Test Reference Range Alanine aminotransferase (ALT, SGPT)
Levels are extremely increased in cases of liver cell necrosis of any cause, right heart failure, acute anoxia, extensive trauma, or left heart failure. A slightly high level may indicate cirrhosis, obstructive jaundice, liver tumors, extensive myocardial infarction, myositis, muscular dystrophy, fatty liver, chronic alcohol abuse, or severe pancreatitis. Levels will by low in cases of pyridoxal phosphate deficiency
Female 7-30 U/liter Male 10-55 U/liter Albumin
There is no naturally occurring hyperalbuminemia. Any condition that results in the decrease of plasma water will increase the concentration of all plasma proteins, including albumin. Low concentrations of blood albumin may be due to acute and chronic inflammation, decreased synthesis by the liver, increased loss via body surfaces, increased catabolism, or increased blood volume. *albumin is the principal oncotically active component of plasma. As the major plasma protein, albumin acts as a nitrogen pool. Its role in transporting bilirubin, bile acids, metal ions, and drugs will be markedly affected by variations in concentrations.
3.1-4.3 g/dl Alkaline phosphatase (adult)
Origins of the major phosphatases are liver, bone, intestine, endometrium, and lung. Ingestion of a meal increases the intestinal isoenzyme of alp in serum, especially in individuals who are blood type o or b and who are Lewis-positive secretors. Increased levels of alp may indicate increased bone metabolism (during healing of fracture, primary and secondary hyperparathyroidism, osteomalacia, or juvenile rickets). May also indicate bone disease, renal disease, or liver disease. Low levels may indicate hypothyroidism, scurvy, gross anemia, vitamin b12 deficiency or nutritional deficiency of zinc or magnesium.
Female 30-100 U/liter Male 45-115 U/liter Androstenedione (adult)
Androstenedione is a major precursor in the biosynthesis of androgens and estrogens. It is produced in adrenals and gonads and serves as prohormone for testosterone and estrone. The test is useful in conjunction with other tests in the evaluation and management of androgen disorders
50-250 ng/dl Aspartate aminotransferase (AST, SGOT)
Increased levels may indicate liver cell necrosis or injury of any cause, including cholestatic and obstructive jaundice, chronic hepatitis, or drug-induced injury to liver. May also be associated with hepatic metastases and hepatoma, necrosis or trauma to heart or skeletal muscle, inflammatory disease of heart or skeletal muscle, heart failure, Forbes’s disease, heat stroke, hypothyroidism, intestinal obstruction, lactate acidosis, or toxic shock syndrome. Also distinguishes neonatal hepatitis from biliary atresia.
Female 9-25 U/liter Male 10-40 U/liter Bilirubin, direct
High serum blood levels are associated with intrahepatic and extrahepatic biliary tree obstruction, hepatocellular damage, cholestasis, Dubin-Johnson syndrome, or rotor’s syndrome.
0.0-0.4 mg/dl Bilirubin, total
High serum levels may indicate hepatocellular damage (inflammatory, toxic, neoplastic), intrahepatic and extrahepatic biliary tree obstruction, hemolytic diseases, fructose intolerance, hypothyroidism or neonatal physiological jaundice
0.0-1.0 mg/dl Calcium
High blood calcium levels may indicate primary and tertiary hyperparathyroidism, malignant disease with bone involvement (in particular metastatic carcinoma of the breast, lung, kidney, multiple myeloma, lymphomas, and leukemia), vitamin d intoxication, milk-alkali syndrome, Paget’s disease with immobilization, thyrotoxicosis, acromegaly, diuretic phase of acute tubular necrosis or dehydration. Low levels of calcium may indicate hypoparathyroidism; vitamin d deficiency, chronic renal failure, magnesium deficiency, prolonged anticonvulsant therapy, acute pancreatitis, anterior pituitary hypofunction, hypoalbuminemia, or inadequate nutrition.
8.5-10.5 mg/dl Carbon dioxide content, total
High levels may indicate respiratory acidosis caused by poor gas exchange or depression of respiratory center; generalized respiratory disease; metabolic acidosis (after severe vomiting in pyloric stenosis, hypokalemic states, or excessive alkali intake). Low levels may indicate compensated respiratory alkalosis, metabolic acidosis in diabetes mellitus, renal glomerular or tubular failure, renal tubular acidosis and intestinal loss of alkali with coexisting increase in c1 and normal anion gap
24-30 mmol/liter Chloride
High chloride levels may be attributed to dehydration, renal tubular acidosis, acute renal failure, diabetes insipidus, metabolic acidosis associated with prolonged diarrhea with loss of nahco3, respiratory alkalosis, and some cases of primary hyperparathyroidism. Low serum chloride levels may be due to excessive sweating, prolonged vomiting from any cause or gastric suction, persistent gastric secretion, salt-losing nephritis, aldosteronism, potassium depletion associated with alkalosis, respiratory acidosis
100-108 mmol/liter Cholesterol
High total cholesterol levels may indicate familial or polygenic hyperlipoproteinemia types IIa and IIb, hyperlipidemia, hyperlipoproteinemias secondary to hepatocellular disease, intra- and extrahepatic cholestasis, chronic renal failure, malignant neoplasms of pancreas and prostate, hypothyroidism, gout, ischemic heart disease, pregnancy, diabetes, alcoholism, analbuminemia, dysglobulinemia, anorexia nervosa, idiopathic hypercalcemia, acute intermittent porphyria, or isolated hgh deficiency. Low levels may be associated with lipoprotein deficiency, hepatocellular necrosis, malignant neoplasm of liver, hyperthyroidism, malabsorption, malnutrition, megaloblastic anemias, chronic obstructive lung disease, mental retardation, rheumatoid arthritis, or intestinal lymphangiectasia. *secondary disorders that elevate cholesterol levels should be ruled out prior to initiating therapy with cholesterol-lowering drugs. *factors that have variable effects on cholesterol levels in different people include posture before and at time of blood sampling, a recent meal, emotional stress, and menstrual cycle.
Desirable < 200 mg / dl Borderline high 200-239 mg/dl High > 239 mg/dl Creatinine
High serum or plasma levels may indicate renal function impairment, both acute and chronic; active acromegaly and gigantism, hyperthyroidism, and meat meals. Creatine supplements can increase creatinine. It is always good to calculate your eGFR to make sure it is not under 60: http://nkdep.nih.gov/lab-evaluation/…culators.shtml
0.6-1.5 mg/dl Dehydroepiandrosterone (DHEA) sulfate (adult)
Decreased levels may be associated with increased age in men & women, hyperlipidemia, psychosis, or psoriasis. Weakly androgenic
Male 10-619 µg/dl Female Premenopausal 12-535 µg/dl Postmenopausal 30-260 µg/dl Estradiol (ultra sensitive)
Estradiol is the most active of endogenous estrogens. The test is of value, together with gonadotropins, in evaluating menstrual and fertility problems in adult females. Measurement is also useful in the evaluation of gynecomastia or feminization states due to estrogen or producing tumors.
Female Menstruating Follicular phase 50-145 pg/ml Midcycle peak 112-443 pg/ml Luteal phase 50-241 pg/ml Postmenopausal <59 pg / ml Male < 50 pg / ml Follicle-stimulating hormone (FSH)
In hypogonadism, FSH and LH levels lower than normal for the patient’s age indicate hypothalamic or pituitary problems; higher levels indicate a primary gonadal defect
Female Menstruating Follicular phase 3.0-20.0 U/liter Ovulatory phase 9.0-26.0 U/liter Luteal phase 1.0-12.0 U/liter Postmenopausal 18.0-153.0 U/liter Male 1.0-12.0 U/liter Globulin High levels may be associated with chronic hepatitis, plasma cell dyscrasias/ lymphoproliferative disorders, cirrhosis, chronic liver diseases, chronic infections or certain autoimmune disorders. Low levels may indicate immune deficiency or suppression or lymphoproliferative disorder. Decreases in all fractions may be seen in bulk loss of proteins into the gut. 2.6-4.1 g/dl Glucose, fasting
Serum glucose levels may be high due to diabetes mellitus, strenuous exercise, increased epinephrine, pancreatic disease or an endocrine disorder. A high serum level may also be related to acute myocardial infarction or severe angina, chronic liver disease, or chronic renal disease.
70-110 mg/dl (gamma)-Glutamyltransferase (GGT)
Very high levels can be associated with obstructive liver disease and posthepatic obstruction. Moderately high levels may indicate liver disease (inflammation, cirrhosis, space-occupying lesions), infectious mononucleosis, renal transplant, hyperthyroidism, myotonic dystrophy, diabetes mellitus, pancreatitis, or alcohol-induced liver disease. Low GGT levels will indicate hypothyroidism. *useful marker for pancreatic cancer, prostatic cancer, and hepatoma because levels reflect remission and recurrence.
Male 1-94 U/liter Female 1-70 U/liter Growth hormone (resting)
Secretion of GH is episodic and pulsatile; highest values occur during periods of deepest sleep. Ability to secrete GH in response to a conventional challenge declines with age. Random levels of GH provide little diagnostic information; GH secretion is best assessed during tests that stimulate or suppress release. Patients with GH-producing pituitary disorders often release GH in response to TRH or GnRH; and patients with suspected GH deficiencies have subnormal responses to stimulation tests (i.e. GH stimulation test after arginine, insulin, l-dopa, glucagon, propanolol and insulin tolerance test.)
2-5 ng/ml Hemoglobin A1C
Glycated hemoglobin concentration appears to reflect the mean blood glucose concentration over the previous 4-8 wks. This test, while not useful for the diagnosis of diabetes mellitus, has been shown to be useful in monitoring its long-term control. Glycated hemoglobins are increased as a reflection of hyperglycemia during the lifespan of erythrocytes
3.8-6.4% High-density lipoprotein cholesterol, as major risk factor
Epidemiological studies demonstrate the inverse association between HDL-c levels and the incidence and prevalence of coronary heart disease (CHD). It is suggested that for every 5 mg/dl decrease in HDL-c below the mean, the risk of CHD increases 25%. Another approach in assessing CHD risk is to calculate the ratio of HDL-c to either LDL-c or total cholesterol. The following primary disease states can lead to secondary decrease in HDL-c: uncontrolled diabetes, premature coronary heart disease, hepatocellular disorders, cholestasis, nephrotic syndrome, and chronic renal failure.
above 40 mg/dl men
above 50 mg/dl women
Decreased serum levels indicate inadequately treated type I diabetes mellitus. High serum levels may indicate insulin overdose, insulin resistance syndromes, or endogenous hyperinsulinemia
2-20 U/ml Lactate dehydrogenase (LDH)
Extremely high levels may indicate megaloblastic and pernicious anemia, extensive carcinomatosis, viral hepatitis, shock, hypoxia or extreme hyperthermia. Very high levels are associated with cirrhosis, obstructive jaundice, renal diseases, neoplastic diseases, skeletomuscular diseases, or congestive heart failure. Mildly high levels are associated with any cellular injury that results in loss of cytoplasm, myocardial or pulmonary infarction, leukemias, hemolytic anemias, hepatitis (nonviral), sickle cell disease, lymphoma, renal infarction, or acute pancreatitis.
110-210 U/liter Lipoprotein(a) 0-30 mg/dl Low-density lipoprotein cholesterol
LDL encompasses all of the lipoproteins with density greater than 1.006 kg/l and less than or equal to 1.063 kg/l. High levels may indicate primary hyperlipoproteinemia types IIa and IIb; tendon and tuberous xanthomas, corneal arcus, and premature coronary heart disease. The following diseases can lead to secondary elevation of LDL-c: hyperlipoproteinemia secondary to hypothyroidism, nephrotic syndrome, hepatic obstruction, hepatic disease, pregnancy, anorexia nervosa, diabetes, chronic renal failure, and Cushing’s syndrome.
Desirable < 130
Borderline high risk 130-159 mg/dl High risk greater than or equal to 160 mg/dl Iron
High serum levels may indicate pernicious, aplastic, and hemolytic anemias; hemochromatosis, acute leukemia, lead poisoning, acute hepatitis, vitamin b6 deficiency, excessive iron supplementation/therapy, repeated transfusions, or nephritis. Low serum iron levels may indicate iron-deficiency anemia, remission of acute and chronic infection, carcinoma, nephrosis, hypothyroidism, or postoperative state. *symptoms of iron poisoning include abdominal pain, vomiting, bloody diarrhea, cyanosis, lethargy, and convulsions. Levels may vary widely for an individual within the same day or from day to day.
45-180 ug/dL (MALES FEMALES). Luteinizing hormone (LH)
Test used to determine the preovulatory LH surge; also provides an integrated picture of LH secretion throughout the day. Shows pituitary or hypothalamic impairment or overproduction
Female Menstruating Follicular phase 2.0-15.0 Ovulatory phase 22-105 Luteal phase 0.6-19 Postmenopausal 16-64 Male 2.0-12.0 Magnesium
Mg plays a vital role in glucose metabolism by facilitating the formation of muscle and liver glycogen from blood-borne glucose. Also participates as a cofactor in the breakdown of glucose, fatty acids, and amino acids during energy metabolism. High serum levels may indicate dehydration, renal insufficiency, uncontrolled diabetes mellitus, adrenocortical insufficiency, Addison’s disease, hypothyroidism or lupus erythematosus. Phytate, fatty acids, and an excess of phosphate impair mg absorption. Symptoms of deficiency usually do not occur until serum levels are above 1 meq / liter
1.4-2.0 meq/liter Phosphorus, inorganic (adult)
Serum phosphorus concentrations have a circadian rhythm (highest level in late morning, lowest in evening) and are subject to rapid change secondary to environmental factors such as diet (carbohydrate), phosphate-binding antacids, and fluctuations in growth hormone, insulin, and renal function. High levels may indicate osteolytic metastatic bone tumors, myelogenous leukemia, milk-alkali syndrome, vitamin d intoxication, healing fractures, renal failure, hypoparathyroidism, pseudohypoparathyroidism, diabetes mellitus with ketosis, acromegaly, portal cirrhosis, pulmonary embolism, lactic acidosis or respiratory acidosis.
2.6-4.5 mg/dl Potassium
High potassium levels are associated with reduced renal excretion of potassium or redistribution of potassium in the body (i.e. Massive hemolysis, severe tissue damage, severe acute starvation-anorexia nervosa, hyperkinetic activity, malignant hyperpyrexia following anesthesia, hyperkalemic periodic paralysis, and dehydration).
3.4-4.8 mmol/liter Progesterone
The diagnostic value of this test lies in its detection of ovulation and in the evaluation of the function of the corpus luteum. Serial sampling during the menstrual cycle is required. During menopause, levels drop to 0
Female Follicular phase > 1 ng / ml Midluteal phase 3-20 ng/ml Male < 1 ng / ml Prolactin
May help assess Prolactin reserve and abnormal Prolactin secretion by the pituitary. May indicate pituitary tumors.
Female Premenopausal 0-20 ng/ml Postmenopausal 0-15 ng/ml Male 0-15 ng/ml Prostate-specific antigen (PSA)
PSA is prostate-tissue specific, not prostate-cancer specific. Used for early detection of the recurrence of prostatic cancer. The test is of great value as a marker in the follow-up of patients at high risk for disease progression. PSA values increase with age.
Female 0 Male less than 40 years of age 0.0-2.0 ng/ml greater than or equal to 40 yr old 0.0-4.0 ng/ml Prostate-specific antigen (PSA), free, in males 45-75 yr old, with PSA values between 4 and 20 ng/ml above 25% associated with benign prostatic hyperplasia Protein, total
High blood levels may be associated with anabolic steroid use, androgens, corticosteroids, coritcotropin, epinephrine, insulin, progesterone, or thyroid preparations. Severe protein deficiency, chronic liver disease, malabsorption syndrome, and malnutrition may also lead to abnormal levels. Serum total protein decreases in the third trimester of pregnancy.
6.0-8.0 g/dl Sodium
High serum levels are associated with water loss in excess of salt through skin, lungs, GI tract, and kidneys. Also may indicate increased renal sodium conservation in hyperaldosteronism, Cushing’s syndrome or disease, inadequate water intake because of inadequate thirst mechanism, dehydration, or excessive saline therapy. Low sodium levels may indicate low sodium intake, sodium losses due to vomiting, diarrhea, excessive sweating with adequate water intake and inadequate salt replacement, diuretics abuse, or salt-losing nephropathy
135-145 mmol/liter Somatomedin C (Insulin-like growth factor I)
Blood concentrations of IGF-1 are constant during the day and after eating. In acromegaly, the test may serve as an indicator of the severity of the disease; serial determinations may be used to monitor efficacy of treatment. In dwarfism IGF-1 may be used to determine the response to GH therapy. Concentrations of IGF-1 rise during the first year of life, reaching the highest values in preadolescent or early adolescent years. Normal values tend to decline progressively until age 50
16-24 yr 182-780 ng/ml 25-39 yr 114-492 ng/ml 40-54 yr 90-360 ng/ml > 54 yr 71-290 ng/ml Testosterone, total (morning sample)
This test is a measure of total circulating testosterone, both protein bound and free. In adult men, serum levels peak in the early morning, decreasing 25% to the evening minimum. Levels increase after exercise and decrease after immobilization and after glucose load. Progressive decreases begin after age 50
Female 6-86 ng/dl Male 270-1070 ng/dl Testosterone, unbound (morning sample)
Free (nonprotein-bound) testosterone is independent of changes in concentrations of the principal testosterone transport protein, sex hormone-binding globulin.
Female 20-40 yr 0.6-3.1 pg/ml 41-60 yr 0.4-2.5 pg/ml 61-80 yr 0.2-2.0 pg/ml Male 20-40 yr 15.0-40.0 pg/ml 41-60 yr 13.0-35.0 pg/ml 61-80 yr 12.0-28.0 pg/ml Thyroid-stimulating hormone (TSH)
First-line test for hyper- and hypothyroidism. Test is considered by some to be the preferred screening test for evaluation of thyrometabolic states. Moderately high TSH is often found in euthyroid patients during treatment of hyperthyroidism.
0.5-5.0 U/ml Thyroxine, total (T4)
Used in conjunction with other tests to measure thryoid function. T4 testing is frequently used when TSH levels are abnormally high or low. In hypothyroidism, total serum t4 falls before t3. High serum levels may represent hyperthyroidism.
4.5-10.9 g/dl Transferrin
Transferrin is the major plasma transport protein for iron. High serum levels may indicate iron deficiency (high levels often precede the appearance of anemia by days to months). Serum ferritin levels fall with iron deficiency and with generalized malnutrition but remain normal in the presence of inflammation and iron deficiency
191-365 mg/dl Triglycerides (fasting)
Increased triglyceride levels indicate hyperlipoproteinemia types I, IIb, III, IV, and V due to familial or sporadic endogenous hypertriglyceridemia. The following primary disease states or conditions can lead to secondary elevation of triglycerides: obesity, impaired glucose tolerance, viral hepatitis, alcoholism, alcoholic cirrhosis, biliary cirrhosis, acute and chronic pancreatitis, extrahepatic biliary obstruction, nephrotic syndrome, chronic renal failure, essential hypertension, acute myocardial infarction, chronic ischemic heart disease, cerebral thrombosis, hypothyroidism, diabetes mellitus, gout, pregnancy, glycogen storage diseases types I, II, III, and IV, down syndrome, respiratory distress syndrome, Werner’s syndrome, anorexia nervosa, or idiopathic hypercalcemia. Low levels of triglycerides may indicate chronic obstructive lung disease, brain infarction, hyperthyroidism, hyperparathyroidism, lactosuria, malnutrition, malabsorption syndrome, intestinal lymphangiectasia or end-stage parenchymal liver disease.
40-150 mg/dl Triiodothyronine, total (T3)
Used in conjunction with other tests to measure thyroid function. High serum levels may indicate hyperthyroidism while low levels may indicate hypothyroidism. At least 80% of circulating T3 is derived from monodeiodination of T4 in peripheral tissues. Free T3 and free T4 can also be of great value in thyroid work-ups. T3 is 4 to 5 times more potent in biological systems than T4.