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Reference ranges for blood tests

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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 percent of the normal population falls within, or two standard deviations from the mean.

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.

All values (except the exceptions below) denote blood plasma concentration, which is approximately 60-100% larger than the actual blood concentration if the amount inside red blood cells (RBCs) is negligible. The precise factor depends on hematocrit as well as amount inside RBCs. Exceptions (that is, values denoting total blood concentration) are:

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

Sorted by concentration

A separate printable combined image is available for mass and molarity

Smaller, narrower boxes indicate a more tight homeostatic regulation.

Substances with a molar mass around 1000g/mol (e.g. thyroxine) would be almost vertically aligned in the mass and molar images if they usually were measured in both units, while substances with higher molar mass (e.g. most proteins, like adrenocorticotropic hormone) would have masses deviating rightwards compared with molarity, and substances with molar mass below 1000g/mol (e.g. electrolytes and metabolites) would have masses deviating to the left.

By mass

Reference ranges for some blood tests, sorted by mass.

By molarity

Reference ranges for some blood tests, sorted by molarity.

By units

Units don't necessarily tell anything about molarity or mass.

White blood cells

Clinical biochemistry

Clinical chemistry (also known as "clinical biochemistry", "chemical pathology" or "pure blood chemistry") is the area of pathology that is generally concerned with analysis of bodily fluids.

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

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] See hypokalemia or hyperkalemia
Chloride (Cl) 95[4]-98 105[4]-107 mmol/L or mEq/L[4]
Osmolality 275[4]-280[6] 295[4]-296[6] mOsm/kg Plasma weight excludes solutes
Osmolarity Slightly less than osmolality mOsm/l Plasma volume includes solutes
Urea 1.2[4]-3.0[7] 3.0[4]-7.0[7] mmol/L ** BUN - blood urea nitrogen
7[4] 18[4]-21[5] mg/dL
* Uric acid[5] 0.18[4] 0.48[4] mmol/L
Female 2.0[6] 7.0[6] mg/dL
Male 2.1 [6] 8.5[6] mg/dL
** Creatinine male 68[8] 118[8] μmol/L May be complemented with creatinine clearance
0.8[9] 1.3[9] mg/dL
female 68[8] 98[8] μmol/L
0.8[9] 1.1[9] mg/dL
BUN/Creatinine Ratio 5[6] 35[6] -
** Glucose (fasting) 3.8[4]-3.9 6.1[10] mmol/L See also glycosylated hemoglobin (in hematology)
65[5]-70[4] 100[10]-110[6] mg/dL
Total serum iron (TSI) male 65[11]-76[5] 176[11]-198[5] µg/dL
11.6[12] 30.4[12] μmol/L
female 26[5]-50[11] 170[11][5] µg/dL
8.9[12] 30.4[12] μmol/L
newborns[11] 100 250 µg/dL
children[11] 50 120 µg/dL
Total iron-binding capacity (TIBC) 240[11]-262[5] 450[11]-474[5]
Transferrin 204[5] 360[5] mg/dL
25[13] 45[13] μmol/L
Transferrin saturation[11] 20 50 %
Ferritin[5] Male 12[14] 300[14] ng/mL
Female 12[14] 150[14]
Ammonia 10[15]-20[16] 35[15]-65[16] μmol/L
Copper 70[6] 150[6] µg/dL
Ceruloplasmin 15[6] 60[6] mg/dL
Lactate (Venous) 4.5[6] 19.8[6] mg/dL
Lactate (Arterial) 4.5[6] 14.4[6] mg/dL
Pyruvate 0.3[6] 0.9[6] mg/dL

Acid and base

Further information: Acid base physiology
Further information: Arterial blood gas
Test 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
PO2 10[4] 13-14[4] kPa
75[5][4]-83[6] 100[5]-105[4] mmHg
Oxygen saturation 96[6] 100[6] %
** PCO2 4.4[4]-4.8 5.8-5.9[4] kPa
33[4]-35[5] 44[4]-45[5] mmHg
Bicarbonate (HCO3-) 18[6] 23[6] mmol/L
Standard bicarbonate (SBCe) 21-22[4] 27-28[4] mmol/L or mEq/L[4]

Liver function

Further information: Liver function tests
Test Lower limit Upper limit Unit Comments
* Total Protein 60[4]-63[5] 78[4], 82[5], 84[6] g/L see hypoproteinemia
* Albumin 35[17][4] 48[5]-55[4] g/L see hypoalbuminemia
3.5[5] 4.8[5]-5.5[4] U/L
Globulins 23[4] 35[4] g/L
* Total Bilirubin 2[4] 17[4] μmol/L
0.1[4]-0.2[5] 1.0[4][6]-1.3[5] mg/dL
* Direct Bilirubin 0.0[4] 5[4] μmol/L
0[5][4] 0.3[5][4]-0.4[6] mg/dL
* Alanine transaminase (ALT) 7[5]-8 [4] 20[4], 56[5] U/L Also called serum glutamic pyruvic transaminase (SGPT)
* Alkaline phosphatase (ALP) 20[4],38[5], 50[6] 70[4], 126[5], 160[6] 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

Test Lower limit Upper limit Unit Comments
Creatine kinase (CK) - male 24[18]-38[5] 174[6] U/L
or ng/mL
Creatine kinase (CK) - female 24[18], 38[5], 96[6] 140[6] U/L
CK-MB[5] 0 3 ng/mL
Troponin[5] 0 0.4 ng/mL

Other enzymes and proteins

Test 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) 50[6] 150[6] U/L
Amylase 25[4], 30[5], 53[6] 110[5], 120[19], 123[6], 125[4] U/L
C-reactive protein (CRP) n/a 5[20]-6[21] mg/L
200[13] nmol/L
D-dimer n/a 500[22] ng/mL Higher in pregnant women[23]
Lipase 7[5]-10[6] 60[5]-150[6] U/L

Other ions and trace metals

Further information: Trace metals
Test Lower limit Upper limit Unit Comments
Ionised calcium (Ca) 1.03[24] 1.23[24] mmol/L Some calcium is bound to albumin, thus not measured by certain techniques.
* Total calcium (Ca) 2.1[4] 2.8[4] mmol/L
8.4[4]-8.5[6] 10.2[4]-10.5[6] mg/dL
Phosphate (HPO42−) 0.8 1.5 [25] mM
Inorganic phosphorus (serum) 1.0[4] 1.5[4] mmol/L
3.0[4] 4.5[4] mg/dL
Copper (Cu) 11[26] 24 μmol/L
Zinc (Zn) 70[6] 102[6] μmol/L
Magnesium 1.5[6] 2.0[6] mEq/L

Lipids

Further information: Blood lipids
Test Patient type Lower limit Upper limit Unit Comments
Triglycerides 10 - 39 years 54[6] 110[6] mg/dL
40 - 59 years 70[6] 150[6] mg/dL
> 60 years 80[6] 150[6] mg/dL
* Total cholesterol 3.6[4] 5.0[27]-6.5[4] mmol/L
120[5]-140[4] 200[5]-250[4] mg/dL
HDL cholesterol female 1.0[28] 2.2[28] mmol/L Therapeutic targets: >1.0 mmol/L [28]
(40 mg/dL)
50[29] 110 mg/dL
HDL cholesterol male 0.9[28] 2.0[28] mmol/L
45 100 mg/dL
LDL cholesterol 2.0[28]-2.4[27] 3.0[27]-3.4[28] mmol/L Therapeutic targets: <2.5 mmol/L.[28]
Not valid when triglycerides >5.0 mmol/L.

Tumour markers

Further information: Tumour markers
Test Lower limit Upper limit Unit Comments
Alpha fetoprotein (AFP) 0 44[5] ng/mL
Beta Human chorionic gonadotrophin (bHCG) n/a 5[5] IU/l in male and non-pregnant female
CA19.9 n/a 40[5] U/ml
Carcinoembryonic antigen (CEA)
non-smokers at 50 years		 n/a 3.6 [30] μg/l
Carcinoembryonic antigen (CEA)
non-smokers at 70 years		 n/a 4.1[30] μg/l
Carcinoembryonic antigen (CEA) - smokers n/a 5[31] μg/l
Prostate specific antigen (PSA) n/a 4[5] μg/L[5] or ng/mL[6] below age 45 <2,5 μg/L
PAP 0 3[6] units/dL (Bodansky units)

Hormones

Further information: Hormones
Category Test Patient type Lower limit Upper limit Unit
Thyroid hormones Thyroid stimulating hormone (TSH or thyrotropin) 0.4[5]-0.5[6] 4.5[5]-6.0[6] mIU/L or μIU/mL
Free thyroxine (FT4) Normal adult 10[32]-12 [33] 23[33] pmol/L
0.7[34] -0.8[5] 1.4[34]-1.5[5] ng/dL
Infant 0-3 d 2.0[34] 5.0[34] ng/dL
Infant 3-30 d 0.9[34] 2.2[34] ng/dL
Child/Adolescent
31 d - 18 y		 0.8[34] 2.0[34] ng/dL
Pregnant 0.5[34] 1.0[34] ng/dL
Total thyroxine 60[32][33] 140[32]-160[33] nmol/L
4[32]-5.5[5] 11[32]-12.3[5] μg/dL
Free triiodothyronine (FT3) Normal adult 0.2[32] 0.5[32] ng/dL
Children 2-16 y 0.1[35] 0.6[35] ng/dL
Total triiodothyronine 1.1[32] 2.7[32] nmol/L
60[5]-75[32] 175[32]-181[5] ng/dL
Thyroxine-binding globulin (TBG) 12[5] 30[5] mg/L
Thyroglobulin (Tg) 1.5[32] 30[32] pmol/L
1[32] 20 [32] μg/L
Other Adrenocorticotropic hormone (ACTH) 1.3 18[36] pmol/L
20[5] 100[5] pg/mL
Growth hormone (fasting) 0 5[4] ng/mL
Growth hormone (arginine stimulation) 7[4] n/a ng/mL
Prolactin n/a 14[5] ng/mL
Testosterone male 8 [37] 27 [37] nmol/L
17 Hydroxyprogesterone male 0.06[6] 3.0[6] mg/L
Female (Follicular phase) 0.2[6] 1.0[6] mg/L
25-hydroxycholecalciferol 8[6] 80[6] ng/mL
20[38] 150[38] nmol/L

Amino acids

Test Patient type Lower limit Upper limit Unit Comment
Homocysteine Female 12-19 years 3.3 [39] 7.2[39] μmol/L Elevated at:
10.4 umol/L
Female >60 years 4.9 [39] 11.6 [39] μmol/L
Male 12-19 years 4.3 [39] 9.9 [39] μmol/L Elevated at:
11.4 umol/L
Male >60 years 5.9 [39] 15.3 [39] μmol/L

Vitamins

Test Patient type Lower limit Upper limit Unit
Vitamin A 30[6] 65[6] µg/dL
Vitamin B9 (Folic acid) Age > 1year 5 [40] ng/mL
11[13] nmol/l
Vitamin B12 (Cobalamin) 130 [41] 700[41] ng/L
100[13] 500[13] pmol/L
Vitamin C (Ascorbic acid) 0.4[6] 1.5[6] mg/dL
25-hydroxycholecalciferol 8[6] 80[6] ng/mL
20[38] 150[38] nmol/L

Toxins

Test Patient type Lower limit Upper limit Unit
Lead 40[6] µg/dL

Hematology

Hematology is the branch of biology (physiology), pathology, clinical laboratory, internal medicine, and pediatrics that is concerned with the study of blood, the blood-forming organs, and blood diseases.

Red blood cells

Test Patient Lower limit Upper limit Unit Comments
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
female 1.9[4] 2.5[4] mmol/L Sex difference negligible until adulthood.
115-120[4][5] 152[5]-160[4][6] g/L
Hemoglobin in plasma 0.16[4] 0.62[4] μmol/L Normally diminutive compared with inside red blood cells
1 4 mg/dL
Glycosylated hemoglobin (HbA1c) 4[42] 5.9[42] % of Hb
Haematocrit (Hct) male 0.4[5], 0.41[4], 0.45[6] 0.52[5],0.53[4] , 0.62[6]
female 0.36[4]-0.37[5][6] 0.46[5][4]-0.48[6]
Child 0.31[5] 0.43[5]
Mean cell volume (MCV) Male 76[6]-82[5] 100[6]-102[5] fL Cells are larger in neonates, though smaller in other children.
Female 78[5] 101[5] fL
Red blood cell distribution width (RDW) 11.5[5] 14.5[5] %
Mean cell haemoglobin (MCH) 0.39[4] 0.54[4] fmol/cell
25[4]-27[6] 32[6]-35[4] pg/cell
Mean corpuscular hemoglobin concentration (MCHC) 31[5]-32[6] 35[5]-36[6] g/dL
19 [43]- 20[43] 22[43] mmol/L
Red blood cells (RBC) male 4.2[6]-4.3[5][4] 5.9[4], 6.2[5], 6.9[6] 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
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

White blood cells

Test Patient type Lower limit Upper limit Unit
White Blood Cell Count (WBC.) Adult 3.9[44], 4.1[5], 4.5[4] 10.0[44], 10.9[5], 11[4]
  • x109/L
  • x103/mm3 or
  • x103/μL
Newborn 9[45] 30[45]
1 year old 6[45] 18[45]
Neutrophil granulocytes
(A.K.A. grans, polys, PMNs, or segs)		 Adult 1.8[44]-2[45] 7[44]-8[45] x109/L
45-54[4] 62[4]-74 % of WBC
Newborn 6[45] 26[45] x109/L
Neutrophilic band forms Adult 0.7[45] x109/L
3[4] 5[4] % of WBC
Lymphocytes Adult 1.0[45][44] 3.5[44]-4.8[45] x109/L
16-25[4] 33[4]-45 % of WBC
Newborn 2[45] 11[45] x109/L
Monocytes Adult 0.2[46][41] 0.8[45][41] x109/L
3[4]-4.0 7[4]-10 % of WBC
Newborn 0.4[45] 3.1[45] x109/L
Mononuclear leukocytes
(Lymphocytes + monocytes)		 Adult 1.5 5 x109/L
20 35 % of WBC
CD4+ cells Adult 0.4 [5] 1.8[5] x109/L
Eosinophil granulocytes Adult 0.04[41] 0.44[41]-0.45[45] x109/L
1[4] 3[4]-7 % of WBC
Newborn 0.02[45] 0.85[45] x109/L
Basophil granulocytes Adult 40[44] 100[41], 200[45], 900[44] x106/L
0.0 0.75[4]-2 % of WBC
Newborn 0.64 [45] x109/L

Coagulation

Test Lower limit Upper limit Unit Comments
Platelet count (Plt) 140[5]-150[4] 350[6], 400[4], 450[5] x109/L
Prothrombin time (PT) 11[4][47]-12[5] 13.5[47], 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

Category Test Patient Lower limit Upper limit Unit Comments
Acute phase protein
markers of Inflammation		 Erythrocyte sedimentation rate
(ESR)		 Male 0 Age÷2[48] mm/hr ESR increases with age and tends to be higher in females.[49]
Female (Age+10)÷2 [48]
C-reactive protein (CRP) 0 5[20]-6[21] mg/L
Alpha 1-antitrypsin (AAT) 20[50] 53[50] μmol/L
150 350 mg/dL
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.
Serology Antistreptolysin O titre
(ASOT)		 Preschoolers n/a 100 units/mL
School age 250[5]
Adult 125[5]

See also

References

  1. ^ MedlinePlus Encyclopedia: 003462
  2. ^ MedlinePlus Encyclopedia: 003468
  3. ^ a b c Unless else specified in boxes, then ref is: Ashwood, Edward R.; Tietz, Norbert W.; Burtis, Carl A. (1994). Tietz textbook of clinical chemistry (2nd ed.). Philadelphia: Saunders. ISBN 0-7216-4472-4.{{cite book}}: CS1 maint: multiple names: authors list (link)
  4. ^ 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 af ag ah ai aj ak al am an ao ap aq ar as at au av aw ax ay az ba bb bc bd be bf bg bh bi bj bk bl bm bn bo bp bq br bs bt bu bv bw bx by bz ca cb cc cd ce cf cg ch ci cj ck cl cm cn co cp cq cr cs ct cu cv cw cx cy cz da db dc dd de df dg dh di 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.{{cite book}}: CS1 maint: multiple names: authors list (link)
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  31. ^ Carcinoembryonic Antigen(CEA) at MedicineNet
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  33. ^ a b c d Euthyroid Patient with Elevated Serum Free Thyroxine George van der Watt1,a, David Haarburger1 and Peter Berman
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  35. ^ a b Serum concentration of free T3, free T4 and TSH in healthy children CIOFFI Michele ; GAZZERRO Patrizia ; VIETRI Maria Teresa ; MAGNETTA Rosa ; DURANTE Adriana ; D'AURIA Annamaria ; PUCA Giovanni Alfredo ; MOLINARI Anna Maria ;
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  37. ^ a b Andrology Australia: Your Health > Low Testosterone > Diagnosis
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  40. ^ University of Kentucky Chandler Medical Center > Clinical Lab Reference Range Guide Retrieved on April 28, 2009
  41. ^ a b c d e f g GPnotebook > B12 Retrieved on April 28, 2009 Cite error: The named reference "gpnotebook" was defined multiple times with different content (see the help page).
  42. ^ a b "Hemoglobin A1c Test". MedicineNet.com. Retrieved 2007-12-26.
  43. ^ a b c Derived from mass concentration, using molar mass of 64,458 g/mol (Van Beekvelt MC, Colier WN, Wevers RA, Van Engelen BG (2001). "Performance of near-infrared spectroscopy in measuring local O2 consumption and blood flow in skeletal muscle". J Appl Physiol. 90 (2): 511–519. PMID 11160049.{{cite journal}}: CS1 maint: multiple names: authors list (link)). 1 g/dL = 0.6206 mmol/L
  44. ^ a b c d e f g h lymphomation.org > Tests & Imaging > Labs > Complete Blood Count Retrieved on May 14, 2009
  45. ^ a b c d e f g h i j k l m n o p q r s t u [http://books.google.com/books?id=3PJVLH1NmQAC Clinical Laboratory Medicine. By Kenneth D. McClatchey. Page 807.
  46. ^ Determination of monocyte count by hematological analyzers, manual method and flow cytometry in polish population Central European Journal of Immunology 1-2/2006. (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,
  47. ^ a b MedlinePlus Encyclopedia: 003652
  48. ^ a b Miller A, Green M, Robinson D (1983). "Simple rule for calculating normal erythrocyte sedimentation rate". Br Med J (Clin Res Ed). 286 (6361): 266. doi:10.1136/bmj.286.6361.266. PMC 6402065. PMID 6402065.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  49. ^ Böttiger LE, Svedberg CA (1967). "Normal erythrocyte sedimentation rate and age". Br Med J. 2 (5544): 85–7. doi:10.1136/bmj.2.5544.85. PMC 6020854. PMID 6020854.
  50. ^ a b Sipahi T, Kara C, Tavil B, Inci A, Oksal A (2003). "Alpha-1 antitrypsin deficiency: an overlooked cause of late hemorrhagic disease of the newborn". J. Pediatr. Hematol. Oncol. 25 (3): 274–5. doi:10.1097/00043426-200303000-00019. PMID 12621252. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
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