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Lab Walk-thru: Kidney, Nutrients, Electrolytes

Remember our original labs?

We're going to finish our look with the kidneys, nutrients, and electrolytes analysis today.

Your kidneys are at work 24 hours a day, filtering your blood by removing wastes and extra water to make urine. 37 million adults in the US have Chronic Kidney Disease, CKD -- but upwards of 90% are completely unaware of their condition.

The eGFR, or estimated Glomerular FIltration Rate, shows us an estimate of how much blood is filtered through the kidneys every minute. It factors in race, age, gender, and your creatinine levels to give us a look at how well your kidneys are functioning. This range can be affected by your diet and nutrition intake, your muscle weight, and certain chronic illnesses.

People at a higher risk of CKD include those with active diabetes, high blood pressure, those who are overweight, over the age of 60, and those with a family history of CKD or kidney failure.

The higher the numbers, the better the kidney function. Lower numbers show us your kidneys aren't working at their best, and when these low numbers become the norm, we start looking at kidney disease and damage.

Signs and symptoms do not typically show up until you are in late-stage territory. Those symptoms may include:

  • urinating more often or less often than your usual

  • itching

  • feeling tired

  • swelling in arms, legs, feet

  • muscle cramps

  • nausea and vomiting

  • loss of appetite

See what I mean when I say labs are just a snapshot of this moment and we need a bigger picture view to work out how to respond? These symptoms could indicate any number of other issues, but multiple labwork over time, showing a pattern of low eGFR plus these symptoms give us some direction for your support.

Yearly lab work is a foundation for taking care of your health and catching trends before they become patterns.

This particular lab shows us the value of calcium.

Calcium in our bodies serves several purposes. It's one of several electrolytes that carry an electrical charge when they meet up with body fluids, such as blood. Most of the calcium in our bodies does not carry a charge and is stored mainly in the bones.

Roughly 40% of our blood calcium is bound to proteins, such as albumin, and acts as a reserve for the cells but has no real active purpose. Only unbound calcium affects the various body functions.

Low calcium or Hypocalcemia is usually the result of the loss of too much calcium in the urine when not enough is moved from the bones into circulation. The causes can vary:

  • low functioning parathyroid (hypoparathyroidism)

  • poor calcium intake or absorption

  • kidney dysfunction (see how that eGFR was also low right now?)

  • Vitamin D deficiency

  • Magnesium deficiency

  • pancreatitis

Everything works together with everything else when it comes to balance in health. Kidney issues such as that low eGFR results in more calcium being released in what urine we have which in turn makes the kidneys less able to activate vitamin D; low magnesium works against parathyroid hormone production, which works against the calcium values. Looking at just one of these doesn't allow you to piece the full puzzle together. You need multiple tests to show the bigger picture.

These are some other electrolytes that may show up on your blood test.

Sodium levels fluctuate with the amount of fluids you take in as well as the amount of fluids you excrete. Summertime here in the Deep South can mess with anyone's sodium levels if we aren't watching what we are drinking and how often.

Potassium is both an electrolyte and a mineral and helps maintain the balance of fluid inside and outside of the body's cells. This level is typically monitored with kidney disease (here it is again, that eGFR coming back up as a possibility to monitor). We would also keep an eye on this value if you had signs of high blood pressure or other heart problems.

One thing works closely with another. Increasing potassium levels and decreasing sodium levels can help lower your blood pressure and reduce your risk of stroke. Magnesium levels affect the absorption and metabolism of potassium and sodium, as do Vitamin D levels. Magnesium is needed to help the kidneys reabsorb potassium and maintain normal levels.

Chloride is a mineral that helps to maintain the acid-base balance in your body. After sodium, chloride is the most abundant electrolyte in serum and plays a key role in regulating body fluid levels and the preservation of electrical neutrality. This level is monitored closely in multiple illnesses and diseases and if often referred to as the Queen of electrolytes. High levels can indicate dehydration, kidney disease, or Cushing's syndrome and increase blood pressure.

Carbon Dioxide is a waste product your body makes when it uses foods for energy. Too much CO2 in the blood can indicate lung disease, Cushing's syndrome, kidney failure, or a metabolic issue. Too little can point to Addisons disease, diabetic ketoacidosis, shock, metabolic issues, respiratory issues such as hyperventilation.

Anion Gap is the measurement of acid-base balance and electrolyte balance in your blood. Low results are not typical; pregnancy values commonly have an increase of 1-2 mmol than non-pregnant numbers. Results below normal ranges are not typical and are usually a result of improper handling of the specimen, or delayed processing of the specimen.

When we do a review of labs we start by looking at everything at face value, which levels are high or low. Then we start the breakdown of what could contribute to those values being out of balance -- age, gender, ethnicity, lifestyle, diet, environment, family and medical history -- to see what is expected and unexpected. Having one or two previous lab results makes the process more complete, but it isn't a requirement. We can see a good deal with a single lab result, but tracking down issues can require more than one. Previous labs can help show us if this is an acute or a chronic issue and potentially when it became problematic to your health.

It is not a short process and we often take 1-2 weeks to pull together a really good picture of your health. From there, you are armed with information so you can ask questions of your Provider and make evidence-informed decisions regarding your treatment options and care plan. If you are interested in seeing what homeopathy or herbal treatments can offer, we have the information we need to individualize your care options and remedy selections.

YOU are the author of your health journey. You can't write your own health story without having the information and the knowledge in your hands. Our 1 year Lab Review package offers you the tools to get your story started and headed back to your best health outlook. We would love to help you get started! Schedule your visit today.


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