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If you recently had a physical exam, your provider likely recommended a blood test called a comprehensive metabolic panel (CMP). This lab test is often ordered at an annual well visit. The results can help flag early warning signs for diabetes or issues with your liver and kidneys.
With electronic medical records releasing results before your healthcare provider has a chance to explain the meaning, it may be difficult to accurately interpret the results. Be sure to check with your healthcare provider for individualized feedback.
What is a comprehensive metabolic panel?
A comprehensive metabolic panel (CMP), also called a chemistry screen, chemistry panel, or chem-14, is a range of blood tests that help provide a better understanding of your body’s chemistry. The test measures 14 different substances in your blood sample. It’s the more thorough counterpart to the basic metabolic panel (BMP), a blood test that measures eight substances. The main focus of this group of lab tests is to evaluate your body’s chemical balance and metabolism. It is used for the following reasons:
- Preventive screening for medical issues
- Diagnosing problems with blood sugar, kidney, or liver function
- Monitoring known chronic conditions
“The metabolic panel is one of the best routine lab tests to help your doctor figure out what’s going on,” says Frank J. Contacessa, MD, an internist at Northwell Health Physician Partners Medicine in Armonk, New York. These lab results help your healthcare provider evaluate how medications you take regularly affect your body.
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What tests are in a comprehensive metabolic panel?
The 14 different substances that are measured during a CMP test are:
- Glucose
- Calcium
- Sodium
- Potassium
- Bicarbonate
- Chloride
- Blood urea nitrogen (BUN)
- Creatinine
- Albumin
- Total protein
- Alkaline phosphatase (ALP)
- Alanine aminotransferase (ALT)
- Aspartate aminotransferase (AST)
- Bilirubin
“When all the tests are analyzed together, it gives a good picture of overall health,” says William Li, MD, a physician, scientist, and author of Eat To Beat Disease. “Any abnormal results can help identify where there may be problems with metabolism and direct a doctor to where to do a deeper dive.”
What does a comprehensive metabolic panel show?
“A comprehensive metabolic panel may indicate kidney disease, liver disease, and gallbladder disease,” Dr. Li says. “It can also show signs of cancer interfering with metabolic function, diabetes, pre-diabetes, and many more. The panel gives a snapshot of how things are going inside the body. It does not nail down a diagnosis. If there are any abnormalities, more tests will likely be needed.”
A comprehensive metabolic panel blood test can be used to check the health and functioning of your organs. The following areas can be evaluated:
- Kidneys and liver health functioning
- Blood sugar levels
- Calcium levels
- Blood protein levels
- Sodium, potassium, and chloride levels (electrolytes)
- Protein levels
- Fluid balance
For example, blood urea nitrogen (BUN) and creatinine are waste products eliminated by your kidneys. Higher-than-normal levels of either lab can indicate decreased kidney function. While potassium, sodium, carbon dioxide, and chloride provide information about electrolyte levels and if the acid-base balance of your body is off. Irregular glucose test results could be an early indicator of blood sugar problems or even prediabetes. Increased levels of ALP, ALT, or AST enzymes may indicate liver dysfunction.
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Comprehensive metabolic panel results
Consult your healthcare provider to help read and interpret your CMP results. If you receive the results before you can consult with your healthcare provider, know that an abnormal result doesn’t necessarily mean that you have a disease. It depends which values are off, how many, and how far outside the typical reference ranges your results fall.
“Abnormal results could mean a diagnosis of heart disease, kidney, or liver failure, or that you are dehydrated,” says Lulu Guo, MD, a family medicine physician at Valley Sleep Center in Arizona. There could be an error in the test, you might need to alter your diet, or just drink more water.
“Any abnormal values mean something is going on and needs more investigation to figure out what it is, and whether an intervention is needed,” Dr. Li says. Your healthcare provider will probably want to do more tests to further determine what’s going on. Every lab has a unique exact “normal range.”
| CMP results meaning | ||
|---|---|---|
| Test | Normal Range | Type of Test |
| Albumin | 3.4 to 5.4 g/dL (34 to 54 g/L) | Blood protein |
| Alkaline phosphatase (ALP) | 20 to 130 U/L | Liver test |
| Alanine aminotransferase (ALT) | 4 to 36 U/L | Liver test |
| Aspartate aminotransferase (AST) | 8 to 33 U/L | Liver test |
| Bilirubin | 0.1 to 1.2 mg/dL (2 to 21 µmol/L) | Liver test |
| Blood urea nitrogen (BUN) | 6 to 20 mg/dL (2.14 to 7.14 mmol/L) | Kidney test |
| Calcium | 8.5 to 10.2 mg/dL (2.13 to 2.55 mmol/L) | Electrolyte panel |
| Carbon dioxide | 23 to 29 mEq/L (23 to 29 mmol/L) | Electrolyte panel |
| Chloride | 96 to 106 mEq/L (96 to 106 mmol/L) | Electrolyte panel |
| Creatinine | 0.6 to 1.3 mg/dL (53 to 114.9 µmol/L) | Kidney test |
| Glucose | 70 to 100 mg/dL (3.9 to 5.6 mmol/L) when fasting; under 200 mg/dl when not fasting | Sugar metabolism |
| Potassium | 3.7 to 5.2 mEq/L (3.70 to 5.20 mmol/L) | Electrolyte panel |
| Sodium | 135 to 145 mEq/L (135 to 145 mmol/L) | Electrolyte panel |
| Total protein | 6.0 to 8.3 g/dL (60 to 83 g/L) | Blood protein |
“You should ask your doctor why this comprehensive metabolic panel was performed, and what he or she was thinking or looking for,” Dr. Li says. He further explains the importance of asking questions about your blood work. “Asking questions will help you as a patient engage your doctors in a conversation about your comprehensive metabolic panel.”
Here are some questions you can ask your provider about your comprehensive metabolic panel test results:
- Are my results normal?
- What do my results mean?
- How do these results relate to my family history?
- Should I make any lifestyle changes?
- What are the next steps?
- Do I need any other blood tests or any other types of tests?
- Do I need to repeat this comprehensive metabolic panel? If so, when?
You might need follow-up tests depending on your results. “Sometimes, your doctor will decide based on all the factors just to repeat the test in a few weeks or months to see if things have gotten better, stayed the same, or gotten worse,” Dr. Li says. “If you are feeling ill, and have an abnormal comprehensive metabolic panel, chances are your doctor will be ordering some additional tests or scans.”
