Tuesday, March 21, 2006

Lab Values

Hematology Values
Normal Adult Female Range: 37 - 47%
Optimal Adult Female Reading: 42%
Normal Adult Male Range 40 - 54%
Optimal Adult Male Reading: 47
Normal Newborn Range: 50 - 62%
Optimal Newborn Reading: 56

Normal Adult Female Range: 12 - 16 g/dl
Optimal Adult Female Reading: 14 g/dl
Normal Adult Male Range: 14 - 18 g/dl
Optimal Adult Male Reading: 16 g/dl
Normal Newborn Range: 14 - 20 g/dl
Optimal Newborn Reading: 17 g/dl

MCH (Mean Corpuscular Hemoglobin)
Normal Adult Range: 27 - 33 pg
Optimal Adult Reading: 30

MCV (Mean Corpuscular Volume)
Normal Adult Range: 80 - 100 fl
Optimal Adult Reading: 90
Higher ranges are found in newborns and infants

MCHC (Mean Corpuscular Hemoglobin Concentration)
Normal Adult Range: 32 - 36 %
Optimal Adult Reading: 34
Higher ranges are found in newborns and infants

R.B.C. (Red Blood Cell Count)
Normal Adult Female Range: 3.9 - 5.2 mill/mcl
Optimal Adult Female Reading: 4.55
Normal Adult Male Range: 4.2 - 5.6 mill/mcl
Optimal Adult Male Reading: 4.9
Lower ranges are found in Children, newborns and infants

W.B.C. (White Blood Cell Count)
Normal Adult Range: 3.8 - 10.8 thous/mcl
Optimal Adult Reading: 7.3
Higher ranges are found in children, newborns and infants.

Normal Adult Range: 130 - 400 thous/mcl
Optimal Adult Reading: 265
Higher ranges are found in children, newborns and infants

NEUTROPHILS and NEUTROPHIL COUNT - this is the main defender of the
body against infection and antigens. High levels may indicate an active
Normal Adult Range: 48 - 73 %
Optimal Adult Reading: 60.5
Normal Children’s Range: 30 - 60 %
Optimal Children’s Reading: 45

LYMPHOCYTES and LYMPHOCYTE COUNT - Elevated levels may indicate an
active viral infections such as measles, rubella, chickenpox, or infectious
Normal Adult Range: 18 - 48 %
Optimal Adult Reading: 33
Normal Children’s Range: 25 - 50 %
Optimal Children’s Reading: 37.5

MONOCYTES and MONOCYTE COUNT - Elevated levels are seen in tissue
breakdown or chronic infections, carcinomas, leukemia (monocytic) or
Normal Adult Range: 0 - 9 %
Optimal Adult Reading: 4.5

EOSINOPHILS and EOSINOPHIL COUNT - Elevated levels may indicate an
allergic reactions or parasites.
Normal Adult Range: 0 - 5 %
Optimal Adult Reading: 2.5

BASOPHILS and BASOPHIL COUNT - Basophilic activity is not fully
understood but it is known to carry histamine, heparin and serotonin. High
levels are found in allergic reactions.
Normal Adult Range: 0 - 2 %
Optimal Adult Reading: 1
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Electrolyte Values
SODIUM - Sodium is the most abundant cation in the blood and its chief
base. It functions in the body to maintain osmotic pressure, acid-base
balance and to transmit nerve impulses. Very Low value: seizure and
Neurologic Sx.
Normal Adult Range: 135-146 mEq/L
Optimal Adult Reading: 140.5

POTASSIUM - Potassium is the major intracellular cation. Very low
value: Cardiac arythemia.
Normal Range: 3.5 - 5.5 mEq/L
Optimal Adult Reading: 4.5

CHLORIDE - Elevated levels are related to acidosis as well as too much
water crossing the cell membrane. Decreased levels with decreased serum
albumin may indicate water deficiency crossing the cell membrane
Normal Adult Range: 95-112 mEq/L
Optimal Adult Reading: 103

CO2 (Carbon Dioxide) - The CO2 level is related to the respiratory
exchange of carbon dioxide in the lungs and is part of the bodies buffering
system. Generally when used with the other electrolytes, it is a good
indicator of acidosis and alkalinity.
Normal Adult Range: 22-32 mEq/L
Optimal Adult Reading: 27
Normal Childrens Range - 20 - 28 mEq/L
Optimal Childrens Reading: 24

CALCIUM - involved in bone metabolism, protein absorption, fat transfer
muscular contraction, transmission of nerve impulses, blood clotting
and cardiac function. Regulated by parathyroid.
Normal Adult Range: 8.5-10.3 mEq/dl
Optimal Adult Reading: 9.4

PHOSPHORUS - Generally inverse with Calcium.
Normal Adult Range: 2.5 - 4.5 mEq/dl
Optimal Adult Reading: 3.5
Normal Childrens Range: 3 - 6 mEq/dl
Optimal Childrens Range: 4.5

ANION GAP (Sodium + Potassium - CO2 + Chloride) - An increased
measurement is associated with metabolic acidosis due to the overproduction of
acids (a state of alkalinity is in effect). Decreased levels may
indicate metabolic alkalosis due to the overproduction of alkaloids (a state
of acidosis is in effect).
Normal Adult Range: 4 - 14 (calculated)
Optimal Adult Reading: 9

Normal Adult Range: 2.3 - 3.3 (calculated)
Optimal Adult Reading: 2.8
Normal Children’s range: 1.3 - 3.3 (calculated)
Optimal Children’s Reading: 2.3

Normal Adult Range: 26 - 38 (calculated)
Optimal Adult Reading: 32
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Hepatic Enzymes
AST (Serum Glutamic-Oxalocetic Transaminase - SGOT ) - found primarily
in the liver, heart, kidney, pancreas, and muscles. Seen in tissue
damage, especially heart and live
Normal Adult Range: 0 - 42 U/L
Optimal Adult Reading: 21

ALT (Serum Glutamic-Pyruvic Transaminase - SGPT) - Decreased SGPT in
combination with increased cholesterol levels is seen in cases of a
congested liver. We also see increased levels in mononucleosis, alcoholism,
liver damage, kidney infection, chemical pollutants or myocardial
Normal Adult Range: 0 - 48 U/L
Optimal Adult Reading: 24

ALKALINE PHOSPHATASE - Used extensively as a tumor marker it is also
present in bone injury, pregnancy, or skeletal growth (elevated readings.
Low levels are sometimes found in hypoadrenia, protein deficiency,
malnutrition and a number of vitamin deficiencies
Normal Adult Range: 20 - 125 U/L
Optimal Adult Reading: 72.5
Normal Childrens Range: 40 - 400 U/L
Optimal Childrens Reading: 220

GGT (Gamma-Glutamyl Transpeptidase) - Elevated levels may be found in
liver disease, alcoholism, bile-duct obstruction, cholangitis, drug
abuse, and in some cases excessive magnesium ingestion. Decreased levels
can be found in hypothyroidism, hypothalamic malfunction and low levels
of magnesium.
Normal Adult Female Range: 0 - 45 U/L
Optimal Female Reading: 22.5
Normal Adult Male Range: 0 - 65 U/L
Optimal Male Reading: 32.5

LDH (Lactic Acid Dehydrogenase) - Increases are usually found in
cellular death and/or leakage from the cell or in some cases it can be useful
in confirming myocardial or pulmonary infarction (only in relation to
other tests). Decreased levels of the enzyme may be seen in cases of
malnutrition, hypoglycemia, adrenal exhaustion or low tissue or organ
Normal Adult Range: 0 - 250 U/L
Optimal Adult Reading: 125

BILIRUBIN, TOTAL - Elevated in liver disease, mononucleosis, hemolytic
anemia, low levels of exposure to the sun, and toxic effects to some
drugs, decreased levels are seen in people with an inefficient liver,
excessive fat digestion, and possibly a diet low in nitrogen bearing foods
Normal Adult Range 0 - 1.3 mg/dl
Optimal Adult Reading: .65
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Renal Related
B.U.N. (Blood Urea Nitrogen) - Increases can be caused by excessive
protein intake, kidney damage, certain drugs, low fluid intake, intestinal
bleeding, exercise or heart failure. Decreased levels may be due to a
poor diet, malabsorption, liver damage or low nitrogen intake.
Normal Adult Range: 7 - 25 mg/dl
Optimal Adult Reading: 16

CREATININE - Low levels are sometimes seen in kidney damage, protein
starvation, liver disease or pregnancy. Elevated levels are sometimes
seen in kidney disease due to the kidneys job of excreting creatinine,
muscle degeneration, and some drugs involved in impairment of kidney
Normal Adult Range: .7 - 1.4 mg/dl
Optimal Adult Reading: 1.05

URIC ACID - High levels are noted in gout, infections, kidney disease,
alcoholism, high protein diets, and with toxemia in pregnancy. Low
levels may be indicative of kidney disease, malabsorption, poor diet, liver
damage or an overly acid kidney.
Normal Adult Female Range: 2.5 - 7.5 mg/dl
Optimal Adult Female Reading: 5.0
Normal Adult Male Range: 3.5 - 7.5 mg/dl
Optimal Adult Male Reading:5.5

BUN/CREATININE - This calculation is a good measurement of kidney and
liver function.
Normal Adult Range: 6 -25 (calculated)
Optimal Adult Reading: 15.5
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PROTEIN, TOTAL - Decreased levels may be due to poor nutrition, liver
disease, malabsorption, diarrhea, or severe burns. Increased levels are
seen in lupus, liver disease, chronic infections, alcoholism, leukemia,
tuberculosis amongst many others.
Normal Adult Range: 6.0 -8.5 g/dl
Optimal Adult Reading: 7.25

ALBUMIN - major constituent of serum protein (usually over 50%). High
levels are seen in liver disease(rarely) , shock, dehydration, or
multiple myeloma. Lower levels are seen in poor diets, diarrhea, fever,
infection, liver disease, inadequate iron intake, third-degree burns and
edemas or hypocalcemia
Normal Adult Range: 3.2 - 5.0 g/dl
Optimal Adult Reading: 4.1

GLOBULIN - Globulins have many diverse functions such as, the carrier
of some hormones, lipids, metals, and antibodies(IgA, IgG, IgM, and
IgE). Elevated levels are seen with chronic infections, liver disease,
rheumatoid arthritis, myelomas, and lupus are present, . Lower levels in
immune compromised patients, poor dietary habits, malabsorption and
liver or kidney disease.
Normal Adult Range: 2.2 - 4.2 g/dl (calculated)
Optimal Adult Reading: 3.2

A/G RATIO (Albumin/Globulin Ratio)
Normal Adult Range: 0.8 - 2.0 (calculated)
Optimal Adult Reading: 1.9
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CHOLESTEROL - High density lipoproteins (HDL) is desired as opposed to
the low density lipoproteins (LDL), two types of cholesterol. Elevated
cholesterol has been seen in artherosclerosis, diabetes, hypothyroidism
and pregnancy. Low levels are seen in depression, malnutrition, liver
insufficiency, malignancies, anemia and infection.
Normal Adult Range: 120 - 240 mg/dl
Optimal Adult Reading: 180

LDL (Low Density Lipoprotein) - studies correlate the association
between high levels of LDL and arterial artherosclerosis
Normal Adult Range: 62 - 130 mg/dl
Optimal Adult Reading: 81 mg/dl

HDL (High Density Lipoprotein) - A high level of HDL is an indication
of a healthy metabolic system if there is no sign of liver disease or
Normal Adult Range: 35 - 135 mg/dl
Optimal Adult Reading: +85 mg/dl

TRIGLYCERIDES - Increased levels may be present in artherosclerosis,
hypothyroidism, liver disease, pancreatitis, myocardial infarction,
metabolic disorders, toxemia, and nephrotic syndrome. Decreased levels may
be present in chronic obstructive pulmonary disease, brain infarction,
hyperthyroidism, malnutrition, and malabsorption.
Normal Adult Range: 0 - 200 mg/dl
Optimal Adult Reading: 100

Normal Adult Range: 1 - 6
Optimal Adult Reading: 3.5
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THYROXINE (T4) - Increased levels are found in hyperthyroidism, acute
thyroiditis, and hepatitis. Low levels can be found in Cretinism,
hypothyroidism, cirrhosis, malnutrition, and chronic thyroiditis.
Normal Adult Range: 4 - 12 ug/dl
Optimal Adult Reading: 8 ug/dl

T3-UPTAKE - Increased levels are found in hyperthyroidism, severe liver
disease, metastatic malignancy, and pulmonary insufficiency. Decreased
levels are found in hypothyroidism, normal pregnancy, and
hyperestrogenis status.
Normal Adult Range: 27 - 47%
Optimal Adult Reading: 37 %

Normal Adult Range: 4 - 12
Optimal Adult Reading: 8

THYROID-STIMULATING HORMONE (TSH) - produced by the anterior pituitary
gland, causes the release and distribution of stored thyroid hormones.
When T4 and T3 are too high, TSH secretion decreases, when T4 and T3
are low, TSH secretion increases.
Normal Adult Range: .5 - 6 miliIU/L

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Creatine phosphokinase (CK) - Levels rise 4 to 8 hours after an acute
MI, peaking at 16 to 30 hours and returning to baseline within 4 days
25-200 U/L
32-150 U/L

CK-MB CK isoenzyme - It begins to increase 6 to 10 hours after an
acute MI, peaks in 24 hours, and remains elevated for up to 72 hours.
< 12 IU/L if total CK is <400 IU/L
<3.5% of total CK if total CK is >400 IU/L

(LDH) Lactate dehydrogenase - Total LDH will begin to rise 2 to 5 days
after an MI; the elevation can last 10 days.
140-280 U/L

LDH-1 and LDH-2 LDH isoenzymes - Compare LDH 1 and LDH 2 levels.
Normally, the LDH-1 value will be less than the LDH-2. In the acute MI,
however, the LDH 2 remains constant, while LDH 1 rises. When the LDH 1 is
higher than LDH 2, the LDH is said to be flipped, which is highly
suggestive of an MI. A flipped pattern appears 12-24 hours post MI and
persists for 48 hours.
LDH-1 18%-33%
LDH-2 28%-40%

SGOT - will begin to rise in 8-12 hours and peak in 18-30 hours
10-42 U/L

Myoglobin - early and sensitive diagnosis of myocardial infarction in
the emergency department This small heme protein becomes abnormal
within 1 to 2 hours of necrosis, peaks in 4-8 hours, and drops to normal in
about 12 hours.
< 1

Troponin Complex - Peaks in 10-24 hours, begins to fall off after 1-2
< 0.4
Table of Cardiac markers
Serum Markers of Myocardial Injury




MB Isoforms

Troponin Complex
cTnI: 5-9 days cTnT: 7-14 days

Typical Marker Values during AMI

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