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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.

Contents


Clinical biochemistry

  • Items marked with a ** are part of "CHEM-7"[1] and CHEM-20
  • Items marked with a * are part of "CHEM-20"[2], but not CHEM-7

Electrolytes and Metabolites

Electrolytes and Metabolites:

Test [3] Patient type Lower limit [3] Upper limit[3] Unit Comments
|- 
| ** Sodium (Na) 
135[4]-137[5] 145[5]-147[4] mmol/L or mEq/L[4]
|- 
| ** Potassium (K) 
3.5[4]-3.6[5] 5.0[5][4]-5.1 mmol/L or mEq/L[4]
|- 
| Chloride (Cl) 
95[4]-98 105[4]-107 mmol/L or mEg/L[4]
|- 
| Osmolality  
275[4] 295[4] mOsm/kg
|- 
|rowspan=2| Urea 
1.2[4]-2.5 3.0[4]-6.4 mmol/L
|- 
| 7[4] 
18[4]-21[5] mg/dL
|- 
|rowspan=2| * Uric acid[5] 
0.18[4] 0.48[4] mmol/L
|-
| 3.0[4]3.5 
8.2[4]-8.5 mg/dL
|- 
|rowspan=4|  ** Creatinine 
male 62 115 ?mol/L May be complemented with creatinine clearance
|- 
| 0.7  
1.3 mg/dL
|- 
|rowspan=2| female  
53 97 ?mol/L
|- 
|  0.6  
1.1 mg/dL
|- 
|rowspan=2| ** Glucose (fasting) 
3.8[4]-3.9 5.8-6.1[4] mmol/L See also glycosylated hemoglobin (in hematology)
|- 
| 65[5]-70[4]  
105-110[5][4] mg/dL
|- 
|rowspan=4| Total serum iron (TSI) 
male 65[6]-76[5] 176[6]-198[5] µg/dL
|- 
| female 
26[5]-50[6] 170[6][5]
|- 
| newborns[6] 
100 250
|- 
| children[6] 
50 120
|- 
| Total iron-binding capacity (TIBC) 
240[6]-262[5] 450[6]-474[5]
|- 
| Transferrin[5] 
204 360 mg/dL
|- 
| Transferrin saturation[6] 
20 50 %
|- 
|rowspan=2| Ferritin[5] 
Male 18 250 ng/mL
|- 
| Female 
12 160
|- 

Acid and base

Lower limit Upper limit Unit Comments
|- 
| pH 
7.34[5]-7.35[4] 7.44[5]-7.45[4]
|-
| [H+] 
36[4] 44[4] nmol/L
|- 
| base excess  
-3 +3
|-
|rowspan=2| PO2 
10[4] 13-14[4] kPa
|-
| 75[5][4] 
100[5]-105[4] mmHg
|-
|rowspan=2| ** PCO2 
4.4[4]4.8 5.8-5.9[4] kPa
|-
| 33[4]-35[5] 
44[4]-45[5] mmHg
|-
| Bicarbonate (HCO3-) 
18 23 mmol/L
|-
| Standard bicarbonate (SBCe) 
21-22[4] 27-28[4] mmol/L or mEq/L[4]
|- 

Liver function

Lower limit Upper limit Unit Comments
|-
|* Total Protein  
60[4]-63[5] 78[4]-82[5] g/L
|- 
|rowspan=2| * Albumin  
35[7][4] 48[5]-55[4] g/L
|-
| 3.5[5] 
4.8[5]-5.5[4] U/L
|- 
| Globulins 
23[4] 35[4] g/L
|-
|rowspan=2| * Total Bilirubin  
2[4] 17[4] ?mol/L
|-
| 0.1[4]-0.2[5] 
1.0[4]-1.3[5] mg/dL
|- 
|rowspan=2| * Direct Bilirubin  
0.0[4] 5[4] ?mol/L
|-
| 0[5][4] 
0.3[5][4] mg/dL
|- 
| * Alanine transaminase (ALT)  
7[5]-8 [4] 20[4], 40, 56[5] U/L Also called serum glutamic pyruvic transaminase (SGPT)
|- 
| * Alkaline phosphatase (ALP)  
20[4]-38[5] 70[4]-126[5] U/L p-NPP at 30 degrees C[4]
Higher in children and pregnant women.
|- 
| * Gamma glutamyl transferase (GGT) 
8[5] 50-78[5] U/L
|- 

Cardiac tests

Lower limit Upper limit Unit Comments
|- 
| Creatine kinase (CK) - male 
24[8]-38[5] 195 U/L
or ng/mL
|- 
| Creatine kinase (CK) - female  
24[9]-38[5] 170 U/L
|- 
| CK-MB[5] 
0 3 ng/mL
|- 
| Troponin[5] 
0 0.4 ng/mL
|- 

Other enzymes and proteins

Lower limit Upper limit Unit Comments
|- 
| * Aspartate transaminase (AST)  
5[5]-8[4] 20[4]-35[5] U/L Also called serum glutamic oxatoacetic transaminase (SGOT)
|- 
| * Lactate dehydrogenase (LDH)  
85 285 U/L
|- 
| Amylase  
25[4]-30[5] 110[5], 120[10], 125[4] U/L
|- 
| C-reactive protein (CRP)  
n/a 5[11] mg/L
|- 
| D-dimer  
n/a 500 ng/mL
|-
| Lipase[5] 
7 60 U/L
|- 

Other ions and trace metals

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.
|- 
|rowspan=2| * Total calcium (Ca)  
2.1[4] 2.8[4] mmol/L
|-
| 8.4[4] 
10.2[4] mg/dL
|-
| Phosphate (HPO42?) 
0.8 1.5 [12] mM
|-
|rowspan=2| Inorganic phosphorus (serum) 
1.0[4] 1.5[4] mmol/L
|-
| 3.0[4] 
4.5[4] mg/dL
|- 
| Copper (Cu)  
11[13] 24 ?mol/L
|- 
| Zinc (Zn)  
10 17 ?mol/L
|- 

Lipids

Lower limit Upper limit Unit Comments
|- 
|rowspan=2| Triglycerides  
0.4 2 mmol/L
|-
| 50[5] 
250[5] mg/dL
|- 
|rowspan=2| * Total cholesterol  
3.6[4] 5.0[14]-6.5[4] mmol/L
|-
| 120[5]-140[4] 
200[5]-250[4] 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[14] mmol/L Not valid when triglycerides >5.0 mmol/L.
|- 

Tumour markers

Lower limit Upper limit Unit Comments
|- 
|rowspan=2| Alpha fetoprotein (AFP)  
n/a 10 kU/l
|-
| 0 
44[5] ng/mL
|-
|rowspan=2| Alpha 1-antitrypsin (AAT) 
20 53 mmol/L
|-
| 150 
350 mg/dL
|- 
| Beta Human chorionic gonadotrophin (bHCG)  
n/a 5[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[5] U/ml
|- 
| Carcinoembryonic antigen (CEA) - non-smokers  
n/a 3 ?g/l
|- 
| Carcinoembryonic antigen (CEA) - smokers  
n/a 5 ?g/l
|- 
| Prostate specific antigen (PSA)  
n/a 4[5] ?g/L
|- 

Hormones

Lower limit Upper limit Unit Comments
|- 
|Thyroid stimulating hormone (TSH) 
0.3 3.0 mIU/L Also called: Thyrotropin
|- 
|rowspan=2| Free thyroxine (FT4)  
9 24 pmol/L
|-
| 0.8[5] 
1.5[5] ng/dL
|-
|rowspan=2| Total thyroxine 
60[15] 140[15] nmol/L
|- 
| 5.5[5] 
12.3[5] ng/mL
|-
|rowspan=2| Free triiodothyronine (FT3)  
2.5 5.3 pmol/L
|-
| 0.2[15] 
0.5[15] ng/dL
|- 
|rowspan=2| Total triiodothyronine 
1.1[15] 2.7[15] nmol/L Values in children may be higher [15]
|-
| 60[5]-75[15] 
175[15]-181[5] ng/dL[15]
|- 
|rowspan=2| Adrenocorticotropic hormone (ACTH)  
1.3 15 pmol/L
|-
| 20[5] 
100[5] 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[4] ng/mL
|-
| Growth hormone (arginine stimulation) 
7[4] 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

Patient Lower limit Upper limit Unit Comments
|- 
|rowspan=4| Haemoglobin (Hb) 
male 2.1[4] 2.7[4] mmol/L Higher in neonates, lower in children.
|-
| 132[5]-135[4] 
162[5]-175[4] g/L
|- 
|rowspan=2| female 
1.9[4] 2.5[4] mmol/L Sex difference negligible until adulthood.
|-
| 115-120[4][5] 
152[5]-160[4] g/L
|-
| Glycosylated hemoglobin (HbA1c) 
4[16] 5.9[16] % of Hb
|- 
|rowspan=3| Haematocrit (Hct) 
male 0.38, 0.4[5], 0.41[4] 0.52-0.53[4]
|- 
| female 
0.36[4]-0.37[5] 0.46[5][4]-0.47
|- 
| Child 
0.31[5] 0.43[5]
|- 
|rowspan=2| Hemoglobin in plasma 
0.16[4] 0.62[4] ?mol/L
|- 
|  
1 4 mg/dL
|- 
|rowspan=2| Mean cell volume (MCV) 
Male 82[5] 102[5] fL Cells are larger in neonates, though smaller in other children.
|-
| Female 
78[5] 101[5] fL
|-
| MCV standard deviation 
35[5] 47[5] fL
|- 
|rowspan=2| Mean cell haemoglobin (MCH) 
0.39[4] 0.54[4] fmol/cell
|-
| 25[4]-26 
34-35[4] pg/cell
|-
| Mean cell haemoglobin concentration (MCHC) 
31[5] 35[5] g/dL
|- 
|rowspan=3| Red cell count (RBC) 
male 4.3[5][4]-4.5 5.9[4]-6.2[5] x1012/L
|- 
| Female 
3.5[4]-3.8[5] 5.5[5][4]-5.8 x1012/L
|- 
| Infant/Child 
3.8[5] 5.5[5] x1012/L
|- 
|rowspan=4| Reticulocytes 
10 100 x109/L
|- 
| Adult 
0.5[5][4] 1.5[5] [4] % of RBC
|- 
| Newborn 
1.1[5] 4.5[5] % of RBC
|- 
| Infant 
0.5[5] 3.1[5] % of RBC
|- 
| Red blood cell distribution width (RDW) 
11.5[5] 14.5[5] % Coefficient of variation
|-
|}

White blood cells

Lower limit Upper limit Unit Comments
|- 
| White Blood Cell Count (WBC.) 
4.1[5]-4.5[4] 10.9[5]-11[4]
  • x109/L
  • x103/mm3 or
  • x103/?L
Higher in neonates and infants.
|- 
|rowspan=2| Neutrophil granulocytes 
2 7.5 x109/L Also known as granulocytes (grans), polys, PMNs, or segs.
|- 
| 45-54[4] 
62[4]-74 % of WBC
|- 
| Neutrophilic band forms  
3[4] 5[4] % of WBC
|- 
|rowspan=2| Lymphocytes 
1.3 4 x109/L
|- 
| 16-25[4] 
33[4]-45 % of WBC
|- 
|rowspan=2| Monocytes  
0.2 0.8 x109/L
|- 
| 3[4]-4.0 
7[4]-10 % of WBC
|-
|rowspan=2| Mononuclear leukocytes 
1.5 5 x109/L Lymphocytes + monocytes.
Mean: 35% of WBC.
|- 
| 20 
35 % of WBC
|- 
| CD4+ cells 
0.4 [5] 1.8[5] x109/L
|-
|rowspan=2| Eosinophil granulocytes 
0.04 0.4 x109/L
|- 
| 1[4] 
3[4]-7 % of WBC
|- 
|rowspan=2| Basophil granulocytes  
0.01 0.1 x109/L
|- 
| 0.0 
0.75[4]-2 % of WBC
|-
|}

Coagulation

Lower limit Upper limit Unit Comments
|- 
| Platelet count (Plt)
140[5]-150[4] 400[4]-450[5] x109/L
|- 
| Prothrombin time (PT)
11[4][17]-12[5] 13.5[17], 14[5], 15[4] 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[5]-29 28[5]-41 s
|- 
| Thrombin clotting time (TCT)
11 18 s
|- 
| Fibrinogen   
1.7[5]-1.8 4.2[5] g/L
|- 
| Bleeding time 
2 9 minutes

Immunology

Test Patient Lower limit Upper limit Unit Comments
|- 
|rowspan="3" valign="top"|Acute phase protein
markers of Inflammation
Erythrocyte sedimentation rate
(ESR)
Male 0 Age÷2[18] mm/hr ESR increases with age and tends to be higher in females.[19]
|-
| Female 
(Age+10)÷2 [18]
|- 
| C-reactive protein (CRP) 
0 6 mg/L
|- 
|rowspan="3" valign="top"|Autoantibodies 
Antinuclear antibodies (ANA)
|- 
| Extractable nuclear antigen (ENA) 
|- 
| Rheumatoid factor (RF) 
0 20-30[5] IU/mL High levels not specific for Rheumatoid Arthritis alone.
|- 
|rowspan=3| Serology 
Antistreptolysin O titre
(ASOT)
Preschoolers n/a 100 units/mL
|-
| School age 
250[5]
|-
| Adult 
125[5]

See also

References

External links

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