Anion Gap Calculator

Table of Contents

What is the anion gap?

It helps to find hidden acids in your blood.

High gap = unmeasured acids which points to toxins, diabetes, or kidney issues.

Normal gap ≠ all clear, you can still have other acid problems.

Anion gap is a metabolic detective:

  • Think of your blood like a balanced see-saw. The anion gap measures the acids we can't directly test for. The maths is: Sodium - (Chloride + Bicarbonate).

High gap = unmeasured acids:

  • When gap jumps above 16, your body's dealing with "uninvited guests" – lactic acid (from severe infection), ketones (diabetic crisis), or toxins.

Normal gap ≠ all clear:

  • Your gap can be normal (8-12) while still having acidosis. This happens with diarrhea or kidney damage – you lose bicarbonate but chloride rises, keeping the math "balanced" while your blood gets acidic.

Albumin changes the rules:

  • Albumin acts like a sponge for acid. Low albumin? Fewer sponges. Your gap looks normal but hidden acids are brewing.

How to use the anion gap calculator

How to use the calculator in 4 steps:

 

  1. Enter your lab values - Sodium, Chloride, and Bicarbonate.
  2. Add albumin if known to get the corrected, more accurate gap.
  3. Click "Calculate" to see results. 
  4. If you need to redo, click "Reset" to start fresh.

**All information is private, no data is saved or shared.**

Anion Gap Calculator

Anion Gap Calculator

Quickly calculate anion gap. Optional albumin correction included.

If you add albumin, the calculator will show corrected AG.

FAQs

Q1. What does this "Gap" actually measure in my blood?

  • Your blood contains positive charges (sodium, potassium) and negative charges (chloride, bicarbonate).
  • The "gap" is the unmeasured negative ions - mostly acids from metabolism or toxins.

Q2. Why don't you include potassium in the calculation?

  • Potassium levels change too rapidly, it jumps between cells and blood constantly.
  • While technically a positive ion, its concentration is so low (3.5-5 mEq/L vs sodium's 135-145) that including it adds noise without better accuracy.
  • *Emergency medicine protocols* specifically use the sodium-only formula for faster, more reliable decisions.

Q3. What causes a high anion gap?

  • Diabetic emergencies - Ketones flood the blood.
  • Lactic acidosis - Oxygen starvation from shock or sepsis.
  • Kidney failure - Can't remove normal acids.
  • Toxins - Alcohol, antifreeze, aspirin overdoses.
  • A high gap above 16 needs same day medical attention - it rarely goes away on its own.

Q4. How Can You Have Acid Problems With a "Normal" Gap?

  • Diarrhea - Loses bicarbonate, gains chloride.
  • Kidney tube defects - Can't hold onto bicarbonate.
  • Certain medications - Especially for blood pressure.
  • IV fluids - Massive saline can dilute bicarbonate.

References

1. Achanti, A. and Szerlip, H.M. (2022). Acid-Base Disorders in the Critically Ill Patient. Clinical Journal of the American Society of Nephrology, 18(1), p.CJN.04500422. doi:https://doi.org/10.2215/cjn.04500422. Link 

 

2. Diagnostic Use of Base Excess in Acid–Base Disorders. (2018). New England Journal of Medicine, 379(5), pp.494–496. doi:https://doi.org/10.1056/nejmc1806372. Link

 

3. Kraut, J.A. and Madias, N.E. (2007). Serum anion gap: its uses and limitations in clinical medicine. Clinical journal of the American Society of Nephrology: CJASN, [online] 2(1), pp.162–174. doi:https://doi.org/10.2215/CJN.03020906. Link


4. Morgan, T.J. (2009). The Stewart Approach – One Clinician’s Perspective. The Clinical Biochemist Reviews, [online] 30(2), p.41. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC2702213 [Accessed 23 Nov. 2025]. Link