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Testing urea levels in blood provides information about your health. This post covers the causes of high and low blood urea nitrogen (BUN) and what they may mean for you.

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What Is Blood Urea Nitrogen (BUN)?

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Blood urea nitrogen (BUN) is a measure of the amount of urea in the blood [R].

It provides useful information about your health.

The liver produces urea as a waste product of the digestion of proteins [R, R].

Urea is a safe vehicle to get rid of excess nitrogen from the body.

Urea is derived from dietary protein and tissue protein turnover [R].

On a normal diet, we produce about 12 g of urea each day [R].

The bulk of the urea, about 10 g each day, is eliminated by the kidneys [R].

A small amount of urea (less than 0.5 g/day) is lost through the gut, lungs, and skin. During exercise, a substantial amount may be lost through sweat [R].

BUN levels represent the balance between urea production (liver), urea breakdown, and urea elimination (kidneys) [R].

Therefore, BUN is an indicator of kidney health and/or liver health.

However, when it comes to kidney function, creatinine is a much more reliable indicator than the BUN, because the BUN is far more likely to be affected by dietary and physiologic conditions not related to kidney function [R].


BUN Blood Tests

Any standard blood test will have BUN or urea numbers. Conventional doctors will look at high or low BUN numbers and not mention anything, but these can indicate that certain processes in the body aren’t optimal.

Why the BUN Test Is Given

A blood urea nitrogen (BUN) test is performed to:

  • See if your kidneys are working normally or if kidney disease is progressing
  • Check for severe dehydration

Optimal and Normal BUN Ranges in Blood Tests

In Europe, the whole urea molecule is measured, whereas in the United States only the nitrogen component of urea is measured (the blood or serum urea nitrogen, i.e., BUN or SUN) [R].

The BUN is roughly one-half of the blood urea [R].

Normal human adult blood should contain between 5 to 20 mg of urea nitrogen per 100 ml (5 to 20 mg/dL) of blood, or 1.8 to 7.1 mmol urea per liter [R].

To convert from mg/dL of blood urea nitrogen to mmol/L of urea, multiply by 0.357.

The range is wide because of normal variations due to protein intake, protein breakdown, state of hydration, liver urea production, and urea elimination by the kidneys [R].

Decreased or elevated BUN concentrations are usually seen in pregnancy [R, R].

I like to see BUN levels between 7 to 15 mg/dL, which I consider a more optimal range.

Factors That Elevate BUN

      • High-protein diet [R]
      • Fever or infection, which increase protein breakdown. Increased protein breakdown is a common feature of illness. Protein breakdown is stimulated by hormones (such as glucagon, epinephrine, and cortisol) and inflammatory cytokines. Protein production, on the other hand, is reduced by lowering growth hormone, insulin, and testosterone levels [R, R]
      • Inflammation or interval training, which results in protein breakdown from muscle
      • Dehydration or low water consumption – I use this as a measure of hydration in clients. BUN increases as blood volume decreases [R]
      • Stress – An inappropriate increase in the activation of the sympathetic, renin-angiotensin-aldosterone, and arginine-vasopressin systems elevate BUN, which is often seen in heart failure. Cortisol will also increase protein breakdown and elevate BUN [R, R]
      • Gut bleeding -When upper GI bleeding occurs, the blood is digested to protein. This protein is transported to the liver, and metabolized to BUN [R, R]
      • Poor circulation, which results in lower blood flow to the kidneys and therefore less of an ability to clear the urea [R, R]
      • Thyroid abnormalities, which result in abnormal kidney function: hypothyroidism, and hyperthyroidism [R, R]
      • Glucocorticoids, Tetracyclines (except doxycycline) and other antianabolic drugs [R]
      • Lower growth hormone or IGF-1. IGF-1 and growth hormone inhibit urea synthesis [R]
      • Kidney disease or failure, and blockage of the urinary tract by a kidney stone [R]

Why Is High BUN Bad?

Elevated urea on its own has some adverse effects. Urea in high concentrations can cause oxidative stress in cells [R, R].

However, high BUN is also an indicator of other underlying conditions.

High BUN indicates increased protein breakdown, which is associated with decreased immune function. A study shows that patients with elevated BUN (> 20 mg/dl) have an increased risk of infection [R].

High BUN is associated with increased mortality in critically ill patients [R, R, R, R].

Elevated BUN is also associated with increased stroke risk in heart surgery, and adverse outcomes in atherosclerosis and heart failure patients [R, RR].

Note that BUN values remain within the normal range until more than 50% of renal function is lost. Within that range, however, a doubling of the values (e.g., BUN rising from 8 to 16 mg/dl) may mean a 50% fall in kidney function [R].

Symptoms of High Urea Nitrogen/BUN

The urea nitrogen test is often ordered for people who are experiencing signs and symptoms of kidney disorders. These symptoms can include:

      • Frequent urination
      • Discolored urine (bloody, dark, or foamy)
      • Joint pain
      • Bone pain
      • Back pain
      • Muscle cramping
      • Restless legs
      • Fatigue
      • Trouble sleeping
      • Poor appetite
      • Swelling (especially in the extremities)
      • Itchiness

BUN to Creatinine Ratio (BUN:creatinine)

A BUN test is usually done with a blood creatinine test.

The level of creatinine in your blood also tells how well your kidneys are working. A high creatinine level may mean your kidneys are not working properly, but if it’s slightly elevated, it could simply mean that you have a lot of muscle.

Blood urea nitrogen (BUN) and creatinine tests can be used together to find the BUN-to-creatinine ratio.

In general, you want to have lower BUN and lower creatinine. However, in most cases, it’s healthier to have a lower ratio of BUN to creatinine (10 is ideal).

Factors That Decrease BUN

      • Low-protein diet, malnutrition, or starvation [R]
      • Impaired liver activity due to liver disease [R]
      • Genetic deficiency of urea cycle enzymes [R]
      • Higher IGF-1 and growth hormone. These inhibit urea synthesis. Growth hormone-deficient children given human growth hormone have lower urea nitrogen, and this is due to decreased urea synthesis [R, R]
      • Anabolic steroids, which decrease protein breakdown
      • Overhydration, or drinking a lot of water
      • Pregnancy (due to increased plasma volume) [R]

How to Decrease or Reduce BUN

There are two main ways to decrease BUN:

      • Drink more water
      • Eat less protein

Ginger may help with the removal of urea from blood. Ginger extract markedly decreased BUN in mice [R].

Inhibiting Arginase

Arginase converts L-arginine to urea. When you inhibit arginase, you decrease urea. The downside to this might theoretically be a buildup of ammonia.

Nickel is required for the conversion of urea-form nitrogen to ammonia. A deficiency of nickel leads to a urea toxicity.

The following inhibit arginase:

Interesting Facts About Urea

Urea is a diuretic, which means it causes us to lose water [R, R].

Urea creams promote rehydration of the skin.

Urea is the main ingredient in urine, which is sometimes used in alternative medicine.

Genetics of Urea

There are 5 key enzymes in the urea cycle:

      • Carbamoyl-phosphate synthetase 1 (CPS1)
      • Ornithine transcarbamylase (OTC)
      • Argininosuccinate synthetase (ASS1)
      • Argininosuccinate lyase (ASL)
      • Arginase 1 (ARG1)

Additionally, a sixth enzyme, N-acetylglutamate synthase (NAGS), is critical for urea cycle function, providing CPS1 with its necessary cofactor. Deficiencies in any of these enzymes result in elevated blood ammonia concentrations, which can have detrimental effects, including central nervous system dysfunction, brain damage, coma, and death [R].

SNPs in the CPS1 gene

SNPs in the OTC gene

Two SNPs – 389 G/A (rs5963409) and -241 A/G (rs5963411) in the OTC gene are associated with the risk of developing Alzheimer’s [R].

SNPs in the ARG1 gene

SNPs in the ARG2 gene

rs742869 (G), a minor allele, is associated (in men) with an increase in Alzheimer’s disease risk, an earlier age at onset, and a potential decrease in Arg2 expression [R].

Irregular BUN levels?

Are your issues with the urea cycle are caused by your genes? Upload your genetic data to SelfDecode to find out. SelfDecode is the best and most powerful genetic application, which will help you interpret your genes. You need to sign up and upload your genetics to see what versions of these genes you have (using 23andme or Ancestry).

Here are relevant SelfDecode pages:

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  • Shir

    Hi, my BUN is low (6) and Bun/creat ratio is low (5.31) the creatinine was normal (1.13). This has been the past 2 tests over 4 months. I can’t find anything on low bun and pretty low bun/creat ration but avg creatinine. Any insight?

  • Namita

    My BUN is 5.90…how to increase it?

  • Jacki

    What should one do if BUN is high?

  • Jocel

    Good Day! My daughter has low BUN, what must be the best to increase it into Normal?

  • Aak

    My bilirubin direct is 20.Is this ok?

    1. Helen

      Hi, you can ask Joe inside of VIP: or over at

  • bill rushing

    my blood test shoes my bun went from17 one year ago to 25. i have been drinking protein shakes at least 3 times a day the last month. could this be a problem?

  • Gulnaazimtiaz

    Yes .it is. suggest about low bun and how to increase it to normal level

  • samani prajna

    cause and effect of low blood urea is not given in this article

    1. Alex last

      Yes there is,its under the causes of high bun,

  • Raymond, craniosacral relexologist & Trauma therapist

    Thank you. Nice approach.

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