be low muscle mass. Or malnutrition. So this is just giving us a little snapshot, but I would say if you have things that are a little bit outside of the ranges for this, don't panic. You need to have other tests done to make sure like you actually have some sort of kidney disease. Most people do not. You will

Brianna: 9:51

And as a, as a general disclaimer for this entire episode, this is not meant to be like, we're gonna diagnose you with kidney disease right now. We're just giving you general information so you can start to understand what. What, what does your CMP mean? What do all these numbers indicate? Just so you have a better understanding. This is not meant to help you, like diagnose yourself with kidney disease or liver disease,

Baylee: 10:15

don't do that. Yeah,

Brianna: 10:16

like that.

Baylee: 10:17

don't take it to Chad GBT and be like, I had high creatinine. What's going on? No. Talk to your doctor. This is just, I feel like most people dunno what these things are. Anytime I go over labs to something, they're like, I don't know. What are you looking for? I don't even know what this means. Everything's fine, I guess. You know, so,

Brianna: 10:31

Yeah. The next ones I mean we also have the BUN BN creatinine ratio. This can help distinguish kidney versus nutrition dehydration issues. So that's another important ratio to look at. And then part of it, liver enzymes. So A ST and A-L-T-A-S-T optimal is like 18 to 26. A LT optimal is 13 to 26. So these are enzymes that are released when liver cells are damaged. So if they're elevated, this could indicate fatty liver overusing alcohol, hepatitis could be doing medications. Now one thing about nutrition, it, this number is strongly linked to metabolic syndrome. It could also be linked to excess sugar or fructose. And we've had some episodes about that recently too, or alcohol intake. And then we also have another one, a LP. So this one optimal is like 65 to 70 units per liter. And this is found in your liver, your bones, your intestines. So elevated a LP numbers could be related to like bone growth could also be like vitamin D deficiency. And even like liver and gallbladder obstructions. So again, we're not saying your gall bladder is obstructed if your ALP is off.

Baylee: 11:50

No.

Brianna: 11:51

We're just letting you know this is what things, it could be related to. Some of these things we freak out about. And a lot of times like, okay, how hydrated were you, especially like the day before. So some of'em are just simply related to dehydration, and that's why I think getting this at least yearly, doing a yearly lab check-in is helpful because you have trends in comparisons, like you can notice, okay, what's consistently increasing? What's consistently decreasing? And if we notice something is way off, then you can take a deeper dive. Like, do we need to look at something like an HTMA? Do we need some gut testing? Like we can always look further into, okay, what's actually going on here?

Baylee: 12:33

And I also, with your liver enzymes, like these can change pretty easily. So if you are coming

Brianna: 12:38

Yes.

Baylee: 12:39

off of a weekend of. Having some drinks or being really dehydrated or maybe eating a lot more fatty foods than you're used to, like you just kind of overdid it. These are probably gonna be a little bit increased at at least your A ST and a LT. Other things that kind of increase it would be like if you're drinking a lot of energy drinks repeatedly, I've seen those have higher ones. That doesn't mean that you're having like. Intensive liver damage. But I mean, your liver is working a little bit harder. Maybe it doesn't like it. So definitely if they're increased, like go get it retested. Don't just think, oh my gosh, this is horrible. It's just a little red flag. It's something to be like, Hey, monitor this. Make some changes. Go get some tests, you know? The next thing is gonna be like your proteins. So total protein is a sum of albumin and globulin. That sounds really complicated. We'll get into what albumin and globulin is, but low means malnutrition or malabsorption or liver and kidney disease, and then high would be dehydration or inflammation in the body. Mm-hmm.

Brianna: 13:42

So then albumin, your optimal is four to 4.4. This is your main blood protein. It helps maintain that fluid balance again, so. This by itself. And I guess I'll say with all this in general too, like we are looking at big picture things. We're not just gonna take one lab and run with it. We kind of see, okay, how are they all related? So low albumin could indicate like for protein intake, liver disease, inflammation or just malabsorption high is usually gonna indicate like dehydration. So nutrition wise it can actually reflect like long-term protein status. How are we doing there? And then globulin optimal is 2.8 to 3.5. So this includes antibodies and carrier proteins. If this number is high, this could indicate chronic inflammation or just like immune activation overall. If it's on the other side, if it's on the lower end, this could be poor nutrition immune deficiency. So with those two, we also have a ratio, the albumin globulin ratio. Ideal. 1.8 to 2.2. So this can help detect, do we have some malnutrition going on versus like immune or inflammatory conditions.

Baylee: 14:56

Yeah, and you have to think too, all this is a snapshot. Like when I look at serum blood, like these labs snapshot in time right now, this day, what's going on? It doesn't tell you huge big picture, but the trends might, so this is where you really do want to get it once a year, maybe twice a year, if there's something you're really like paying attention to and like follow the trends.'cause that's, that's gonna tell you like the bigger story of like what's going on with your health over time. And then like Bailey had mentioned, the HTMA, that's more of like what's been going on with some of these minerals for a while, which may be different than what's what you're looking at right now. You know, if that makes sense.

Brianna: 15:36

Yeah, so overall, I mean, we personally use this to screen for, do we have some underlying issues going on that we need to target for? This is part of like the medical nutrition therapy we can offer as dieticians. It can help us like monitor progress, especially if you have like diabetes, obesity, metabolic syndrome or like kidney or liver conditions. Kind of lets us know what's going on inside the body that we can't necessarily see, and it can help us prioritize, like what do we need to target nutrition wise that can help guide our recommendations as to what you need.

Baylee: 16:11

Yeah, and this is really important, like why, or this is the re one of the reasons why it's really important to work with a dietician. Especially as you're getting older and you're aging, you may have multiple different issues going on and you need someone who knows how to read labs and adjust dietary recommendations based on the whole picture. Not just a very narrow, I mean, there's a difference. I think people don't understand how long dieticians go to school. Every single class we have is nutrition. Nutrition, like we know, like big picture. So there's a lot going into play. Your metabolic health is really important. Understanding how to follow those trends and have individualized interventions is really important. Yeah.

Brianna: 16:55

We hope this episode was helpful, just to kind of give you a better idea of what we are looking at when we see A CMP. And we're actually gonna build off this episode next week. We're gonna come in and talk about some additional labs, like looking at cholesterol panel thyroid panel, and some extra ones we like, especially like insulin. So stay tuned for next week. We'll dive more into your labs and we hope this was helpful. We'll talk to you guys soon. Bye.