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When it comes to assessing your health and diagnosing potential illnesses, blood tests play a crucial role. Two of the most ordered blood tests are the basic metabolic panel 8 and the comprehensive metabolic panel 14. While they may sound similar, these tests have key differences and similarities. In this CMP vs. BMP labs article, we will explore how these tests differ and help you understand which is more appropriate for you.
The Basic Metabolic Panel (BMP) and Comprehensive Metabolic Panel (CMP) are common blood tests that measure different substances in your blood, providing insights into your body’s metabolism, chemical balance, and the function of various organs.
Both panels typically assess key elements like:
While they share these core components, the CMP expands significantly on the BMP by including additional tests primarily focused on liver function and protein levels.
The key additions in a CMP are:
Because the BMP lacks these specific liver markers and protein tests, the CMP offers a more thorough evaluation of liver health and can also provide clues about your nutritional status. Therefore, while both tests are valuable, the CMP provides a broader snapshot of your overall metabolic health, particularly concerning the liver.
The basic metabolic panel (BMP) is a blood test commonly ordered as part of a routine checkup or when symptoms of metabolic disorders are observed. A BMP test can help diagnose conditions such as diabetes, kidney disease, liver disease, and electrolyte imbalances. The test is useful for monitoring the efficacy of medications and treatments and managing chronic conditions.
Eight substances were screened through a BMP blood test. All of which provide clarity about your health, specifically your metabolism and vital organ functions.
The blood glucose level can provide insights into your risk of developing diabetes or if you already have diabetes. A blood glucose test is also instrumental in monitoring treatment.
Significantly high levels (hyperglycemia) or low levels (hypoglycemia) detected during this test can indicate various metabolic issues requiring further evaluation. Within the BMP, this glucose value complements the kidney function and electrolyte results to provide a clearer picture of your current metabolic status.
BUN is a waste product from protein metabolism. Increased BUN can indicate kidney and urinary tract issues as well as dehydration.
Doctors typically evaluate BUN in conjunction with creatinine, another kidney marker included in the BMP, to better assess overall kidney function. Although less common, significantly low BUN levels might point towards severe liver disease or malnutrition.
Another waste product, creatinine, is produced by the muscles and filtered in the kidneys. Therefore, high creatinine levels can be linked to kidney problems.
Measuring creatinine is a standard component of the BMP, providing essential data on kidney filtration. Doctors use this specific BMP result to help assess how well your kidneys perform their vital waste-removal functions.
As one of the essential electrolytes in the body, sodium helps keep the balance of fluids in the cells, the circulation of nutrients in the blood vessels, and maintains the efficient functions of organs. When sodium levels are not within the normal range, it may suggest issues in blood pressure and fluid retention, among others.
The BMP directly measures sodium concentration in your blood, offering key insights into your body’s fluid balance. Detecting abnormal sodium levels through this test can be vital for diagnosing or monitoring conditions ranging from dehydration and kidney dysfunction to the effects of certain medications.
Like sodium, potassium is another type of electrolyte that contributes to vital functions in the body, such as fluid balance, nerve impulse transmission, muscle contraction, blood pressure control, and protein metabolism. An imbalance in potassium can signal critical health issues. For example, low potassium or hypokalemia can lead to arrhythmia, fatigue, muscle weakness, and digestive distress.
On the other hand, high potassium levels, known as hyperkalemia, can also pose significant health risks. Hyperkalemia can potentially lead to dangerous heart rhythms, muscle fatigue, or paralysis.
Chloride joins the other electrolytes in maintaining nerve and muscle functions. It provides insights into your hydration, salt consumption, and underlying conditions like kidney disease. Chloride imbalance is also detected through a chloride blood test and can be managed or lowered through natural ways and medical treatment.
Chloride levels often fluctuate with sodium levels, as both are vital for regulating the body’s fluid balance and maintaining proper cellular hydration. Furthermore, chloride plays a key role in maintaining the body’s acid-base balance, often shifting in response to changes in bicarbonate levels, which are also measured in the BMP. Thus, interpreting a chloride result requires careful consideration alongside other BMP components to understand the complete clinical picture.
Another electrolyte, calcium, can paint a picture of your parathyroid health, vitamin D intake, kidney disease, etc. The body tightly regulates calcium levels, primarily through the interplay of parathyroid hormone and vitamin D, which affects absorption from the diet and release from bones.
Abnormal calcium levels(1) detected in a BMP can therefore signal underlying issues ranging from bone diseases and certain cancers to malnutrition or problems with hormonal regulation. Interpreting calcium results often involves considering other BMP components, especially kidney function markers like BUN and creatinine, as kidney disease significantly impacts calcium balance.
Significantly high (hypercalcemia) or low (hypocalcemia) levels can cause noticeable symptoms. Therefore, calcium measurement is a key part of evaluating overall metabolic health.
Carbon dioxide is the waste product that the cell produces during cellular respiration. Abnormal CO2 levels may indicate an issue with your lung function.
In the context of a BMP, this value typically measures total carbon dioxide, which primarily exists as bicarbonate in the blood(2). Bicarbonate helps maintain the body’s proper acid-base (pH) balance. Therefore, irregularities can suggest kidney problems or other conditions affecting this delicate pH equilibrium. Assessing CO2 alongside other electrolytes in the BMP helps clinicians get a clearer picture of the overall metabolic status.
You can order the basic metabolic panel 8 (BMP) blood test online. Simply locate a partner laboratory near you to have your blood sample collected and analyzed.
Known as a comprehensive metabolic panel, a CMP 14 blood test provides valuable information about an individual’s overall health and organ function. The test consists of 14 different blood tests that assess different aspects of the body’s metabolism. Healthcare professionals use it to evaluate organ function, monitor conditions, and screen for health problems.
The comprehensive metabolic panel 14 (CMP) blood tests cover all eight substances screened in the BMP test. But it’s different because it has six additional tests for liver enzymes.
Albumin is a type of protein secreted from the liver. If the blood test shows abnormal albumin levels, it can be linked to issues involving the liver or kidneys. This vital protein helps keep fluid within your bloodstream and prevents it from leaking into other tissues. It also functions as a carrier, transporting hormones, vitamins, and enzymes throughout your body.
Significantly low albumin might point towards liver damage (like cirrhosis), kidney disease (such as nephrotic syndrome where protein is lost in urine), malnutrition, or severe inflammation. Meanwhile, high albumin levels are less frequent but often suggest dehydration rather than a specific organ disease.
Bilirubin is produced when red blood cells (RBCs) break down. It is metabolized by the liver, excreted in bile, and eliminated through the digestive system. Elevated bilirubin in the blood is a red flag for potential liver or biliary disease.
A noticeable sign of significantly high bilirubin levels(3) is jaundice, which causes a characteristic yellowing of the skin and the whites of the eyes. The CMP typically measures the total amount of bilirubin circulating in the bloodstream. This measurement helps doctors assess how effectively the liver is processing waste and can point towards conditions like hepatitis, cirrhosis, or gallstones obstructing bile flow. Its inclusion in the CMP makes it a valuable part of screening for and monitoring hepatobiliary disorders.
This test checks for two key proteins together in the blood. One is albumin, and your liver produces it. The other is called globulin, a group of proteins that fight infections. It can help diagnose conditions affecting the liver, kidneys, and blood plasma.
Often, laboratories report these values along with a calculated globulin level(4) (Total Protein minus Albumin) and an Albumin/Globulin (A/G) ratio. This A/G ratio provides further insight, as certain diseases characteristically alter the balance between these protein types. For instance, low albumin might indicate poor nutrition or liver disease, while high globulin could suggest inflammation or certain immune disorders.
ALP is an enzyme found in different organs like the liver, kidneys, bones, and placenta in pregnant women. Its level is tested to help diagnose liver and bone disorders. Elevated levels detected in a CMP often indicate potential liver damage or blockage of bile ducts, as the enzyme leaks into the blood when these tissues are affected. However, increased bone cell activity(5), such as during fracture healing, periods of rapid growth, or in certain bone diseases, can also cause ALP levels to rise.
Interpreting the ALP result typically involves assessing it alongside other liver function tests included in the CMP, like bilirubin, ALT, and AST. This comparison helps clinicians differentiate whether an elevated ALP points towards a liver condition or suggests investigating potential bone disorders.
ALT is a liver enzyme that breaks down food for energy. The ALT blood test measures its level in the blood, which can indicate liver damage or other conditions.
Normally, ALT concentrations within the bloodstream are low, as the enzyme is primarily active inside liver cells (hepatocytes). When these liver cells become damaged or inflamed due to injury or disease, they release more ALT into the circulation.
Consequently, elevated ALT levels detected during the test are often an early indicator of potential liver damage or stress. Its relative specificity to the liver makes the ALT measurement a key component of the CMP for assessing liver health.
AST is an enzyme found in many tissues throughout the body, but it’s most concentrated in the liver, heart, and skeletal muscle. It is one of the substances measured to assess liver function. Elevated levels of AST in the blood may indicate liver damage or disease, such as hepatitis, cirrhosis, or liver cancer.
Doctors often analyze AST levels alongside ALT for a more accurate picture of liver health. The specific ratio between AST and ALT can sometimes help differentiate between various liver conditions. Because AST is also present in muscle and heart tissues, damage to these areas can also lead to increased levels in the blood. Interpreting AST results requires considering the entire CMP panel and the patient’s overall health context, not just this single value in isolation.
Your doctor may ask you to order a CMP 14 blood test online instead of the BMP test if there’s a need to assess your liver health and other body functions, in which additional tests are necessary. This could be due to your symptoms, your medical history, or a family history of liver disease.
A CMP is generally recommended by doctors over a BMP when a more extensive evaluation of a patient’s metabolic status and organ function is required. This often occurs during routine health check-ups for a broader screening, especially if assessing liver health is desired, as the CMP includes specific liver enzymes (ALT, AST, ALP) and bilirubin, which the BMP lacks.
Doctors also favor a CMP vs. BMP when investigating symptoms potentially related to liver disease, monitoring patients with known liver conditions, assessing nutritional status through protein levels, or evaluating patients taking medications that could affect the liver. If there’s a need to look beyond basic electrolytes, kidney function, and glucose to include liver function and protein levels, the CMP becomes the more appropriate choice.
A CMP blood test differs from a CBC or complete blood count in that a CMP screens for substances indicative of metabolic disorders or problems related to organ dysfunction, while a CBC assesses blood cells to help diagnose and monitor infections, blood disorders, and problems related to immunity. Both lab tests, however, provide an overview of your general health.
Yes, you will be asked to fast for 12 hours before the blood sample collection to ensure that the results are accurate. Make sure not to consume anything except for water during the said timeframe as part of your preparation before the blood test.
People undergoing a routine checkup typically need a BMP blood test. Healthcare providers also request this test to assess your metabolism, especially if you’re being treated in the emergency room. If you show symptoms related to metabolic disorders, you’ll likely need the BMP test as well for proper diagnosis and monitoring when the condition is confirmed.
Individuals who wish to better control their health should consider taking the BMP 8 blood test or the CMP 14 test for healthcare providers to understand their health status. While the BMP test is the standard test for routine checkups, your doctor may recommend the CMP test based on your previous or current health profile. If you’re still torn between a comprehensive metabolic panel vs. a basic metabolic panel test, consult your doctor to help you decide.
1 Cheng, L., Lian, J., Ding, Y., Wang, X., Mujtaba Munir, M. A., Ullah, S., Wang, E., He, Z., & Yang, X. (2024). Calcium deficiency and its implications for cardiovascular disease and cancer: Strategies for resolution via agronomic fortification. Food Science & Nutrition, 12(11), 8594-8607. https://doi.org/10.1002/fsn3.4464
2 Kim, A., Yamaguchi, L., Keswani, S., Yang, V., & McWhorter, Y. (2023). Correlation Between Serum and Arterial Blood Gas Bicarbonate in Patients Admitted to the Intensive Care Unit. Cureus, 15(4), e37703. https://doi.org/10.7759/cureus.37703
3 Vitek, L., Stec, D. E., & Tiribelli, C. (2023). The physiology of bilirubin: Health and disease equilibrium. Trends in Molecular Medicine, 29(4), 315. https://doi.org/10.1016/j.molmed.2023.01.007
4 O’Brien A, Bransfield A, O’Halloran F, Mykytiv V. Calculated Globulin as a potential screening tool for paraproteinemia to aid in the early diagnosis of Multiple Myeloma. Clin Biochem. 2023 Jun;116:113-119. doi: 10.1016/j.clinbiochem.2023.04.008. Epub 2023 Apr 27. PMID: 37119921.
5 Kim, T., Park, S. Y., Shin, J. H., Lee, S., Joo, K. B., & Koo, B. S. (2023). Association between changes in serum alkaline phosphatase levels and radiographic progression in ankylosing spondylitis. Scientific Reports, 13(1), 1-8. https://doi.org/10.1038/s41598-023-36340-9
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