Introduction

Hello! Today, we’re diving into an essential topic for anyone looking to take charge of their health: revealing the important nutritional information in routine lab tests, specifically the CMP-14 and CBC. These tests are often part of your regular health check-ups, but did you know they contain valuable health insights that are frequently overlooked? It's important to understand what your doctor is evaluating, why the tests are important, and what insights and actionable steps you can take from your bloodwork results. Let’s break it down together.

What Are the CMP-14 and CBC Tests?

The CMP-14 (Comprehensive Metabolic Panel) and CBC (Complete Blood Count) are two of the most commonly performed blood tests in all of medicine. Chances are you've had these done yearly during a routine checkup. They provide a snapshot of your overall health and can help detect many nutritional and health conditions.

A comprehensive metabolic panel abbreviated using the letters, CMP on your lab script usually has a number behind it which indicates the number of testing elements being assessed. In my office, I run a CMP-14 which evaluates 14 different markers in your blood. Another routine blood test is the CBC, which lets us know immune function, anemia, and nutritionally your B-vitamin status so you have plenty of energy with little fatigue.

CMP-14:

This test measures 14 substances in your blood and provides information about your body’s chemical balance and metabolism. It includes:

• Glucose: Your blood sugar level, which can indicate diabetes.
• Calcium: Essential for bones, muscles, nerves, and heart function.
• Electrolytes: Sodium, potassium, carbon dioxide, and chloride levels, which are crucial for maintaining fluid balance.
• Proteins: Albumin and total protein levels, indicating liver and kidney function.
• Liver Enzymes: ALP, ALT, AST, and bilirubin levels to assess liver health.

CBC:

This test measures different components of your blood and can help diagnose various conditions from infections to blood disorders. A CBC, which stands for complete blood count doesn't give specific information about your blood sugar level but reveals issues related to fatigue, like anemia, and infection, including the possibilities of a parasitic infection, and nutritional deficiencies. Tests on a CBC include:

• White Blood Cells (WBC): Your immune system’s defenders.
• Red Blood Cells (RBC): Carry oxygen throughout your body.
• Hemoglobin: The protein in RBCs that carries oxygen.
• Hematocrit: The proportion of blood that is made up of RBCs.
• Platelets: Essential for blood clotting.

Why Are These Tests Commonly Used?

This is where the interpretation of these tests can diverge. A physician uses these labs as a general screening tool or symptom checker.

1. Baseline Health Assessment: CMP-14 and CBC tests are often used as part of routine check-ups to provide a baseline of your health. They can detect early signs of health issues before symptoms appear.
2. Monitoring Chronic Conditions: For those with chronic conditions such as diabetes, liver disease, or kidney disease, these tests help monitor the condition and the effectiveness of treatments.
3. Diagnostic Tool: When you feel unwell, these tests can help identify the cause by revealing infections, anemia, or metabolic imbalances.
4. Pre-Surgical Screening: Before undergoing surgery, these tests ensure you’re in good health to handle the procedure and recover well.

Functional Nutrition Interpretation of CMP-14 and CBC

As a functional nutritionist, I use these tests to get insights as part of a holistic approach to health, emphasizing the connection between diet, lifestyle, and overall well-being. Here’s how I use CMP-14 and CBC tests:

1. Preventive and Holistic Focus: As a Functional nutritionist, I use CMP-14 and CBC tests to assess a comprehensive understanding of a client’s baseline health. These tests help identify potential imbalances or deficiencies that might not yet be causing symptoms but could impact long-term health.
2. Root Cause Analysis: Instead of just treating symptoms, I aim to uncover the underlying causes of health issues. It's important to me to find the common denominator for someone's health and interpret their test results within the context of their diet, lifestyle, and overall health history to create a personalized wellness plan.
3. Nutritional and Lifestyle Interventions: Based on test results, I recommend specific dietary changes, high-quality nutritional supplements, and lifestyle modifications to address imbalances and promote optimal health. If at all possible, I want to avoid having medications prescribed unless necessary.
4. Client Education and Empowerment: When I review the results of a CMP-14 and CBC, I spend more time educating the client about the implications of their test results, which empowers them to take an active role in their health journey. By emphasizing the importance of nutrition and lifestyle choices in achieving and maintaining health.

Blood Sugar Testing and Your Health

Let's Take a Closer Look at Blood Sugar

Understanding your blood sugar levels is crucial, especially if you’re concerned about diabetes or metabolic health. Let’s dive into what these numbers mean and when you should be concerned.

What Is Blood Sugar and Why Is It Important?

Blood sugar, or glucose, is the primary energy source for your body’s cells. It comes from the food you eat and is transported through the bloodstream to cells, providing the fuel you need for everything from brain function to muscle movement. Maintaining balanced blood sugar levels is vital for overall health.

The Best Blood Test for Blood Sugar, Can It Be Found on a CMP-14?



The Best Blood Tests for Blood Sugar

When it comes to assessing blood sugar levels, there are several key tests we can use to get a comprehensive picture of your glucose metabolism and diabetes risk but only one of them can be found on a CMP-14.

The Comprehensive Metabolic Panel (CMP-14) includes a fasting blood sugar (FBS) test as part of its standard panel. Here’s how it fits into the CMP-14:

• Fasting Blood Sugar (FBS): This test is included in the CMP-14 and provides a snapshot of your blood glucose level after fasting for 8-12 hours. It’s useful for initial screening and monitoring of blood sugar levels.

While the FBS test on a CMP-14 is valuable, it’s important to note that it provides only a single point-in-time measurement. For a more comprehensive understanding of your blood sugar control, additional tests like the HbA1c and OGTT may be recommended by your healthcare provider.

Why You Might Need Additional Blood Sugar Testing

1. Long-Term Blood Sugar Control: The HbA1c test gives a broader picture of your average blood sugar levels over the past few months, which is crucial for diagnosing and managing diabetes.
2. Diagnosing Diabetes and Prediabetes: The oral Glucose Tolerance Test can help diagnose conditions not detectable on a single fasting blood sugar test.
3. Detecting Variations in Blood Sugar: Random blood sugar tests can identify spikes or drops in blood sugar that may not be apparent during fasting.

Additional blood Sugar Tests to Consider

When it comes to getting a comprehensive picture of your glucose metabolism and diabetes risk these other tests can be helpful:

Hemoglobin A1c (HbA1c) Test

• Description: Provides an average blood sugar level over the past 2-3 months by measuring the percentage of glucose attached to hemoglobin in your red blood cells.
• Normal Range: Below 5.7% for non-diabetics.
• Significance: Indicates long-term blood sugar control and helps diagnose diabetes.

Oral Glucose Tolerance Test (OGTT)

• Description: Measures blood sugar levels before and after consuming a sugary drink, typically over a 2-hour period.
• Normal Range: Below 140 mg/dL after 2 hours.
• Significance: Diagnoses diabetes and gestational diabetes (diabetes during pregnancy).

Fructosamine

• Description: Measures average blood sugar over the last two-to-three-week period. It was used mostly to evaluate diabetes blood sugar control, but I also use it to assess how well an eating plan is working to stabilize blood sugar levels.
• Normal Range: Below 190-228 µmol/L.
• Significance: Useful for a quick assessment of blood sugar levels but less reliable for diagnosis.

Normal vs Abnormal Blood Sugar Levels When Interpreted by a Function Nutritionist?

When you receive your CMP-14 results, one of the key markers you'll see is your blood glucose level. Blood sugar matters over time and evaluating more than just a fasting glucose can be beneficial.  Here's a breakdown of how I interpret blood sugar levels and what these numbers mean:

• Normal Blood Sugar Levels: For a fasting blood sugar test (usually done after you haven’t eaten for 8-12 hours), a normal range is typically between 75 to 86 mg/dL (milligrams per deciliter).
• Elevated Blood Sugar Levels: Between 86 - 99 mg/dL I consider these elevated blood sugar numbers and you must start to make dietary changes
• Prediabetes: If your fasting blood sugar is between 100 and 125 mg/dL, it’s considered high and falls into the prediabetes range. This means you have a higher risk of developing diabetes. But it’s not inevitable with lifestyle changes, it can often be reversed.
• Diabetes: A fasting blood sugar level of 126 mg/dL or higher on two separate tests indicates diabetes. If your blood sugar level is this high, you must make dietary and lifestyle changes. Most physicians will use medication to manage the condition and prevent complications. Some of my clients came into my care being diabetic and we were able to lower their blood sugar to normal ranges very quickly with diet and supplements.

What level of blood sugar is dangerous?

In my professional opinion, if your fasting blood sugar levels are consistently over 90, your levels are too high and in the danger zone. Consistent fasting blood sugar levels in this zone are already creeping up and chances are you don’t know the danger of your eating choices.

High blood sugar levels, if left unmanaged, can lead to a range of serious health problems, including:

• Heart Disease: High blood sugar can damage blood vessels and the nerves that control your heart. This increases the risk of heart disease and stroke.
• Kidney Damage: Over time, high glucose levels can damage the kidneys, leading to chronic kidney disease or even kidney failure.
• Vision Problems: High blood sugar can harm the blood vessels in your eyes, leading to diabetic retinopathy, which can cause blindness if not treated.
• Nerve Damage: Known as neuropathy, this can cause pain, tingling, or loss of feeling in the hands and feet. Severe nerve damage can lead to more serious complications, such as infections or even amputations.
• Poor Healing: High blood sugar can impair the body’s ability to heal wounds, making infections and ulcers more likely.

What to Do If Your Blood Sugar Levels Are High

If your CMP-14 results show elevated blood sugar levels, don’t panic. There are several steps you can take to manage and reduce your blood sugar:

1. Dietary Changes: Focus on a balanced diet rich in fiber, lean proteins, and healthy fats while limiting refined sugars, too much fruit and carbs.
2. Regular Exercise: Physical activity helps your body use insulin more efficiently, which can lower blood sugar levels.
3. Weight Management: Achieving and maintaining a healthy weight can significantly improve blood sugar control.
4. Regular Monitoring: Keeping track of your blood sugar levels over time lets you know when to take action and focus on eating better. Healthcare providers might be looking at your current results without comparing them to your results creeping up over time. This is why watching your lab numbers' historical changes can be preventative.  
5. Work with a Functional Nutritionist: Getting help to lower your sugar and dependence on carbs, will help your blood sugar levels. Having a plan to lower your blood sugar with a supplement and changes in your eating behaviors can give you quick results.

Blood Sugar Levels and Fatty Liver Disease on Lab Tests

What Is Fatty Liver Disease?

Fatty liver disease occurs when excess fat builds up in the liver. It can be categorized into two types:

• Non-Alcoholic Fatty Liver Disease (NAFLD): Fat accumulation not related to alcohol consumption.
• Alcoholic Fatty Liver Disease: Fat accumulation due to excessive alcohol intake.

If left untreated, fatty liver disease can progress to more severe conditions such as non-alcoholic steatohepatitis (NASH), cirrhosis, or liver failure.

Understanding the CMP-14 and Liver Enzymes

The Comprehensive Metabolic Panel (CMP-14) is a blood test that provides information about your overall metabolic health, including kidney and liver function. As we discussed it does include your fasting blood sugar. It also includes markers relevant to liver health:

• Alanine Aminotransferase (ALT): An enzyme found in the liver that helps convert proteins into energy for the liver cells. Elevated levels can indicate liver damage.
• Aspartate Aminotransferase (AST): Another enzyme found in the liver and other tissues such as the heart and muscles. High levels can indicate liver damage or disease.
• Alkaline Phosphatase (ALP): An enzyme related to bile ducts; often increased when they are blocked or inflamed.
• Bilirubin: A substance produced during the normal breakdown of red blood cells. Elevated levels can indicate liver or bile duct problems.
• Total Protein and Albumin: Levels can reflect liver function, as the liver produces many essential proteins.

Can a CMP-14 Diagnose Fatty Liver Disease?

While the CMP-14 can provide valuable clues about liver health, it is not sufficient to diagnose fatty liver disease. Here’s why:

1. Detection of Liver Damage: Elevated levels of ALT and AST in the CMP-14 can indicate liver damage, which is common in fatty liver disease. However, these markers are not specific to fatty liver and can be elevated due to other liver conditions or even muscle injury, a GGT should be considered,
2. Indirect Indications: The CMP-14 can suggest the presence of liver dysfunction or inflammation through elevated ALP and bilirubin levels, but these too are not specific to fatty liver disease.
3. Absence of Direct Imaging: A definitive diagnosis of fatty liver disease typically requires imaging studies such as an ultrasound, CT scan, or MRI, which can visualize fat accumulation in the liver.
4. Liver Biopsy: In some cases, a liver biopsy might be necessary to confirm the diagnosis and determine the extent of liver damage or inflammation.

How Do I Get My Labs Interpreted Nutritionally?

Chances are you've had these blood tests, a CMP-14, and a CBC, completed within the last year. While CMP-14 and CBC tests are the most frequently ordered blood tests they are also invaluable. If you want to look at your health preventatively and use targeted supplementation, consider having Dr. Plank evaluate and interpret your blood testing.

Please keep in mind these tests don’t cover everything. Many important nutritional markers, such as CRP, Vitamin D, B12, and ferritin, are not included. Overlooking these can leave gaps in your health assessment and nutritional foundation.

As a Functional Nutritionist, I believe in a comprehensive whole-body approach to health. This is possible when the correct blood work is ordered and interpreted.

Are you ready to get insights into your blood sugar and liver health? Schedule a free Best Next Step consultation call with me, Dr. Susan Plank, and let’s explore how we can personalize your health journey and find those missing pieces.