Osmolality - blood test
Osmolality is a test that measures the concentration of all chemical particles found in the fluid part of blood.
Osmolality can also be measured with a urine test.
How the Test is Performed
How to Prepare for the Test
Follow any instructions from your health care provider about not eating before the test. Your provider may tell you to temporarily stop taking any medicines that may interfere with test results. Such medicines may include water pills (diuretics).
How the Test will Feel
When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing or a slight bruise. This soon goes away.
Why the Test is Performed
This test helps check your body's water balance. Your doctor may order this test if you have signs of any of the following:
- Low sodium (hyponatremia) or water loss
- Poisoning from harmful substances such as ethanol, methanol, or ethylene glycol
- Problems producing urine
In healthy people, when osmolality in the blood becomes high, the body releases antidiuretic hormone (ADH).
This hormone causes the kidneys to reabsorb water. This results in more concentrated urine. The reabsorbed water dilutes the blood. This allows blood osmolality to fall back to normal.
Low blood osmolality suppresses ADH. This reduces how much water the kidneys reabsorb. Dilute urine is passed to get rid of the excess water, which increases blood osmolality back toward normal.
Normal values range from 275 to 295 mosm/kg.
Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.
What Abnormal Results Mean
A higher than normal level may be due to:
- Diabetes insipidus
- High blood sugar level (hyperglycemia)
- High level of nitrogen waste products in the blood(uremia)
- High sodium level (hypernatremia)
- Stroke or head trauma resulting in decreased ADH secretion
- Water loss (dehydration)
Lower than normal levels may be due to:
- ADH oversecretion
- Adrenal gland not working normally
- Conditions linked to lung cancer
- Drinking too much water or fluid
- Low sodium level (hyponatremia)
- Underactive thyroid gland (hypothyroidism)
Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Oh MS. Evaluation of renal function, water, electrolytes, and acid-base balance. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 14.
Pincus MR, Abraham NZ Jr. Toxicology and therapeutic drug monitoring. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 23.
Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Oglvie, PhD, and the A.D.A.M. Editorial team.