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Is A Low Anion Gap A Serious Cause For Concern?

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Posted on Thu, 25 May 2023
Question: I received a blood test result that shows low agap level of 3 (normal being 5 and up). I'm worried about this being related to certain cancers. Can I provide you with my full blood results and have your opinion? Please see below

General Chemistry

Sodium Lvl
138 mmol/L Sodium Lvl
Reference Range:137 mmol/L - 145 mmol/L

Potassium Lvl
 5.1 mmol/L Potassium Lvl
Reference Range:3.5 mmol/L - 5.1 mmol/L

Chloride
 103 mmol/L Chloride
Reference Range:98 mmol/L - 107 mmol/L

CO2
 32 mmol/L (High) CO2
Reference Range:22 mmol/L - 30 mmol/L

BUN
 15 mg/dL BUN
Reference Range:7 mg/dL - 17 mg/dL

Creatinine
 0.81 mg/dL Creatinine
Reference Range:0.52 mg/dL - 1.04 mg/dL

Glucose Lvl Random
 114 mg/dL Glucose Lvl Random
Reference Range:65 mg/dL - 140 mg/dL

Calcium Lvl
 9.8 mg/dL Calcium Lvl
Reference Range:8.4 mg/dL - 10.2 mg/dL

AGAP
 3 mmol/L (Low) AGAP
Reference Range:5 mmol/L - 15 mmol/L

GFR XXXXXXX XXXXXXX
 > 60 mL/min/1.73 m2 GFR XXXXXXX XXXXXXX

GFR Non XXXXXXX XXXXXXX
> 60 mL/min/1.73 m2 GFR Non XXXXXXX XXXXXXX

Urinalysis

POC Urinalysis Glucose
 Negative POC Urinalysis Glucose

POC Urinalysis Bilirubin
 Negative POC Urinalysis Bilirubin

POC Urinalysis Ketone
 Negative POC Urinalysis Ketone

POC Urinalysis Specific Gravity
 1.010 POC Urinalysis Specific Gravity

POC Urinalysis Blood
 Negative POC Urinalysis Blood

POC Urinalysis pH
 7 POC Urinalysis pH

POC Urinalysis Protein
 Negative POC Urinalysis Protein

POC Urinalysis Urobilinogen
 0.2 mg/dl (normal) POC Urinalysis Urobilinogen

POC Urinalysis Nitrite
Negative POC Urinalysis Nitrite

POC Urinalysis Leukocyte
 Small (+) POC Urinalysis Leukocyte


doctor
Answered by Dr. Monish De (23 minutes later)
Brief Answer:
Blood, urine and bone marrow biopsy test

Detailed Answer:

Hi,

Your AGAP of 3 mmol is low.Other parameters are within normal range.

It means you are having low anion gap and it occurs from the presence of abnormal positively charged proteins

Low AGAP can occur in from a cancer condition called multiple myeloma.

Multiple myeloma is blood cancer that develops in the plasma cells found in the soft spongy tissue at the center of your bones called bone marrow

I would advise you to do blood and urine tests as well as a bone marrow biopsy. Consult your doctor regarding these tests.

Hope I have answered your query. If you have more queries i will be glad to help.

Regards,
Dr. Monish De
Oncologist
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Monish De (35 minutes later)
Are there no other reasons that my agap level would be low? Is it most likely cancer? There were no proteins found in my urine.
doctor
Answered by Dr. Monish De (4 minutes later)
Brief Answer:
Blood test for calcium, magnesium, TSH and vitamin-D

Detailed Answer:

Hi,

Other causes of low AGAP level could be hypercalcemia, hyperparathyroidism, hypermagnesemia and excess Vitamin D

I would advise you to do a blood test for calcium, thyroid stimulating hormone, magnesium and vitamin D.

Also, bone marrow biopsy is a must to rule out multiple myeloma.

Hope I have answered your query.

Regards.
Dr. Monish De
Oncologist
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Yogesh D
doctor
Answered by
Dr.
Dr. Monish De

Oncologist

Practicing since :2004

Answered : 2229 Questions

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Is A Low Anion Gap A Serious Cause For Concern?

Brief Answer: Blood, urine and bone marrow biopsy test Detailed Answer: Hi, Your AGAP of 3 mmol is low.Other parameters are within normal range. It means you are having low anion gap and it occurs from the presence of abnormal positively charged proteins Low AGAP can occur in from a cancer condition called multiple myeloma. Multiple myeloma is blood cancer that develops in the plasma cells found in the soft spongy tissue at the center of your bones called bone marrow I would advise you to do blood and urine tests as well as a bone marrow biopsy. Consult your doctor regarding these tests. Hope I have answered your query. If you have more queries i will be glad to help. Regards, Dr. Monish De Oncologist