What is a chloride blood test?
A chloride blood test (serum chloride) measures the level of chloride in your blood. Chloride is one of the electrolytes in your blood. Electrolytes are minerals that carry an electric charge when they are dissolved in a liquid. The electrolytes in your blood — chloride, sodium, potassium and bicarbonate — help control nerve and muscle function and maintain the acid-base balance (pH balance) of your blood and your water balance. The amount of chloride in your blood is often measured along with other electrolytes to diagnose or monitor certain medical conditions, including:
- Kidney disease.
- Heart failure.
- Liver disease.
- High blood pressure.
- What is a chloride blood test used for?
Healthcare providers usually don’t order individual chloride blood tests. Chloride blood tests are usually included in the following routine blood tests and screenings that measure multiple things in your blood:
- Comprehensive metabolic panel (CMP).
- Basic metabolic panel (BMP).
- Electrolyte panel.
The results of a chloride blood test, alongside the results of other electrolyte tests, can help diagnose a condition related to an imbalance of acids or fluids in your body.
Why do I need a chloride blood test?
Your healthcare provider may have ordered a chloride blood test as part of a routine blood panel. Your healthcare provider may also order a chloride blood test if you have symptoms of an acid or fluid imbalance, including:
- Experiencing multiple instances of vomiting.
- Having diarrhea.
- Feeling very tired (fatigue).
- Feeling weak.
- Experiencing dehydration.
- Having difficulty breathing (respiratory distress).
What is a normal chloride blood test result?
A typical normal range for a chloride blood test for an adult is 96 to 106 milliequivalents per liter (mEq/L) or 96 to 106 millimoles per liter. However, laboratories may have different reference ranges for normal chloride levels. When you get your blood test results back, there will be information that indicates what that lab’s normal blood chloride range is. If you have any questions about your results, be sure to ask your healthcare provider.
Sources:
- Chloride Test -- https://www.testing.com/tests/chloride/
- Health Encyclopedia, Chloride -- https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=chloride
- Blood Tests -- https://www.nhlbi.nih.gov/health/blood-tests
- MedlinePlus. Chloride Blood Test -- https://medlineplus.gov/lab-tests/chloride-blood-test
- Merck Manual Consumer Version. Overview of Electrolytes -- https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/electrolyte-balance/overview-of-electrolytes
References:
American Board of Internal Medicine. ABIM Laboratory Test Reference Ranges -- https://www.abim.org/Media/bfijryql/laboratory-reference-ranges.pdf
Lewis JL III. Overview of Electrolytes. Merck Manual Consumer Edition -- https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/electrolyte-balance/overview-of-electrolytes
A.D.A.M. Medical Encyclopedia. Chloride Test – Blood -- https://medlineplus.gov/ency/article/003485.htm
Hinkle J, Cheever K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Chloride, Serum; p. 153–4.
Merck Manual Consumer Version: Merck & Co. Inc.; c2022. Acidosis -- https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/acid-base-balance/acidosis
Merck Manual Consumer Version: Merck & Co. Inc.; c2022. Addison Disease (Addison's Disease; Primary or Chronic Adrenocortical Insufficiency) -- https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/adrenal-gland-disorders/addison-disease
Merck Manual Consumer Version: Merck & Co Inc.; c2022. Acidosis -- https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/acid-base-balance/acidosis
Merck Manual Consumer Version: Merck & Co. Inc.; c2022. Overview of Acid-Base Balance -- https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/acid-base-balance/overview-of-acid-base-balance
Merck Manual Professional Version: Merck & Co. Inc.; c2022. Acid-Base Disorders -- http://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/acid-base-regulation-and-disorders/acid-base-disorders
National Heart, Lung, and Blood Institute: U.S. Department of Health and Human Services; Blood Tests -- http://www.nhlbi.nih.gov/health-topics/blood-tests
Adrogué HJ, Madias NE. Respiratory acidosis, respiratory alkalosis, and mixed disorders. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6th ed. Philadelphia, PA: Elsevier; 2019:chap 14.
Giavarina D. Blood biochemistry: measuring major plasma electrolytes. In: Ronco C, Bellomo R, Kellum JA, Ricci Z, eds. Critical Care Nephrology. 3rd ed. Philadelphia, PA: Elsevier; 2019:chap 54.
Seifter JR. Acid-base disorders. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 110.
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What does a high chloride level mean?
If your results reveal that you have higher-than-normal levels of chloride in your blood, it may indicate that you have:
- Dehydration.
- Kidney disease.
- Cushing’s syndrome.
- Metabolic acidosis (having too much acid in your blood, or a lower-than-normal blood pH).
- Respiratory alkalosis (having a low level of carbon dioxide in your blood due to breathing excessively, or hyperventilating).
An increased level of blood chloride is typically caused by dehydration but may also occur with problems that cause high blood sodium (such as Cushing syndrome or kidney disease). A high amount of chloride also occurs when too much base is lost from the body (causing metabolic acidosis) or when a person hyperventilates (causing respiratory alkalosis).
It’s important to remember that a high chloride result doesn’t necessarily mean that you have a medical condition. Certain situations and medications can also increase your chloride levels.
To lower chloride levels in the blood, it is crucial to address the underlying cause. Here are some general strategies that might help:
→ Dietary modifications: Avoiding high-chloride foods like table salt and processed foods can be beneficial.
→ Hydration: Increasing water intake can dilute chloride levels in the blood.
→ Medication adjustment: Consult a healthcare professional to assess any medications that might be contributing to high chloride levels.
The most effective approach would depend on the specific cause of elevated chloride levels. Consulting a healthcare provider for personalized guidance and treatment is crucial.
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If your results reveal that you have lower-than-normal levels of chloride in your blood, it may indicate that you have:
- Heart failure.
- Lung diseases, such as emphysema.
- Addison's disease.
- Metabolic alkalosis (having too much base in your blood, or a higher-than-normal blood pH).
A decreased level of blood chloride occurs with any disorder that causes low blood sodium. Congestive heart failure, prolonged vomiting, Addison disease, emphysema or other chronic lung diseases causing respiratory acidosis, and loss of acid from the body (causing metabolic alkalosis) all result in low levels of chloride in the blood.
A decreased level of urine chloride can be seen with Cushing syndrome, Conn syndrome, congestive heart failure, malabsorption syndrome, and diarrhea.
It’s important to remember that a low chloride result doesn’t necessarily mean that you have a medical condition. Certain situations and medications can also increase your chloride levels.
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Alanine-aminotransferase (ALT, SGPT), Albumin, Serum, Albumin/Globulin (A/G) Ratio, Alkaline Phosphatase (ALP), Aspartate-aminotransferase (AST, SGOT), Bilirubin Total, Blood urea nitrogen (BUN), BUN/Creatinine Ratio, Calcium, Serum, Carbon Dioxide (CO2), CHLORIDE, RANDOM URINE, Chloride, Serum, CHLORIDE/CREAT RATIO, Creatinine, Serum, eGFR - Estimated Glomerular Filtration Rate (African Am), eGFR - Estimated Glomerular Filtration Rate (Non-African Am), eGFR / Cystatin C, Fibrosis-4 (FIB-4), Globulin, Serum (aka Globulin, Total), Glucose, Glucose Non-Fasting, Intestinal Isoenzymes (Alkaline Phosphatase), POTASSIUM, RANDOM URINE, Potassium, Serum (Kalium), POTASSIUM/CREAT RATIO, SODIUM, RANDOM URINE, Sodium, Serum (Natrium), SODIUM/CREAT RATIO, Total Protein, Serum, Urea
