Reference ranges for common blood tests: Meaning (information, definition, explanation, facts)

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.

It must be remembered that the reference range will vary, depending on the age, sex and race of a population, and even the machines the laboratory uses to do the tests. Also remember that by definition 5% of the normal population will fall outside the reference range.

These are approximate adult values that are intended as a guide to students and those interested,

Clinical biochemistry

Metabolytes

Test Range Comments
Sodium (Na) 130 - 145 mmol/L
Potassium (K) 3.5 - 5.0 mmol/L
Urea 2.6 - 6.8 mmol/L
Creatinine 50 - 110 μmol/L
Glucose (fasting) 4.2 - 6.1 mmol/L

Liver function tests

Total Protein 60 - 80 g/L
Albumin 30 - 50 g/L
Total Bilirubin 2 - 14 μmol/L
Direct Bilirubin 0 - 4 μmol/L
Alanine transaminase (ALT) 8 - 40 U/L Also called serum glutamic pyruvic transaminase (SGPT)
Alkaline phosphatase (ALP) 40 - 130 U/L Higher in children and pregnant women.
Gamma glutamyl transferase

Other enzymes and proteins

Creatine kinase (CK) 22 - 198 U/L
Aspartate transaminase (AST) 8 - 35 U/L
Lactate dehydrogenase (LDH) 85 - 285 U/L
Amylase 25 - 125 U/L
C-reactive protein (CRP)

Other ions and trace metals

Ionised calcium (Ca) 1.15 - 1.29 mmol/L Some calcium is bound to albumin, thus not measured by certain techniques.
Total calcium (Ca) 2.05 - 2.55 mmol/L
Copper (Cu) 11 - 26 μmol/L
Zinc (Zn) 10 - 17 μmol/L

Lipids

Triglycerides 0.4 - 2.0 mmol/L
Total cholesterol 3.0 - 5.5 mmol/L
HDL cholesterol (male) 0.7 - 1.9 mmol/L
(female) 0.9 - 2.4 mmol/L
LDL cholesterol 2.4 - 4.0 mmol/l Not valid when triglycerides >5.0 mmol/L.

Tumour markers

Alpha-fetoprotein (AFP) 1-15 kIU/L
CA-125
Prostate specific antigen (total PSA) After age 40, normal levels increase every decade.

Hormones

Thyroid stimulating hormone (TSH) 0.5 - 4.7 mIU/L Also called: Thyrotropin
Free thyroxine (FT4) 9.0 - 24 pmol/L
Free triiodothyronine (FT3) 2.5 - 5.3 pmol/L
Adrenocorticotropic hormone (ACTH) 1.3 - 15 pmol/L
Cortisol (0830 h) 250 - 850 nmol/L Cortisol levels are higher in the morning than at night.
Cortisol (1630 h) 110 - 390 nmol/L
Prolactin (male)
(female)
Testosterone (male) 8 - 38 nmol/L
(male prepuberty) 0.1 - 0.5 nmol/L
(female) 0.3 - 2.5 nmol/L

Haematology

Red blood cells

Haemoglobin (Hb) (male) 130 - 180 g/L Higher in neonates, lower in children.
(female) 115 - 160 g/L Sex difference negligible until adulthood.
Haematocrit (Hct) (male) 0.38 - 0.52
(female) 0.35 - 0.47
Mean cell volume (MCV) 80 - 98 fL
Mean cell haemoglobin (MCH) 26 - 34 pg
Red cell count (male) 4.5 - 6.5 x1012/L
(female) 3.8 - 5.8 x1012/L
Reticulocytes 10 - 100 x109/L
Erythrocyte
sedimentation rate (ESR)

White blood cells

Total white blood cells 4.0 - 11.0 x109/L Higher in neonates and infants.
Neutrophil granulocytes 2.0 - 7.5 x109/L
Lymphocytes 1.0 - 4.0 x109/L
Monocytes 0.0 - 0.8 x109/L
Eosinophil granulocytes 0.0 - 0.5 x109/L
Basophil granulocytes 0.0 - 0.2 x109/L

Coagulation

Prothrombin time (PT) 7 - 10 s
INR 0.8 - 1.2 The INR is a corrected ratio of a patients PT to normal
Activated partial thromboplastin time (APTT) 29 - 41 s
Thrombin clotting time (TCT) 11 - 18 s
Fibrinogen 1.8 - 4.0 g/L
Bleeding time 2 - 8 minutes

Immunology

Antinuclear antibodies (ANA)
Extractable nuclear antigen (ENA)

Serology

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