Reference ranges for blood tests

Source: Wikipedia, the free encyclopedia.
Reference
ranges

In:

Reference ranges (reference intervals) for blood tests are sets of values used by a

bodily fluids.[citation needed
]

Blood test results should always be interpreted using the reference range provided by the laboratory that performed the test.[1]

Interpretation

A reference range is usually defined as the set of values 95 percent of the normal population falls within (that is, 95% prediction interval).[2] It is determined by collecting data from vast numbers of laboratory tests.[citation needed]

Plasma or whole blood

In this article, all values (except the ones listed below) denote

red blood cells (RBCs) is negligible. The precise factor depends on hematocrit as well as amount inside RBCs. Exceptions are mainly those values that denote total blood concentration, and in this article they are:[3]

  • All values in Hematology – red blood cells (except hemoglobin in plasma)
  • All values in Hematology – white blood cells
  • Platelet count (Plt)

A few values are for inside red blood cells only:

  • Vitamin B9 (folic acid/folate) in red blood cells
  • Mean corpuscular hemoglobin concentration (MCHC)

Units

Arterial or venous

If not otherwise specified, a reference range for a blood test is generally the

blood gases, which are generally given for arterial blood.[citation needed
]

Still, the blood values are approximately equal between the arterial and venous sides for most substances, with the exception of acid–base, blood gases and drugs (used in therapeutic drug monitoring (TDM) assays).[6] Arterial levels for drugs are generally higher than venous levels because of extraction while passing through tissues.[6]

Usual or optimal

congestive heart failure, respectively, for the aforementioned substances.[7][8][9]

Variability

Further information: Reference range

References range may vary with age, sex, race, pregnancy,

standardisation, lack of certified reference material and differing antibody reactivity.[11] Also, reference ranges may be inaccurate when the reference groups used to establish the ranges are small.[12]

Sorted by concentration

By mass and molarity

Smaller, narrower boxes indicate a more tight homeostatic regulation when measured as standard "usual" reference range.

molarity below. (A separate printable image is available for mass and molarity
)

Hormones predominate at the left part of the scale, shown with a red at ng/L or pmol/L, being in very low concentration. There appears to be the greatest cluster of substances in the yellow part (μg/L or nmol/L), becoming sparser in the green part (mg/L or μmol/L). However, there is another cluster containing many metabolic substances like cholesterol and glucose at the limit with the blue part (g/L or mmol/L).[citation needed]

The unit conversions of substance concentrations from the molar to the mass concentration scale above are made as follows:

  • Numerically:
  • Measured directly in distance on the scales:
,

where distance is the direct (not logarithmic) distance in number of decades or "octaves" to the right the mass concentration is found. To translate from mass to molar concentration, the dividend (molar mass and the divisor (1000) in the division change places, or, alternatively, distance to right is changed to distance to left. Substances with a molar mass around 1000g/mol (e.g. thyroxine) are almost vertically aligned in the mass and molar images. Adrenocorticotropic hormone, on the other hand, with a molar mass of 4540,[13] is 0.7 decades to the right in the mass image. Substances with molar mass below 1000g/mol (e.g. electrolytes and metabolites) would have "negative" distance, that is, masses deviating to the left. Many substances given in mass concentration are not given in molar amount because they haven't been added to the article.

The diagram above can also be used as an alternative way to convert any substance concentration (not only the normal or optimal ones) from molar to mass units and vice versa for those substances appearing in both scales, by measuring how much they are horizontally displaced from one another (representing the molar mass for that substance), and using the same distance from the concentration to be converted to determine the equivalent concentration in terms of the other unit. For example, on a certain monitor, the horizontal distance between the upper limits for parathyroid hormone in pmol/L and pg/mL may be 7 cm, with the mass concentration to the right. A molar concentration of, for example, 5 pmol/L would therefore correspond to a mass concentration located 7 cm to the right in the mass diagram, that is, approximately 45 pg/mL.

By units

Units do not necessarily imply anything about molarity or mass.

A few substances are below this main interval, e.g.

thyroid stimulating hormone, being measured in mU/L, or above, like rheumatoid factor and CA19-9
, being measured in U/mL.

By enzyme activity

White blood cells

Sorted by category

Ions and trace metals

Further information: Trace metal and Metals in medicine

Included here are also related binding proteins, like ferritin and transferrin for iron, and ceruloplasmin for copper.

Test Lower limit Upper limit Unit* Comments
Sodium (Na) 135,[14] 137[5][15] 145,[5][15] 147[14] mmol/L or mEq/L[14] See hyponatremia or hypernatremia
310,[16] 320[16] 330,[16] 340[16] mg/dL
Potassium (K) 3.5,[5][14] 3.6[15] 5.0,[5][14][15] 5.1 mmol/L or mEq/L[14] See hypokalemia or hyperkalemia
14[17] 20[17] mg/dL
Chloride (Cl) 95,[14] 98,[18] 100[5] 105,[14] 106,[18] 110[5] mmol/L or mEq/L[14] See hypochloremia or hyperchloremia
340[19] 370[19] mg/dL
Ionized calcium (Ca) 1.03,[20] 1.10[5] 1.23,[20] 1.30[5] mmol/L See
hypocalcaemia or hypercalcaemia
4.1,[21] 4.4[21] 4.9,[21] 5.2[21] mg/dL
Total calcium (Ca) 2.1,[14][22] 2.2[5] 2.5,[5][22] 2.6,[22] 2.8[14] mmol/L
8.4,[14] 8.5[23] 10.2,[14] 10.5[23] mg/dL
Total serum iron (TSI) – male 65,[24] 76[15] 176,[24] 198[15] µg/dL See hypoferremia or the following: iron overload (hemochromatosis), iron poisoning, siderosis, hemosiderosis, hyperferremia
11.6,[25][26] 13.6[26] 30,[25] 32,[26] 35[26] μmol/L
Total serum iron (TSI) – female 26,[15] 50[24] 170[15][24] µg/dL
4.6,[26] 8.9[25] 30.4[25] μmol/L
Total serum iron (TSI) –
newborns
 100[24] 250[24] µg/dL
18[26] 45[26] µmol/L
Total serum iron (TSI) – children 50[24] 120[24] µg/dL
9[26] 21[26] µmol/L
Total iron-binding capacity (TIBC) 240,[24] 262[15] 450,[24] 474[15] μg/dL
43,[26] 47[26] 81,[26] 85[26] µmol/L
Transferrin 190,[27] 194,[5] 204[15] 326,[5] 330,[27] 360[15] mg/dL
25[28] 45[28] μmol/L
Transferrin saturation 20[24] 50[24] %
postmenopausal
females		 12[29] 300[29][30] ng/mL or µg/L
27[31] 670[31] pmol/L
Ferritin – premenopausal females 12[29] 150[29] – 200[30] ng/mL or µg/L
27[31] 330[31] – 440[31] pmol/L
Ammonia 10,[32] 20[33] 35,[32] 65[33] μmol/L See hypoammonemia and hyperammonemia
17,[34] 34[34] 60,[34] 110[34] μg/dL
Copper (Cu) 70[23] 150[23] µg/dL See hypocupremia or hypercupremia
11[35][36] 24[35] μmol/L
Ceruloplasmin 15[23] 60[23] mg/dL
1[37] 4[37] μmol/L
Phosphate (HPO42−) 0.8 1.5[38] mmol/L See hypophosphatemia or hyperphosphatemia
Inorganic phosphorus (serum) 1.0[14] 1.5[14] mmol/L
3.0[14] 4.5[14] mg/dL
Zinc (Zn) 60,[39] 72[40] 110,[40] 130[39] μg/dL See zinc deficiency or zinc poisoning
9.2,[41] 11[5] 17,[5] 20[41] µmol/L
Magnesium 1.5,[23] 1.7[42] 2.0,[23] 2.3[42] mEq/L or mg/dL See
hypomagnesemia or hypermagnesemia
0.6,[43] 0.7[5] 0.82,[43] 0.95[5] mmol/L
  • Note: Although 'mEq' for mass and 'mEq/L' are sometimes used in the United States and elsewhere, they are not part of
    SI
    and are now considered redundant.

Acid–base and blood gases

Further information: Acid–base homeostasis
Further information: Arterial blood gas test and Arterial blood gas test § Parameters and reference ranges

If arterial/venous is not specified for an acid–base or blood gas value, then it generally refers to arterial, and not venous which otherwise is standard for other blood tests.[citation needed]

Acid–base and blood gases are among the few blood constituents that exhibit substantial difference between arterial and venous values.[6] Still, pH, bicarbonate and base excess show a high level of inter-method reliability between arterial and venous tests, so arterial and venous values are roughly equivalent for these.[44]

Test Arterial/Venous Lower limit Upper limit Unit
pH Arterial 7.34,[15] 7.35[14] 7.44,[15] 7.45[14]
Venous 7.31[45] 7.41[45]
[H+] Arterial 36[14] 44[14] nmol/L
3.6[46] 4.4[46] ng/dL
Base excess Arterial & venous[45] −3[45] +3[45] mEq/L
Oxygen partial pressure
(pO2)
Arterial pO2
 10,[14] 11[47] 13,[47] 14[14] kPa
75,[14][15] 83[23] 100,[15] 105[14]
mmHg or torr
Venous 4.0[47] 5.3[47] kPa
30[45] 40[45] mmHg or torr
Oxygen saturation Arterial 94,[45] 95,[18] 96[23] 100[18][23] %
Venous Approximately 75[18]
Carbon dioxide partial pressure
(pCO2)
Arterial PaCO2
 4.4,[14] 4.7[47] 5.9,[14] 6.0[47] kPa
33,[14] 35[15] 44,[14] 45[15] mmHg or torr
Venous 5.5,[47] 6.8[47] kPa
41[45] 51[45] mmHg or torr
Absolute content of carbon dioxide (CO2) Arterial 23[45] 30[45] mmol/L
100[48] 132[48] mg/dL
Bicarbonate (HCO3−) Arterial & venous 18[23] 23[23] mmol/L
110[49] 140[49] mg/dL
Standard bicarbonate
(SBCe)		 Arterial & venous 21, 22[14] 27, 28[14] mmol/L or mEq/L[14]
134[49] 170[49] mg/dL

Liver function

Further information: Liver function tests
Test Patient type Lower limit Upper limit Unit Comments
Total protein (TotPro) 60,[14] 63[15] 78,[14] 82,[15] 84[23] g/L See serum total protein Interpretation
Albumin 35[14][50] 48,[15] 55[14] g/L See hypoalbuminemia
3.5[15] 4.8,[15] 5.5[14] U/L
540[51] 740[51] μmol/L
Globulins
 23[14] 35[14] g/L
Total bilirubin 1.7,[52] 2,[14] 3.4,[52] 5[5] 17,[14][52] 22,[52] 25[5] μmol/L
0.1,[14] 0.2,[15] 0.29[53] 1.0,[14][23] 1.3,[15] 1.4[53] mg/dL
Direct/conjugated bilirubin 0.0[14] or N/A[5] 5,[14] 7[5][52] μmol/L
0[14][15] 0.3,[14][15] 0.4[23] mg/dL
Alanine transaminase (ALT/ALAT[5]) 5,[54] 7,[15] 8[14] 20,[14] 21,[18] 56[15] U/L Also called serum glutamic pyruvic transaminase (SGPT)
Female 0.15[5] 0.75[5] µkat/L
Male 0.15[5] 1.1[5]
Aspartate transaminase (AST/ASAT[5]) Female 6[55] 34[55] IU/L Also called
serum glutamic oxaloacetic transaminase (SGOT)
0.25[5] 0.60[5] µkat/L
Male 8[55] 40[55] IU/L
0.25[5] 0.75[5] µkat/L
Alkaline phosphatase (ALP) 0.6[5] 1.8[5] µkat/L
Female 42[54] 98[54] U/L
Male 53[54] 128[54]
Gamma glutamyl transferase
(GGT)		 5,[54] 8[15] 40,[54] 78[15] U/L
Female 0.63[56] µkat/L
Male 0.92[56] µkat/L

Cardiac tests

Test Patient type Lower limit Upper limit Unit Comments
Creatine kinase (CK) Male 24,[57] 38,[15] 60[54] 174,[23] 320[54] U/L or ng/mL
0.42[58] 1.5[58] µkat/L
Female 24,[57] 38,[15] 96[23] 140,[23] 200[54] U/L or ng/mL
0.17[58] 1.17[58] µkat/L
CK-MB
 0 3,[15] 3.8,[5] 5[54] ng/mL or μg/L[5]
Myoglobin Female 1[59] 66[59] ng/mL or µg/L
Male 17[59] 106[59]
Cardiac troponin T (low sensitive) 0.1[7] ng/mL 99th percentile
cutoff
Cardiac troponin I

(high sensitive)

0.03[7] ng/mL 99th percentile
cutoff
Cardiac troponin T (high sensitive) Male 0.022[7] ng/mL 99th percentile
cutoff
Female 0.014[7] ng/mL 99th percentile
cutoff
newborn/infants not established more than adults [60][61]
BNP
article
Interpretation Range / Cutoff
Congestive heart failure
unlikely
< 100 pg/mL[8][9]
"Gray zone" 100–500 pg/mL[8][9]
Congestive heart failure
likely
> 500 pg/mL[8][9]
NT-proBNP
-more detailed ranges in NT-proBNP article
Interpretation Age Cutoff
Congestive heart failure
likely
<
75 years
> 125 pg/mL[62]
> 75 years > 450pg/mL[62]

Lipids

Further information: Blood lipids
Test Patient type Lower limit Upper limit Unit
Therapeutic target
Triglycerides 10–39 years 54[23] 110[23] mg/dL < 100 mg/dL[63]
or 1.1 mmol/L[63]
0.61[64] 1.2[64] mmol/L
40–59 years 70[23] 150[23] mg/dL
0.77[64] 1.7[64] mmol/L
> 60 years 80[23] 150[23] mg/dL
0.9[64] 1.7[64] mmol/L
Total cholesterol 3.0,[65] 3.6[14][65] 5.0,[5][66] 6.5[14] mmol/L < 3.9 mmol/L[63]
120,[15] 140[14] 200,[15] 250[14] mg/dL < 150 mg/dL[63]
HDL cholesterol
 Female 1.0,[67] 1.2,[5] 1.3[65] 2.2[67] mmol/L > 1.0[67] or 1.6[65] mmol/L
40[68] or 60[69] mg/dL
40,[68] 50[70] 86[68] mg/dL
HDL cholesterol Male 0.9[5][67] 2.0[67] mmol/L
35[68] 80[68] mg/dL
LDL cholesterol

(Not valid when
triglycerides >5.0 mmol/L)		 2.0,[67] 2.4[66] 3.0,[5][66] 3.4[67] mmol/L < 2.5 mmol/L[67]
80,[68] 94[68] 120,[68] 130[68] mg/dL < 100 mg/dL[68]
LDL/HDL quotient n/a 5[5] (unitless)

Tumour markers

Further information:
Tumour markers
Test Patient type
Cutoff
 Unit Comments
Alpha fetoprotein
(AFP)		 44[15] ng/mL or µg/L Hepatocellular carcinoma or testicular cancer
Beta
human chorionic gonadotrophin
(β-hCG)		 In males and non-pregnant females 5[15] IU/L or mU/mL choriocarcinoma
CA19-9 40[15] U/mL Pancreatic cancer
CA-125
 30,[71] 35[72] kU/L or U/mL
Carcinoembryonic antigen (CEA) Non-smokers, 50 years 3.4,[5] 3.6[73] μg/L
Non-smokers, 70 years 4.1[73]
Smokers 5[74]
Prostate specific antigen
(PSA)		 40–49 years 1.2–2.9[75] μg/L[5][15] or ng/mL[23] More detailed cutoffs in PSA – Serum levels
70–79 years, non-
African-American
 4.0–9.0[75]
70–79 years, African-American 7.7–13[75]
PAP 3[23] units/dL (Bodansky units)
Calcitonin 5,[76] 15[76] ng/L or pg/mL Cutoff against
cutoffs in Calcitonin
article

Endocrinology

Thyroid hormones

Further information: Thyroid function tests
Test Patient type Lower limit Upper limit Unit
Thyroid stimulating hormone

(TSH or thyrotropin)		 Adults –
standard range		 0.3,[5] 0.4,[15] 0.5,[23] 0.6[77] 4.0,[5] 4.5,[15] 6.0[23] mIU/L or μIU/mL
Adults –
optimal range
 0.3,[78] 0.5[79] 2.0,[79] 3.0[78]
Infants 1.3[80] 19[80]
Free
thyroxine (FT4)
-more detailed ranges in
Thyroid function tests
article
 Normal adult 0.7,[81] 0.8[15] 1.4,[81] 1.5,[15] 1.8[82] ng/dL
9,[5][83] 10,[84] 12[85] 18,[5][83] 23[85] pmol/L
Child/Adolescent
31 d – 18 y		 0.8[81] 2.0[81] ng/dL
10[83] 26[83] pmol/L
Pregnant 0.5[81] 1.0[81] ng/dL
6.5[83] 13[83] pmol/L
Total thyroxine 4,[84] 5.5[15] 11,[84] 12.3[15] μg/dL
60[84][85] 140,[84] 160[85] nmol/L
Free triiodothyronine (FT3) Normal adult 0.2[84] 0.5[84] ng/dL
3.1[86] 7.7[86] pmol/L
Children 2-16 y 0.1[87] 0.6[87] ng/dL
1.5[86] 9.2[86] pmol/L
Total triiodothyronine 60,[15] 75[84] 175,[84] 181[15] ng/dL
0.9,[5] 1.1[84] 2.5,[5] 2.7[84] nmol/L
Thyroxine-binding globulin (TBG) 12[15] 30[15] mg/L
Thyroglobulin (Tg) 1.5[84] 30[84] pmol/L
1[84] 20[84] μg/L

Sex hormones

Further information:
Sex steroid

The diagrams below take inter-cycle and inter-woman variability into account in displaying reference ranges for estradiol, progesterone, FSH and LH.

Levels of estradiol (the main estrogen), progesterone, luteinizing hormone and follicle-stimulating hormone during the menstrual cycle.[88]
Test Patient type Lower limit Upper limit Unit
Dihydrotestosterone adult male 30 85 ng/dL
Testosterone Male, overall 8,[89] 10[90] 27,[89] 35[90] nmol/L
230,[91] 300[92] 780–1000[91][92] ng/dL
Male < 50 years 10[5] 45[5] nmol/L
290[91] 1300[91] ng/dL
Male > 50 years 6.2[5] 26[5] nmol/L
180[91] 740[91] ng/dL
Female 0.7[90] 2.8–3.0[90][5] nmol/L
20[92] 80–85[92][91] ng/dL
17α-Hydroxyprogesterone male 0.06[23] 3.0[23] mg/L
0.18[93] 9.1[93] µmol/L
Female (Follicular phase) 0.2[23] 1.0[23] mg/L
0.6[93] 3.0[93] µmol/L
Follicle-stimulating
hormone (FSH)
-more detailed menstrual cycle
ranges in separate diagram
 Prepubertal <1[94] 3[94] IU/L
Adult male 1[94] 8[94]
Adult female (follicular
and luteal phase)		 1[94] 11[94]
Adult female (Ovulation) 6[94]
95% PI (standard)		 26[94]
95% PI)
5[95]
90% PI (used in diagram)		 15[95]
(90% PI)
Post-menopausal female 30[94] 118[94]
Luteinizing hormone (LH)
-more detailed menstrual cycle
ranges in separate diagram
 Female, peak 20[95]
90% PI (used in diagram)		 75[95]
(90% PI)		 IU/L
Female, post-menopausal 15[96] 60[96]
Male aged 18+ 2[97] 9[97]
Estradiol
(an estrogen)
-more detailed ranges in
estradiol article
 Adult male 50[98] 200[98] pmol/L
14[99] 55[99] pg/mL
Adult female (day 5 of follicular phase,
and luteal phase)		 70[98] 500,[98] 600[98] pmol/L
19[99] 140,[99] 160[99] pg/mL
Adult female – free (not protein bound) 0.5[100] 9[100] pg/mL
1.7[100] 33[100] pmol/L
Post-menopausal female N/A[98] < 130[98] pmol/L
N/A[99] < 35[99] pg/mL
Progesterone
-more detailed ranges
in Progesterone article
 Female in mid-luteal phase (day 21–23) 17,[95] 35[101] 92[101] nmol/L
6,[95] 11[102] 29[102] ng/mL
Androstenedione Adult male and female 60[96] 270[96] ng/dL
Post-menopausal female < 180[96]
Prepubertal < 60[96]
Dehydroepiandrosterone sulfate
-more detailed ranges
in DHEA-S article
 Adult male and female 30[103] 400[103] µg/dL
SHBG
-more detailed ranges
in SHBG article
 Adult female 40[104] 120[104] nmol/L
Adult male 20[104] 60[104]
Anti-Müllerian hormone (AMH)
-more detailed ranges in
AMH article
 13–45 years 0.7[105] 20[105] ng/mL
5[106] 140[106] pmol/L

Other hormones

Further information:
Hormones
Test Patient type Lower limit Upper limit Unit
Adrenocorticotropic hormone (ACTH) 2.2[107] 13.3[107] pmol/L
20[15] 100[15] pg/mL
Cortisol 09:00
am
 140[108] 700[108] nmol/L
5[109] 25[109] μg/dL
Midnight 80[108] 350[108] nmol/L
2.9[109] 13[109] μg/dL
Growth hormone (fasting) 0 5[14] ng/mL
arginine stimulation
)		 7[14] n/a ng/mL
IGF-1
-more detailed ranges in
IGF-1 article
 Female, 20 yrs 110[110] 420[110] ng/mL
Female, 75 yrs 55[110] 220[110]
Male, 20 yrs 160[110] 390[110]
Male, 75 yrs 48[110] 200[110]
Prolactin
-more detailed ranges in
Prolactin article
 Female 71,[111] 105[111] 348,[111] 548[111] mIU/L
3.4,[111] 3.9[111] 16.4,[111] 20.3[111] µg/L
Male 58,[111] 89[111] 277,[111] 365[111] mIU/L
2.7,[111] 3.3[111] 13.0,[111] 13.5[111] µg/L
Parathyroid hormone (PTH) 10,[112] 17[113] 65,[112] 70[113] pg/mL
1.1,[5] 1.8[114] 6.9,[5] 7.5[114] pmol/L
Standard reference range
 8,[23][115] 9[115] 40,[115] 80[23] ng/mL
20,[116] 23[117] 95,[117] 150[116] nmol/L
Therapeutic target range
 30,[118] 40[119] 65,[119] 100[118] ng/mL
85,[63] 100[119] 120,[63] 160[119] nmol/L
Plasma renin activity 0.29,[120] 1.9[121] 3.7[120][121] ng/(mL·h)
3.3,[122] 21[123] 41[122][123]
mcU
/mL
Aldosterone
-more detailed ranges in
Aldosterone article
 Adult 19,[122] 34.0[122] ng/dL
530,[124] 940[124] pmol/L
Aldosterone-to-renin ratio
-more detailed ranges in
Aldosterone/renin ratio article
 Adult 13.1,[125] 35.0[125] ng/dL per ng/(mL·h)
360,[125] 970[125] pmol/liter per µg/(L·h)

Vitamins

Also including the vitamin B12)-related amino acid homocysteine.

Test Patient type
Standard range
Optimal range
 Unit
Lower limit Upper limit Lower limit Upper limit
Vitamin A 30[23] 65[23] µg/dL
Vitamin B9

(Folic acid/Folate) – Serum		 Age > 1 year 3.0[126] 16[126] 5[127] ng/mL or μg/L
6.8[128] 36[128] 11[128] nmol/L
Vitamin B9
(Folic acid/Folate) – Red blood cells
 200[126] 600[126] ng/mL or μg/L
450[128] 1400[128] nmol/L
Pregnant 400[126] ng/mL or μg/L
900[126] nmol/L
Vitamin B12 (Cobalamin) 130,[129] 160[130] 700,[129] 950[130] ng/L
100,[131] 120[5] 520,[131] 700[5] pmol/L
Homocysteine
-more detailed ranges in
Homocysteine article
 3.3,[132] 5.9[132] 7.2,[132] 15.3[132] 6.3[63] μmol/L
45,[133] 80[133] 100,[133] 210[133] 85[63] μg/dL
Vitamin C (Ascorbic acid) 0.4[23] 1.5[23] 0.9[63] mg/dL
23[134] 85[134] 50[63] μmol/L
25-hydroxycholecalciferol (a vitamin D
)		 8,[23][115] 9[115] 40,[115] 80[23] 30,[118] 40[119] 65,[119] 100[118] ng/mL
20,[116] 23[117] 95,[117] 150[116] 85,[63] 100[119] 120,[63] 160[119] nmol/L
Vitamin E 28[63] μmol/L
1.2[63] mg/dL

Toxic Substances

Test Limit type Limit Unit
Lead
Optimal health range
 < 20[18] or 40[23] µg/dL
Blood ethanol content
 Limit for drunk driving 0,[135] 0.2,[135] 0.8[135]
‰
or g/L
17.4[136] mmol/L

Hematology

Red blood cells

These values (except Hemoglobin in plasma) are for total blood and not only blood plasma.

Test Patient Lower limit Upper limit Unit Comments
Hemoglobin (Hb) Male 2.0,[137] 2.1[14][138] 2.5,[137] 2.7[14][138] mmol/L Higher in
neonates
, lower in children.
130,[5] 132,[15] 135[14] 162,[15] 170,[5] 175[14] g/L
Female 1.8,[137] 1.9[14][138] 2.3,[137] 2.5[14][137][138] mmol/L Sex difference negligible until adulthood.
120[5][14][15] 150,[5] 152,[15] 160[14][23] g/L
Hemoglobin subunits (sometimes displayed simply as "Hemoglobin") Male 8.0,[139] 8.4[139] 10.0,[139] 10.8[139] mmol/L 4 per hemoglobin molecule
Female 7.2,[139] 7.6[139] 9.2,[139] 10.0[139]
Hemoglobin in plasma 0.16[14] 0.62[14] μmol/L Normally diminutive compared with inside red blood cells
1 4 mg/dL
Glycated hemoglobin (HbA1c) < 50 years 3.6[5] 5.0[5] % of Hb
> 50 years 3.9[5] 5.3[5]
Haptoglobin < 50 years 0.35[5] 1.9[5] g/L
> 50 years 0.47[5] 2.1[5]
Hematocrit (Hct) Male 0.39,[5] 0.4,[15] 0.41,[14] 0.45[23] 0.50,[5] 0.52,[15] 0.53,[14] 0.62[23] L/L
Female 0.35,[5] 0.36,[14] 0.37[15][23] 0.46,[5][14][15] 0.48[23] L/L
Child 0.31[15] 0.43[15] L/L
Mean corpuscular volume (MCV) Male 76,[23] 82[15] 100,[23] 102[15] fL Cells are larger in
neonates
, though smaller in other children.
Female 78[15] 101[15] fL
Red blood cell distribution width (RDW) 11.5[15] 14.5[15] %
Mean cell hemoglobin (MCH) 0.39[14] 0.54[14] fmol/cell
25,[14] 27[5][23] 32,[23] 33,[5] 35[14] pg/cell
Mean corpuscular hemoglobin concentration (MCHC) 4.8,[140] 5.0[140] 5.4,[140] 5.6[140] mmol/L
31,[15] 32[5][23] 35,[15] 36[5][23] g/dL or %[note 1]
Erythrocytes/
Red blood cells
(RBC)		 Male 4.2,[23] 4.3[5][14][15] 5.7,[5] 5.9,[14] 6.2,[15] 6.9[23] x1012/L
or
million
/mm3
Female 3.5,[14] 3.8,[15] 3.9[5] 5.1,[5] 5.5[14][15]
Infant/Child 3.8[15] 5.5[15]
Reticulocytes Adult 26[5] 130[5] x109/L
0.5[14][15] 1.5[14][15] % of RBC
Newborn 1.1[15] 4.5[15] % of RBC
Infant 0.5[15] 3.1[15] % of RBC
Immature reticulocyte fraction (IRF) Adult 1.6[141] 12.1[141] % of reticulocytes
Reticulocyte hemoglobin equivalent Adult 30.0[141] 37.6[141] %
24.1[142] 35.8[142] pg
Immature platelet fraction (IPF) Adult 0.8[141] 5.6[141] %

White blood cells

These values are for total blood and not only blood plasma.

Test Patient type Lower limit Upper limit Unit
White Blood Cell Count (WBC
)		 Adult 3.5,[5] 3.9,[143] 4.1,[15] 4.5[14] 9.0,[5] 10.0,[143] 10.9,[15] 11[14]
  • x109/L
  • x103/mm3 or
  • x103/μL
Newborn 9[144] 30[144]
1 year old 6[144] 18[144]
Neutrophil granulocytes

(A.K.A. grans, polys, PMNs, or segs)		 Adult 1.3,[5] 1.8,[143] 2[144] 5.4,[5] 7,[143] 8[144] x109/L
45–54[14] 62,[14] 74 % of WBC
Newborn 6[144] 26[144] x109/L
Neutrophilic band forms Adult 0.7[144] x109/L
3[14] 5[14] % of WBC
Lymphocytes Adult 0.7,[5] 1.0[143][144] 3.5,[143] 3.9,[5] 4.8[144] x109/L
16–25[14] 33,[14] 45 % of WBC
Newborn 2[144] 11[144] x109/L
Monocytes Adult 0.1,[5] 0.2[145][146] 0.8[5][144][146] x109/L
3,[14] 4.0 7,[14] 10 % of WBC
Newborn 0.4[144] 3.1[144] x109/L
Mononuclear leukocytes

(Lymphocytes + monocytes)		 Adult 1.5 5 x109/L
20 35 % of WBC
CD4+ T cells
 Adult 0.4,[15] 0.5[18] 1.5,[18] 1.8[15] x109/L
Eosinophil granulocytes
 Adult 0.0,[5] 0.04[146] 0.44,[146] 0.45,[144] 0.5[5] x109/L
1[14] 3,[14] 7 % of WBC
Newborn 0.02[144] 0.85[144] x109/L
Basophil granulocytes
 Adult 40[143] 100,[5][146] 200,[144] 900[143] x106/L
0.0 0.75,[14] 2 % of WBC
Newborn 0.64[144] x109/L

Coagulation

Test Lower limit Upper limit Unit Comments
Thrombocyte/
Platelet
count (Plt)		 140,[15] 150[5][14] 350,[5][23] 400,[14] 450[15] x109/L or
x1000/µL
Mean platelet volume (MPV) 7.2,[147] 7.4,[148] 7.5[149] 10.4,[148] 11.5,[149] 11.7[147]
fL
Prothrombin time (PT) 10,[18] 11,[14][150] 12[15] 13,[18] 13.5,[150] 14,[15] 15[14] s PT reference varies between laboratory kits – INR is standardised
INR
 0.9[5] 1.2[5] The INR is a corrected ratio of a patient's PT to normal
Activated partial thromboplastin time
(APTT)		 18,[15] 30[5][18] 28,[15] 42,[5] 45[18] s
Thrombin clotting time
(TCT)		 11 18 s
Fibrinogen 1.7,[15] 2.0[5] 3.6,[5] 4.2[15] g/L
Antithrombin 0.80[5] 1.2[5] kIU/L
0.15,[151] 0.17[152] 0.2,[151] 0.39[152] mg/mL
Bleeding time 2 9 minutes
Viscosity
 1.5[153] 1.72[153] cP

Immunology

Acute phase proteins

Acute phase proteins are markers of inflammation
.

Test Patient Lower limit Upper limit Unit Comments
Erythrocyte sedimentation rate
(ESR)		 Male 0 Age÷2[154] mm/h ESR increases with age and tends to be higher in females.[155]
Female (Age+10)÷2[154]
C-reactive protein (CRP) 5,[5][156] 6[157] mg/L
200,[158] 240[158] nmol/L
Alpha 1-antitrypsin
(AAT)		 20,[159] 22[160] 38,[160] 53[159] μmol/L
89,[161] 97[5] 170,[5] 230[161] mg/dL
Procalcitonin 0.15[162] ng/mL or μg/L

Isotypes of antibodies

Further information: Antibody
Test Patient Lower limit Upper limit Unit
IgA Adult 70,[5] 110[163] 360,[5] 560[163] mg/dL
IgD 0.5[163] 3.0[163]
IgE 0.01[163] 0.04[163]
IgG 800[163] 1800[163]
IgM 54[163] 220[163]

Autoantibodies

For clinical associations, see Autoantibody.

Autoantibodies are usually absent or very low, so instead of being given in standard reference ranges, the values usually denote where they are said to be present, or whether the test is a

positive test
. There may also be an equivocal interval, where it is uncertain whether there is a significantly increased level.

Test Negative Equivocal Positive Unit
anti-SS-A
(Ro)		 < 1.0[164] n/a ≥ 1.0[164] Units (U)
anti-SS-B
(La)		 < 1.0[165] n/a ≥ 1.0[165]
Anti ds-DNA
 < 30.0[166] 30.0–75.0[166] > 75.0[166] International Units per millilitre (IU/mL)
Anti ss-DNA < 8[167] 8–10[167] > 10[167] Units per millilitre (U/mL)
Anti-histone antibodies < 25[167] n/a[167] > 25[167]
Cytoplasmic anti-neutrophil
cytoplasmic antibodies (c-ANCA)		 < 20[167] 21–30[167] > 30[167]
Perinuclear anti-neutrophil
cytoplasmic antibodies (p-ANCA)		 < 5[167] n/a > 5[167]
Anti-mitochondrial antibodies
(AMA)		 < 0.1[168] 0.1-0.9[168] ≥ 1.0[168] Units (U)
Rheumatoid factor (RF) < 20 20–30 > 30[15] Units per millilitre (U/mL)
Antistreptolysin O titre
(ASOT) in
preschoolers		 > 100
ASOT at school age > 250[15]
ASOT in adults > 125[15]
Test Negative Low/weak positive Moderate positive High/strong positive Unit
Anti-phospholipid
IgG		 < 20[167] 20–30[167] 31–50[167] > 51[167] GPLU/mL[167]
Anti-phospholipid IgM < 1.5[167] 1.5–2.5[167] 2–9.9[167] > 10[167] MPL /mL[167]
Anti-phospholipid IgA < 10[167] 10–20[167] 21–30[167] > 31[167]
arb U/mL[167]
Anti-citrullinated protein antibodies
 < 20[167] 20–39[167] 40–59[167] > 60[167] EU[167]

Other immunology

Test Lower limit Upper limit Unit
Serum free light chains (FLC): kappa/lambda ratio 0.26[169] 1.65[169] (unitless)

Other enzymes and proteins

Test Lower limit Upper limit Unit Comments
Serum total protein 60,[14] 63[15] 78,[14] 82,[15] 84[23] g/L
Further information: Serum total protein § Interpretation
Lactate dehydrogenase (LDH) 50[23] 150[23] U/L
0.4[54] 1.7[54] μmol/L
1.8[5] 3.4[5] µkat/L < 70 years old[5]
Amylase 25,[14] 30,[15] 53[23] 110,[15] 120,[170] 123,[23] 125,[14] 190[54] U/L
0.15[5] 1.1[5] µkat/L
200[158] 240[158] nmol/L
D-dimer
-more detailed ranges in D-dimer article
 n/a 500[171] ng/mL Higher in pregnant women[172]
0.5[5] mg/L
Lipase 7,[15] 10,[23] 23[54] 60,[15] 150,[23] 208[54] U/L
Angiotensin-converting enzyme (ACE) 23[54] 57[54] U/L
Acid phosphatase 3.0[54] ng/mL
Eosinophil cationic protein (ECP) 2.3[5] 16[5] µg/L

Other electrolytes and metabolites

Electrolytes and metabolites: For iron and copper, some related proteins are also included.

Test Patient type Lower limit Upper limit Unit Comments
Osmolality 275,[14] 280,[23] 281[5] 295,[14] 296,[23] 297[5] mOsm/kg Plasma weight excludes solutes
Osmolarity
 Slightly less than osmolality mOsm/L Plasma volume includes solutes
Urea 3.0[173] 7.0[173] mmol/L BUN – blood urea nitrogen
7[14] 18,[14] 21[15] mg/dL
* Uric acid[15] 0.18[14] 0.48[14] mmol/L
Female 2.0[23] 7.0[23] mg/dL
Male 2.1[23] 8.5[23] mg/dL
Creatinine Male 60,[5] 68[174] 90,[5] 118[174] μmol/L May be complemented with
creatinine clearance
0.7,[175] 0.8[175] 1.0,[175] 1.3[175] mg/dL
Female 50,[5] 68[174] 90,[5] 98[174] μmol/L
0.6,[175] 0.8[175] 1.0,[175] 1.1[175] mg/dL
BUN/Creatinine Ratio 5[23] 35[23] –
Plasma
glucose
(fasting)		 3.8,[14] 4.0[5] 6.0,[5] 6.1[176] mmol/L See also glycated hemoglobin (in hematology)
65,[15] 70,[14] 72[177] 100,[176] 110[23] mg/dL
Full blood glucose (fasting) 3.3[5] 5.6[5] mmol/L
60[177] 100[177] mg/dL
Random glucose 3.9[178] 7.8[178] mmol/L
70[179] 140[179] mg/dL
Lactate (Venous) 4.5[23] 19.8[23] mg/dL
0.5[180] 2.2[180] mmol/L
Lactate (Arterial) 4.5[23] 14.4[23] mg/dL
0.5[180] 1.6[180] mmol/L
Pyruvate
 300[23] 900[23] μg/dL
34[181] 102[181] μmol/L
Ketones 1[182] mg/dL
0.1[182] mmol/L

Medication

Test Lower limit Upper limit Unit Comments
Digoxin 0.5[183] 2.0[183] ng/mL Narrow
therapeutic window
0.6[183] 2.6[183] nmol/L
Lithium 0.4,[184] 0.5,[185][186] 0.8[187] 1.3[185][186] mmol/L Narrow
therapeutic window
Paracetamol 30[188] mg/L Risk of
paracetamol toxicity
at higher levels
200[188] µmol/L

See also

Notes

  1. ^ The MCHC in g/dL and the mass fraction of hemoglobin in red blood cells in % are numerically identical in practice, assuming a RBC density of 1g/mL and negligible hemoglobin in plasma.

References

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    PMID 7600690
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  41. ^ a b Derived from mass values using molar mass of 65.38 g/mol
  42. ^ a b Derived from molar values using molar mass of 24.31 g/mol
  43. ^ a b Derived from mass values using molar mass of 24.31 g/mol
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    PMID 18593963
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  91. ^ a b c d e f g Derived from molar values using molar mass of 288.42g/mol
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    S2CID 524952
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  101. ^ a b Derived from mass values using molar mass of 314.46 g/mol
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  109. ^ a b c d Derived from molar values using molar mass of 362 g/mol
  110. ^
    PMID 17997337
    .
  111. ^
    PMID 18719199
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  112. ^ a b Derived from molar values using molar mass of 9.4 kDa
  113. ^
    PMID 16690460
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  114. ^ a b Derived from mass values using molar mass of 9.4 kDa
  115. ^ a b c d e f Derived from molar values using molar mass 400.6 g/mol
  116. ^
    Google Book Search
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  117. ^
    PMID 15321818
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  118. ^
    S2CID 260166796
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  119. ^
    PMID 16002891
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    PMID 2893797
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  124. ^ a b Converted from mass values using molar mass of 360.44 g/mol
  125. ^
    PMID 15483077
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  129. ^ a b GPnotebook > B12 Retrieved on April 28, 2009
  130. ^ a b Derived form molar values using molar mass of 1355g/mol
  131. ^ a b Derived from mass values using molar mass of 1355g/mol
  132. ^ a b c d "Homocysteine". www.thedoctorsdoctor.com.
  133. ^ a b c d Derived from molar values using molar massof 135 g/mol
  134. ^ a b Derived from mass values using molar mass of 176 grams per mol
  135. ^ a b c For Driving under the influence by country, see Drunk driving law by country
  136. ^ Derived from mass values using molar mass of 46g/mol
  137. ^
    S2CID 15468862
    .
  138. ^ a b c d Normal Lab Values Archived 2014-12-16 at the Wayback Machine at Marshall University Joan C. Edwards School of Medicine. Retrieved July 2013
  139. ^
    S2CID 3091357
    .
  140. ^
    S2CID 15468862
    .. Subsequently, 1 g/dL = 0.1551 mmol/L
  141. ^
    PMID 27863758.{{cite journal}}: CS1 maint: multiple names: authors list (link
    )
  142. ^
    PMID 16999719.{{cite journal}}: CS1 maint: multiple names: authors list (link
    )
  143. ^ a b c d e f g h lymphomation.org > Tests & Imaging > Labs > Complete Blood Count Retrieved on May 14, 2009
  144. ^
    ISBN 9780683307511
    – via Google Books.
  145. ^ "Determination of monocyte count by hematological analyzers, manual method and flow cytometry in Polish population" Central European Journal of Immunology (Centr Eur J Immunol 2006; 31 (1–2): 1–5) authors: Elżbieta Górska, Urszula Demkow, Roman Pińkowski, Barbara Jakubczak, Dorota Matuszewicz, Jolanta Gawęda, Wioletta Rzeszotarska, Maria Wąsik,
  146. ^ a b c d e gpnotebook.co.uk > blood constituents (reference range) Retrieved on May 14, 2009
  147. ^
    PMID 21620440
    .
  148. ^ a b Normal Values: RBC, Hgb, Hct, Indices, RDW, Platelets, and MPV (Conventional Units) Archived 2011-07-27 at the Wayback Machine From labcareplus. Retrieved 4 nov, 2010
  149. ^
    PMID 9666418
    .
  150. ^ a b MedlinePlus Encyclopedia: 003652
  151. ^ a b Antithrombin III at eMedicine
  152. ^ a b Antithrombin CO000300 in Coagulation Test Handbook at Massachusetts General Hospital. In turn citing:
    • Elizabeth M. Van Cott, M.D., and Michael Laposata, M.D., Ph.D., "Coagulation." In: Jacobs DS et al, ed. The Laboratory Test Handbook, 5th Edition. Lexi-Comp, Cleveland, 2001; 327–58.
  153. ^ a b "Home". pathology.bsuh.nhs.uk. Retrieved November 20, 2009.
  154. ^
    PMID 6402065
    .
  155. PMID 6020854
    .
  156. ^ "C-reactive protein". GPnotebook.
  157. ^ 2730 Serum C-Reactive Protein values in Diabetics with Periodontal Disease Archived 2008-12-20 at the Wayback Machine A.R. Choudhury, and S. Rahman, Birdem, Diabetic Association of Bangladesh, Dhaka, Bangladesh. (the diabetics were not used to determine the reference ranges)
  158. ^ a b c d Derived from mass using molar mass of 25,106 g/mol
  159. ^
    PMID 12621252
    .
  160. ^ a b Derived from mass values using molar mass of 44324.5 g/mol
  161. ^ a b Derived from molar values using molar mass of 44324.5 g/mol
  162. ^ "Procalcitonin, Serum". Mayo Clinic. Retrieved 2015-03-01.
  163. ^ a b c d e f g h i j The Society for American Clinical Laboratory Science > Chemistry Tests > Immunoglobulins Archived 2009-10-15 at the Wayback Machine Retrieved on Nov 26, 2009
  164. ^ a b "SSA – Clinical: SS-A/Ro Antibodies, IgG, Serum". www.mayocliniclabs.com. Mayo Clinic Laboratories. Retrieved 2 July 2020.
  165. ^ a b "SSB – Clinical: SS-B/La Antibodies, IgG, Serum". www.mayocliniclabs.com. Mayo Clinic Laboratories. Retrieved 2 July 2020.
  166. ^ a b c "ADNA – Clinical: DNA Double-Stranded Antibodies, IgG, Serum". www.mayocliniclabs.com. Mayo Clinic Laboratories. Retrieved 2 July 2020.
  167. ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae chronolab.com > Autoantibodies associated with rheumatic diseases > Reference ranges Archived 2013-07-30 at the Wayback Machine Retrieved on April 29, 2010
  168. ^ a b c "AMA – Clinical: Mitochondrial Antibodies (M2), Serum". www.mayocliniclabs.com. Mayo Clinic Laboratories. Retrieved 2 July 2020.
  169. ^
    PMID 15855274
    .
  170. ^ "Reference range (amylase)". GPnotebook.
  171. PMID 12456231
    .
  172. PMID 15764641
    .
  173. ^
    PMID 7400337
    .
  174. ^
    S2CID 35866310
    .
  175. ^ a b c d e f g h Derived from molar values by multiplying with the molar mass of 113.118 g/mol, and divided by 10.000 to adapt from μg/L to mg/dL
  176. ^ a b MedlinePlus Encyclopedia: Glucose tolerance test
  177. ^ a b c Derived from molar values using molar mass of 180g/mol
  178. ^ a b Derived from mass values using molar mass of 180g/mol
  179. ^ a b "Diabetes – Prevention". Cleveland Clinic. Retrieved 2016-06-23. Last revised 1/15/2013
  180. ^ a b c d Derived from mass values using molar mass of 90.08 g/mol
  181. ^ a b Derived from mass values using molar mass of 88.06 g/mol
  182. ^ a b Ketones at eMedicine
  183. ^
    ISBN 9780781728454
    .
  184. ^ The UK Electronic Medical Compendium recommends 0.4–0.8 mmol/L plasma lithium level in adults for prophylaxis of recurrent affective bipolar manic-depressive illness Camcolit 250 mg Lithium Carbonate Archived 2016-03-04 at the Wayback Machine Revision 2 December 2010, Retrieved 5 May 2011
  185. ^
    doi:10.1093/jat/2.5.193
    .
  186. ^ a b R. Baselt, Disposition of Toxic Drugs and Chemicals in Man, 8th edition, Biomedical Publications, Foster City, CA, 2008, pp. 851–54.
  187. S2CID 12103424.) concluded the higher rate of relapse for the "low" dose was due to abrupt changes in the lithium serum levels[improper synthesis?
    ]
  188. ^
    ISBN 9781455749874
    .

External links

Further reading

  • Rappoport, n.; Paik, P.; Oskotsky, B.; Tor, R.; Ziv, E.; Zaitlen, N.; Butte, A. (4 November 2017). "Creating ethnicity-specific reference intervals for lab tests from EHR data".
    bioRxiv 10.1101/213892
    .
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