Physician explaining to patient what a comprehensive metabolic panel is

What Is a Comprehensive Metabolic Panel?

Medically reviewed on June 27, 2022 by Jordan Stachel, M.S., RDN, CPT. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


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Your health is composed of so many different components that interact with each other and often dictate each other’s functions. Keeping track of these different components can help to monitor your health and identify any potential diseases or disorders before they become more severe.

While there are numerous different test options for each specific component of your health, two common tests are the basic metabolic test or comprehensive metabolic panel test. A comprehensive metabolic test is a useful tool for measuring several different things to evaluate metabolism. Learn more about the comprehensive metabolic panel below.

Understanding a Comprehensive Metabolic Panel

A comprehensive metabolic panel is also known as a chem 14 test, chemistry panel, chemistry screen, or metabolic panel. The panel measures 14 different components present in your blood, which can provide information about the body’s metabolism and general chemical balance and insight into your overall health [1].

Why You Might Need a Comprehensive Metabolic Panel

Your healthcare provider may order a comprehensive metabolic panel as a part of your regular health exam. A CMP test result that has abnormal levels can help to diagnose a medical condition or monitor an existing medical condition.2 Your provider may want to check your liver health and will order a comprehensive metabolic panel if they believe you might be at risk for liver or kidney disease [1].

What Does a Comprehensive Metabolic Panel Measure?

A comprehensive metabolic panel test specifically measures the levels of 14 different substances that end up in the blood.

Glucose

Glucose is a type of sugar. It is also the body’s main source of fuel because it is readily accessible to all the cells. It comes from the foods and beverages that you consume. The digestive system breaks down all the food you eat, turning it into glucose that ends up in the blood. Once in the blood, the glucose gets transported throughout the body to feed every cell and organ. A hormone called “insulin” normally keeps glucose levels in check, helping to move the sugar from the blood into the body’s cells [3].

Glucose, also referred to as “blood sugar,” can be a good indicator of metabolism and overall health. Glucose levels that are too high or too low can point to certain health issues. High blood glucose levels (medically known as hyperglycemia) may be a sign of diabetes [4].

Calcium

Calcium is an essential mineral that is most associated with strong, healthy bones and teeth. However, your muscles, nerves, and heart also need calcium to function properly. While about 99 percent of the body’s calcium exists in the bones, about 1 percent can be found in the blood [5].

Too much or too little calcium can point to problems in the thyroid, kidneys, or bones or dietary deficiencies [5].

Electrolytes

Electrolytes are essential minerals that produce an electrical charge when placed in a polar solvent. While that might seem disconcerting, that tiny electrical charge is necessary for several functions throughout the body. They keep you hydrated, regulate your muscle contractions, and balance all internal pH levels. Electrolytes also control basic nervous system functions [6].

A comprehensive metabolic panel measures the levels of four electrolytes:

  • Carbon dioxide
  • Chloride
  • Potassium
  • Sodium [1]

You often lose electrolytes through sweat, urine, and diarrhea. This can lead to low electrolyte levels, which can contribute to health problems. You typically get enough electrolytes through diet. Any excess is expelled via urine. Having too little or too much of any electrolyte may indicate dehydration, kidney problems, or other medical problems [6].

Albumin

A protein made in the liver, albumin essentially keeps blood and other parts of the body’s fluid in the bloodstream. This prevents them from leaking into surrounding tissues. Albumin also carries hormones, enzymes, vitamins, and other substances through the body [7].

An albumin test can determine proper liver and kidney functions and identify problems in those organs. Kidney failure often results in albumin leaking into the urine, leading to low albumin levels in blood [7].

Total Protein

Total protein refers to the total amount of two types of proteins (albumin and globulin) found in the fluid of the blood. Globulins are part of the immune system and assist with fighting infections and clotting blood, among other functions [8].

Any abnormalities in your total protein levels may indicate kidney or liver problems. Abnormal total protein levels in the blood may also point to nutrition problems or deficiencies [8].

Liver Enzymes

A comprehensive metabolic panel looks at three different enzymes made in the liver:

  • ALP (alkaline phosphatase) – ALP is mostly found in the liver, kidneys, digestive system, and bones, but it can be found throughout the body. Any damage to the liver may result in ALP leaking into the bloodstream [9].
  • ALT (alanine transaminase) – Similar to ALP, high levels of ALT in the blood can point to liver damage or liver disease [10].
  • AST (aspartate aminotransferase) – Present in the liver and muscles, AST can leak into the blood following liver disease [11].

Bilirubin

Your red blood cells naturally break down over time, making room for fresh red blood cells. Bilirubin is a product of this breakdown. It appears as a yellowish pigment and can be found in bile, a substance in the liver that helps to break down food. Bilirubin eventually passes through the liver and gets flushed out of the body [12].

Higher levels of bilirubin can indicate problems in the liver or bile ducts. Increased bilirubin production may also indicate hemolysis, or an increased rate of red blood cell death [12]. Liver damage can also cause bilirubin to leak into the blood, which can lead to jaundice [13].

Kidney Waste Products

Comprehensive metabolic panels also look at the levels of two waste products from the kidneys: creatinine and blood urea nitrogen (BUN). As your muscles move and flex throughout the day, they naturally produce a waste product called “creatinine.” When things are functioning normally, the kidney filters the creatinine out of the blood, and it eventually gets excreted out of the body with urine. A buildup of creatinine in the blood can point to kidney issues [14].

As the liver breaks down proteins, it produces ammonia, a chemical that contains nitrogen. The nitrogen combines with other elements, turning into the waste product urea. The kidneys normally filter the urea nitrogen out of the blood. High urea nitrogen levels may suggest that the kidneys aren’t working efficiently or may otherwise be damaged [15].

Preparing for a Comprehensive Metabolic Panel

A comprehensive metabolic panel typically requires a standard blood draw from a vein in your arm. You may need to fast for at least eight hours before a CMP, which means not eating or drinking anything other than water. Fasting allows for more accurate results as food can cause fluctuations in glucose, calcium, and other substances [1].

What's the Difference: Basic vs. Comprehensive Metabolic Panel

What Is a Basic Metabolic Panel?

What Is Included in a Comprehensive Metabolic Panel?

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References

1. Comprehensive Metabolic Panel (CMP). Medline Plus. URL. Accessed June 27, 2022.

2. Comprehensive Metabolic Panel. Michigan medicine. URL. Accessed June 27, 2022.

3. Blood Sugar. Medline Plus. URL. Accessed June 27, 2022.

4. Blood Glucose Test. Medline Plus. URL. Accessed June 27, 2022.

5. Calcium Blood Test. Medline Plus. URL. Accessed June 27, 2022.

6. What are Electrolytes? Cedars Sinai. URL. Accessed June 27, 2022.

7. Albumin Blood Test. Medline Plus. URL. Accessed June 27, 2022.

8. Total protein. UCSF health. URL. Accessed June 27, 2022.

9. Alkaline Phosphatase. Medline Plus. URL. Accessed June 27, 2022.

10. ALT Blood Test. Medline Plus. URL. Accessed June 27, 2022.

11. AST Test. Medline Plus. URL. Accessed June 27, 2022.

12. Bilirubin test. Mayo Clinic. URL. Accessed June 27, 2022.

13. Bilirubin Blood Test. Medline Plus. URL. Accessed June 27, 2022.

14. Creatinine Test. Medline Plus. URL. Accessed June 27, 2022.

15. Blood urea nitrogen (BUN) test. Mayo Clinic. URL. Accessed June 27, 2022.

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