Decode Your Labs: Mastering the Complete Metabolic Panel (CMP) for Better Health

Have you ever received your lab results and thought, What do all these numbers mean for my health? In this episode of Metabolic Minutes, Nurse Practitioner Elizabeth breaks down the key components of the Complete Metabolic Panel (CMP) in simple, actionable terms. Learn how kidney health, liver function, and electrolytes play critical roles in reversing metabolic conditions like prediabetes, diabetes, and obesity.

From understanding GFR to optimizing magnesium levels, this episode equips you with the knowledge to take charge of your metabolic health and make informed decisions. Join us to uncover the science behind your labs—and how to improve them with everyday lifestyle changes.

What You'll Learn:

• How to interpret kidney markers like BUN, creatinine, and GFR.
• The impact of hydration and insulin resistance on kidney function.
• Why electrolytes like magnesium and bicarbonate are vital for overall health.
• The role of liver enzymes in preventing fatty liver disease.
• Practical meal tips to support your metabolism and improve fasting glucose levels.

Key Topics Discussed:

1. Kidney Health:
   • Understanding BUN, creatinine, and GFR levels.
2. Electrolyte Balance:
   • The importance of sodium, potassium, magnesium, and bicarbonate for optimal body function.
   • Natural food sources for magnesium and when supplementation may be necessary.
3. Liver Function:
   • How liver enzymes (AST, ALT, ALP) indicate liver health.
   • The connection between insulin resistance and fatty liver disease.
4. Practical Tips for Better Labs:
   • Why carb-heavy dinners sabotage your metabolism and fasting glucose.
   • Simple strategies to help your liver work effectively overnight.
5. Protein and Blood Health:
   • What protein ratios reveal about spleen function and overall hydration.

Show Resources:

• Recommended Foods:
  • Leafy greens (spinach, kale), nuts (almonds, cashews), and seeds (chia, flax) for magnesium.
• Key Quotes:
  • "Take care of your kidneys like they your two little babies.”
  • "Your liver is the maid and butler of your body—don’t overload it before bedtime."

Conclusion:

Understanding your lab results is the first step toward taking control of your metabolic health. By making small, intentional changes—like staying hydrated, eating the right foods, and timing your meals wisely—you can support your kidneys, liver, and overall metabolic function.

Don’t forget to tune in to the next episode, where we’ll decode lipids, thyroid markers, and inflammation. Until then, hydrate with water, shop the grocery store perimeter, and give your metabolism the support it deserves! YE5uw136Wdom7YL78J5j

Transcript

[00:00:00] Introduction: Understanding Your Lab Results
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Elizabeth, NP: Who has ever gotten the email from their PCP, and it says,

Dr. Office: We've gotten your labs back. Your GFR is down and your BUN and creatinine are elevated. The doctor has sent a prescription to your pharmacy and would like to follow up with you in eight weeks to recheck. Have a great day.

Elizabeth, NP: And we're left scratching our head, wondering exactly what am I supposed to do with this information?

What does it all mean? So, on today's episode, we're going to be doing part two of our lab series and understanding how we have an influence over what those lab values are.


[00:00:40] Welcome to Metabolic Minutes
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Voice-Over: Welcome to Metabolic Minutes, the show where veteran nurse practitioner Elizabeth is going to break down all the sciencey stuff about how to reverse metabolic syndromes like obesity, prediabetes, and type 2 diabetes, all without needing a biology degree or a nap.

Ain't nobody got time for that. Just quick tips to help you build your battle plan to repair your broken metabolism. Let's crush this.


[00:01:06] Kidney Analysis: BUN, Creatinine, and GFR
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Elizabeth, NP: Today, I'm going to start with a very familiar lab panel that you've probably all heard of from your annual PCP visits, and it's called the Complete Metabolic Profile, nicknamed CMP by us medical professionals.

So the CMP usually starts out with a kidney. analysis, and it starts with the blood urea nitrogen, the creatinine, and the GFR, a. k. a. glomerular filtration rate. Say that three times fast. So the blood urea nitrogen is a laboratory test that measures the amount of urea nitrogen in your blood. I know that's a bunch of gobbledygook, but in essence, it's a waste product formed in the liver.

And it's formed when your body breaks down proteins. So it is important to understand that protein metabolism can be affected by hydration, liver function, kidney function, and it's also influenced by some of the medications you're taking. The blood area nitrogen, we want to be normal so that it indicates how well hydrated you are and that we get a picture of what's happening in your body with the diet that you're on and the medications you're taking.

The next component of this kidney analysis is the creatinine. Creatinine is a waste product and it's produced by the breakdown of creatine, which you've probably heard if you knew anybody that ever lifted weights and took a creatine supplement. It's a compound we get from food that helps supply energy to muscles. It's filtered out by the blood and it is excreted by the kidneys in the urine.

So, we measure creatinine levels as a key indicator of kidney function. If it's elevated, also if BUN is elevated, it indicates impairment. All right? So, these two influence this next item which we pronounced earlier, glomerular filtration rate, or GFR. And this is the take home message that I want you to hear now.

The GFR is the filtration rate on the kidney. However, I want you to think of it just like a filter, okay? So if your filter is clogged or gunky, it cannot filter as many waste products and therefore they build up in your blood. So we want, as a general rule, no matter who you are, what your ethnicity is, we want your GFR to be high, meaning we want to filter a lot.

If it starts to go down, one of the things I'm always thinking about is how hydrated are you? Are you drinking water? Okay. Another thing that influences it that I'm convinced of is all these zero and diet drinks. If they contain phenylketonuria's, phenylalanine, aspartame, avoid them. They're bad for your kidneys.

The GFR will go down in people with insulin resistance and the more severe their diabetes gets because that filter is getting gunky from blood sludge. The blood sludge occurred when the insulin resistance started because those muscle cells- remember to our first part of the lab series- would not bring in that glucose into the cell to metabolize it. It left it out in the bloodstream and your kidneys-they're miraculous, and they try really hard to help your body get it out of the bloodstream.

But over time, as they're trying to filter all this blood sludge, and maybe you're also not drinking enough water, they're getting sticky and icky and they cannot filter out what they need to. So, one of the things that I want you to take away from this is when you have insulin resistance, you are starting to have multi organ repercussions and one of those organs that is affected is the kidneys.

So you better take care of them like they are your two little babies. You need to hydrate well, you need to mind your sugar levels, and make sure that your filter on your kidney is not getting clogged. Alright, let's move on.


[00:05:35] Electrolytes and Their Importance
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Elizabeth, NP: The other thing in the complete metabolic profile that we always look at is your electrolytes.

We want your sodium, potassium, chloride, magnesium, calcium, and bicarb to be within normal ranges on your metabolic profile. This helps you function optimally. And keeps you in equilibrium. When any of these are out of whack, you can have serious repercussions depending on how out of whack they are, whether they're too low or too high.

And when I mean serious, it can cause cardiac effects, kidney effects, and um, sometimes can even lead to hospitalization. Luckily, when you are fairly well controlled with your metabolic disorder, these will be in within normal range. But it's always monitored for that reason.


[00:06:19] Magnesium: The Vital Mineral
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Elizabeth, NP: Magnesium plays A vital role in a lot of our metabolic processes.

It can affect mental health, energy production, cardiovascular health. It's crucial for the production of what you may have remembered in your 8th grade biology class, ATP. Which is the body's main energy molecule that you find in the mitochondria. It helps convert food into energy, making it essential for combating fatigue.

It helps with your bones. So it can prevent osteoporosis when in the right amounts. I really prefer people to get their magnesium from natural sources. The best sources for magnesium are going to be like leafy green vegetables, spinach, kale, Swiss chard, collard greens. Nuts and seeds are my favorite place to get them.

And that would look like almonds, cashews, walnuts, peanuts, pumpkin seeds, flax seeds, chia seeds. If you are a picky eater and tend to have a very narrow diet, that was, that would be when we often recommend supplementation. It can also help with smooth muscle relaxation and can help with some of the sleep disorders.

But you do need to speak to your PCP and make sure that they know what your magnesium level is before you're on it. Now, one of the other.


[00:07:48] Bicarbonate and Insulin Resistance
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Elizabeth, NP: Components of the electrolytes that I like to point out too is what we call bicarbonate and sometimes when you look on the lab, it'll say CO2. So one thing to understand when you have insulin resistance and you develop diabetes, so you have all that sugar kind of backing up in the bloodstream, it becomes acidic and your body does not like acid.

It's very caustic to your cells. everything starts to inflame. So bicarb levels, depending on the metabolic disorder, can sometimes be out of whack when it's severe. Most of the time, it's not. You're going to feel it if it's off. And some people lay, just live in the borderline area. But it's something to be aware of.


[00:08:28] Liver Enzymes and Their Role
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Elizabeth, NP: The other Part of the complete metabolic panel that I really want you to take home and think about today is the liver enzymes. AST, ALT, and ALP are part of the liver enzyme panel in this comprehensive metabolic panel and they are telling us how well your liver is working based on these specific enzymes.

So the first enzyme is going to be ALP. Aspartate aminotransferase. Don't worry, I'm not going to quiz you on that. That is really helping the liver, heart, muscles, and other tissue metabolize amino acids. The ALT is alanine aminotransferase, we're having all kinds of fun words today that you can't say three times fast, I double dare you.

So these, the ALT, they can indicate liver damage and inflammation from especially fatty liver disease or alcohol related liver damage. And. When they're damaged, you have an issue converting proteins and energy for liver cells.


[00:09:37] Fatty Liver Disease and Its Implications
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Elizabeth, NP: So what I want you to think about if you have insulin resistance, so you have a problem with weight, you're pre diabetic, or you have diabetes, is you are at risk for developing fatty liver disease.

Well, why is that? Because remember all the blood sugar. That's hence the name staying in the blood and it won't go into the muscle cells to be metabolized. When it's hanging out in the blood and causing blood sludge, you have other factors that are coming in that are saying, Hey, this is a traffic jam in the blood cells.

We don't want this person to, you know, have a heart attack. Let's get it out of the way. Let's pack it up and move it somewhere else. Well, guess where it goes first. It goes to the liver, and so the liver tries very hard to pack all this unneeded, unused energy from glucose. It hoards it around the liver, creating a fatty liver.

It impairs the liver's functions, one being lipid metabolism, so lipids is fat, excess liver fat interferes with the liver's ability to process and store fats properly. This will cause your triglycerides, which we'll talk about in another episode, to increase in the blood. The other thing it impairs is glucose metabolism.

The liver regulates glucose storage. and the release of glucose when you need it. The fat accumulation impairs that process and it contributes to all of this insulin resistance and type 2 diabetes. When the liver is encased in fat, it also prevents you from detoxing from all of those metabolites I mentioned earlier, the blood urea, nitrogens, things like that.

It also affects your protein synthesis. Your liver synthesizes essential proteins that we talked about in the very first episode. And when you have a fatty liver, it impairs these processes. When you have a fatty liver, it can also impair your bile production. You've heard of bile. It's what digests your fats and helps you absorb all those important fat soluble vitamins like vitamin A, D, E, E and K.

And when you have excess fat, it can ultimately result in those nutrient deficiencies. And finally, It affects inflammation when you have excess liver fat, it causes something called oxidative stress, and this can lead to cirrhosis. So this is another important thing to understand of when you are trying to heal your body with good food or good fuel, you are preventing.

this accumulation of fat infiltrating your liver and causing all these domino effects.


[00:12:42] The Liver: Your Body's Maid and Butler
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Elizabeth, NP: The way I want you to think about your liver is pretend it is the maid and butler of your body. Wouldn't that be nice for all of us to have a maid and a butler? Well, guess what you do in your body? So one of the really interesting things that happen Is when the sun goes down, you have hormones that basically turn on and they make you sleepy and they also prompt your liver to start cleaning the house and getting rid of hoarding.

If you have too much weight, you're pre diabetic or diabetic, you've kind of turned into a hoarder inside. And you need an intervention, and your liver is there trying to do that. So if you have hoarded too much, and your house and your liver is stored in fat, then it cannot do the job of the butler and maid at night, which is get rid of unused energy stores.

If you are ever feeling overwhelmed on where to start with your nutritional plan for life, your lifestyle changes, one of the best places to start is dinner. And the reason that is, is because if you pile on a carb heavy meal, say a casserole, your pizza, your pasta. What that is doing is it is like the hour before the maid and the butler show up to do their job and you let your kids run through the house and dump Legos all over the floor and throw their dirty laundry everywhere.

Take a deep breath. Can you tell what stage of life I'm in? And they arrive to do some deep cleaning and they go, Oh, good grief. We are never going to get to the details and put a dent in all this hoarding in the amount of time we have while they're asleep. Okay. This isn't going to happen. And guess what?

You might notice that in the morning, you have a higher fasting glucose, which I covered in the first lab episode. So that is why it's imperative to let your liver do the work at night that it needs to. Do not challenge it all day and especially at dinner with all these unneeded Carbohydrates.

Carbohydrates are generally needed before you're going to do the bulk of your activity. They're not needed before you go and take a nap. So I want you to really ponder that and think about that, because if you hear one thing I say today, that is, a really good nugget of information. The other thing we monitor in the comprehensive metabolic panel is going to be your, uh, bilirubin protein albumin globulins.

Basically, what we're looking at with these is your protein ratios, how well your spleen is working, how well your blood vessels, Can keep the fluid inside. Most peoples are pretty decent unless they are really, really not getting enough protein or they're too sedentary. Um, you'll notice that these definitely get out of whack.


[00:15:55] Conclusion and Next Episode Preview
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Elizabeth, NP: Okay, class. I think that was enough for today. Hopefully you got through your morning coffee. Or you got to work and you can move on with your day without a cliffhanger. On the next episode, we will cover the last part of the most common labs and I'll go over lipids, your thyroid and inflammatory markers.

Until next time, hydrate with water and stay on that perimeter when you're shopping in the grocery store. 

Voice-Over: The information provided in this podcast is not a substitute for professional medical advice or treatment. Always seek the advice of your qualified health care provider with any questions you may have regarding a medical condition.

Never disregard professional medical advice or delay seeking it because of something you have heard on this podcast. The opinions shared are our own and may not reflect the views of your health care provider.