Reference_ranges_for_blood_tests

Reference ranges for blood tests

A reference range is a set of values used by a health professional to interpret a set of medical test results. The range is usually defined as the set of values 95% of the normal population falls within.

The reference range will vary, depending on the age, sex and race of a population, and even the instruments the laboratory uses to perform the tests. Furthermore, by definition, 5% of the normal population will fall outside the reference range. The values given below therefore are given as examples only and should not be used to interpret individual test results. Factors other than medical conditions can affect laboratory values, such as male or female sex, diet, use of drugs (prescribed, over-the-counter and herbal remedies), and stress, as well as other more exotic factors like altitude.

Clinical biochemistry

  • Items marked with a ** are part of "CHEM-7" and CHEM-20
  • Items marked with a * are part of "CHEM-20", but not CHEM-7

Electrolytes and Metabolites

Electrolytes and Metabolites:

Test Patient type Lower limit Upper limit Unit Comments
** Sodium (Na) 135-137 145-147 mmol/L or mEq/L
** Potassium (K) 3.5-3.6 5.0-5.1 mmol/L or mEq/L
Chloride (Cl) 95-98 105-107 mmol/L or mEg/L
Osmolality 275 295 mOsm/kg
Urea 1.2-2.5 3.0-6.4 mmol/L ** BUN - blood urea nitrogen
7 18-21 mg/dL
* Uric acid 0.18 0.48 mmol/L
3.03.5 8.2-8.5 mg/dL
** Creatinine male 62 115 μmol/L May be complemented with creatinine clearance
0.7 1.3 mg/dL
female 53 97 μmol/L
0.6 1.1 mg/dL
** Glucose (fasting) 3.8-3.9 5.8-6.1 mmol/L See also glycosylated hemoglobin (in hematology)
65-70 105-110 mg/dL
Total serum iron (TSI) male 65-76 176-198 µg/dL
female 26-50 170
newborns 100 250
children 50 120
Total iron-binding capacity (TIBC) 240-262 450-474
Transferrin 204 360 mg/dL
Transferrin saturation 20 50 %
Ferritin Male 18 250 ng/mL
Female 12 160

Acid and base

Test Lower limit Upper limit Unit Comments
pH 7.34-7.35 7.44-7.45
[H+] 36 44 nmol/L
base excess -3 +3
PO2 10 13-14 kPa
75 100-105 mmHg
** PCO2 4.44.8 5.8-5.9 kPa
33-35 44-45 mmHg
Bicarbonate (HCO3-) 18 23 mmol/L
Standard bicarbonate (SBCe) 21-22 27-28 mmol/L or mEq/L

Liver function

Test Lower limit Upper limit Unit Comments
* Total Protein 60-63 78-82 g/L
* Albumin 35 48-55 g/L
3.5 4.8-5.5 U/L
Globulins 23 35 g/L
* Total Bilirubin 2 17 μmol/L
0.1-0.2 1.0-1.3 mg/dL
* Direct Bilirubin 0.0 5 μmol/L
0 0.3 mg/dL
* Alanine transaminase (ALT) 7-8 20, 40, 56 U/L Also called serum glutamic pyruvic transaminase (SGPT)
* Alkaline phosphatase (ALP) 20-38 70-126 U/L p-NPP at 30 degrees C
Higher in children and pregnant women.
* Gamma glutamyl transferase (GGT) 8 50-78 U/L

Cardiac tests

Test Lower limit Upper limit Unit Comments
Creatine kinase (CK) - male 24-38 195 U/L
or ng/mL
Creatine kinase (CK) - female 24-38 170 U/L
CK-MB 0 3 ng/mL
Troponin 0 0.4 ng/mL

Other enzymes and proteins

Test Lower limit Upper limit Unit Comments
* Aspartate transaminase (AST) 5-8 20-35 U/L Also called serum glutamic oxatoacetic transaminase (SGOT)
* Lactate dehydrogenase (LDH) 85 285 U/L
Amylase 25-30 110, 120, 125 U/L
C-reactive protein (CRP) n/a 5 mg/L
D-dimer n/a 500 ng/mL
Lipase 7 60 U/L

Other ions and trace metals

Test Lower limit Upper limit Unit Comments
Ionised calcium (Ca) 1.15 1.29 mmol/L Some calcium is bound to albumin, thus not measured by certain techniques.
* Total calcium (Ca) 2.1 2.8 mmol/L
8.4 10.2 mg/dL
Phosphate (HPO42−) 0.8 1.5 mM
Inorganic phosphorus (serum) 1.0 1.5 mmol/L
3.0 4.5 mg/dL
Copper (Cu) 11 24 μmol/L
Zinc (Zn) 10 17 μmol/L

Lipids

Test Lower limit Upper limit Unit Comments
Triglycerides 0.4 2 mmol/L
50 250 mg/dL
* Total cholesterol 3.6 5.0-6.5 mmol/L
120-140 200-250 mg/dL
HDL cholesterol (male) 0.7 1.9 mmol/L
HDL cholesterol (female) 0.9 2.4 mmol/L
LDL cholesterol 2.4 3 mmol/L Not valid when triglycerides >5.0 mmol/L.

Tumour markers

Test Lower limit Upper limit Unit Comments
Alpha fetoprotein (AFP) n/a 10 kU/l
0 44 ng/mL
Alpha 1-antitrypsin (AAT) 20 53 mmol/L
150 350 mg/dL
Beta Human chorionic gonadotrophin (bHCG) n/a 5 IU/l in male and non-pregnant female
CA-125 (also CA12.5) n/a 35 U/ml
CA15.3 n/a 28 U/ml
CA19.9 n/a 40 U/ml
Carcinoembryonic antigen (CEA) - non-smokers n/a 3 μg/l
Carcinoembryonic antigen (CEA) - smokers n/a 5 μg/l
Prostate specific antigen (PSA) n/a 4 μg/L

Hormones

Test Lower limit Upper limit Unit Comments
Thyroid stimulating hormone (TSH) 0.3 3.0 mIU/L Also called: Thyrotropin
Free thyroxine (FT4) 9 24 pmol/L
0.8 1.5 ng/dL
Total thyroxine 60 140 nmol/L
5.5 12.3 ng/mL
Free triiodothyronine (FT3) 2.5 5.3 pmol/L
0.2 0.5 ng/dL
Total triiodothyronine 1.1 2.7 nmol/L Values in children may be higher
60-75 175-181 ng/dL
Adrenocorticotropic hormone (ACTH) 1.3 15 pmol/L
20 100 pg/mL
Cortisol (0830 h) 250 850 nmol/L Cortisol levels are higher in the morning than at night.
Cortisol (1630 h) 110 390 nmol/L
Growth hormone (fasting) 0 5 ng/mL
Growth hormone (arginine stimulation) 7 n/a ng/mL
Prolactin (male) n/a 450 mIU/L
Prolactin (female) n/a 580 mIU/L
Testosterone (male) 8 38 nmol/L
Testosterone (male prepuberty) 0.1 0.5 nmol/L
Testosterone (female) 0.3 2.5 nmol/L

Hematology

Red blood cells

Test Patient Lower limit Upper limit Unit Comments
Haemoglobin (Hb) male 2.1 2.7 mmol/L Higher in neonates, lower in children.
132-135 162-175 g/L
female 1.9 2.5 mmol/L Sex difference negligible until adulthood.
115-120 152-160 g/L
Glycosylated hemoglobin (HbA1c) 4 5.9 % of Hb
Haematocrit (Hct) male 0.38, 0.4, 0.41 0.52-0.53
female 0.36-0.37 0.46-0.47
Child 0.31 0.43
Hemoglobin in plasma 0.16 0.62 μmol/L
1 4 mg/dL
Mean cell volume (MCV) Male 82 102 fL Cells are larger in neonates, though smaller in other children.
Female 78 101 fL
MCV standard deviation 35 47 fL
Mean cell haemoglobin (MCH) 0.39 0.54 fmol/cell
25-26 34-35 pg/cell
Mean cell haemoglobin concentration (MCHC) 31 35 g/dL
Red cell count (RBC) male 4.3-4.5 5.9-6.2 x1012/L
Female 3.5-3.8 5.5-5.8 x1012/L
Infant/Child 3.8 5.5 x1012/L

Reticulocytes 10 100 x109/L
Adult 0.5 1.5 % of RBC
Newborn 1.1 4.5 % of RBC
Infant 0.5 3.1 % of RBC
Red blood cell distribution width (RDW) 11.5 14.5 % Coefficient of variation

White blood cells

Test Lower limit Upper limit Unit Comments
White Blood Cell Count (WBC.) 4.1-4.5 10.9-11
  • x109/L
  • x103/mm3 or
  • x103/μL

Higher in neonates and infants.
Neutrophil granulocytes 2 7.5 x109/L Also known as granulocytes (grans), polys, PMNs, or segs.
45-54 62-74 % of WBC
Neutrophilic band forms 3 5 % of WBC
Lymphocytes 1.3 4 x109/L
16-25 33-45 % of WBC
Monocytes 0.2 0.8 x109/L
3-4.0 7-10 % of WBC
Mononuclear leukocytes 1.5 5 x109/L Lymphocytes + monocytes.
Mean: 35% of WBC.
20 35 % of WBC
CD4+ cells 0.4 1.8 x109/L
Eosinophil granulocytes 0.04 0.4 x109/L
1 3-7 % of WBC
Basophil granulocytes 0.01 0.1 x109/L
0.0 0.75-2 % of WBC

Coagulation

Test Lower limit Upper limit Unit Comments
Platelet count (Plt) 140-150 400-450 x109/L
Prothrombin time (PT) 11-12 13.5, 14, 15 s PT reference varies between laboratory kits - INR is standardised
INR 0.9 1.2 The INR is a corrected ratio of a patients PT to normal
Activated partial thromboplastin time (APTT) 18-29 28-41 s
Thrombin clotting time (TCT) 11 18 s
Fibrinogen 1.7-1.8 4.2 g/L
Bleeding time 2 9 minutes

Immunology

Category Test Patient Lower limit Upper limit Unit Comments
Acute phase protein
markers of Inflammation
Erythrocyte sedimentation rate
(ESR)
Male 0 Age÷2 mm/hr ESR increases with age and tends to be higher in females.
Female (Age+10)÷2
C-reactive protein (CRP) 0 6 mg/L
Autoantibodies Antinuclear antibodies (ANA)
Extractable nuclear antigen (ENA)
Rheumatoid factor (RF) 0 20-30 IU/mL High levels not specific for Rheumatoid Arthritis alone.
Serology Antistreptolysin O titre
(ASOT)
Preschoolers n/a 100 units/mL
School age 250
Adult 125

See also

References

External links

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