Lab result explainedMetabolic panelLast updated November 8, 2026

Anion gap: how it is calculated and what a high or low anion gap means

Anion gap (AG) · Basic or comprehensive metabolic panel (calculated) · reported in mEq/L (identical to mmol/L for these ions)

The anion gap is not something the lab measures directly. It is a number calculated from three results on your metabolic panel, sodium, chloride and bicarbonate (CO2), using the formula anion gap = sodium − (chloride + bicarbonate). It estimates the acids and other negatively charged particles in your blood that the panel does not measure, and its main job is to tell clinicians whether an acid is building up in the body. On most modern analyzers a normal anion gap is roughly 3 to 12 mEq/L; labs that include potassium in the formula quote about 12 to 16 mEq/L.

A high anion gap matters most when bicarbonate is also low, because that combination, called high anion gap metabolic acidosis, means an acid is accumulating: lactic acid in shock or sepsis, ketoacids in uncontrolled diabetes or starvation, retained acids in kidney failure, or a poison such as methanol or antifreeze. A high anion gap with normal bicarbonate and no symptoms is usually a minor finding, often from mild dehydration, a ketogenic diet, a hard workout or simply the lab's chemistry.

A low anion gap is far less common and is almost always explained by low albumin, since albumin carries most of the negative charge the gap represents. Because of this, when albumin is low the gap is corrected upward (about 2.5 mEq/L for every 1 g/dL that albumin is below 4.0) before deciding whether an acid is present. Very low or negative values occasionally point to a paraprotein in multiple myeloma or to lab interference, and are repeated before anything is concluded.

AG at a glance

What it is: a calculated value, sodium − (chloride + bicarbonate), that estimates unmeasured acids and negatively charged proteins in blood.
Normal: about 3–12 mEq/L on modern analyzers (older ranges 8–16); 10–20 mEq/L (often quoted 12–16) if potassium is added to the sodium. Use your lab's printed range.
Corrected anion gap: add 2.5 mEq/L for every 1 g/dL that albumin is below 4.0 g/dL; a gap of 10 with an albumin of 2.0 corrects to 15.
High with low bicarbonate = high anion gap metabolic acidosis: lactic acidosis, ketoacidosis, kidney failure or a toxic ingestion. Above 20 almost always means acidosis; above 30 is severe.
Low (under about 3) is usually low albumin; rarely multiple myeloma, lithium, bromide or a lab error.
Next step: read with bicarbonate, glucose, creatinine, lactate and ketones; a high gap with symptoms (fast deep breathing, vomiting, confusion) needs same-day assessment.

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What AG measures

Blood is electrically neutral: the positive ions (cations) and negative ions (anions) balance exactly. A metabolic panel measures the main cation, sodium, and the two main anions, chloride and bicarbonate, but not the smaller anions such as albumin, phosphate, sulfate, lactate, ketoacids and other organic acids. Subtracting the measured anions from sodium leaves a gap that represents those unmeasured anions. In health, most of the gap is albumin (about 2.5 mEq/L per g/dL) with a smaller contribution from phosphate.

When an acid enters the blood, it is buffered by bicarbonate, so bicarbonate falls, and the acid's anion (lactate, beta-hydroxybutyrate, formate, glycolate, sulfate) takes its place as an unmeasured anion. Bicarbonate goes down, the gap goes up by the same amount, and sodium and chloride barely move. That is why a high anion gap with low bicarbonate is such a specific signal of acid accumulation. If instead bicarbonate is lost from the body (diarrhoea, renal tubular acidosis) or diluted with saline, chloride rises to fill the space and the gap stays normal: a normal anion gap, or hyperchloremic, acidosis.

Two formulas are in use. Most US labs and most clinical guidance use sodium − (chloride + bicarbonate), without potassium, because potassium is small and tightly controlled. Some labs and UK and European practice add potassium: (sodium + potassium) − (chloride + bicarbonate), which gives a value about 4 mEq/L higher. The reference range also depends on the analyzer: older flame-photometry methods gave a normal gap of 8 to 16, while modern ion-selective electrodes read chloride higher and give a normal gap of roughly 3 to 12 (mean about 6), which is why ranges vary so much between labs. The gap is reported in mEq/L, which is the same as mmol/L for these ions.

Normal range for AG

Reference ranges vary between labs and by age, sex and pregnancy. Use the range printed on your own report.

Group	Typical range (mEq/L (identical to mmol/L for these ions))	Notes
Normal, formula without potassium: Na − (Cl + HCO3)	About 3–12 mEq/L	Modern ion-selective-electrode analyzers; older methods quoted 8–16. Mayo Clinic uses 7–15. Labs differ; use the printed range.
Normal, formula with potassium: (Na + K) − (Cl + HCO3)	About 10–20 mEq/L (often quoted 12–16)	Roughly 4 mEq/L higher than the version without potassium. Check which formula your lab used before comparing.
Corrected anion gap for low albumin	Observed gap + 2.5 × (4.0 − albumin in g/dL)	Albumin provides most of the normal gap; an albumin of 2.0 g/dL hides about 5 mEq/L of gap. Used in hospital and intensive care.
Mildly raised	Upper limit to about 20 mEq/L	Mild dehydration, ketogenic diet, recent intense exercise, early kidney disease, metabolic alkalosis, or acidosis in its early stages. Interpret with bicarbonate.
High anion gap metabolic acidosis	Above about 12–16 mEq/L with bicarbonate below 22 mEq/L	Lactic acidosis, ketoacidosis, kidney failure or toxic ingestion until proven otherwise. Above 20 is almost always a true acidosis.
Severely raised	Above 30 mEq/L	Usually lactic acidosis in shock, severe diabetic ketoacidosis, methanol or ethylene glycol poisoning. A medical emergency.
Low	Below about 3 mEq/L (below 6–8 on older ranges)	Low albumin is the usual reason; rarely multiple myeloma, lithium, bromide or iodide, or very high calcium or magnesium.
Negative	Below 0 mEq/L	Almost always a lab error or bromide interference with the chloride measurement; the panel is repeated.

High anion gap

A high anion gap means there are more unmeasured negatively charged particles in your blood than usual. The first thing a clinician checks is bicarbonate. If bicarbonate is low (under about 22 mEq/L), you have a high anion gap metabolic acidosis, and the gap is being filled by an acid: lactate from poor oxygen delivery or sepsis, ketoacids from uncontrolled diabetes, alcohol binges or starvation, sulfate and phosphate retained in kidney failure, or the breakdown products of methanol, ethylene glycol, aspirin or certain medications. The mnemonic GOLD MARK (glycols, oxoproline, L-lactate, D-lactate, methanol, aspirin, renal failure, ketoacidosis) covers nearly every cause.

The size of the gap tracks the severity. A gap of 13 to 20 with slightly low bicarbonate is common in early kidney disease, mild dehydration or mild ketosis. A gap above 20 nearly always represents a genuine acid load, and above 30 the cause is usually lactic acidosis, severe ketoacidosis or a toxic alcohol. Clinicians also calculate the delta ratio, (anion gap − 12) ÷ (24 − bicarbonate): a ratio between about 0.8 and 2 means a pure high-gap acidosis, below 0.8 suggests a mixed picture with bicarbonate loss, and above 2 suggests a coexisting metabolic alkalosis or chronic lung disease.

If bicarbonate is normal, a modestly high gap is usually unimportant. Metabolic alkalosis (for example after vomiting or diuretics) raises the gap by a few points because albumin becomes more negatively charged and lactate rises slightly; a hard workout raises lactate for an hour or two; a ketogenic diet adds 2 to 4 mEq/L of ketoacids; and some analyzers simply run high. A gap of 13 or 14 on a routine panel in someone who feels well, with normal bicarbonate, glucose and creatinine, is not a finding that needs further work beyond perhaps a repeat.

Common causes

Lactic acidosis
The most common cause of a very high gap in hospital. Shock, sepsis, severe heart failure, major bleeding, cardiac arrest, seizures and bowel ischemia drive lactate above 4 mmol/L (type A); liver failure, metformin accumulation in kidney failure, some HIV drugs, thiamine deficiency and cancers cause it without obvious low oxygen (type B).
Diabetic ketoacidosis
Insulin deficiency makes the liver produce beta-hydroxybutyrate and acetoacetate; the gap is typically 20 to 35 with glucose over 250 mg/dL, bicarbonate under 18 and pH under 7.3. SGLT2 inhibitor drugs can cause ketoacidosis with near-normal glucose (euglycemic DKA), which is easy to miss.
Alcoholic and starvation ketoacidosis
A drinking binge with little food, or prolonged fasting, pushes ketone production up; alcoholic ketoacidosis often has a gap of 20 to 30 with normal or low glucose, and usually a raised lactate too. Starvation ketosis alone rarely drops bicarbonate below 18.
Kidney failure
Failing kidneys retain sulfate, phosphate, urate and other organic acids. The gap rises gradually, usually to 15 to 20, once eGFR falls below about 20 mL/min; in acute kidney injury it can climb faster.
Methanol and ethylene glycol poisoning
Windscreen fluid, some solvents and antifreeze are converted to formic acid and glycolic/oxalic acid. A rapidly rising gap, often above 30, with a raised osmolal gap and visual symptoms (methanol) or calcium oxalate crystals in urine and kidney injury (ethylene glycol), is a medical emergency.
Aspirin (salicylate) overdose
Produces a mixed respiratory alkalosis and high anion gap metabolic acidosis, with ringing in the ears, fast breathing, sweating and confusion; chronic overuse in older adults can present more subtly.
Medications and other toxins
Propylene glycol (the solvent in intravenous lorazepam and some other drugs), high-dose acetaminophen in malnourished or chronically ill people (pyroglutamic acidosis), isoniazid, iron overdose, toluene inhalation and metformin in kidney failure all raise the gap.
D-lactic acidosis
In people with short bowel syndrome or after some bariatric surgery, gut bacteria ferment carbohydrate into D-lactate, which standard lactate assays do not detect; episodes cause confusion and slurred speech after high-carbohydrate meals.
Metabolic alkalosis, dehydration and sample effects
Each raises the gap a few points without acidosis: alkalosis increases the negative charge on albumin, dehydration concentrates proteins, and delays in processing a sample let cells generate lactate. Prolonged tourniquet time and fist-clenching do the same.
Ketogenic diet and intense exercise
Nutritional ketosis adds about 2 to 4 mEq/L of ketoacids to the gap with little change in bicarbonate; a sprint or heavy lifting session raises lactate to 10 mmol/L or more for an hour. Neither is harmful in itself, but both can confuse a routine panel.

Symptoms that can go with it

Often none when the gap is only slightly raised and bicarbonate is normal
Fast, deep breathing (Kussmaul breathing) as the lungs blow off carbon dioxide to compensate for acid
Nausea, vomiting and abdominal pain, prominent in diabetic ketoacidosis
Fruity or acetone-smelling breath with ketoacidosis
Intense thirst and passing large volumes of urine with high blood sugar
Confusion, drowsiness, headache or, in methanol poisoning, blurred vision
Fast heart rate, low blood pressure and cold hands and feet in lactic acidosis from shock
Extreme fatigue and muscle weakness

Low anion gap

A low anion gap means there are fewer unmeasured negatively charged particles than expected, or more unmeasured positively charged ones. In practice the explanation is nearly always low albumin, because albumin contributes about 2.5 mEq/L of gap for every 1 g/dL. Someone with an albumin of 2.0 g/dL from liver disease, nephrotic syndrome or serious illness will have a gap about 5 mEq/L lower than usual, and this can hide a real acidosis, which is why the corrected gap is calculated in hospital.

If albumin is normal, a low gap prompts a look for a positively charged protein. In some types of multiple myeloma the abnormal IgG antibody carries a positive charge and lowers the gap, sometimes to zero or below; a low gap in an older adult with anemia, bone pain, high total protein or kidney problems is one of the classic clues that leads to protein electrophoresis. Lithium at high levels, bromide (in some sedatives and brominated vegetable oil) and iodide interfere with the chloride measurement and produce a falsely low or negative gap, and very high calcium or magnesium lower it slightly.

A single low value on a routine panel in someone who feels well, with normal albumin and total protein, is most often analyzer variation and is simply repeated. A negative anion gap is almost always a laboratory error or bromide interference.

Common causes

Low albumin (hypoalbuminemia)
The most common cause by far. Liver cirrhosis, nephrotic syndrome, malnutrition, protein-losing gut disease, burns and any serious inflammatory illness lower albumin; each 1 g/dL fall lowers the gap by about 2.5 mEq/L.
Multiple myeloma and other paraproteins
IgG myeloma proteins are often positively charged at blood pH, offsetting part of the gap; a very low or negative gap with high total protein, anemia, high calcium or kidney impairment prompts serum protein electrophoresis and free light chains.
Lithium toxicity
Lithium is a positively charged ion that the panel does not measure; at toxic levels (above about 2 mmol/L) it lowers the gap by several points.
Bromide and iodide
Both are read as chloride by most analyzers, inflating the chloride result and shrinking or reversing the gap. Sources include some older sedatives, pyridostigmine bromide, brominated vegetable oil and iodine-containing contrast or supplements.
Marked hypercalcemia or hypermagnesemia
Calcium and magnesium are unmeasured cations; when very high they lower the gap by 1 to 3 mEq/L.
Laboratory variation or error
Small errors in three separate measurements add up; a gap that is a few points below range with normal albumin is usually analyzer noise, and a negative gap is repeated before being believed.
Dilution and overhydration
Large volumes of intravenous fluid dilute albumin and other proteins, lowering the gap by a point or two.

Symptoms that can go with it

None from the low gap itself; symptoms reflect the cause
Swelling of the legs or abdomen, fatigue and easy bruising with low albumin from liver or kidney disease
Bone pain, tiredness, repeated infections or unexplained anemia, which with a low gap raise the question of myeloma
Tremor, confusion, unsteadiness or diarrhoea in someone taking lithium
Drowsiness, skin rash or confusion with bromide exposure

Read it alongside

CO2 (bicarbonate) — a high gap with a low bicarbonate is the classic high-gap metabolic acidosis, but a normal bicarbonate does not rule it out, because a coexisting metabolic alkalosis (vomiting, diuretics) can hide the fall; a low bicarbonate with a normal gap is normal-gap (hyperchloremic) acidosis.
Chloride — rises in normal anion gap acidosis (diarrhoea, renal tubular acidosis, saline infusion) and is read with sodium to judge whether chloride is relatively high.
Albumin — needed to correct the gap; a normal gap with an albumin of 2 g/dL may be hiding an acidosis.
Glucose and blood or urine ketones (beta-hydroxybutyrate) — confirm or exclude diabetic, alcoholic or starvation ketoacidosis.
Lactate — the single most common cause of a very high gap; above 4 mmol/L with acidosis is a marker of shock or sepsis.
Creatinine and eGFR — kidney failure raises the gap gradually; acute kidney injury accompanies ethylene glycol poisoning and rhabdomyolysis.
Blood gas (pH and pCO2) — tells whether the acidosis is compensated and whether a second acid-base disorder is present.
Serum osmolality and osmolal gap — an osmolal gap above 10 mOsm/kg with a high anion gap points to methanol, ethylene glycol or another toxic alcohol.

What usually happens next

If your gap is a few points above range with normal bicarbonate, glucose, creatinine and no symptoms, expect a repeat panel rather than further tests; ask whether your lab's range reflects its analyzer and whether potassium was included in the formula.
A high gap with low bicarbonate is worked up the same day: glucose and ketones, lactate, creatinine, a blood gas, a medication and alcohol history and, if a toxic ingestion is possible, serum osmolality and specific drug levels.
If albumin is low, ask for the corrected anion gap; the correction can turn a normal-looking gap into a significant one.
A persistently low gap with normal albumin, particularly in someone over 50 with anemia, bone pain or kidney impairment, is followed by serum protein electrophoresis and free light chains to look for a paraprotein.
In chronic kidney disease, the gap and bicarbonate are tracked over time; a bicarbonate drifting below 22 mEq/L is usually treated, and diet is part of that discussion.
People with diabetes who see a high gap should check for ketones and review sick-day rules and insulin or SGLT2 inhibitor use with their clinician.

Diet, lifestyle and natural levers with evidence

What can move AG once the cause is known. Nothing here replaces finding the cause.

Sick-day rules and hydration if you have diabetes

Moderate evidence

Most episodes of diabetic ketoacidosis follow an illness, missed insulin or vomiting with poor fluid intake, and are preventable. Structured education that teaches people to check ketones when unwell or when glucose stays above 250 mg/dL, never to stop basal insulin, and to keep drinking fluids has cut DKA admissions substantially in diabetes services that have introduced it. Drinking enough during illness also limits the dehydration that raises the gap on its own.

If ketones are moderate or high, or you are vomiting and cannot keep fluids down, this needs urgent medical care, not home management. SGLT2 inhibitors can cause ketoacidosis with normal glucose; ask your clinician when to pause them.

Fruit- and vegetable-rich diet to lower dietary acid load in kidney disease

Moderate evidence

Meat, cheese and grains generate acid when metabolised; fruit and vegetables generate base. In randomised trials in people with stage 3 and 4 chronic kidney disease and low bicarbonate, adding two to four servings of fruit and vegetables a day raised plasma bicarbonate by about 1 to 2 mEq/L over one to three years, about as much as sodium bicarbonate tablets, and slowed the decline in kidney function compared with usual care. Lowering acid production also reduces the sulfate and phosphate load that widens the gap.

In advanced kidney disease, potassium-rich produce can raise potassium to dangerous levels; this approach was tested only in people whose potassium was normal and monitored. Ask your kidney team first.

Limit alcohol, and never binge on an empty stomach

Moderate evidence

Alcoholic ketoacidosis develops after heavy drinking with little food and vomiting, typically producing a gap of 20 to 30 mEq/L; alcohol also impairs the liver's clearance of lactate. Cutting intake, eating when drinking and avoiding multi-day binges removes the trigger. Following the US guideline of no more than two drinks a day for men and one for women is associated with far lower rates of both ketoacidosis and alcohol-related lactic acidosis.

Adequate thiamine (vitamin B1) if you are at risk of deficiency

Preliminary evidence

Thiamine is needed to convert pyruvate into energy; without it, cells make lactate instead. Thiamine deficiency causes an unexplained lactic acidosis in people with heavy alcohol use, after bariatric surgery, on prolonged intravenous nutrition, and in critical illness, and case series show lactate falling within hours of thiamine replacement. Trials of routine thiamine in septic shock have been mixed, so the evidence supports correcting deficiency rather than supplementing everyone.

Know what a ketogenic diet does to the gap

Preliminary evidence

Nutritional ketosis raises blood beta-hydroxybutyrate to roughly 0.5 to 3 mmol/L and the anion gap by about 2 to 4 mEq/L, with bicarbonate usually staying above 20; this is expected and not a reason to stop. Staying well hydrated and including non-starchy vegetables, which supply base, keeps the shift small. Ketoacidosis on a ketogenic diet is rare and almost always involves type 1 diabetes, an SGLT2 inhibitor, breastfeeding with very low intake, or prolonged fasting during illness.

Do not combine a very-low-carbohydrate diet with an SGLT2 inhibitor without medical supervision; several cases of euglycemic ketoacidosis have been reported.

When to see a clinician promptly

An anion gap above about 20 mEq/L, or any high gap with bicarbonate below 18 mEq/L: possible lactic acidosis, ketoacidosis or poisoning, needs same-day (usually emergency) assessment.
Fast deep breathing, vomiting, abdominal pain, fruity breath or confusion in someone with diabetes, or a glucose over 250 mg/dL with moderate or large ketones: diabetic ketoacidosis is a medical emergency.
Any possibility of swallowing antifreeze, windscreen fluid, methanol or a large amount of aspirin, even if you feel well, because symptoms are delayed and early treatment prevents blindness and kidney failure.
A high gap in someone taking metformin who has become dehydrated, has kidney disease or feels very unwell.
A low or negative gap with normal albumin, especially with bone pain, anemia, high calcium or kidney impairment, to be assessed for myeloma.
A gap that is drifting upward over repeat tests alongside a falling bicarbonate or eGFR in chronic kidney disease.

Frequently asked questions

How do you calculate the anion gap?

Take your sodium and subtract the sum of chloride and bicarbonate (listed as CO2 on US panels): anion gap = Na − (Cl + HCO3). With sodium 140, chloride 104 and bicarbonate 24, the gap is 140 − 128 = 12 mEq/L. Some labs add potassium to sodium first, which makes the result about 4 higher and shifts the normal range to roughly 12 to 16. If albumin is low, add 2.5 for every 1 g/dL below 4.0 to get the corrected gap.

What is a normal anion gap?

It depends on the lab and the formula. On modern analyzers most labs quote about 3 to 12 mEq/L without potassium (Mayo Clinic uses 7 to 15), and about 10 to 20 (commonly 12 to 16) with potassium. Older textbooks give 8 to 16. The range printed on your report is the one to use; a value one or two points outside it with normal bicarbonate is rarely important.

Is an anion gap of 14, 16 or 18 high?

On a lab whose range tops out at 12, a gap of 14 to 18 is mildly raised. Whether it matters depends on bicarbonate: if bicarbonate is normal (22 to 29 mEq/L) and you feel well, the likely explanations are mild dehydration, a low-carbohydrate diet, recent exercise or analyzer variation. If bicarbonate is under about 20, a gap of 16 to 18 suggests an early acidosis from kidney disease, ketones or lactate and is worked up. Above 20 the gap is considered high regardless of lab.

What does a high anion gap mean?

It means there are extra unmeasured acids or negatively charged particles in the blood. With a low bicarbonate it indicates high anion gap metabolic acidosis, caused by lactic acid (shock, sepsis, severe illness), ketoacids (uncontrolled diabetes, alcohol binge, starvation), acids retained in kidney failure, or toxins such as methanol, ethylene glycol or aspirin. With a normal bicarbonate, a slightly high gap is usually a minor effect of dehydration, diet, exercise or the lab method.

What does a low anion gap mean?

Most often that your albumin is low, since albumin is the main component of the normal gap; liver disease, kidney protein loss, malnutrition and serious illness all do this. If albumin is normal, a low gap can be a clue to multiple myeloma (a positively charged antibody protein), lithium toxicity, or interference from bromide or iodide. A negative gap is almost always a lab error. Many slightly low results are simply analyzer variation and normalise on repeat.

What is the corrected anion gap and when is it used?

Albumin accounts for about 2.5 mEq/L of gap per g/dL, so when albumin is low the gap looks falsely normal. The corrected gap = observed gap + 2.5 × (4.0 − albumin in g/dL). For example, a gap of 11 with an albumin of 2.4 g/dL corrects to 15, which may reveal an acidosis the raw number hid. It is used mainly in hospital and intensive care, where low albumin is common.

Does a high anion gap mean diabetic ketoacidosis?

Not by itself. DKA is diagnosed when the gap is high (usually above 12) together with bicarbonate under 18 mEq/L, blood pH under 7.3, glucose typically over 250 mg/dL, and raised ketones. A high gap with normal glucose and no ketones points elsewhere, most often lactate or kidney function. People taking SGLT2 inhibitors can develop DKA with near-normal glucose, so ketones are checked whenever the gap is high and bicarbonate is low.

Can dehydration cause a high anion gap?

Yes, modestly. Dehydration concentrates albumin and other proteins and often raises lactate a little, adding a few points to the gap, and it can tip someone with mild kidney disease or ketosis into a clearer acidosis. Rehydration brings the gap back down within a day. Severe dehydration from vomiting usually produces a metabolic alkalosis instead, which also nudges the gap up without acidosis.

References

Anion gap blood test. MedlinePlus, US National Library of Medicine (2023)View source
Kraut JA, Madias NE. Serum anion gap: its uses and limitations in clinical medicine. Clinical Journal of the American Society of Nephrology (2007)
Kraut JA, Nagami GT. The serum anion gap in the evaluation of acid-base disorders: what are its limitations and can its effectiveness be improved?. Clinical Journal of the American Society of Nephrology (2013)
Figge J, Jabor A, Kazda A, Fencl V. Anion gap and hypoalbuminemia. Critical Care Medicine (1998)
Winter SD, Pearson JR, Gabow PA, Schultz AL, Lepoff RB. The fall of the serum anion gap. Archives of Internal Medicine (1990)
Emmett M, Narins RG. Clinical use of the anion gap. Medicine (Baltimore) (1977)
Mehta AN, Emmett JB, Emmett M. GOLD MARK: an anion gap mnemonic for the 21st century. The Lancet (2008)
Kitabchi AE, Umpierrez GE, Miles JM, Fisher JN. Hyperglycemic crises in adult patients with diabetes. Diabetes Care (2009)
Kraut JA, Kurtz I. Toxic alcohol ingestions: clinical features, diagnosis, and management. Clinical Journal of the American Society of Nephrology (2008)
Goraya N, Simoni J, Jo CH, Wesson DE. A comparison of treating metabolic acidosis in CKD stage 4 hypertensive kidney disease with fruits and vegetables or sodium bicarbonate. Clinical Journal of the American Society of Nephrology (2013)
Metabolic acidosis. Merck Manual Professional Version (2024)

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This page is educational and is not medical advice or a diagnosis. Lab results have to be interpreted together with your history, symptoms and other results by a clinician who knows you. Do not start or stop a supplement to change a lab value before the cause is known.