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Getting a Patient History


Click here to contact me with questions about your laboratory results - I do not volley e-mails back and forth because it is just too time consuming to keep track of who is responding to what e-mail. If you have a health question, please read about Signs and Symptoms before our conversation.

This is a brief summary of lab value interpretation and is not intended in any way to be comprehensive or replace any conversation of your results with your doctor.


SODIUM - Sodium is the most abundant cation (pronounced cat-ion) in the blood and its chief base. It functions in the body to maintain osmotic pressure, acid-base balance and to transmit nerve impulses. Very Low value: seizure and neurologic symptoms.

Sodium, serum: 135-145 mEq/L
Sodium, urine: 135-145 mEq/L

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POTASSIUM - Potassium is the major intracellular cation. Very low value: Cardiac arrhythmia.

Potassium, serum: 3.5 - 5.0 mEq/L
Potassium, urine: varies with diet

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CHLORIDE - Elevated levels are related to acidosis as well as too much water crossing the cell membrane. Decreased levels with decreased serum albumin may indicate water deficiency crossing the cell membrane (edema).

Chloride, CSF: 118-132 mEq/L (CSF = CerebroSpinal Fluid)
Chloride, serum: 98-108 mEq/L
Chloride, sweat: 0-35 mmol/L
Chloride, urine: varies with diet

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CO2 (Carbon Dioxide) - The CO2 level is related to the respiratory exchange of carbon dioxide in the lungs and is part of the bodies buffering system. Generally when used with the other electrolytes, it is a good indicator of acidosis and alkalinity.

Normal Adult Range: 22-32 mEq/L
Optimal Adult Reading: 27
Normal Childrens Range - 20 - 28 mEq/L
Optimal Childrens Reading: 24

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CALCIUM - involved in bone metabolism, protein absorption, fat transfer muscular contraction, transmission of nerve impulses, blood clotting and cardiac function. Regulated by parathyroid.

Calcium, ionized: 4.4 - 5.1 mg/dL
Calcium, serum: 8.4 - 10.2 mEq/dl
Calcium, urine: 100 - 300 mg/24 h

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PHOSPHORUS - Generally inverse with Calcium.

Phosphorus, serum: 3.0 - 4.5 mg/dL

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ANION GAP (Sodium + Potassium - CO2 + Chloride) - An increased measurement is associated with metabolic acidosis due to the overproduction of acids (a state of alkalinity is in effect). Decreased levels may indicate metabolic alkalosis due to the overproduction of alkaloids (a state of acidosis is in effect).

Normal Adult Range: 7 - 16 mEq/L

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Normal Adult Range: 2.3 - 3.3 (calculated)
Optimal Adult Reading: 2.8
Normal Children’s range: 1.3 - 3.3 (calculated)
Optimal Children’s Reading: 2.3

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Normal Adult Range: 26 - 38 (calculated)
Optimal Adult Reading: 32

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Electrolytes (salts) are chemical substances in the body that have become ions in your body fluids and have the capacity to conduct electricity. Basically, an ion is an atom or a group of atoms that have lost or gained one or more electrons thereby giving it a positive or negative charge. Because of this 'charge' in body fluids it has the ability to conduct electricity. How cool is that? It's not like we are plastic and can't be shocked. We can even rub out foot on carpet and shock someone else. The body is indeed 'electric'. The 'body fluids' I'm referring to is your blood, plasma and interstitial fluid (the fluid between your cells). Your body fluids have a fair amount of sodium chloride (Na+Cl- aka table salt) swishing through it. Electricity requires voltage and it is through this positive and negative charges in the cells that makes the ability to conduct electricity in the body possible in order to keep your heart beating and your nervous system operating.

Electrolytes are present in the human body and the balancing act of the electrolytes in our bodies is essential for normal function of our cells and organs. There has to be a balance.

Positive ions such as sodium, potassium, magnesium and calcium are called cations. That's pronounced 'cat' ions.

Negative ions such as chloride, bicarbonate and sulfate are called anions. That's pronounced 'an' ions.

The common electrolytes that are measured by doctors with blood testing include bicarbonate, chloride, potassium and sodium. The functions and normal range values for these electrolytes are described below.

Potassium is the major positive ion (cation) inside of cells and is controlled very carefully by the kidneys. It is important for the proper functioning of the nerves and muscles, particularly the heartbeat. Any value outside the expected range, high or low, requires medical attention. This is especially important if you are taking a diuretic (water pill) or heart pill (Digitalis, Lanoxin, etc.). The chemical abbreviation for potassium is K+ on the periodic table of elements. The proper level of potassium is essential for normal cell function.

The normal blood potassium level is 3.5 - 5.0 milliEquivalents/liter (mEq/L), or in international units, 3.5 - 5.0 millimoles/liter (mmol/L).

An abnormal increase in potassium (hyperkalemia) or a decrease in potassium (hypokalemia) can seriously affect the nervous system and increases the chance of arrhythmias (irregular heartbeats), which can prove to be fatal when they are extreme. Since potassium is normally excreted by the kidneys, disorders that decrease the function of the kidneys can result in hyperkalemia. It is important to note that certain medications can also predispose a person to hyperkalemia. Hypokalemia can occur due to kidney disease, diarrhea, eating disorders, heavy sweating, prescription drugs, vomiting or other causes.

Sodium is the major positive ion (cation) outside of cells and is also regulated by the kidneys and adrenal glands. Notice from the posting above how potassium functions inside the cell and sodium functions outside of the cell. There are many causes of high or low sodium levels, but the most common causes due to diuretics, diabetes drugs like chlorpropamide and excessive water intake in those with heart or liver disease. The chemical abbreviation for potassium is Na+ on the periodic table of elements. When sodium (Na+) is combined with chloride (Cl-) the result is sodium chloride (Na+Cl-) aka table salt.

A Normal blood sodium level is 135 - 145 milliEquivalents/liter (mEq/L), or in international units, 135 - 145 millimoles/liter (mmol/L).

Excess sodium that is consumed in the diet will be excreted in the urine. What sodium does is regulate the total amount of water in the body. It also regulates the transmission of sodium into and out of individual cells. Since so many body functions and processes require electrical signals for communication (namely the brain, muscles and nervous system, the movement of sodium in and out of cells is vital in generating electrical signals. If there is an extreme fluctuation in sodium levels this can cause cells to malfunction, which can prove to be fatal.

An excess in sodium levels in the blood in relation to water is called 'hypernatremia'. Causes of hypernatremia may include kidney disease, lack or little water intake or loss of water due to diarrhea and/or vomiting.

A decrease in sodium levels in the blood in relation to water is called 'hyponatremia'. This occurs when there is an increase in the amount of body water in relation to sodium. This occurs with diseases of the liver, kidney, burn victims and those who suffer from congestive heart failure and other conditions.

Chloride a major negative ion (anion) found inside of the cells and the blood. Chloride helps the body maintain its normal balance of fluids. Just like potassium and sodium, chloride can have fatal consequences when the increase or decrease is extreme.

The normal serum range for chloride is 98 - 108 mmol/L.

Increased chloride levels is 'hyperchloremia'. Elevated levels are seen in diarrhea, some kidney disease and sometimes in overactive parathyroid glands.

Decreased chloride levels is 'hypochloremia'. Chloride is normally lost in the urine, sweat and stomach secretions but an excessive loss can happen from heavy sweating, vomiting and adrenal gland or kidney disease.

Bicarbonate acts as a 'buffer' to maintain the normal levels of acidity (pH) in blood and other fluids in the body. A buffer is a substance that preserves the original concentration of a fluid. This is why bicarbonate levels are measured to monitor the acidity of the blood and other body fluids. Acidity is affected by foods or medications that are ingested and also affected by the function of the kidneys and lungs. This is why a bicarbonate is often given to balance the pH of the urine when it is too acidic as a result of medications. The chemical abbreviation for bicarbonate is HCO3- or represented as the concentration of carbon dioxide (CO2). CO2 reflects the acid status of your blood. Low CO2 levels can be due to either increased acidity from uncontrolled diabetes, kidney disease, metabolic disorders, or low CO2 can be due to chronic hyperventilation.

The normal serum range for bicarbonate is 22-30 mmol/L.

A bicarbonate test is usually performed with other blood electrolytes. Fluctuations in the normal bicarbonate level may be due to issues with respiratory function, kidney disease, metabolic conditions, medications or other causes.

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**This web site's goal is to provide you with information that may be useful in attaining optimal health. Nothing in it is meant as a prescription or as medical advice. You should check with your physician before implementing any changes in your exercise or lifestyle habits, especially if you have physical problems or are taking medications of any kind.