Common laboratory values: CBC, electrolytes, lipoproteins, albumin, wbc with differential etc

Laboratory Values

Unless noted, all values are for adults

Updated Laboratory Section can be found here:

labs_home.htm

Arterial blood gases - review; Anion gap (review); ANC calculator.

Albumin

3.2 - 5 g/dl

Alkaline phosphatase
(Adults: 25-60)

33 - 131 IU/L

Adults > 61 yo:

51 - 153 IU/L

Ammonia

20 - 70 mcg/dl

Bilirubin, direct

0 - 0.3 mg/dl

Bilirubin, total

0.1 - 1.2 mg/dl

Blood Gases

Arterial

Venous

7.35 - 7.45

7.32 - 7.42

pCO₂

35 - 45

38 - 52

pO₂

70 - 100

28 - 48

HCO₃

19 - 25

O₂ Sat %

90 - 95

40 - 70

BUN

7 - 20 mg/dl

Complete blood count (CBC) Adults

Male

Female

Hemoglobin (g/dl)

13.5 - 16.5

12.0 - 15.0

Hematocrit (%)

41 - 50

36 - 44

RBC's ( x 10⁶/ml)

4.5 - 5.5

4.0 - 4.9

RDW (RBC distribution width)

< 14.5

MCV

80 - 100

MCH

26 - 34

MCHC %

31 - 37

Platelet count

100,000 to 450,000

Creatine kinase (CK) isoenzymes

CK-BB

CK-MB (cardiac)

0 - 3.9%

CK-MM

96 - 100%

Creatine phosphokinase (CPK)

8 - 150 IU/L

Creatinine (mg/dl)

0.5 - 1.4

Electrolytes

Calcium

8.8 - 10.3 mg/dL

Calcium, ionized

2.24 - 2.46 meq/L

Chloride

95 - 107 mEq/L

Magnesium

1.6 - 2.4 mEq/L

Phosphate

2.5 - 4.5 mg/dL

Potassium

3.5 - 5.2 mEq/L

Sodium

135 - 147 mEq/L

Other

Ferritin (ng/ml)

13 - 300

Folate (ng/dl)

3.6 - 20

Glucose, fasting (mg/dl)

60 - 110

Glucose (2 hours postprandial) (mg/dl)

Up to 140

Hemoglobin A_1c

<6% of total Hb
AACE Guidelines (2011)
Hemoglobin A1c, % (as a screening test)

5.4 - Normal
-------------------------
5.5-6.4 - High risk/prediabetes; requires screening by glucose criteria
-------------------------

6.5 -Diabetes, confirmed by repeating the test on a different day
=================
In general, therapy should target a A1C level of 6.5% or less for most nonpregnant adults.

Iron (mcg/dl)

65 - 150

Lactic acid (meq/L)

0.7 - 2.1

LDH (lactic dehydrogenase)

56 - 194 IU/L

Lipoproteins and triglycerides

Cholesterol, total

< 200 mg/dl

HDL cholesterol

35 mg/dL. Negative risk factor:

60 mg/dL

LDL cholesterol

65 - 180 mg/dl

Triglycerides

45 - 155 mg/dl (< 160)

Osmolality

289 - 308 mOsm/kg

SGOT (AST)

< 35 IU/L (20-48)

SGPT (ALT)

<35 IU/L

Thyroid Function tests

Thyroid Function Testing

Thyroid Function Test	Measurement	Normal Range
Total T4 (TT4)	bound and free T4	4.5 -11.5 mg/dL
Free T4 (FT4)	free T4	0.8 -2.8 ng/dL
Free T4 Index (FT4I)	estimate of free T4 FT4I = TT4 x RT3U	1.0 -4.3 U
Total T3 (TT3)	bound and free T3	75 -200 ng/dL
Resin T3 Uptake (RT3U)	binding capacity of TBG	25 -35%
TRH	TRH	5 -25 mIu/mL
TSH	TSH	0.5 - 4.70 µIU/mL American Association of Clinical Endocrinologists guidelines changed their normal range for TSH to 0.3 - 3.04 mIU/L.
Thyroglobulin	Thyroglobulin	5-25 ng/mL
Radioactive Iodine Uptake (RAIU)	Distribution of radiolabeled iodine in the thyroid	5 hr – 5 to 15% 24 hr – 15 to 35%

Notes:
Free T4 - much more useful then total T4 (e.g. interested in unbound or active form). Total T4 not commonly measured. Greatly affected by TBG.
Free T4 index: indirect measure of free T4. Corrects for high/low values of TBG.
Total T3: not as useful as free T3, however, may be useful in locating problems with TBG, or if looking for problems with peripheral conversion of T4 to T3.
Resin T3 Uptake: if low, then TBG binding capacity is high. Opposite if high.
TSH: best measure to determine thyroid function.
Thyroglobulin: nonspecific test that is elevated when the thyroid gland is inflamed or enlarged.

Free T3

2.3-4.2 pg/ml

Total iron binding capacity (TIBC)

250 - 420 mcg/dl

Transferrin

> 200 mg/dl

Uric acid (male)

2.0 - 8.0 mg/dl

(female)

2.0 - 7.5 mg/dl

WBC + differential

WBC (cells/ml)

4,500 - 10,000

Segmented neutrophils

54 - 62%

Band forms

3 - 5% (above 8% indicates left shift)

Basophils

0 - 1 (0 - 0.75%)

Eosinophils

0 - 3 (1 - 3%)

lymphocytes

24 - 44 (25 - 33%)

Monocytes

3 - 6 (3 - 7%)

Absolute Neutrophil Count (ANC) - Oncology

Equations:
(1) Segs and bands reported as a percentage:
WBC * ((segs / 100) + (bands / 100))

(2) Segs and bands reported in total numbers:
WBC * (segs + bands)

Neutrophils (aka polymorphonuclear cells, PMNs, granulocytes, segmented neutrophils, or segs) fight against infection and represent a subset of the white blood count. Neutropenia by definition is an ANC below 1800/mm3 (some sources use a lower value).

Absolute neutrophil count (ANC) of 1000-1800:
Most patients will be given chemotherapy in this range.
Risk of infection is considered low.

Mild neutropenia - Absolute neutrophil count (ANC) of 500-1000:
Carries with it a moderate risk of infection.

Absolute neutrophil count (ANC) of less than 500:
Severe neutropenia - high risk of infection. Remember that a reduced WBC is known as leukopenia.

The WBC consists of the following (differential):
Lymphocytes: 20-40%
Neutrophils: 50-60%
Basophils: 0.5-2%
Eosinophils: 1-4%
Monocytes: 2-9% (average: 4%).
ANC = Total WBC x (% "Segs" + % "Bands")
Equivalent to: WBC x ((Segs/100) + (Bands/100))

The ANC refers to the total number of neutrophil granulocytes present in the blood.

Normal value:

1500 cells/mm3.
Mild neutropenia:

1000 - <1500/mm3.
Moderate neutropenia:

500 - <1000/mm3.
Severe neutropenia: < 500/mm3.

Reference:
Ayalew Tefferi, MD, ed. Primary Hematology. Totowa, NJ: Humana Press, 2001

Updated Laboratory Section
can be found here:

labs_home.htm