Low Anion Gap

[IvoryDancer]

Anyone have experience with a Low Anion Gap in their bloodwork? My ESR was 110+, I have hand, neck, back pain (upper, mid & lower) and hip pain, but CRP was negative and RA factor was negative. Am 61-year-old female and was diagnosed with PMR last year, but I think the (primary) doctor was wrong, from what I’m reading of other’s symptoms. Will make appointment after 1st of the year with rheumy, when my insurance kicks in. But just wondering if anyone could point me in the right way of thinking about this. Thanks in advance.

[Telian]

Hi IvoryDancer

I’m sorry but can’t help with your query but sure someone more knowledgeable on this will be along soon.

Best wishes

[IvoryDancer in reply to Telian]

Thank you, best wishes to you, too.

[Canarylady]

Hi there,So sorry you are in such pain,I m going through the same as you at the moment,sadly I ve had to move jobs and my home,so stress really has upset my body.

I m still on a high dose of preds,I ve only managed to get down from 60mg to 18mg in the last 3 months,I have no support from my rheumy and very little from my doctor.

I know my little note to you doesn’t help with your questions but it’s just to let you know I m thinking of you and I m sure one of our brilliant ladies will be along soon to answer your questions.

Hope you are keeping well and safe.

Best wishes

Ruth

[IvoryDancer in reply to Canarylady]

I’m sorry you’re having to go thru so much too. It really is stressful and frustrating when the docs don’t support you. Thanks for thinking of me.

[123-go]

I have never heard of anion gap but a very quick 'look up' mentions electrolytes which are observed in blood work for PMR but not associated with pain. What dose of Pred were you prescribed on diagnosis and what are you on now? A time frame would be useful.I'm sorry you feel so poorly.

[PMRpro Ambassador]

healthline.com/health/low-a...

Rather more background info would be helpful. Why do you think the GP/PCP was wrong in diagnosing PMR? There is obviously a source of inflammation somewhere - and a normal range CRP and RF doesn't mean it isn't PMR or isn't RA if it comes to that since both can manifest as sero-negative forms. What are YOUR symptoms - each of us is individual and my symptoms may not match yours but they do fit into the spectrum of PMR.

True low anion gap is very rare - and the first thing to do is check the blood tests because errors and processing problems from taking the sample right the way through to reporting can happen. Has the albumin been checked?

[piglette]

I think your doctor should be asking for a second blood test with results like that to ensure that they are correct. I assume your CRP was normal. It is not possible to have a negative figure.

[BlueEmpath]

I have 3 rounds of bloodwork over 18 months that all show low anion gap. I have just noticed this by comparing all of my results myself. None of my doctors have ever mentioned it to me despite the big L for low on all of the reports. A google search shows this is rare and often lab error — but certainly not 3 times in a row! Did you find out anything about yours?

[Lorelle09 in reply to BlueEmpath]

Do you ever find out about your low anion gap? Can I ask what were your readings and what is the labs value range? Reason I’m asking is because mine was low in January and then again in February. The normal range at my lab is 14-17. In January mine was 13 then in February 11. Last year it was in the normal range though?

[BlueEmpath in reply to Lorelle09]

In the US (at least at my lab) the range is 5-15 mmol/L. Mine has been 4 mmol/L on two occasions and 3 mmol/L on one. No doctor has brought it up as a concern. But I am desperately searching for answers as to why I am suffering from severe peripheral neuropathy.

[Lorelle09 in reply to BlueEmpath]

I live in the US as well but my lab ranges differently. Yes it would be nice to know why the number is consistently low. I hope we both find answers.

[LuvSmallDogs in reply to BlueEmpath]

Here our labs use the normal range as being 7-15. Since 2016 my Anion Gap has been 6, but todays labs show it as being 4. That is little better than half of the lowest normal. I am trying to learn what it means, as my neph tells me nothing. On the web it seems it can mean several things (if I am reading things correctly). 1. It can mean low albumin. My albumin level has dropped from 4.5 to todays number of 4.2. So, I really don't see my albumin level as causing the low Anion Gap. What I think (from what I've read), is that I have gotton too Alkaline by using Calcium Citrate, Magnesium Citrate, Pink Salt, rising potassium levels, etc. The 'Citrate's forms are more alkalizing that other forms of vitamins. Also, I eat a very vegan diet, but in normal people that should not create such a low Anion Gap. There are various medical conditions that can cause it: heart, kidney, liver disease, or cancer. --- I am not totally sure that my understanding of the causes of low Anion Gap are correct, but from what I understand of what I've read, this is what I got out of it. So, now I will be lowering or removing my supplements of calcium, magnesium, pink salt etc, and will use regular salt. I am using a food logging site called Cronometer that tells me ALL my nutrients, so this will make it much easier to regulate these factors. -- I know I am late to this thread, but I hope my input will help those in this thread, or others who come looking for "Anion Gap".