Advanced Metabolic Panel Blood Test

The balance of electrolytes in our blood is vital for the correct functioning of nerves and muscles, the maintenance of our heart rhythm and a whole host of other essential metabolic functions. Disturbances in electrolyte levels may result in no symptoms at all but, if severe, may have life threatening consequences. In between these two scenarios are a range of more or less significant symptoms depending on the severity of the abnormality, and the particular electrolyte that is abnormal. In this test we check for sodium, potassium, chloride and calcium. 

We also measure the level of the waste product creatinine from which we can estimate the health of your kidneys (which is given as the eGFR). The kidneys are crucial in maintaining the balance of electrolytes in the blood and so kidney health and normal electrolyte levels are closely bound. 

Liver function is tested because the health of your liver is so important to your overall health, but also because electrolyte abnormalities can occur in liver disease, particularly in the later stages of the disease. 

Lastly, we check blood sugar levels in the form of glucose which is the body’s energy source. Abnormal levels of glucose may indicate diabetes or pre-diabetes.

Even if your blood tests are normal, you should see a doctor if you have any of the symptoms below.

• Progressive weakness or lethargy.
• Confusion. 
• Severe muscle cramps.
• Unexplained weight loss.
• Unexplained abdominal swelling.
• Yellowing of the skin or eyes.

This is a fasting test so have nothing to eat and only drink water from 10pm the night before you take the test.

We are not able to report on the Potassium measurement for the finger prick version of this test, due to very unstable nature of Potassium, for which we require a venous sample.

What are the symptoms of electrolyte imbalances? 

This depends on the electrolyte that is either high or low. In many cases, if the imbalance is mild, there will be no symptoms. Major electrolyte imbalances can cause lethargy, muscle cramps, nausea, weakness, and eventually, severe problems such as seizures and cardiac arrest. 

If I forget to fast, is the test still valid? 

We interpret the blood glucose level on the assumption that you have fasted, so if you forget to fast then it may lead us to believe there is a problem when there actually isn’t. The fasting glucose also allows us to look for ‘impaired fasting glucose’ which is high blood sugar levels despite having fasted. This is a sign that you are at high risk of progressing to diabetes. A ‘random’ glucose (i.e. taken when you haven’t fasted) can still be useful, a normal result is reassuring but a high result should prompt further investigations. 

What causes damage to the liver? 

The liver can be damaged by many things. It may be damaged by infectious illnesses such as hepatitis or by illness caused by genetic factors or autoimmune conditions. It can also be damaged by alcohol, other toxins, and some medications. For this reason, you need to have your liver function tested regularly when you are on certain medications.

One very common cause of liver disease is ‘fatty liver disease’ which is when fat builds up in the liver. The cause of excess fat in the liver is usually the same as excess fat elsewhere in the body - an unhealthy lifestyle. Is liver damage permanent? The liver has excellent powers of regeneration and liver disease can often be halted and reversed, particularly in the early stages.

The key is removing the cause of the damage which in many cases is alcohol or excess calorie intake. Liver damage can however progress to scarring which is known as cirrhosis. Cirrhosis is irreversible and can eventually lead to death.

• You want to know what your electrolyte levels are 
• You are worried about diabetes 
• You are taking medication that may affect your electrolyte levels
• You want to check that your kidneys are healthy
• You want to check that your liver is healthy

You may want to take the advanced metabolic panel if you want to know that you have the the correct balance of blood electrolytes, you are worried about diabetes, or you want to check that your kidneys and liver are healthy. You might also want to take this test if you are on medication that might affect your electrolyte levels, such as many blood pressure medications.