Blood test

Low cholinesterase level in the blood

Blood test
>
Low cholinesterase level in the blood

What is a low cholinesterase level in the blood called?

  • Cholinesterase low

What is the normal cholinesterase level in the blood?

If you need to know which are the cholinesterase reference ranges or you require more information about the role of cholinesterase in the blood you can visit: Normal cholinesterase level in the blood

What does a low total cholinesterase level in the blood mean?

A low level of cholinesterase in the blood may be due to three main reasons:

  • A possible insecticide poisoning: Organophosphorus pesticides (parathion, sarin, tetraethyl pyrophosphate, etc.) and carbamates cause a decrease in cholinesterase serum level.
  • In a perioperative management prior to anesthesia: The cholinesterase test is performed to detect a genetic disorder that may be dangerous in surgery after the application of a muscle relaxant called Succinylcholine (suxamethonium).
  • Due to a liver disorder such as cirrhosis or hepatitis.

A low cholinesterase blood level means:

  • Moderate cholinesterase decrease (< 8 U/ml in adults):

    The meaning of a low value of cholinesterase in the blood depends on reason to perform the test:

    • Insecticide poisoning: If it is a mild poisoning you may suffer fatigue, dizziness, headache, nausea or diarrhea. If it is a moderate poisoning, chest pain or difficulty walking may be added. If it is a severe poisoning you may suffer from respiratory problems, cramps or loss of consciousness.
    • Prior to anesthesia: A value below the normal range may be a sign of a genetic disorder (usually with a family pattern). It is advisable to make a test called dibucain inhibition test to give additional information about the disorder.
    • Liver disease: A decrease around 30 to 50% may be a sign of an acute hepatitis. A decrease around 50 to 70% may be a sign of an advanced cirrhosis or a cancer with liver metastasis.

Which factors can reduce the total cholinesterase level in the blood?

Some particular health situation or drugs may reduce your cholinesterase level in the blood:

  • Caffeine
  • Pregnancy
  • Organophosphorus pesticide poisoning
  • Malnutrition
  • Menstruation
  • Drugs
    • Antiarrhythmic agents
      • Atropine
      • Quinidine
    • Antiasthmatic drugs
      • Theophylline
    • Antineoplastics
      • Cyclophosphamide
    • Oral Contraceptives
    • Drugs for acid related disorders
      • Ranitidine
    • Sex hormones
      • Estrogens
    • Acetylcholinesterase inhibitors
      • Physostigmine
      • Neostigmine
      • Pyridostigmine
    • Opiate
      • Codeine
      • Morphine
    • Vitamin K

Which diseases can reduce your total cholinesterase level in the blood?

The following diseases can explain a cholinesterase level in the blood lower than normal:

  • Viral hepatitis
  • Hepatic cirrhosis
  • Liver cancer
  • Myocardial infarction
  • Paroxysmal nocturnal hemoglobinuria

What can I do to increase the total cholinesterase level in the blood?

If cholinesterase levels are low, it is necessary to study the possible causes to reverse them. If it is due to pesticide poisoning, future exposure to these substances should be avoided.

There are also many drugs tan can interfere with the cholinesterase level in the blood. Please, ask your doctor if the medication you are taking may interfere with cholinesterase level in the blood.

Where can I find more information about cholinesterase level in the blood?

You can visit our pages about:

Which values are considered a low cholinesterase level in the blood?

The following values are considered to be above the normal range:

IMPORTANT: These levels are expressed in U/ml. They are an example of a healthy man of about 45 years old with no known disease and not taking any medication. The ranges can be different depending on the laboratory or on your personal circumstances.

Cholinesterase
Moderate cholinesterase decrease
7.9 U/ml7.8 U/ml7.7 U/ml7.6 U/ml7.5 U/ml7.4 U/ml7.3 U/ml7.2 U/ml
7.1 U/ml7 U/ml6.9 U/ml6.8 U/ml6.7 U/ml6.6 U/ml6.5 U/ml6.4 U/ml
6.3 U/ml6.2 U/ml6.1 U/ml6 U/ml5.9 U/ml5.8 U/ml5.7 U/ml5.6 U/ml
5.5 U/ml5.4 U/ml5.3 U/ml5.2 U/ml5.1 U/ml5 U/ml4.9 U/ml4.8 U/ml
4.7 U/ml4.6 U/ml4.5 U/ml4.4 U/ml4.3 U/ml4.2 U/ml4.1 U/ml4 U/ml
3.9 U/ml3.8 U/ml3.7 U/ml3.6 U/ml3.5 U/ml3.4 U/ml3.3 U/ml3.2 U/ml
3.1 U/ml3 U/ml2.9 U/ml2.8 U/ml2.7 U/ml2.6 U/ml2.5 U/ml2.4 U/ml
2.3 U/ml2.2 U/ml2.1 U/ml2 U/ml1.9 U/ml1.8 U/ml1.7 U/ml1.6 U/ml
1.5 U/ml1.4 U/ml1.3 U/ml1.2 U/ml1.1 U/ml1 U/ml0.9 U/ml0.8 U/ml
0.7 U/ml0.6 U/ml0.5 U/ml0.4 U/ml0.3 U/ml0.2 U/ml0.1 U/ml0 U/ml
Last update: 18/11/2020

Bibliography

  • Tietz. Fundamentals of Clinical Chemistry. Carl A. Burtis, Edward R. Ashwood, David E. Bruns, Barbara G. Sawyer. WB Saunders Company, 2008. Pag 328. ISBN: 978-0-7216-3865-2.

Rating Overview

Share your thoughts about this content
Poor
Excellent

E-mail (Optional):
Add a review