What is a Bicarbonate(HCO3-) test?

The bicarbonate test or CO2 blood test determines the amount of bicarbonate in the blood. Bicarbonate (HCO3) is gas waste left when your body burns food for energy. Your blood brings bicarbonate to your lungs and exhales as carbon dioxide (CO2). Bicarbonate is excreted and reabsorbed by your kidneys regulating the acid-base balance in the blood. Too much or too little bicarbonate can be a sign of several conditions, including diarrhoea, liver failure, kidney disease, and anorexia. 

What is a bicarbonate (HCO3-) test used for?

The bicarbonate (HCO3-) test is used to diagnose electrolyte imbalances, acidosis, or alkalosis. It assesses treatment effectiveness, monitors conditions like kidney disease and hypertension, and analyzes the body’s acid-base balance. Often conducted with an electrolyte panel, including sodium, potassium, and chloride tests.

Understanding the test results of the Bicarbonate Test

Test results for the Bicarbonate (HCO3-) Test, can vary based on factors like age, gender, and health history. A positive result doesn’t necessarily indicate a health issue. Consult your healthcare provider for personalized interpretation. 

Below are reference ranges for normal bicarbonate(HCO3-) levels in blood:

Age

Bicarbonate level (mmol/L)

12-24 months

17-25 

3-5 years

18-26 

6-7 years

20-28 

8-17 years

21-29 

18-60 years

22-29 

>60 years

23-31 

>90 years

20-29 

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    References

      1. (NIH), N. L. (2020, July 30). Carbon Dioxide (CO2) in Blood. Retrieved from MedlinePlus: https://medlineplus.gov/lab-tests/carbon-dioxide-co2-in-blood/
      2. Allen, S. (2018, October 6). Acidosis. Retrieved from Healthline: https://www.healthline.com/health/acidosis#risk-factors
      3. Raphael, K. (2016, February 1). WHY LOW BICARBONATE LEVELS MIGHT SIGNAL A RISK FOR PREMATURE DEATH. Retrieved from The UNIVERSITY of UTAH: https://healthcare.utah.edu/the-scope/shows.php?shows=0_rlyoritx
      4. Research, M. F. (2022, January 18). PEDIATRIC CATALOG. Retrieved from Mayo clinic laboratories pediatric catalog: https://pediatric.testcatalog.org/show/HCO3
      5. Smith, M. (2020, January 26). What Is a Bicarbonate Blood Test? Retrieved from WebMD:https://www.webmd.com/a-to-z-guides/bicarbonate-blood-test-overview#:~:text=Bicarbonate%20is%20a%20form%20of,body%20burns%20food%20for%20energy.&text=Too%20much%20or%20too%20little,dioxide%20is%20in%20your%20blood.
      6. Testing.com. (2021, November 9). Bicarbonate (Total CO2). Retrieved from Testing.com:https://www.testing.com/tests/bicarbonate-total-co2/#:~:text=Any%20disease%20or%20condition%20that,of%20your%20acid%2Dbase%20balance.
      7. University of Rochester Medical Center Rochester, N. (2022, January 18). Health Encyclopedia. Retrieved from University of Rochester Medical Center Rochester, NY: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=bicarbonate

    Frequently Asked Questions

    A bicarbonate test is necessary for various purposes. It helps in diagnosing issues like vomiting or diarrhea, potentially related to metabolic problems. It also identifies respiratory disorders, notably acid-base imbalances, in those with breathing difficulties. Abnormal bicarbonate levels may indicate underlying health problems such as weakness or fatigue. Moreover, for patients with liver, lung, or digestive conditions, regular bicarbonate testing monitors treatment effectiveness.

    During a bicarbonate blood test, a healthcare professional will draw a blood sample from your arm. Inform them about any medications or supplements you're taking, as they can impact the results. In the lab, acid is added to the sample to release carbon dioxide from the bicarbonate. The bicarbonate level is determined by the rate at which the sample's acidity changes.

    Fasting is typically not required for a serum bicarbonate test. However, consumption of highly acidic fruits like grapefruits or tangerines may affect the results. Follow any specific instructions provided by your healthcare provider.

    Symptoms of high bicarbonates (metabolic alkalosis) may include confusion (which can progress to stupor or coma), hand tremors, light-headedness, muscle twitching, nausea, vomiting, numbness or tingling in the face, hands, or feet, and prolonged muscle spasms (tetany).

    Low bicarbonate levels stem from two key factors Metabolic acidosis and Respiratory compensation. Metabolic acidosis occurs when kidneys retain excess acid due to issues like circulation problems, kidney dysfunction, or a high-fat, low-carb diet. Alternatively, respiratory compensation happens when lungs expel too much carbon dioxide, causing a drop in bicarbonate. Other factors include kidney disease, aspirin overdose, Addison's disease, diabetic ketoacidosis, and ethylene glycol poisoning.

    Typically, there are no specific preparations needed for a Bicarbonate (HCO3-) test. However, it's important to inform your healthcare provider about any medications you are taking, as certain drugs can influence the test results. Never adjust or discontinue your medication without consulting your provider first.

    High bicarbonate levels, known as alkalosis, can be caused by lung diseases, Cushing’s syndrome (an adrenal gland disorder), hormonal imbalances, and kidney disorders. Alkalosis signifies an excessive base level in the blood.

    Yes, pregnant women can undergo a bicarbonate test. However, it's important to note that during a normal pregnancy, increased ventilation due to progesterone can affect blood oxygenation, potentially leading to lower observed CO2 levels in the test results.