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What Causes Low Anion Gap?

Posted on Tue, 14 Jul 2015

Question: Hi - I am a 51 year old female in good health, not on any medication. I recently had blood and urine tests done as part of my routine yearly. The doctor said all was good but I asked for a copy of the results. All was good on the blood except my Anion Gap is 5 (test range is 8 - 25). My test in 2013 had an Anion Gap of 11 (test range 4 - 18) and the test in 2012 had a gap of 13 (test range of 4 - 18). I'd like to know if this is something I should be following up on even though my doctor said all was fine. The only causes I can find on line for a low Anion Gap are a decreased level of sodium in the blood (mine is at 139 on a test range of 137 - 145) or multiple myeloma. Urinalysis was all good except Specific Gravity, UA of 1.002 and pH, UA of 8.0 but the reading I have done indicated not too much cause for concern with either of these results. Any advice would be appreciated. Thanks

Answered by Dr. Ivo Ditah (29 minutes later)

Brief Answer:
There is no reason to get worried at this time!

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about this low anion gap and all the inconveniences this has caused you. Anion gap expresses the differences in the various ions measured in the body. With no symptoms, I will treat this as an incidental finding and rerun for a control in 3months. if it stays abnormal, only then will I want to dig further into the causes of low anion gap. This is because this is often wrongly reported with no disease significance.

For now, do not worry about this. I will recommend a control in 3months. If it is still low, we will explore for causes of low anion knowing it is for del and not an incidental finding.

I hope this helps. I wish you well. Thanks for using our services and do feel free to ask for more information and clarifications if need be.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ivo Ditah (49 minutes later)

Hi Dr. Ivo Ditah

Thanks so much for your reply. Would you please clarify the following from your reply "If it is still low, we will explore for causes of low anion knowing it is for del and not an incidental finding." What does "knowing it is for del" mean?

It's been about 4 months now since the test, as it took a while for me to get the actual results in hand, so I will call for a follow-up.

Thanks again,XXXX

Answered by Dr. Ivo Ditah (1 hour later)

Brief Answer:
Am sorry for the typographical error!

Detailed Answer:
Hi,

I actually meant to say “ ....knowing it is for real(founded) and not an incidental finding”. You can get a control right now given the fact that the last test was some 4months ago already.

Keep me posted with your progress. I wish you well.

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar