Bicarbonate is an electrolyte, a negatively charged ion that is used by the body to help maintain the body’s acid-base (pH) balance. It also works with the other electrolytes (sodium, potassium, and chloride) to maintain electrical neutrality at the cellular level. This test measures the total amount of carbon dioxide (CO2) in the blood, which occurs mostly in the form of bicarbonate (HCO3–). The CO2 is mainly a by-product of various metabolic processes.
Measuring bicarbonate as part of an electrolyte or metabolic panel may help diagnose an electrolyte imbalance or acidosis or alkalosis. Acidosis and alkalosis describe the abnormal conditions that result from an imbalance in the pH of the blood caused by an excess of acid or alkali (base). This imbalance is typically caused by some underlying condition or disease.
The lungs and kidneys are the major organs involved in regulating blood pH through the removal of excess bicarbonate.
The lungs flush acid out of the body by exhaling CO2. Raising and lowering the respiratory rate alters the amount of CO2 that is breathed out, and this can affect blood pH within minutes.
The kidneys eliminate acids in the urine and they regulate the concentration of bicarbonate (HCO3–, a base) in blood. Acid-base changes due to increases or decreases in HCO3– concentration occur more slowly than changes in CO2, taking hours or days.
Any disease or condition that affects the lungs, kidneys, metabolism, or breathing has the potential to cause acidosis or alkalosis.
The bicarbonate test gives a healthcare practitioner a rough estimate of your acid-base balance. This is usually sufficient, but measurements of gases dissolved in the blood (blood gases) may be done if more information is needed. Bicarbonate is typically measured along with sodium, potassium, and possibly chloride in an electrolyte panel as it is the balance of these molecules that gives the healthcare practitioner the most information.
Bicarbonate Reference Ranges:
The reference ranges provided here represent a theoretical guideline that should not be used to interpret your test results. Some variation is likely between these numbers and the reference range reported by the lab that ran your test. Please consult your healthcare provider.
| AGE | CONVENTIONAL UNITS2 | SI UNITS3 |
|---|---|---|
| 0-18 years | Not available due to wide variability. See child’s lab report for reference range. | |
| Adult | 23-29 mEq/L | 23-29 mmol/L |
| >60 years | 23-31 mEq/L | 23-31 mmol/L |
| >90 years | 20-29 mEq/L | 20-29 mmol/L |
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A bicarbonate level that is higher or lower than normal may mean that the body is having trouble maintaining its acid-base balance, either by failing to remove carbon dioxide through the lungs or the kidneys or perhaps because of an electrolyte imbalance, particularly a deficiency of potassium. Both of these imbalances may be due to a wide range of conditions.
Examples of conditions that can cause a high bicarbonate level include:
- Severe, prolonged vomiting and/or diarrhea
- Lung diseases, including COPD
- Cushing syndrome
- Conn syndrome
- Metabolic alkalosis
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A bicarbonate level that is higher or lower than normal may mean that the body is having trouble maintaining its acid-base balance, either by failing to remove carbon dioxide through the lungs or the kidneys or perhaps because of an electrolyte imbalance, particularly a deficiency of potassium. Both of these imbalances may be due to a wide range of conditions.
Examples of conditions that can cause a low bicarbonate level include:
- Addison disease
- Chronic diarrhea
- Diabetic ketoacidosis
- Metabolic acidosis
- Respiratory alkalosis, which can be caused by hyperventilation
- Shock
- Kidney disease
- Ethylene glycol or methanol poisoning
- Salicylate (aspirin) overdose
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I have been using Healthmatters.io since 2021. I travel all over the world and use different doctors and health facilities. This site has allowed me to consolidate all my various test results over 14 years in one place. And every doctor that I show this to has been impressed. Because with any health professional I talk to, I can pull up historical results in seconds. It is invaluable. Even going back to the same doctor, they usually do not have the historical results from their facility in a graph format. That has been very helpful.
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What fantastic service and great, easy-to-follow layouts! I love your website; it makes it so helpful to see patterns in my health data. It's truly a pleasure to use. I only wish the NHS was as organized and quick as Healthmatters.io. You've set a new standard for health tracking!
Paul
Healthmatters Pro Member since 2024
As a PRO member and medical practitioner, Healthmatters.io has been an invaluable tool for tracking my clients' data. The layout is intuitive, making it easy to monitor trends and spot patterns over time. The ability to customize reports and charts helps me present information clearly to my clients, improving communication and outcomes. It's streamlined my workflow, saving me time and providing insights at a glance. Highly recommended for any practitioner looking for a comprehensive and user-friendly solution to track patient labs!
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