Comprehensive Metabolic Panel (CMP)
A 14-test panel: glucose, kidney markers (BUN, creatinine, eGFR), liver enzymes (ALT, AST, ALP, bilirubin), electrolytes (sodium, potassium, chloride, CO2), calcium, albumin and total protein.
The best value in all of bloodwork — for ~$9 it screens kidney function, liver function, hydration, electrolytes and blood sugar. Essential baseline for anyone using compounds metabolized hepatically or cleared renally.
The plan of attack
In this order. Most people start at step four, which is why they change five things at once and learn nothing.
- Confirm the number is real
Haemolysis (burst red cells). Red cells rupturing in the tube spill their contents into the serum. Potassium, LDH, AST and magnesium are far higher inside cells than outside, so a haemolysed sample reports them falsely high. Caused by a difficult draw, a narrow needle, or shaking the tube. The lab usually flags it. If your result is odd and the report mentions haemolysis, that is your answer — repeat the draw. - Read it with its partner
Fast 9–12h. If liver enzymes are up, repeat rested and sober before drawing conclusions. Draw it alongside: Cystatin C with eGFR, Fasting Insulin, Lipid Panel (Cholesterol, HDL, LDL, Triglycerides). - Work out which direction is yours
If it's high — Elevated liver enzymes signal hepatocellular stress; investigate rather than ignore, but consider training and creatine first in this population.
If it's low — Low albumin can reflect malnutrition, inflammation, or liver/kidney disease. - Fix it in this order
Nutrition. For fatty liver (by far the most common cause of mildly elevated ALT): fat loss, reduced fructose and alcohol, higher protein. Even 5–10% body weight loss meaningfully reduces liver fat.
Lifestyle. Eliminate alcohol, lose visceral fat, exercise. Don't draw within 48–72h of heavy training.
Supplements. Omega-3s, vitamin E (in NAFLD), TUDCA (used by those on hepatotoxic orals), NAC, milk thistle (modest evidence). Choline supports hepatic fat export.
Hormones. Avoid or minimize oral 17-alpha-alkylated androgens — they are the most hepatotoxic category by a wide margin. Review all medications with a provider.
Compounds. Two critical caveats: (1) Don't test within 48–72h of hard training — ALT/AST and CK will be muscle-derived, not liver. (2) A 'high' creatinine in a muscular person on creatine is frequently benign — Cystatin C is the accurate kidney measure because it's unaffected by muscle mass.
Work down the list, not across it. Adding a compound on top of an unfixed diet is why generic protocols fail. - Retest
Every 3–6 months on any oral compound; annually otherwise. Change one thing at a time, or the retest can't tell you which thing worked.
How to fix it
📚 KDIGO 2024 CKD Guideline. Pettersson J et al., Br J Clin Pharmacol 2008 — exercise-induced transaminase elevation.
🩸 Test your Comprehensive Metabolic Panel (CMP)
Order directly through Marek Diagnostics — no doctor's visit needed, drawn at any Quest location in the US. Code CAMERON applies 10% off automatically.
Order this test — 10% off → Browse all 102 markers →What Comprehensive Metabolic Panel (CMP) is usually tested alongside
On its own, one marker is a data point. These panels include Comprehensive Metabolic Panel (CMP) plus the markers that make it interpretable — each names every test, why it is on the list, and loads the whole set into your cart in one click at 10% off.
includes this + 6 more markers · built for men — Never had proper bloodwork, or want the highest-value snapshot for the least money.
includes this + 7 more markers — Weight that won't shift, energy crashes after meals, expanding waistline, family history of diabetes, or a fasting glucose that's crept into the 90s.
includes this + 6 more markers · built for women — Never had proper bloodwork, or want the highest-value snapshot for the least money.
What moves your Comprehensive Metabolic Panel (CMP)
14 compounds in the Vault have a documented effect on this marker, or are a reason to have measured it first:
Browse all 237 compounds & 350 supplements →
Would you feel it? Symptoms Comprehensive Metabolic Panel (CMP) helps explain
People rarely search for a marker — they search for how they feel. These are the complaints where this marker is worth checking, and whether it is a first-line test or a follow-up once the obvious causes are ruled out.
Why your Comprehensive Metabolic Panel (CMP) might be wrong
Most abnormal results are interference, not disease. These are the things that measurably move this specific marker — check them before you change anything. Each one says whether the number is wrong and should be repeated, badly timed and should be redrawn, or real with a cause worth explaining.
Clenching your fist pumps potassium out of muscle and can raise a measured potassium enough to trigger a false alarm. A long tourniquet concentrates protein, calcium and everything protein-bound.
Do not pump your fist. Ask for the tourniquet to come off early. An isolated high potassium with no symptoms is usually this.
Red cells rupturing in the tube spill their contents into the serum. Potassium, LDH, AST and magnesium are far higher inside cells than outside, so a haemolysed sample reports them falsely high. Caused by a difficult draw, a narrow needle, or shaking the tube.
The lab usually flags it. If your result is odd and the report mentions haemolysis, that is your answer — repeat the draw.
Raises creatinine — a breakdown product of creatine — without harming the kidney at all. This is one of the most common false alarms in this audience, and it also drags the calculated eGFR down.
Expect it if you supplement creatine or carry muscle. Cystatin C settles it, because it is independent of muscle.
Muscle damage and the inflammatory response to hard exercise shift this for days afterwards.
No hard or unfamiliar training for 48–72 hours before the draw.
What Comprehensive Metabolic Panel (CMP) means in combination
A single marker tells you a little. Combinations tell you the story — these are the named patterns this marker takes part in, and what each one points at.
Classic compensated insulin resistance. Your pancreas is working overtime to keep glucose normal — so the standard screening tests look fine while the underlying problem builds.
This is the most reversible stage. Fat loss, resistance training, post-meal walks, fiber, reduced refined carbohydrate. Consider berberine or inositol; metformin/GLP-1 if clinically appropriate.
Metabolic dysfunction-associated fatty liver — now the most common liver disease there is. It gets dismissed as "slightly high liver enzymes" for years while fibrosis accumulates silently.
5–10% body weight loss meaningfully reduces liver fat and is the single highest-yield intervention. Cut alcohol and fructose, raise protein. If ALT has been up for months, an ELF score answers "is there actual scarring" without a biopsy.
Creatinine is a muscle breakdown product — more muscle and creatine supplementation raise it without any kidney dysfunction. Standard eGFR equations systematically misclassify lifters.
Get Cystatin C before panicking or changing anything. KDIGO specifically recommends it when creatinine-based estimates may be unreliable. If cystatin C is normal, your filtration is fine.
Cystatin C is not affected by muscle mass, so when it agrees with a low eGFR the filtration problem is genuine rather than an artefact of being muscular.
This is a clinician conversation, not a supplement one. Blood pressure and glucose control are the two things that change the trajectory. Review NSAID use, creatine, and protein intake honestly, and get urine albumin checked.
What to test next
Markers rarely answer alone. These are the ones that put Comprehensive Metabolic Panel (CMP) in context — each with its own full breakdown.
Frequently asked questions
Each analyte has its own range — see your report Ranges vary by laboratory and assay — always compare to the range printed on your own report.
eGFR >90 · ALT <30 · AST <30 · albumin 4.0–5.0 g/dL · fasting glucose 70–90 mg/dL
Elevated liver enzymes signal hepatocellular stress; investigate rather than ignore, but consider training and creatine first in this population.
Low albumin can reflect malnutrition, inflammation, or liver/kidney disease.
You can order Comprehensive Metabolic Panel (CMP) directly through Marek Diagnostics without a doctor's visit — drawn at any Quest Diagnostics location in the US. Code CAMERON applies 10% off automatically.