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Hi @sallylynn, Blood numbers can fluctuate readily even during any given day.
If you were to have your numbers checked daily you’d see a wide range of fluctuation in the numbers. I had a bone marrow transplant where I had 2 or more sets of blood work done daily. It was fascinating to see the range of numbers change within the day depending on my hydration and med intakes.
There’s really no universal “normal” anion gap because labs and healthcare providers measuring the numbers may have different reference ranges for a normal anion gap. I notice a difference between the parameters set by my Mayo lab and my local hospital.
The anion gap is a calculation of the difference between the amounts of some negatively charged electrolytes (such as chloride and bicarbonate) and the amount of positively charged electrolytes (such as sodium) in your blood.
That can vary by the amount of hydration in your body, foods you eat, medications, health of kidney, liver, etc.. Reading through some past replies, I see you have kidney disease. Were you told to avoid excess protein? The most common cause of a low anion gap is a low level of albumin, a protein in the blood. Eating more protein can help raise that level of albumin. But I realize that may be a fine line for you.
Doctors look for trends in blood results. Your doctor isn’t doing a knee jerk reaction to your blood work because everything else seems to be looking good…not flagged. So this could be a one-off event. More concerning would be a too high anion reading. A little more than 2 weeks ago your numbers were fine so unless your doctor sees a downward trend she’s not sensing anything alarming. What was your albumin number? If it was ok, then your doctor will expect this low anion number wasn’t significant.
When is your next set of labs?
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She has not set up any labs. I did request a re-check of my Anion Gap hence even Mayo and Hopkins recommends the Doctor do a re-check to rule out "Lab error". I have not heard form her as of yet.
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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.