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Reference ranges for blood tests

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Reference ranges for blood test are sets of values used by a health professional to interpret a set of medical test results from blood samples. (note: this is a cut down version of the original at wikipedia)

Below are sets of guidelines for normal blood test values for factors monitored during HRT, or tested before surgery.

Electrolytes and Metabolites

Test [1] Patient type Lower limit [1] Upper limit[1] Unit Comments
Sodium (Na) 135[2]-137 145-147[2] mmol/L or mEq/L[2]
31[3] - 32[3] 33[3] - 34[3] mg/dl
Potassium (K) 3.5[2]-3.6 5.0[2]-5.1 mmol/L or mEq/L[2] See hypokalemia or hyperkalemia
14[4] 20[4] mg/dl
Chloride (Cl) 95[2]-98 105[2]-106 mmol/L or mEq/L[2]
340[5] 370[5] mg/dl
275[2]-280 295[2]-296 mOsm/kg Plasma weight excludes solutes
Osmolarity Slightly less than osmolality mOsm/l Plasma volume includes solutes
Urea 1.2[2]-3.0[6] 3.0[2]-7.0[6] mmol/L BUN - blood urea nitrogen
7[2] 18[2]-21 mg/dL
* Uric acid 0.18[2] 0.48[2] mmol/L
Female 2.0 7.0 mg/dL
Male 2.1 8.5 mg/dL
Creatinine male 68[7] 118[7] μmol/L May be complemented with creatinine clearance
0.8[8] 1.3[8] mg/dL
female 68[7] 98[7] μmol/L
0.8[8] 1.1[8] mg/dL
BUN/Creatinine Ratio 5 35 -
Glucose (fasting) 3.8[2]-3.9 6.1[9] mmol/L See also glycosylated hemoglobin (in hematology)
65-70[2] 100[9]-110 mg/dL
Total serum iron (TSI) male 65[10]-76 176[10]-198 µg/dL
11.6[11][12] - 13.6[12] 30[11], 32[12], 35[12] μmol/L
female 26-50[10] 170[10] µg/dL
4.6[12] - 8.9[11] 30.4[11] μmol/L
newborns 100[10] 250[10] µg/dL
18[12] 45[12] µmol/L
children 50[10] 120[10] µg/dL
9[12] 21[12] µmol/L
Total iron-binding capacity (TIBC) 240[10]-262 450[10]-474 μg/dL
43[12] - 47[12] 81[12] - 85[12] µmol/L
Transferrin 190[13] - 204 330[13] - 360 mg/dL
25[14] 45[14] μmol/L
Transferrin saturation[10] 20 50  %
Ferritin Male 12[15] 300[15] ng/mL
27 [16] 670[16] pmol/L
Female 12[15] 150[15] ng/mL
27 [16] 330[16] pmol/L
Ammonia 10[17]-20[18] 35[17]-65[18] μmol/L
17[19] - 34[19] 60[19] - 110[19] μg/dL
Copper 70 150 µg/dL
11 [20] 24[20] μmol/L
Ceruloplasmin 15 60 mg/dL
1 [21] 4[21] μmol/L
Lactate (Venous) 4.5 19.8 mg/dL
0.5[22] 2.2[22] mmol/L
Lactate (Arterial) 4.5 14.4 mg/dL
0.5[22] 1.6[22] mmol/L
Pyruvate 300 900 μg/dL
34 [23] 102[23] μmol/L

Liver function

Test Patient type Lower limit Upper limit Unit Comments
Serum total protein 60[2]-63 78[2], 82, 84 g/L see hypoproteinemia
Serum albumin 35[2][24] 48-55[2] g/L see hypoalbuminemia
3.5 4.8-5.5[2] U/L
540[25] 740[25] μmol/L
Globulins 23[2] 35[2] g/L
Total Bilirubin 1.7[26], 2[2], 3.4[26] 17[2][26] - 22[26] μmol/L
0.1[2]-0.2 1.0[2]-1.3 mg/dL
Direct Bilirubin 0.0[2] 5[2] - 7[26] μmol/L
0[2] 0.3[2]-0.4 mg/dL
Alanine transaminase (ALT) 1, 5[27], 7, 8[2] 20[2], 21, 56 U/L Also called serum glutamic pyruvic transaminase (SGPT)
Aspartate transaminase (AST) Female 6[28] 34[28] IU/L Also called
serum glutamic oxaloacetic transaminase (SGOT)
Male 8[28] 40[28]
Alkaline phosphatase (ALP) Female 42[27] 98[27] U/L
Male 53[27] 128[27]
Gamma glutamyl transferase (GGT) 5[27] - 8 40[27]-78 U/L

Sex hormones

Main article: Sex steroid

Test Patient type Lower limit Upper limit Unit
Testosterone Male 8 [29] - 10[30] 27 [29] - 35[30] nmol/L
230 [31] - 300 [32] 780[31] - 1000[32] ng/dL
Female 0.7[30] 2.8[30] nmol/L
20[32] 80[32] ng/dL
17 Hydroxyprogesterone male 0.06 3.0 mg/L
Female (Follicular phase) 0.2 1.0 mg/L
Follicle-stimulating hormone (FSH) Prepubertal <1 [33] 3[33] IU/L
Adult male 1[33] 8 [33]
Adult female (follicular
and luteal phase) 		1[33] 11[33]
Adult female (Ovulation) 6[33]
95% PI (standard) 		26[33]
95% PI)
5[34]
90% PI (used in diagram) 		15[34]
(90% PI)
Post-menopausal female 30[33] 118[33]
Luteinizing hormone (LH) Female, peak 20[34]
90% PI (used in diagram) 		75[34]
(90% PI) 		IU/L
Female, post-menopausal 15[35] 60 [35]
Estradiol (an estrogen) Adult male 50[36] 200 [36] pmol/L
1.4[37] 5.5[37] ng/dL
Adult female (follicular phase, day 5) 70[36]
95% PI (standard) 		500 [36]
95% PI 		pmol/L
110[34]
90% PI (used in diagram) 		220[34]
90% PI
1.9[37] (95% PI) 14[37] (95% PI) ng/dL
3.0[37] (90% PI) 6.0[37] (90% PI)
Adult female (preovulatory peak) 400[36] 1500[36] pmol/L
11[37] 41[37] ng/dL
Adult female (luteal phase) 70[36] 600[36] pmol/L
1.9[37] 16[37] ng/dL
Post-menopausal female N/A [36] < 130[36] pmol/L
N/A[37] < 3.5[37] ng/dL
Progesterone Female at day of ovulation 2.2[34] (90% PI) 9[34] (90% PI) nmol/L
70[38] (90% PI) 280[38] (90% PI) ng/dL
Androstenedione Adult male and female 60[35] 270[35] ng/dL
Post-menopausal female < 180[35]
Prepubertal < 60[35]

Other hormones

Main article: Hormones

Test Patient type Lower limit Upper limit Unit
Adrenocorticotropic hormone (ACTH) 4.4[39] 18[40] -22[39] pmol/L
20 80[41] - 100 pg/mL
Cortisol 09:00 am 140[42] 700[42] nmol/L
5[43] 25[43] μg/dL
Midnight 80[42] 350[42] nmol/L
2.9[43] 13[43] μg/dL
Growth hormone (fasting) 0 5[2] ng/mL
Growth hormone (arginine stimulation) 7[2] n/a ng/mL
Prolactin n/a 14 ng/mL
Parathyroid hormone (PTH) 17[44] 70[44] pg/mL
1.8[45] 7.5[45] pmol/L
25-hydroxycholecalciferol (a vitamin D)
-Standard reference range 		8[46] - 9[46] 40[46] - 80 ng/mL
20[47] - 23[48] 95[48] - 150[47] nmol/L
25-hydroxycholecalciferol
-Therapeutic target range 		30[49] - 40[50] 65[50] - 100[49] ng/mL
85[51] - 100[50] - 120[51] - 160[50] nmol/L

Coagulation

Test Lower limit Upper limit Unit Comments
Platelet count (Plt) 140-150[2] 350, 400[2], 450 x109/L
Prothrombin time (PT) 10, 11[2][52]-12 13, 13.5[52], 14, 15[2] s PT reference varies between laboratory kits - INR is standardised
International normalized ratio (INR) 0.9 1.2 The INR is a corrected ratio of a patients PT to normal
Activated partial thromboplastin time (APTT) 18 - 30 28-45 s
Thrombin clotting time (TCT) 11 18 s
Fibrinogen 1.7-1.8 4.2 g/L
Bleeding time 2 9 minutes
Blood viscosity 1.5[53] 1.72[53] centipoise (cP)

References

  1. ↑ 1.0 1.1 1.2 Unless else specified in boxes, then ref is: Ashwood, Edward R.; Tietz, Norbert W.; Burtis, Carl A. (1994). Tietz textbook of clinical chemistry, 2nd, Philadelphia: Saunders. ISBN 0-7216-4472-4. 
  2. ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 Last page of Deepak A. Rao; Le, Tao; Bhushan, Vikas (2007). First Aid for the USMLE Step 1 2008 (First Aid for the Usmle Step 1). McGraw-Hill Medical. ISBN 0-07-149868-0. 
  3. ↑ 3.0 3.1 3.2 3.3 Derived from molar values using molar mass of 22.99 g·mol−1
  4. ↑ 4.0 4.1 Derived from molar values using molar mass of 39.10 g·mol−1
  5. ↑ 5.0 5.1 Derived from molar values using molar mass of 35.45 g·mol−1
  6. ↑ 6.0 6.1 Gardner MD, Scott R (April 1980). "Age- and sex-related reference ranges for eight plasma constituents derived from randomly selected adults in a Scottish new town". J. Clin. Pathol. 33 (4): 380–5. doi:10.1136/jcp.33.4.380. PMID 7400337. 
  7. ↑ 7.0 7.1 7.2 7.3 Finney H, Newman DJ, Price CP (January 2000). "Adult reference ranges for serum cystatin C, creatinine and predicted creatinine clearance". Ann. Clin. Biochem. 37 ( Pt 1): 49–59. doi:10.1258/0004563001901524. PMID 10672373. 
  8. ↑ 8.0 8.1 8.2 8.3 molar value multiplied by the molar mass of 113.118 g/mol, and divided by 10.000 to adapt from μ_/L to m_/dL
  9. ↑ 9.0 9.1 Template:MedlinePlus
  10. ↑ 10.00 10.01 10.02 10.03 10.04 10.05 10.06 10.07 10.08 10.09 10.10 Slon S (2006-09-22). Serum Iron. University of Illinois Medical Center. Retrieved on 2006-07-06.
  11. ↑ 11.0 11.1 11.2 11.3 Diagnostic Chemicals Limited > Serum Iron-SL Assay July 15, 2005
  12. ↑ 12.00 12.01 12.02 12.03 12.04 12.05 12.06 12.07 12.08 12.09 12.10 12.11 12.12 Derived from mass values using molar mass of 55.85 g·mol−1
  13. ↑ 13.0 13.1 Table 1. Page 133. Clinical Chemistry 45, No. 1, 1999 (stating 1.9–3.3 g/L)
  14. ↑ 14.0 14.1 Derived by dividing mass values with molar mass
  15. ↑ 15.0 15.1 15.2 15.3 Ferritin by: Mark Levin, MD, Hematologist and Oncologist, Newark, NJ. Review provided by VeriMed Healthcare Network
  16. ↑ 16.0 16.1 16.2 16.3 Derived from mass values using molar mass of 450,000 g·mol−1
  17. ↑ 17.0 17.1 Mitchell ML, Filippone MD, Wozniak TF (August 2001). "Metastatic carcinomatous cirrhosis and hepatic hemosiderosis in a patient heterozygous for the H63D genotype". Arch. Pathol. Lab. Med. 125 (8): 1084–7. PMID 11473464. 
  18. ↑ 18.0 18.1 Diaz J, Tornel PL, Martinez P (July 1995). "Reference intervals for blood ammonia in healthy subjects, determined by microdiffusion". Clin. Chem. 41 (7): 1048. PMID 7600690. 
  19. ↑ 19.0 19.1 19.2 19.3 Derived from molar values using molar mass of 17.03 g/mol
  20. ↑ 20.0 20.1 Derived from mass values using molar mass of 63.55 g·mol−1
  21. ↑ 21.0 21.1 Derived from mass using molar mass of 151kDa
  22. ↑ 22.0 22.1 22.2 22.3 Derived from mass values using molar mass of 90.08 g/mol
  23. ↑ 23.0 23.1 Derived from mass values using molar mass of 88.06 g/mol
  24. ↑ Template:GPnotebook
  25. ↑ 25.0 25.1 Derived from mass using molecular weight of 65kD
  26. ↑ 26.0 26.1 26.2 26.3 26.4 Derived from mass values using molar mass of 585g/mol
  27. ↑ 27.0 27.1 27.2 27.3 27.4 27.5 27.6 Fachwörterbuch Kompakt Medizin E-D/D-E. Author: Fritz-Jürgen Nöhring. Edition 2. Publisher:Elsevier, Urban&FischerVerlag, 2004. ISBN 3437151207, 9783437151200. Length: 1288 pages
  28. ↑ 28.0 28.1 28.2 28.3 GPnotebook > reference range (AST) Retrieved on Dec 7, 2009
  29. ↑ 29.0 29.1 Andrology Australia: Your Health > Low Testosterone > Diagnosis
  30. ↑ 30.0 30.1 30.2 30.3 Derived from mass values using molar mass of 288.42g/mol
  31. ↑ 31.0 31.1 Derived from molar values using molar mass of 288.42g/mol
  32. ↑ 32.0 32.1 32.2 32.3 MedlinePlus - Testosterone Update Date: 3/18/2008. Updated by: Elizabeth H. Holt, MD, PhD, Yale University. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director
  33. ↑ 33.0 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 reference range (FSH) GPnotebook. Retrieved on September 27, 2009
  34. ↑ 34.0 34.1 34.2 34.3 34.4 34.5 34.6 34.7 Values taken from day 1 after LH surge in: Establishment of detailed reference values for luteinizing hormone, follicle stimulating hormone, estradiol, and progesterone during different phases of the menstrual cycle on the Abbott ARCHITECT analyzer. Reto Stricker, Raphael Eberhart, Marie-Christine Chevailler, Frank A. Quinn, Paul Bischof and Rene´ Stricker. Clin Chem Lab Med 2006;44(7):883–887 PMID: 16776638
  35. ↑ 35.0 35.1 35.2 35.3 35.4 35.5 New York Hospital Queens > Services and Facilities > Patient Testing > Pathology > New York Hospital Queens Diagnostic Laboratories > Test Directory > Reference Ranges Retrieved on Nov 8, 2009
  36. ↑ 36.0 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 GPNotebook - reference range (oestradiol) Retrieved on September 27, 2009
  37. ↑ 37.00 37.01 37.02 37.03 37.04 37.05 37.06 37.07 37.08 37.09 37.10 37.11 Derived from molar values using molar mass of 272.38g/mol
  38. ↑ 38.0 38.1 Derived from molar values using molar mass of 314.46 g/mol
  39. ↑ 39.0 39.1 Derived from mass values using molar mass of 4540g/mol according to PROOPIOMELANOCORTIN; NCBI --> POMC Retrieved on September 28, 2009
  40. ↑ Adrenocorticotropic Hormone:Normal. WebMD (09-03-2006). Retrieved on 2008-11-09.
  41. ↑ Derived from molar values using molar mass of 4540g/mol according to PROOPIOMELANOCORTIN; NCBI --> POMC Retrieved on September 28, 2009
  42. ↑ 42.0 42.1 42.2 42.3 Biochemistry Reference Ranges at Good Hope Hospital Retrieved on Nov 8, 2009
  43. ↑ 43.0 43.1 43.2 43.3 Derived from molar values using molar mass of 362 g/mol
  44. ↑ 44.0 44.1 Table 2 in: Aloia JF, Feuerman M, Yeh JK (2006). "Reference range for serum parathyroid hormone". Endocr Pract 12 (2): 137–44. PMID 16690460. 
  45. ↑ 45.0 45.1 Derived from mass values using molar mass of 9.4 kDa
  46. ↑ 46.0 46.1 46.2 Derived from molar values using molar mass 400.6 g/mol
  47. ↑ 47.0 47.1 Bender, David A. (2003). "Vitamin D", Nutritional biochemistry of the vitamins. Cambridge: Cambridge University Press. ISBN 0-521-80388-8.  Retrieved December 10, 2008 through Google Book Search.
  48. ↑ 48.0 48.1 Bischoff-Ferrari, H.A., Dietrich, T., Orav, J.E., Hu, F.B., Zhang, Y., Karlson, E., Dawson-Hughes, B. 2004. Higher 25-hydroxyvitamin D levels are associated with better lower extremity function in both active and inactive adults 60+ years of age. American Journal of Clinical Nutrition. 80:752-758.
  49. ↑ 49.0 49.1 Reusch J, Ackermann H, Badenhoop K (May 2009). "Cyclic changes of vitamin D and PTH are primarily regulated by solar radiation: 5-year analysis of a German (50 degrees N) population". Horm. Metab. Res. 41 (5): 402–7. doi:10.1055/s-0028-1128131. PMID 19241329. 
  50. ↑ 50.0 50.1 50.2 50.3 Letter: Calcium and vitamin D in preventing fractures. Data are not sufficient to show inefficacy Alex Vasquez, researcher. BMJ 2005;331:108-109 (9 July), doi:10.1136/bmj.331.7508.108-b.
  51. ↑ 51.0 51.1 Adëeva Nutritionals Canada > Optimal blood test values Retrieved on July 9, 2009
  52. ↑ 52.0 52.1 Template:MedlinePlus
  53. ↑ 53.0 53.1 [1] Retrieved on November 20, 2009

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