Your CMP results: which of the 14 markers to fix first

Prediabetes (100–125 mg/dL) is largely reversible with lifestyle changes. Once it becomes Type 2 diabetes (≥126 mg/dL on two readings), reversal requires more intensive intervention and is not guaranteed.

What moves fasting glucose fastest: cut refined carbohydrates and added sugar, the single most effective dietary intervention. Move after meals: a 10–15 minute walk after eating lowers post-meal glucose by 20–30% in most people. Resistance training increases insulin sensitivity faster than cardio does for fasting glucose. Lose 5–10% of body weight if overweight: this alone produces the largest and most sustained glucose reduction of any lifestyle intervention per the ADA.

Fasting glucose of 90–99 mg/dL is within reference range, still warrants a dietary review if it's crept up from a previous lower reading. The trend matters as much as the absolute value.

Elevated ALT and AST in the 1–3x upper-normal range are most often caused by non-alcoholic fatty liver disease, alcohol, or medications. All three respond to intervention. ALT typically normalises within 8–12 weeks of sustained dietary changes.

What works: reduce alcohol (ALT begins normalising within 2–4 weeks of abstinence in alcohol-related cases). Cut refined carbohydrates and fructose, the dietary drivers of hepatic fat accumulation. Lose 7–10% of body weight if overweight: this level of weight loss produces histological improvement in NAFLD, not just enzyme normalisation. Aerobic exercise at 150 min/week reduces liver fat independently of weight loss.

ALT values above 3x the upper limit of normal warrant further investigation (ultrasound, hepatitis B/C testing) before assuming lifestyle cause.

Unlike glucose and liver enzymes, impaired kidney function (eGFR below 60) doesn't typically reverse with lifestyle changes. The goal is to slow progression. Confirmed KDIGO G3a or below (eGFR below 59) should involve a clinician, management includes blood pressure control (target below 130/80 mm Hg per KDIGO), protein intake optimisation, and monitoring for worsening.

A single low eGFR reading is not diagnostic. Acute illness, dehydration, heavy exercise, and certain medications can all temporarily suppress eGFR. Confirm with a repeat test 90 days later before drawing conclusions.

BUN elevated with normal creatinine and eGFR is often dehydration or high protein intake, address those before treating it as kidney disease.

Sodium, chloride, and bicarbonate abnormalities are rarely driven by diet. They reflect fluid status, kidney function, or hormonal dysregulation. If your glucose, liver, and kidney markers are fine and only sodium or CO₂ is slightly out of range, the most likely explanations are hydration status at the time of the draw or a lab artifact from a difficult blood draw.

Potassium is the exception. Mildly low potassium (3.0–3.5 mEq/L) does respond to dietary intervention, increase potassium-rich foods (bananas, spinach, sweet potato, avocado) and reduce sodium intake. If you're on a diuretic, discuss potassium supplementation with your doctor. Potassium above 5.5 mEq/L warrants investigation regardless of symptoms. it can affect cardiac rhythm without warning.