Low Anion Gap

Posted by sallylynn @sallylynn, Sep 13, 2023

I just had blood work done on 09/11/2023. Basic Metabolic Panel. The one that concerned me was Anion Gap. The normal range is 7-13. Mine was 6. On August 24, 2023, 18 days earlier, it was 11. My Anion Gap dropped 5 numbers. I contacted my Doctor with my rightful concerns, hence it is considered "Very rare" to have a below normal Anion Gap. My Doctor was quite "Nonchalant" and told me this it is "Normal" and numbers can slightly fluctuate and "Not to worry", well, I am and that is no small fluctuation! **Mayo claims IF your Anion Gap is "Below normal", your doctor should order a re-test to rule out "Lab error". She did NOT even consider this! I asked her to do a re-test to rule out any disease or cancer, if she doesn't, I may call the Supervisor of the Clinic. I have to literally beg. Your thoughts or opinions would be great. If a hematologist see's this post, I would like your opinion.

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Thank you so much for responding~ I really appreciate it. I should mention my Creatinine was .095 (Normal) on Aug.24, and on Sept. 11 it was 1.05, a bit over average. My eGFR was 68 on Aug.24, and dropped to 60 on Sept.11.- On August 24 my Albumin was 3.6(Normal) my Platelets were 227(Normal) My WBC was 3.6(Below Average). My Red Cell Count was 4.1M/ul(Normal). These are my Anion Gap numbers of recent, starting from most recent: 6,11,11,11,8,7,9,12,11,11.
So, too see 6 was shocking. Nothing has changed in my intake of Protein. The only thing I am doing different now is taking vitamin B12 500mcg per day. I should mention on July 26, out of no where, I developed a neuropathy. Two days later, my ankle bones were aching. I was diagnosed with neuropathy. They gave me Gabapentin. I only took it for 3 days. I started taking B12. My B12 labs were in normal but very low at 268 where the normal low range is 213. My neuropathy got better for awhile, feeling hopeful, but now again my hands tingle, my arms, and body sometimes and I do feel bone pain on and off in my lower legs and ankles. It wakes me up at night. I guess that is why I am worried now with the low Anion Gap. I just find it odd with all those Anion Gaps in the normal range, why it dropped so suddenly. ~ Any advise would be great. Thank you.

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My Anion Gap has been low for the last 6 of 7 CMP tests.
Actually 5 is the highest it’s been…lol 2 to 3 is about the average I’ve see.
And AST, ALT and LIPASE are all real low and aoit of range.

And all I get is the same answer you got,….. all well it could be a false ready, maybe the numbers are off…., try it again… etc etc etc

Mean time I feel like crap lol

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“These are relatively common diseases that are missed relatively commonly and are associated with significant amounts of harm,” said Dr. David Newman-Toker, a neurologist at Johns Hopkins University. He led the study’s research team from the Johns Hopkins Armstrong Institute Center for Diagnostic Excellence, in partnership with researchers from the Risk Management Foundation of Harvard Medical Institutions Inc.

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Hi Sallylynn. I know this is from about two years ago but wondering if you were able to get a different doctor or more answers? I also just came up with a low anion gap, I have a stress injury without a distinct fracture in my hip and a bony lesion in another part of my hip (sacral ala). My Beta 2 Microglubin is also ever so slightly elevated as well as a slightly low RBC. I know its probably not MM, but this all seems to point to some type of bone marrow disorder but no one seems concerned about the Anion Gap. Also worried because the Beta 2 Microglubin is just over the limit but that could indicate early stages of MM or a bone marrow issue.
Looking for any help or advice. Thanks!

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So my husband had .5 (point five) anion gap over a course of 6 to 9 months and asked two doctors about it… neither seemed to be worried…. Meanwhile I’m going NOOoo.
All other labs were normal… he’s a bypass patient from 13 years ago, no issues, on thyroid medication and has sleep apnea.

Has an PCP appointment soon and it will be addressed.

Any questions or suggestions to PCP we should know in advance?

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Profile picture for rjperk633 @rjperk633

So my husband had .5 (point five) anion gap over a course of 6 to 9 months and asked two doctors about it… neither seemed to be worried…. Meanwhile I’m going NOOoo.
All other labs were normal… he’s a bypass patient from 13 years ago, no issues, on thyroid medication and has sleep apnea.

Has an PCP appointment soon and it will be addressed.

Any questions or suggestions to PCP we should know in advance?

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Two separate tests over 6 to 9 month period…..

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Profile picture for sallylynn @sallylynn

Hi Cindy. For 2 months I have been telling her this, the bone pain with neuropathy. I have intentionally leaving all my symptoms on my My Chart, leaving a digital paper trail. I even documented that she told me I do not have cancer, because if I do, it is documented what she said and refused to do a re-check of my BMP. I even told the ER on July 26, they ran all the blood work, said I was fine. Went back to ER on Aug.24 with same complaint, actually started weeping, they ran the blood work, said it all looked great, the only exception was my WBC were lower at 3.6. Sept.11 I went to my clinic for a BMP and my Anion Gap was 6. My Calcium was 10 which is very close to being over the range. I feel at this point I am just in a bad dream. SOMETHING is causing this & they are not concerned, you would think they would be concerned with a patient with bone pain, but, they are not. Just so you know, a new report came out recently and it is scary shocking: 7.4 million patients are misdiagnosed of the 130 million annual visits to ERs. The number translates to about 1 in 18 people receiving a wrong diagnosis. 2.6 million patients receive a harm that could have been prevented. Misdiagnosis of disease or other medical conditions leads to hundreds of thousands of deaths and permanent disabilities each year in the United States, according to a report published this week.

About 371,000 people die and 424,000 sustain permanent disabilities – such as brain damage, blindness, loss of limbs or organs or metastasized cancer – each year as a result.
Look at those numbers! This is just the USA alone!
With misdiagnosis that touched my Family memebers personally, and now with my current situation, it is very east to mistrust and second guess a doctor.

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@sallylynn
unfortunately i can’t help you but i have a similar situation going on. i’m 40 years old, woke up one morning 4 months ago with both feet numb and tingling. from there it all has gotten worse. testing shows polyneuropathy both legs from knee to feet sensory and motor. very painful muscle spams everyday. i’m not in a wheelchair anytime i leave my house cause i can only walk a few steps and i walk like a toddler. for the past 4 months my anion gap has been going down. the last three test i’m at a 3. my doctors don’t know why and don’t seem concerned with any of it. i’m a 40 year old mother, wife and can’t do anything can’t work, in constant pain and these doctors just keep throwing pills at me and sending my on my way. i don’t even fill the prescriptions cause i don’t want to be passed out all day.
If you get any answers please let me know and i will do the same. i pray we both get answers we need

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My Low Anion Gap levels are consistently low. Results today indicate 4.
Have had major inflammation issues with skin for months now, bone pain in hips, ribs and teeth. Age is 67.
Energy levels consistently low. Diagnosed 2 .5 years ago with meningioma brain tumor almost 3cm treated with 3 sessions of Gamma Knife and have had 7 diagnostic and follow up MRI's over this period. Had surgery for shoulder for major bone spur some years ago, then just last month for bone spur surgery in nose. Have had other ganglian cysts and have had neuropathy treated with Gabapentin and Cymbalta Duloxetine last few years and had a pinched nerve in front of left hip. Lost 50 lbs with help of Ozempic and that has made no real change in neuropathy. Have had unexplained falling issues which led to the brain tumor finding but Doctors say that the brain tumor is not the cause of the neuropathy, falls and injuries etc. Did complete blood panel today. Have been seen a lot for severe skin issues since last October. Now I am on Rinvoq temporarily so skin has finally cleared after the first prescription failed to bring any lasting change. What should be my next step? Conditions were causing great deal of anxiety and insomnia and depression. I fear that when my 4 week trial of Rinvoq runs out that skin issues will come back. Previous diagnosis of depression, chronic fatigue, fibromyalgia, possibly Ehler Danlos but that was never confirmed but have had years of body pain treated by DO, Chiro, about 20 years of Physical Therapy, years of accupuncture and Hellerwork and massage etc. Other med I tried for skin was Cibinqo but as soon as I stopped taking it condition came roaring back. Other meds I am on are Minoxidil for hair loss, Oxybutynin Chloride Er, Omeprazole Dr, and Rosuvastatin 10 Mg. I fell and hit my head during MRI exam last late Sept and that was followed by 24 hours period of unconscious/sleep and about a week of or two of fevers and feeling very unwell. Have 4 mm nodule in left lung and Dr just going to watch it for a year. Congenital issue with 7 or 8 secondary teeth (on top) that never existed making a huge fixed bridge necessary that anchored onto my last upper molars in 1982. This was before dental advances in implants and I was only 22 or 23 at the time and the choice was massive bridge or dentures. Still have a lot of jaw pain. Welcome any physician reading this to weigh in since I really thought I was going to die last October. I have had on and off periods of difficulty breathing and wore a heart monitor which did not detect much abnormal cardiac activity. Two sisters had early heart attacks age 40ish, one sister who also was smoker had hodgkins age 22 and died of COPD age 67 three years ago. Other sister had second heart attack with stents 3 years ago followed by breast cancer. Heart issues and cancer abundant in my family history. I have never smoked, eat pretty well, don't eat any fried foods/chips etc, am chemically sensitive and have a lot of allergies. Apologize for the length of this. Mother had breast cancer age 65 died age 79 of either lymphoma or BC (uncertain of which), father died age 84 of heart and multiple cancers. Can share labs if Mayo Dr wants to look at them.

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