My messed up mitral valve could be the culprit, but the hemo ordered the test, so starting with her but reminding her of co-morbidities. I do not get the metabolic panel routinely, but have had in the past to rule out lupus, gout, and rheumatoid arthritis. Had some of the symptoms, but tests neg. I have felt real good, so last week's level was a surprise. Waiting, waiting.