Blood tests & normal range

A blood test is when a sample of blood is taken for testing in a laboratory.

Blood tests have a wide range of uses and are one of the most common

m
types of medical test. For example, a blood test can be used to:
• assess your general state of health
confirm the presence of a bacterial or viral infection

ya
•

• see how well certain organs, such as the liver and kidneys, are
functioning
Blood

e
Blood is pumped around the body by the heart. It supplies oxygen to the
body’s organs, muscles and tissues, and removes carbon dioxide.

Na
The blood that circulates around the body contains many different
substances. About 40% of the blood’s volume is made up of blood cells.
There are three types of blood cell:
• red blood cells carry oxygen from the lungs and transport it
around the body
• white blood cells form part of the body’s immune system and
help defend the body against infection
ha
• platelets are cells that help the blood to clot (thicken) when
you cut yourself
The remaining 60% of blood is made up of plasma. Plasma mainly consists
of water, but also contains proteins and chemicals, such as hormones,
nid

glucose and salt.

Uses of blood tests

Blood tests are very useful for a number of reasons, which are described
below.
Assessing organs
Ma

As blood circulates through your body’s organs, it is very sensitive to any

changes or damage to the organs. For example, if your liver becomes
damaged, it will release certain enzymes into the blood, which can be
detected using a blood test.
Checking for infection
As blood plays an important part in the immune system’s defence against
infection, changes in the make-up of blood can provide important clues
about possible infections.

m
For example, certain viruses, such as HIV, will cause your immune system
to produce special proteins called antibodies. By checking the blood for
certain types of antibody, it is possible to confirm (or rule out) whether an

ya
infection has occurred.
Measuring oxygen and carbon dioxide

As blood is the body’s oxygen supply system, testing can provide important
information about possible respiratory conditions (conditions that affect

e
your lungs).
For example, the volume of oxygen and carbon dioxide in your blood can

working.
Genetic testing
Na
be measured. This is one method of determining how well your lungs are

Blood tests are a convenient way to obtain a DNA sample for genetic
testing and screening. For example, blood tests can be used to diagnose
genetic conditions, such as cystic fibrosis (a genetic disorder that
ha
causes internal bodily secretions to become thick and sticky, interfering
with the function of certain organs, such as the lungs).

Types of blood test

nid

Some widely used blood tests are described below.

Full blood count (FBC)

A full blood count (FBC) is probably the most widely used blood test. It is
used to assess your general state of health and to screen for certain
conditions, such as anaemia.
Ma

During an FBC, a small sample of blood will be taken from a vein in your
arm. The amount of different types of blood cells in the sample will be
measured.
On its own, an FBC cannot usually provide a definitive diagnosis of a
condition, but it can provide important ‘clues’ about possible problems
with your health.
 • A low red blood cell count may be due toanaemia (iron
deficiency), which has a number of possible causes, including
internal bleeding or a poor diet.

m
• A high red blood cell count may be due to an underlying lung or
kidney disease.
• A low white blood cell count may be due to problems with your
bone marrow, such as a viral infection of your bone marrow or

ya
cancer of the bone marrow, such as leukaemia.
• A high white blood cell count usually suggests that you have an
infection somewhere in your body.
• A low platelet count may be due to a viral infection, such

e
as rubella (german measles), or an autoimmune condition
(where the immune system attacks healthy tissue), such

• Na
as lupus(inflammation in the body’s tissues).
A high platelet count may be due to inflammatory conditions,
such as rheumatoid arthritis (pain and inflammation of the
joints), or a problem with your spleen, such as a ruptured
(split) spleen. The spleen is an organ that removes damaged
blood cells from your blood.
Electrolyte test
ha

An electrolyte test is used to measure the levels of electrolytes in your

blood. This is sometimes known as your electrolyte balance. Electrolytes
are minerals that are found in the body. They have a number of important
functions, including:
nid

• helping to move nutrients into cells (and waste products out of

them)
• helping to maintain a healthy water balance in your body
• helping to stabilise levels of acid and alkali in your body
There are three main electrolytes that can be measured with an electrolyte
Ma

test:
• sodium
• potassium
• chloride
Raised or lowered levels of any of these electrolytes can have a number of
possible causes.
 • A raised sodium level (hypernatremia) could be the result of
dehydration, kidney disease or persistent diarrhoea.
• A low sodium level (hyponatremia) could be the result of

m
poorly controlled diabetes, liver disease, a lack of sodium in
your diet or pneumonia. Some types of medication can also
lower your sodium level, such as carbamazepine (used to treat
epilepsy) and sertraline (sometimes used to treat depression).

ya
• A raised potassium level (hyperkalemia) could be the results of
kidney failure. A type of medication used to treat high blood
pressure, known as an ACE inhibitor, can also raise potassium
levels.

e
• A low potassium level (hypokalemia) could be the result of
heavy sweating or persistent vomiting or diarrhoea.
•

Na
A raised chloride level (hyperchloremia) could be the result of
some types of kidney disease, diarrhoea or overactive
parathyroid glands (glands that are found in your neck and
help to regulate the amount of calcium in your body).
• A decreased chloride level (hypochloremia) could be the result
of heavy sweating, vomiting and some types of kidney disease.
Blood glucose test
ha

A blood glucose test is used to help diagnose diabetes and to monitor the
health of people who have had a diagnosis of diabetes confirmed.
Diabetes develops either because the body cannot produce enough insulin
or because the insulin does not work in the right way. Insulin is a hormone
nid

that the body uses to convert glucose (sugar) into energy.

People with diabetes often have high levels of glucose in their blood.
Reducing the glucose levels is an important part of the treatment of
diabetes. This is because if the blood glucose levels become too high, a
range of serious complications, such as kidney disease or nerve damage,
Ma

may occur.
Therefore, most people with diabetes will need regular blood glucose tests.
Small blood glucose test kits are available for use at home. These only
require a small ‘pin prick’ of blood for testing.
Some types of blood glucose test require you not to eat anything for
several hours before the test. Your GP or diabetes care team can tell
you whether this is the case.
ELISA test

An enzyme-linked immunosorbent assay (ELISA) test can be used to check

whether you have an infection, such asHIV, or a specific allergy, such as

m
a peanut allergy.
If you have a viral or a bacterial infection or you have developed an
allergy, your immune system will produce specific antibodies in response
to the infection or allergy.

ya
The ELISA test involves taking a small blood sample and checking to see
whether it contains the associated antibody.
Blood gas test

e
A blood gas test is used to check two things:
• the balance of oxygen and carbon dioxide in your blood
•

•
Na
the balance of acid and alkali in your blood (the pH balance)
An imbalance in either of these can be caused by:
problems with your respiratory system
problems with your metabolism (the chemical reactions that
are used by the body to break down food into energy)
Respiratory causes of an imbalance could be:
ha
• pneumonia
• chronic obstructive pulmonary disorder (COPD)
• hyperventilation
Metabolic causes of an imbalance could be:
nid

• diabetes
• kidney failure
• persistent vomiting
Genetic testing

Some widely used types of genetic testing are described below.

Ma

Gene test

A gene test is used when healthcare professionals suspect that a specific

genetic mutation may be responsible for a person’s symptoms. The test
involves extracting a sample of DNA from your blood, then searching the
sample for the suspected genetic mutation.
Genetic conditions that can be diagnosed using a gene test include:
 • haemophilia : a condition that affects the blood’s ability to clot
(thicken)
• cystic fibrosis: a condition that causes a build-up of sticky

m
mucus in the lungs
• sickle cell anaemia: a condition that causes a shortage of
normal red blood cells
• polycystic kidney disease: a condition that causes cysts to

ya
develop inside the kidneys
Chromosome testing

Chromosome testing, also known as karyotyping, is a more general test

than a gene test. It is used when healthcare professionals suspect that a

e
person’s symptoms may be caused by a gene-related problem but they do
not know which gene is responsible.

Na
Chromosome testing involves taking a blood sample and examining one of
the blood cells under a powerful microscope. This allows the person who is
carrying out the test to examine the chromosomes directly.
Chromosomes are coils of DNA that are found in every cell. By counting the
chromosomes (each cell should have 23 pairs of chromosomes) and by
checking their shape, it may be possible to detect genetic abnormalities.
Chromosome testing is often used:
ha
• to test children who have physical or developmental problems
that have no apparent cause
• for couples who have experienced
repeatedmiscarriages (usually three or more in a row)
nid

Genetic screening

Genetic screening is similar to gene testing except that it is used in people

who have no obvious symptoms. For example, genetic screening is carried
out during pregnancy (antenatal screening) to check for some of the most
common genetic conditions, such as:
Ma

• Down's syndrome
• sickle cell anaemia
• thalassaemia
Genetic screening may also be offered to people who are thought to be at
risk of developing a genetic condition. For example, if your brother or
sister developed a genetic condition in later life, such as Huntington's
disease, you may want to find out whether there is a risk that you could
also develop the condition.
A number of genetic conditions, such as sickle cell anaemia, can only be
passed on to a child if both parents have a copy of the genetic mutation.

m
If there is a chance that you have one copy of the mutated gene, for
example there is a history of sickle cell anaemia in your family, you and
your partner may want to be screened to determine whether there is a risk

ya
of giving birth to a child with the condition.
Blood typing

A blood typing test is used to identify your blood group. Your blood group
is determined by two specialised proteins, known as antigens, which are

e
found on the surface of your red blood cells.
The first antigen, known as the ABO antigen, comes in four possible types:
•

•
A
B
AB
O
Na
The second antigen, known as the Rhesus antigen, comes in two possible
types:
ha
• Rhesus positive (which is usually shortened to Rhd+)
• Rhesus negative (which is usually shortened to Rhd-)
Your blood type is based on the combination of both antigens. For
example, if you have a combination of the AB antigen and the Rhd +
nid

antigen, your blood type would be AB+.

Blood typing is used before a blood transfusion is given (or before you
provide blood for donation). This is because it is important that anyone
who receives blood is given blood that matches their blood group. If you
were given blood that did not match your blood group, your immune
system may attack the red blood cells, which could lead to potentially life-
Ma

threatening complications.
Blood typing is also used during pregnancy as there is a small risk that the
unborn child may have a different blood group from the mother. This could
lead to the mother's immune system attacking the baby’s red blood cells.
This is known rhesus disease.
Rhesus disease can sometimes develop if the mother's blood group is Rhd-
and the father's is Rh+. As a result, blood typing tests are used during the
routine screening programme in pregnancy.
If testing reveals that there is a risk of rhesus disease developing, extra

m
precautions can be taken to safeguard the health of your baby. For
example, a blood transfusion can be given to the baby when it is still in the
womb to increase the number of red blood cells.

ya
Blood cholesterol test

Cholesterol is a fatty substance that is known as a lipid. It is mostly

created by the liver from the fatty foods in your diet and is vital for the
normal functioning of the body.

e
Having an excessively high level of lipids in your blood (hyperlipidemia)
can have a serious effect on your health because it increases your risk of

Na
having a heart attack or stroke.
Blood cholesterol testing is usually recommended if you have one or more
risk factors that increase your chances of developing a cardiovascular
disease (CVD). A cardiovascular disease is a disease that affects the
normal flow of blood through the body, such as a stroke or heart attack.
The risk factors for developing a CVD include:
• being diagnosed with coronary heart disease, stroke or mini-
ha
stroke, or leg artery disease
• being over 40 years of age
• being obese
• having high blood pressure (hypertension)
nid

If you are unsure whether you would benefit from having a blood
cholesterol test, ask your GP for advice.
Blood cholesterol levels are measured with a simple blood test. Before
having the test, you may be asked not to eat for 12 hours (which usually
includes the period when you are asleep at night). This will ensure that all
Ma

food is completely digested and will not affect the outcome of the test.
Your GP or practice nurse can carry out the blood test and will take a blood
sample, either using a needle and a syringe, or by pricking your finger. If
the test identifies high cholesterol levels, treatment options include:
• making lifestyle changes, such as reducing the amount of fat in
your diet
 • taking medication, such as statins, to reduce your cholesterol
level
Liver function test

m
A liver function test is a type of blood test that is used to help diagnose
certain liver conditions, such as:
• hepatitis (infection of the liver)

ya
• cirrhosis (scarring of the liver)
• alcoholic liver disease (liver damage and related loss of
function which is caused by excessive alcohol consumption)
When the liver is damaged, it releases enzymes into the blood. At the same
time, levels of proteins that the liver produces to keep the body healthy

e
begin to drop.
By measuring the levels of these enzymes and proteins, it is possible to

Blood culture Na
build up a reasonably accurate picture of how well the liver is functioning.

A blood culture is a test to check whether there is a bacterial infection of

the blood (septicaemia). Septicaemia is potentially very dangerous
because, if the infection spreads throughout the blood, it can trigger a
massive drop in blood pressure. This is known as septic shock and it can be
ha
fatal.
A blood culture involves taking a small sample of blood from a vein in your
arm and from another part of your body. Both samples are introduced to
nutrients that are designed to encourage the growth of bacteria (a process
known as culturing). If there are any traces of bacteria in your blood,
nid

culturing should allow the person carrying out the test to identify them.
Two blood samples are needed in case one is accidentally contaminated by
the bacteria that live on your skin.

How a blood test is performed

Ma

Taking a blood sample

A blood test usually involves taking a blood sample from a blood vessel in
your arm. The arm is a convenient part of the body to use because it can be
easily uncovered. The usual place for a sample is the inside of the elbow or
wrist, where the veins are relatively close to the surface.
Blood samples from children are usually taken from the back of the hand.
The child's hand will be anaesthetised (numbed) with a special cream

m
before the sample is taken.
A tight band (tourniquet) is usually put around your upper arm. This
squeezes the arm, temporarily slowing down the flow of blood out of the

ya
arm, and causing the vein to swell with blood. This makes it easier for a
blood sample to be taken.
Before taking the sample, the doctor or nurse may need to wipe the area
with an antiseptic wipe, although this is not always necessary.
A needle attached to a syringe or to a special blood collecting container is

e
pushed into the vein. The syringe is used to draw out a sample of your
blood. You may feel a slight pricking sensation as the needle goes in, but it

Na
should not be painful. If you do not like needles and injections, tell the
person who is taking the sample so they can make you more comfortable.
If you feel faint, lie down.
When the sample has been taken, the needle will be removed. Pressure is
applied to the tiny break in the skin for a few minutes using a cotton wool
pad to stop the bleeding and to prevent bruising. A plaster may then be put
on the small wound to keep it clean and prevent infection.
ha
After the test

After the blood sample has been taken, it will be put into a bottle and
labelled with your name. It will then be sent to a laboratory where it will
be examined under a microscope or tested with chemicals, depending on
nid

what is being checked. The results are sent back to the hospital or to your
GP, and you will be told when and how you will be given them.
Sometimes, receiving results can be stressful and upsetting. If you are
worried about the outcome of a test, you may choose to take a trusted
friend or relative with you. For some tests, such as HIV, you will be offered
specialist counselling to help you deal with your results.
Ma

How do I understand my test results?

It can sometimes be worrying when you have to have tests done. And, not
knowing what the abbreviations stand for when you get your test results
can be really frustrating. GPs and nurses are used to shortening the names
of tests, but this can make it confusing for you.
If you are not sure about something regarding a test, just ask your GP, or
your practice nurse, and they will be happy to explain.

Some commonly used test abbreviations are explained below.

m
• BP - blood pressure. It is usually written as one number over
another; for example, if you have a reading of 140/90 or more, you

ya
have high blood pressure (HBP, or hypertension). If you have a
reading of 90/60 or less, you have low blood pressure (LBP, or
hypotension).
• CVS - chorionic villus sampling. This is a test available to pregnant
women that can detect Down's syndrome (a disorder which affects a

e
child's physical and mental development), cystic fibrosis (a genetic
disorder which affects the lungs), and other foetal disorders.
•

•
Na
ECG or EKG - electrocardiogram. This is an electrical recording of
your heart. This test is often used if you have high blood pressure, or
heart disease.
FBC - full blood count. This is a blood test that is used to determine
your general health and to identify conditions such as anaemia,
which causes you to have fewer red blood cells than normal. RBC
means red blood cell count, and WBC means white blood cell count.
ha
• HbA1c test - this is a blood test that measures your recent average
blood glucose level. It is used in the treatment of diabetes.
• hCG test - this is the medical name for a pregnancy test. It is usually
involves taking a urine sample, but sometimes can also include a
blood test.
nid

• IVP - intravenous pyelogram. This is an X-ray study of your urinary

system.
• LFTs - liver function tests. These are blood tests to check that your
liver is working properly.
• MSU - mid-stream specimen of urine. This is a urine test used to
Ma

check for urine infections. It is taken halfway through the stream of

urine. Your GP, or practice nurse, will explain how it is done.
• PAP - this is another name for the cervical screening test. A sample
of cells from your cervix is taken to test for pre-cancerous cells. Most
women between the ages of 25-64 have a cervical screening test
every 3-5 years.
• PSA - prostate specific antigen. This is a blood test that can detect
prostate disorders, including prostate cancer (a cancer that only
affects men).
TFTs - thyroid function tests. These are blood tests to check that your

m
•
thyroid gland is working properly.
• TIBC - total iron-binding capacity. This is a blood test is used to
detect anaemia and other blood disorders.

ya
• U&Es - urea and electrolytes. This is a blood test that looks at your
body's blood chemistry to assess fluid and mineral levels. It helps a
doctor to understand how your kidneys and metabolism (energy
levels) are working.
• B12 - B12 is a vitamin. If you do not have enough of this vitamin, you

e
may become anaemic.
• CT scan or CAT scan - computerised tomography scan. This scan

•
inside of your body.
Na
takes a series of X-rays of your body at slightly different angles, and
then joins them together to produce very detailed images of the

D&C - dilatation and curettage. This is a surgical procedure to obtain

tissue from the lining of the uterus.
• LDL/HDL - low density lipoprotein/high density lipoprotein. These
refer to the two types of cholesterol that are found in the blood. You
ha
may see these abbreviations if you have a blood test to measure your
blood cholesterol level.
• MRI scan - magnetic resonance imaging scan. This scan uses a strong
magnetic field and radio waves to produce detailed pictures of the
inside of your body.
nid

• STI - sexually transmitted infection.

• Albumin – This is the main protein which is in blood. low levels can
indicate certain types of chronic illnesses such as liver disorders
• Elecs / U&E’s – Urea and Electrolytes – This is done to assess your
Electrolyte (minerals) levels There are three main electrolytes that can
be measured with an electrolyte test, sodium, potassium and chloride.
Ma

The test will show how well your kidneys are working
• Ferritin – A protein – This is to check the levels are correct as they are
important for red blood cell production, and the levels of iron stored in
your body. Normal range is Male: 12-300 ng/mL – Female: 12-150
ng/mL – nanograms per milliliter
o The different types of white cells in adults are:
 o (HCT) Haematocrit –This is a measure of thickness, viscosity, of
red blood cell content called packed cell volume PCV of your blood
• (HbA1c) -Haemoglobin A1c -This measures the glycated haemoglobin
which is where the glucose has attached it self to red blood it is often

m
used to measure your management of your diabetes. Normal levels are
HbA1c of 6% or less
• LDH – Lactate Dehydrogenase –This is an enzyme if the levels are
raised this can indicate damage to cells and tissue. It is also used to

ya
monitor progress
o LDL – Low density lipoprotein -Cholesterol – this is the “bad”
cholesterol – it is protein which carries cholesterol to the arteries
and blood vessels causing build up and blockages this can cause a
heart attack or stroke

e
o Magnesium – a deficiency in this basic element of the blood can be
due to difficulties with absorption which can be due to medication,
intestinal problems or heart disease. High levels may be due to

•
kidney failure
Na
ALT- Alanine aminotransferase – This is an enzyme and the test is
performed to check to see if you have a liver problem
Amylase – This is an enzyme and if the levels are raised this may
indicate a problem possibly pancreatitis (the pancreas is important for
secreting enzymes for digestion and regulating blood sugar levels with
the hormone insulin)
ha
• (BNP) Beta-Natriuretic Peptide – This can be done to check fluid in
your lungs and for deteriorating heart disease
• (BUN) Blood Urea Nitrogen - This test is performed to assess the levels
which if raised may indicate renal function impairment. If it is low it
can indicate liver failure amongst other conditions
nid

• B12 and Folate – This is done to diagnose the cause of anaemia or

nerve damage- Neuropathy
• Calcium –Is found in bone and blood calcium is tested to monitor how
much is circulating and affecting conditions of the heart, nerves and
kidneys as well as bones and teeth
• Card Enz –Cardiac Enzymes – This test is performed when a heart
attack is suspected
Ma

• Chol – Cholesterol – This is to test if you have heart disease or

circulatory problems this is a common test which is offered to people
who have family history of high blood pressure or if you are over 50
years old – high levels need to be treated as otherwise you may be at
risk of heart disease or a stroke
• Chloride – This is important for nerve and muscle function and distinct
variations may indicate disease
• Creatinine –This is a waste product and high levels can possibly
indicate further tests will need to be undertaken to rule out poor
kidney function
• ESR – Erythrocyte Sedimentation Rate – This screens for infection and

m
monitors inflammation. Normal results are Men under 50 years old:
less than 15 mm/hr -Men over 50 years old: less than 20 mm/hr –
Women under 50 years old: less than 20 mm/hr -Women over 50 years
old: less than 30 mm/hr

ya
• FBC – Full blood count – This is done to check your general health and
to screen for disorders, such as anaemia, infection, and nutrition
• Normal levels are:
o Haemoglobin

adult males 13.5-17.50 g/dL

e

adult females 11.5-16.5 g/dL
o Red cell count

o




Haematocrit


Na
adult males is 4.5-6.5 x 1012/L
adult females 3.8-5.8 x 1012/L

adult males is 0.40-0.50

adult females 0.37-0.47
o MCV (Mean cell volume) range for adults is 76-100 fL
o MCH (Mean cell haemoglobin) range for adults is 27-32 pg, and the
ha
normal
o MCHC (Mean cell haemoglobin concentration) range is 31-36 g/L
o White cell count for adults is 4.0-10.0 x 109/L
o The different types of white cells in adults are:

Basophils: 0.05-0.1 x 109/L
nid

Eosinophils: 0.02-0.4 x 109/L

Lymphocytes: 1.0-3.5 x 109/L

Monocytes: 0.2-1.0 x 109/L

Neutrophils:2.0-7.5×109/L
o Platelet count for adults is 150-450 x 109/L
FSH – Follicle Stimulation Hormone – This is done to check your
Ma

•
pituitary gland which regulates the hormones, along with the trigger
for your ovaries to prepare to release an egg
• GGT – This is an enzyme which is utilized in muscle, liver and heart
function if this is raised it may indicate that disease is affecting these
organs
• Globulin - These are proteins you will need to prepare for the test by
not eating for four hours prior to the blood being taken. It is important
 to discuss with your doctor any medication you are taking prior to the
test. The results will help with the diagnosis of immunoglobulin
disorders
• Glucose – This checks the levels of plasma glucose in your blood. For

m
an initial reading you may have to fast (stop eating) for up to 12
hours/ over night before the bloods are taken. If you have diabetes
you can monitor your own levels The ideal values are: 4 to 7mmol/l
before meals : less than 10mmol/l 90 minutes after a meal : around

ya
8mmol/l at bedtime
• (HGB) – Haemoglobin – This is a protein and transports oxygen around
the body and is usually performed to assess anaemia if too low or heart
disease if too high
• Hepatitis A – This is performed to see if you have the infective hepatitis

e
A virus (Hav) which affects the liver and to monitor your recovery
process
• Hepatitis B – This is done to see if the vaccine against hep B has

•
which inflames the liver
Na
produced an immunity or to monitor the course of the liver damage
Hepatitis C – Is performed to assess if you have this viral disease

Hepatitis D – Delta agent -people who have this have Hepatitis B

infection already. It can make the whole situation worse for a patient if
not picked up
• INR – International Normalised Ratio – This is to test your blood
ha
clotting mechanisms for people who take anti-coagulants (blood
thinning medicine) like Warfarin. The normal range is INR of 0.9 -1.1 if
you are high risk the values will be different
• Phosphorus -This is a mineral and vital for muscle and nerve
functionality conditions can be affected if levels are either too high or
too low
nid

• PT – Prothrombin time – this is performed to check how well your

blood thinning(anti-coagulants) medicine is working
• (RBC) – Red Blood Cell count – Low levels of these cells which carry
oxygen around your body can indicate Anaemia
• RF - Rheumatoid Factor – This is a protein found in the blood when
rheumatoid arthritis is suspected – however some people have
Ma

naturally raised levels with no rheumatoid disease present

• Sodium –This is part of your electrolyte levels. These levels affect the
kidneys and adrenal glands if levels are high or low it can be indicative
of disease
• TIBC - Total iron binding capacity this is a blood test which is used to
detect anaemia liver function and other blood disorders
• Total Bilirubin – This is the waste product of red blood cells it is what
gives your faeces the brown colour. If levels are raised yellowing of the
skin occurs and c be an indication of liver disease. Normal levels are
Total bilirubin-0.3-1.0mgs/dl. Direct bilirubin-0.1-0.3mgs/dl. Indirect

m
bilirubin-0.2-0.7mgs/dl
• Total Protein – this is to measure all the proteins in your blood. Your
doctor will be primarily looking for indications of liver or kidney
disorders

ya
• TFT – Thyroid function test – To test for levels of TSH – Thyroid
Stimulation Hormone this shows if the thyroid is under active or over
active.- this relates to your energy levels
• Triglycerides – this is a form of fat. If the levels are high it puts you at
an increased risk of a stroke or heart disease. To measure these levels

e
accurately you will need to fast (not eat) for up to 12 hours before
bloods are taken. These fats should not exceed 2.0 mmol/l
• WBC – White Cell Count – This is performed when you may have an

Na
infection or an allergic reaction to something , it is also performed to
monitor treatment you may be having

Blood Test Results Explained with Normal Values

Big cut & paste from steroid.com explains every part of a blood test with
normal values, fantastic bit of info for those who get bloodwork done. Mars
ha
has pointed out the units are US units and NOT SI units, quite right so I
will convert them when I get time, meanwhile the conversion id 10 ng/dl =
0.35 nmol/l

Level With Me, Doc… How Long Have I Got?

A Comprehensive Look at Lab Tests
nid

by C, Colston

You just had some blood work done, and the friggin' doctor or his nurses
are guarding the results as if they're state secrets. However, after much
cajoling and explaining that you'd like to at least be an informed partner in
your own goshdarn health care, they begrudgingly give you a copy of your
Ma

lab tests.

Trouble is, as much as you've been posturing about how you've had more
than a smattering of medical education, you still can't figure out what half
the tests are for and whether or not those abnormal values are anything to
worry about.
Well, in the following article, I'm going to go over each of the most
common tests. I'll include why it's performed, what it tells you, and what
the typical ranges are for normal humans. That way, you'll have something
more to go on in assessing your health other than your family doctor

m
saying, "Well, these few values are a little worrisome, but you'll probably
be okay."

One note, though, before I get started. The values I'll be listing are merely

ya
averages and the ranges may vary slightly from laboratory to laboratory.
Also, if there's only one range given, it applies to both men and women.

Lipid Panel — Used to determine possible risk for coronary and vascular
disease. In other words, heart disease.

e
HDL/LDL and Total Cholesterol

Na
These lipoproteins should look rather familiar to most of you. HDL is simply
the "good" lipoprotein that acts as a scavenger molecule and prevents a
buildup of material. LDL is the "bad" lipoprotein which collects in arterial
walls and causes blockage or a reduction in blood flow. The total
cholesterol to HDL ratio is also important. I went in to detail about this
particular subject — as well as how to improve your lipid profile — in my
article "Bad Blood".
ha

Nevertheless, a quick remonder: your HDL should be 35 or higher; LDL

below 130; and total to HDL ratio should be below 3.5. Oh and don't forget
VLDL (very low density lipoprotein) which can be extremely worrisome.
You should have less than 30 mg/dl in order to not be considered at risk
nid

for heart disease.

On a side note, I'm sure some of you are wishing that you had abnormally
low plasma cholesterol levels (as if it's something to brag about), but the
fact is that having extremely low cholesterol levels is actually indicative of
severe liver disease.
Ma

Triglycerides

Triglycerides are simply a form of fat that exists in the bloodstream.

They're transported by two other culprits, VLDL and LDL. A high level of
triglycerides is also a risk factor for heart disease as well. Triglycerides
levels can be increased if food or alcohol is consumed 12 to 24 hours prior
to the blood draw and this is the reason why you're asked to fast for 12-14
hours from food and abstain from alcohol for 24 hours. Here are the
normal ranges for healthy humans.

16-19 yr. old male

m
40-163 mg/dl

Adult Male
40-160 mg/dl

ya
16-19 yr. old female
40-128 mg/dl

Adult Female

e
35-135 mg/dl

Homocysteine

Na
Unfortunately, this test isn't always ordered by the doctor. It should be.
Homocysteine is formed in the metabolism of the dietary amino acid
methionine. The problem is that it's a strong risk factor for atherosclerosis.
In other words, high levels may cause you to have a heart attack. A good
number of lifters should be concerned with this value as homocysteine
levels rise with anabolic steroid usage.
ha

Luckily, taking folic acid (about 400-800 mcg.) as well as taking a good
amount of all B vitamins in general will go a long way in terms of
preventing a rise in levels of homocysteine.
nid

Normal ranges:

Males and Females age 0-30

4.6-8.1 umol/L

Males age 30-59

Ma

6.3-11.2 umol/L

Females age 30-59

4.5-7.9 umol/L

>59 years of age

5.8-11.9 umol/L
The Hemo Profile

These are various tests that examine a number of components of your

blood and look for any abnormalities that could be indicative of serious

m
diseases that may result in you being an extra in the HBO show, "Six Feet
Under."

WBC Total (White Blood Cell)

ya
Also referred to as leukocytes, a fluctuation in the number of these types
of cells can be an indicator of things like infections and disease states
dealing with immunity, cancer, stress, etc.

e
Normal ranges:

4,500-11,000/mm3

Neutrophils Na
This is one type of white blood cell that's in circulation for only a very short
time. Essentially their job is phagocytosis, which is the process of killing
and digesting bacteria that cause infection. Both severe trauma and
bacterial infections, as well as inflammatory or metabolic disorders and
ha
even stress, can cause an increase in the number of these cells. Having a
low number of neutrophils can be indicative of a viral infection, a bacterial
infection, or a rotten diet.

Normal ranges:
nid

2,500-8,000 cells per mm3

RBC (Red Blood Cell)

These blood cells also called erythrocytes and their primary function is to
Ma

carry oxygen (via the hemoglobin contained in each RBC) to various

tissues as well as giving our blood that cool "red" color. Unlike WBC, RBC
survive in peripheral blood circulation for approximately 120 days. A
decrease in the number of these cells can result in anemia which could
stem from dietary insufficiencies. An increase in number can occur when
androgens are used. This is because androgens increase EPO
(erythropoietin) production which in turn increases RBC count and thus
elevates blood volume. This is essentially why some androgens are better
than others at increasing "vascularity." Anyhow, the danger in this could
be an increase in blood pressure or a stroke.

Androgen-using lifters who have high values should consider making

m
modifications to their stack and/or immediately donating some blood.

Normal ranges:

ya
Adult Male
4,700,000-6,100,000 cells/uL

Adult Female
4,200,000-5,400,000 cells/uL

e
Hemoglobin

Na
Hemoglobin is what serves as a carrier for both oxygen and carbon dioxide
transportation. Molecules of this are found within each red blood cell. An
increase in hemoglobin can be an indicator of congenital heart disease,
congestive heart failure, sever burns, or dehydration. Being at high
altitudes, or the use of androgens, can cause an increase as well. A
decrease in number can be a sign of anemia, lymphoma, kidney disease,
sever hemorrhage, cancer, sickle cell anemia, etc.
ha

Normal ranges:

Males and females 6-18 years

10-15.5 g/dl
nid

Adult Males
14-18 g/dl

Adult Females
12-16 g/dl
Ma

Hematocrit

The hematocrit is used to measure the percentage of the total blood

volume that's made up of red blood cells. An increase in percentage may
be indicative of congenital heart disease, dehydration, diarrhea, burns, etc.
A decrease in levels may be indicative of anemia, hyperthyroidism,
cirrhosis, hemorrhage, leukemia, rheumatoid arthritis, pregnancy,
malnutrition, a sucking knife wound to the chest, etc.

Normal ranges:

m
Male and Females age 6-18 years
32-44%

Adult Men

ya
42-52%

Adult Women
37-47%

e
MCV (Mean Corpuscular Volume)

This is one of three red blood cell indices used to check for abnormalities.

Na
The MCV is the size or volume of the average red blood cell. A decrease in
MCV would then indicate that the RBC's are abnormally large(or
macrocytic), and this may be an indicator of iron deficiency anemia or
thalassemia. When an increase is noted, that would indicate abnormally
small RBC (microcytic), and this may be indicative of a vitamin B12 or folic
acid deficiency as well as liver disease.
ha
Normal ranges:

Adult Male
80-100 fL
nid

Adult Female
79-98 fL

12-18 year olds

78-100 fL
Ma

MCH (Mean Corpuscular Hemoglobin)

The MCH is the weight of hemoglobin present in the average red blood cell.
This is yet another way to assess whether some sort of anemia or
deficiency is present.

Normal ranges:
12-18 year old
35-45 pg

Adult Male

m
26-34 pg

Adult Female
26-34 pg

ya
MCHC (Mean Corpuscular Hemoglobin Concentration)

The MCHC is the measurement of the amount of hemoglobin present in the

average red blood cell as compared to its size. A decrease in number is an

e
indicator of iron deficiency, thalassemia, lead poisoning, etc. An increase is
sometimes seen after androgen use.

Normal ranges:

12-18 year old

31-37 g/dl
Na
Adult Male
31-37 g/dl
ha

Adult Female
30-36 g/dl

RDW (Red Cell Distribution Width)

nid

The RDW is an indicator of the variation in red blood cell size. It's used in
order to help classify certain types of anemia, and to see if some of the red
blood cells need their suits tailored. An increase in RDW can be indicative
of iron deficiency anemia, vitamin B12 or folate deficiency anemia, and
diseases like sickle cell anemia.
Ma

Normal ranges:

Adult Male
11.7-14.2%

Adult Female
11.7-14.2%
Platelets

Platelets or thrombocytes are essential for your body's ability to form

blood clots and thus stop bleeding. They're measured in order to assess

m
the likelihood of certain disorders or diseases. An increase can be
indicative of a malignant disorder, rheumatoid arthritis, iron deficiency
anemia, etc. A decrease can be indicative of much more, including things
like infection, various types of anemia, leukemia, etc.

ya
On a side note for these ranges, anything above 1 million/mm3 would be
considered a critical value and should warrant concern and/or giving
second thoughts as to whether you should purchase a lifetime subscription
to Muscle Media.

e
Normal ranges:

Child
150,000-400,000/mm3 Na
(Most commonly displayed in SI units of 150-400 x 10(9th)/L

Adult
150,000-400,000/mm3
(Most commonly displayed in SI units of 150-400 x 10(9th)/L
ha

ABS (Differential Count)

The differential count measures the percentage of each type of leukocyte

or white blood cell present in the same specimen. Using this, they can
nid

determine whether there's a bacterial or parasitic infection, as well as

immune reactions, etc.

Neutrophils

As explained previously, severe trauma and bacterial infections, as well as

inflammatory disorders, metabolic disorders, and even stress can cause an
Ma

increase in the number of these cells. Also, on the other side of the
spectrum, a low number of these cells can indicate a viral infection, a
bacterial infection, or a deficient diet.

Percentile Range:

55-70%
Basophils

These cells, and in particular, eosinophils, are present in the event of an

allergic reaction as well as when a parasite is present. These types of cells

m
don't increase in response to viral or bacterial infections so if an increased
count is noted, it can be deduced that either an allergic response has
occurred or a parasite has taken up residence in your shorts.

ya
Percentile Range:

Basophils
0.5-1%

e
Eosinophils
1-4%

Lymphocytes and Monocytes

Na
Lymphocytes can be divided in to two different types of cells: T cells and B
cells. T cells are involved in immune reactions and B cells are involved in
antibody production. The main job of lymphocytes in general is to fight off
— Bruce Lee style — bacterial and viral infections.
ha
Monocytes are similar to neutrophils but are produced more rapidly and
stay in the system for a longer period of time.

Percentile Range:
nid

Lymphocytes
20-40%

Monocytes
2-8%
Ma

Selected Clinical Values

Sodium

This cation (an ion with a postive charge) is mainly found in extracellular
spaces and is responsible for maintaining a balance of water in the body.
When sodium in the blood rises, the kidneys will conserve water and when
the sodium concentration is low, the kidneys conserve sodium and excrete
water. Increased levels can result from excessive dietary intake, Cushing's
syndrome, excessive sweating, burns, forgetting to drink for a week, etc.
Decreased levels can result from a deficient diet, Addison's disease,
diarrhea, vomiting, chronic renal insufficiency, excessive water intake,

m
congestive heart failure, etc. Anabolic steroids will lead to an increased
level of sodium as well.

Normal range:

ya
Adults
136-145 mEq/L

Potassium

e
On the other side of the spectrum, you have the most important
intracellular cation. Increased levels can be an indicator of excessive

Na
dietary intake, acute renal failure, aldosterone-inhibiting diuretics, a
crushing injury to tissues, infection, acidosis, dehydration, etc. Decreased
levels can be indicative of a deficient dietary intake, burns, diarrhea or
vomiting, diuretics, Cushing's syndrome, licorice consumption, insulin use,
cystic fibrosis, trauma, surgery, etc.

Normal range:
ha

Adults
3.5-5 mEq/L

Chloride
nid

This is the major extracellular anion (an ion carrying a negative charge).
Its purpose it is to maintain electrical neutrality with sodium. It also
serves as a buffer in order to maintain the pH balance of the blood.
Chloride typically accompanies sodium and thus the causes for change are
essentially the same.
Ma

Normal range:

Adult
98-106 mEq/L
Carbon Dioxide

The CO2 content is used to evaluate the pH of the blood as well as aid in
evaluation of electrolyte levels. Increased levels can be indicative of

m
severe diarrhea, starvation, vomiting, emphysema, metabolic alkalosis,
etc. Increased levels could also mean that you're a plant. Decreased levels
can be indicative of kidney failure, metabolic acidosis, shock, and
starvation.

ya
Normal range:

Adults
23-30 mEq/L

e
Glucose

Na
The amount of glucose in the blood after a prolonged period of fasting (12-
14 hours) is used to determine whether a person is in a hypoglycemic (low
blood glucose) or hyperglycemic (high blood glucose) state. Both can be
indicators of serious conditions. Increased levels can be indicative of
diabetes mellitus, acute stress, Cushing's syndrome, chronic renal failure,
corticosteroid therapy, acr*****ly, etc. Decreased levels could be
indicative of hypothyroidism, insulinoma, liver disease, insulin overdose,
ha
and starvation.

Normal range:

Adult Male
nid

65-120 mg/dl

Adult Female
65-120 mg/dl

BUN (Blood Urea Nitrogen)

Ma

This test measures the amount of urea nitrogen that's present in the blood.
When protein is metabolized, the end product is urea which is formed in
the liver and excreted from the bloodstream via the kidneys. This is why
BUN is a good indicator of both liver and kidney function. Increased levels
can stem from shock, burns, dehydration, congestive hear failure,
myocardial infarction, excessive protein ingestion, excessive protein
catabolism, starvation, sepsis, renal disease, renal failure, etc. Causes of a
decrease in levels can be liver failure, overhydration, negative nitrogen
balance via malnutrition, pregnancy, etc.

Normal range:

m
Adults
10-20 mg/dl

ya
Creatinine

Creatinine is a byproduct of creatine phosphate, the chemical used in

contraction of skeletal muscle. So, the more muscle mass you have, the
higher the creatine levels and therefore the higher the levels of creatinine.

e
Also, when you ingest large amounts of beef or other meats that have high
levels of creatine in them, you can increase creatinine levels as well. Since
creatinine levels are used to measure the functioning of the kidneys, this

Na
easily explains why creatine has been accused of causing kidney damage,
since it naturally results in an increase in creatinine levels.

However, we need to remember that these tests are only indicators of

functioning and thus outside drugs and supplements can influence them
and give false results, as creatine may do. This is why creatine, while
increasing creatinine levels, does not cause renal damage or impair
ha
function. Generally speaking, though, increased levels are indicative of
urinary tract obstruction, acute tubular necrosis, reduced renal blood flow
(stemming from shock, dehydration, congestive heart failure,
atherosclerosis), as well as acr*****ly. Decreased levels can be indicative
of debilitation, and decreased muscle mass via disease or some other
nid

cause.

Normal range:

Adult Male
0.6-1.2 mg/dl
Ma

Adult Female
0.5-1.1 mg/dl

BUN/Creatinine Ratio

A high ratio may be found in states of shock, volume depletion,

hypotension, dehydration, gastrointestinal bleeding, and in some cases, a
catabolic state. A low ratio can be indicative of a low protein diet,
malnutrition, pregnancy, severe liver disease, ketosis, etc. Keep in mind,
though, that the term BUN, when used in the same sentence as hamburger
or hotdog, usually means something else entirely. An important thing to

m
note again is that with a high protein diet, you'll likely have a higher ratio
and this is nothing to worry about.

Normal range:

ya
Adult
6-25

Calcium

e
Calcium is measured in order to assess the function of the parathyroid and
calcium metabolism. Increased levels can stem from hyperparathyroidism,

Na
metastatic tumor to the bone, prolonged immobilization, lymphoma,
hyperthyroidism, acr*****ly, etc. It's also important to note that anabolic
steroids can also increase calcium levels. Decreased levels can stem from
renal failure, rickets, vitamin D deficiency, malabsorption, pancreatitis, and
alkalosis.

Normal range:
ha

Adult
9-10.5 mg/dl

Liver Function
nid

Total Protein

This measures the total level of albumin and globulin in the body. Albumin
is synthesized by the liver and as such is used as an indicator of liver
function. It functions to transport hormones, enzymes, drugs and other
Ma

constituents of the blood.

Globulins are the building blocks of your body's antibodies. Measuring the
levels of these two proteins is also an indicator of nutritional status.
Increased albumin levels can result from dehydration, while decreased
albumin levels can result from malnutrition, pregnancy, liver disease,
overhydration, inflammatory diseases, etc. Increased globulin levels can
result from inflammatory diseases, hypercholesterolemia (high
cholesterol), iron deficiency anemia, as well as infections. Decreased
globulin levels can result from hyperthyroidism, liver dysfunction,
malnutrition, and immune deficiencies or disorders.

m
As another important side note, anabolic steroids, growth hormone, and
insulin can all increase protein levels.

Normal range:

ya
Adult
Total Protein: 6.4-8.3 g/dl
Albumin: 3.5-5 g/dl
Globulin: 2.3-3.4 g/dl

e
Albumin/Globulin Ratio:

Adult
0.8-2.0

Bilirubin
Na
Bilirubin is one of the many constituents of bile, which is formed in the
liver. An increase in levels of bilirubin can be indicative of liver stress or
ha
damage/inflammation. Drugs that may increase bilirubin include oral
anabolic steroids (17-AA), antibiotics, diuretics, morphine, codeine,
contraceptives, etc. Drugs that may decrease levels are barbiturates and
caffeine. Non-drug induced increased levels can be indicative of gallstones,
extensive liver metastasis, and cholestasis from certain drugs, hepatitis,
nid

sepsis, sickle cell anemia, cirrhosis, etc.

Normal range:

Total Bilirubin for Adult

0.3-1.0 mg/dl
Ma

Alkaline Phosphatase

This enzyme is found in very high concentrations in the liver and for this
reason is used as an indicator of liver stress or damage. Increased levels
can stem from cirrhosis, liver tumor, pregnancy, healing fracture, normal
bones of growing children, and rheumatoid arthritis. Decreased levels can
stem from hypothyroidism, malnutrition, pernicious anemia, scurvy
(vitamin C deficiency) and excess vitamin B ingestion. As a side note,
antibiotics can cause an increase in the enzyme levels.

Normal range:

m
16-21 years
30-200 U/L

ya
Adult
30-120 U/L

AST (Aspartate Aminotransferase, previously known as SGOT)

e
This is yet another enzyme that's used to determine if there's damage or
stress to the liver. It may also be used to see if heart disease is a
possibility as well, but this isn't as accurate. When the liver is damaged or

Na
inflamed, AST levels can rise to a very high level (20 times the normal
value). This happens because AST is released when the cells of that
particular organ (liver) are lysed. The AST then enters blood circulation
and an elevation can be seen. Increased levels can be indicative of heart
disease, liver disease, skeletal muscle disease or injuries, as well as heat
stroke. Decreased levels can be indicative of acute kidney disease,
beriberi, diabetic ketoacidosis, pregnancy, and renal dialysis.
ha

Normal range:

Adult
0-35 U/L (Females may have slightly lower levels)
nid

ALT (Alanine Aminotransferase, previously known as SGPT)

This is yet another enzyme that is found in high levels within the liver.
Injury or disease of the liver will result in an increase in levels of ALT. I
should note however, that because lesser quantities are found in skeletal
Ma

muscle, there could be a weight-training induced increase . Weight training

causes damage to muscle tissue and thus could slightly elevate these
levels, giving a false indicator for liver disease. Still, for the most part, it's
a rather accurate diagnostic tool. Increased levels can be indicative of
hepatitis, hepatic necrosis, cirrhosis, cholestasis, hepatic tumor,
hepatotoxic drugs, and jaundice, as well as severe burns, trauma to
striated muscle (via weight training), myocardial infarction,
mononucleosis, and shock.
Normal range:

Adult

m
4-36 U/L

Endocrine Function

ya
Testosterone (Free and Total)

This is of course the hormone that you should all be extremely familiar
with as it's the name of this here magazine! Anyhow, just as some
background info, about 95% of the circulating Testosterone in a man's

e
body is formed by the Leydig cells, which are found in the testicles. Women
also have a small amount of Testosterone in their body as well. (Some
more than others, which accounts for the bearded ladies you see at the

Na
circus, or hanging around with Chris Shugart.) This is from a very small
amount of Testosterone secreted by the ovaries and the adrenal gland (in
which the majority is made from the adrenal conversion of
androstenedione to Testosterone via 17-beta HSD).

Nomal range, total Testosterone:

ha
Male

Age 14
<1200 ng/dl <42nmol/l
nid

Age 15-16
100-1200 ng/dl 3.5- 42 nmol/l

Age 17-18
300-1200 ng/dl 10.5 -42 nmol/l
Ma

Age 19-40
300-950 ng/dl 10.5 - 33 nmol/l

Over 40
240-950 ng/dl 8.4 - 33 nmol/l

Female
Age 17-18
20-120 ng/dl 0.7 - 4.2 nmol/l

Over 18

m
20-80 ng/dl 0.7 - 2.8 nmol/l

Normal range, free Testosterone:

ya
Male
50-210 pg/ml

LH (Luteinizing Hormone)

e
LH is a glycoprotein that's secreted by the anterior pituitary gland and is
responsible for signaling the leydig cells to produce Testosterone.
Measuring LH can be very useful in terms of determining whether a

Na
hypogonadic state (low Testosterone) is caused by the testicles not being
responsive despite high or normal LH levels (primary), or whether it's the
pituitary gland not secreting enough LH (secondary). Of course, the
hypothalamus — which secretes LH-RH (luteinizing hormone releasing
hormone) — could also be the culprit, as well as perhaps both the
hypothalamus and the pituitary.
ha
If it's a case of the testicles not being responsive to LH, then things like
clomiphene and hCG really won't help. If the problem is secondary, then
there's a better chance for improvement with drug therapy. Increased
levels can be indicative of hypogonadism, precocious puberty, and pituitary
adenoma. Decreased levels can be indicative of pituitary failure,
nid

hypothalamic failure, stress, and malnutrition.

Normal ranges:

Adult Male
1.24-7.8 IU/L
Ma

Adult Female
Follicular phase: 1.68-15 IU/L
Ovulatory phase: 21.9-56.6 IU/L
Luteal phase: 0.61-16.3 IU/L
Postmenopausal: 14.2-52.3 IU/L
Estradiol

With this being the most potent of the estrogens, I'm sure you're all aware
that it can be responsible for things like water retention, hypertrophy of

m
adipose tissue, gynecomastia, and perhaps even prostate hypertrophy and
tumors. As a male it's very important to get your levels of this hormone
checked for the above reasons. Also, it's the primary estrogen that's
responsible for the negative feedback loop which suppresses endogenous

ya
Testosterone production. So, if your levels of estradiol are rather high, you
can bet your ass that you'll be hypogonadal as well.

Increased estradiol levels can be indicative of a testicular tumor, adrenal

tumor, hepatic cirrhosis, necrosis of the liver, hyperthyroidism, etc.

e
Normal ranges:

Adult Male
10-50 pg/ml

Adult Female
Na
Follicular phase: 20-350 pg/ml
Midcycle peak: 150-750 pg/ml
Luteal phase: 30-450 pg/ml
ha
Postmenopausal: 20 pg/ml or less

Thyroid (T3, T4 Total and Free, TSH)

T3 (Triiodothyronine)
nid

T3 is the more metabolically active hormone out of T4 and T3. When levels
are below normal it's generally safe to assume that the individual is
suffering from hypothyroidism. Drugs that may increase T3 levels include
estrogen and oral contraceptives. Drugs that may decrease T3 levels
include anabolic steroids/androgens as well as propanolol (a beta
Ma

adrenergic blocker) and high dosages of salicylates. Increased levels can

be indicative of Graves disease, acute thyroiditis, pregnancy, hepatitis, etc.
Decreased levels can be indicative of hypothyroidism, protein malnutrition,
kidney failure, Cushing's syndrome, cirrhosis, and liver diseases.

Normal ranges:

16-20 years old

80-210 ng/dl

20-50 years
75-220 ng/dl or 1.2-3.4 nmol/L

m
Over 50
40-180 ng/dl or 0.6-2.8 nmol/L

ya
T4 (Thyroxine)

T4 is just another indicator of whether or not someone is in a hypo or

hyperthyroid state. It too is rather reliable but free thyroxine levels should
be assessed as well. Drugs that increase of decrease T3 will, in most cases,

e
do the same with T4. Increased levels are indicative of the same things as
T3 and a decrease can be indicative of protein depleted states, iodine
insufficiency, kidney failure, Cushing's syndrome, and cirrhosis.

Normal ranges:

Adult Male
Na
4-12 ug/dl or 51-154 nmol/L

Adult Female
ha
5-12 ug/dl or 64-154 nmol/L

Free T4 or Thyroxine

Since only 1-5% of the total amount of T4 is actually free and useable, this
nid

test is a far better indicator of the thyroid status of the patient. An

increase indicates a hyperthyroid state and a decrease indicates a
hypothyroid state. Drugs that increase free T4 are heparin, aspirin,
danazol, and propanolol. Drugs that decrease it are furosemide,
methadone, and rifampicin. Increased and decreased levels are indicative
of the same possible diseases and states that are seen with T4 and T3.
Ma

Normal ranges:

0.8-2.8 ng/dl or 10-36 pmol/L

TSH (Thyroid Stimulating Hormone)

Measuring the level of TSH can be very helpful in terms of determining if

the problem resides with the thyroid itself or the pituitary gland. If TSH
levels are high, then it's merely the thyroid gland not responding for some
reason but if TSH levels are low, it's the hypothalamus or pituitary gland
that has something wrong with it. The problem could be a tumor, some

m
type of trauma, or an infarction.

Drugs that can increase levels of TSH include lithium, potassium iodide and
TSH itself. Drugs that may decrease TSH are aspirin, heparin, dopamine,

ya
T3, etc. Increased TSH is indicative of thyroiditis, hypothyroidism, and
congenital cretinism. Decreased levels are indicative of hypothyroidism
(pituitary dysfunction), hyperthyroidism, and pituitary hypofunction.

Normal ranges:

e
Adult
2-10 uU/ml or 2-10 mU/L

Na
For more info on the thyroid in general, check out my article "The Thyroid
Handbook."

Conclusion

Hopefully this article will help to shed some light on the questions you
ha
have or may have in the future in regards to a blood test. Now perhaps you
can truly rest assured after viewing things yourself. Hell, you may even
impress your doctor, but wait, this is the same guy who thinks walking for
20 minutes is plenty of exercise for the day!
nid
Ma
 Blood Tests For Evaluating Arthritis

Part 1 - General Blood Tests

m
 Complete Blood Count (CBC)
 Chemistry Panels

Part 2 - Specialized Blood Tests

ya
 Erythrocyte Sedimentation Rate (ESR or Sedrate)
 Rheumatoid Factor (RF)
 HLA B27 Typing
 Antinuclear Antibody (ANA)
C-Reactive Protein (CRP)

e

 Lupus Erythematosus (LE) Test
 Anti-CCP
Anti-DNA and Anti-Sm

 Complement

Complete Blood Count (CBC)

Na
The complete blood count is a test of red blood cells, white blood cells, and
platelets. Blood consists of these components suspended in a thick, colorless
fluid called plasma. Automated machines rapidly count the cell types.
ha

White Cells

The white cell count is normally between 5,000-10,000. Increased values

suggest inflammation or infection.
nid

Such things as exercise, cold, and stress can temporarily elevate the white
cell count.

Red Cells

Normal values for the red cell count vary with gender.
Ma

 Males normally have values around 5-6 million per microliter.

 Females have a lower normal range at 3.6-5.6 million red cells per
microliter.
Hemoglobin / Hematocrit

Hemoglobin, the iron containing component of red cells which carries

oxygen, is also measured in a complete blood count. The normal hemoglobin
value for males is 13-18 g/dl. Normal for females is 12-16 g/dl.

m
The hematocrit measures the percent of total blood volume which is red
cells. Normal value for males is 40-55%, and the normal value for females is
36-48%. Generally, the hemoglobin times 3 equals the hematocrit.
Decreased values are indicative of anemia.

ya
The MCV, MCH, MCHC are red cell indices which indicate the size and
hemoglobin content of individual red cells. These indices give clues as to the
probable cause of an existing anemia.

e
Platelets

Platelets are components which are important in clot formation.

Na
Many medications used in the treatment of arthritis can decrease the platelet
count or affect platelet function. Normal values range from 150,000-400,000.

Differential

The percent and absolute number of each type of white blood cell is called
the differential.
ha

 Neutrophils are increased in bacterial infections and acute inflammation.

 Lymphocytes are increased in viral infections.
 Monocytes are increased in chronic infections and eosinphils are increased
in allergies.
 Basophils, which are generally 1 or 2% do not usually increase.
nid

Inflammation

The process of inflammation can cause changes in the blood count. The red
cell count may go down, the white cell count may go up, and the platelet
count may be elevated. Whileanemia may accompany inflammatory arthritis
Ma

it may be caused by other things such as blood loss or iron deficiency. Only
when other causes have been ruled out can a doctor interpret blood
abnormalities as a sign of inflammation.
 Inflammation - Test Your Knowledge
Chemistry Panels

The chemistry panels are a series of tests which are used to evaluate overall
health. For example, according to A.D.A.M., "the CHEM-20 is a group of 20
chemical tests performed on serum (the portion of blood without cells).

m
Electrolytes are ionized salts in blood or tissue fluids (ions are atoms or
molecules that carry an electrical charge). Electrolytes in the body include
sodium, potassium, chloride, and many others."

ya
The tests also include heart risk indicators, diabetes indicators, as well as
tests for:

 kidney function
 liver function

e
 thyroid function
For example, a patient with a high creatinine level may have a problem with
the kidneys.Creatinine is a waste product found in the blood. Certain types of

Na
inflammatory arthritis can affect kidney function. Certain arthritis drugs can
affect kidney function too. Uric acid is another test of the blood chemistry
panel which, if elevated, may be indicative of gout.
 Blood Tests Used To Monitor Arthritis Treatments
 Liver Panel Blood Tests Checks For Toxicity

Erythrocyte Sedimentation Rate (ESR)

ha

The erythrocyte sedimentation rate is a test which involves placing a blood

sample in a tube and determining how fast the red blood cells settle to the
bottom in one hour. When inflammation occurs the body produces proteins in
the blood which make the red cells clump together. Heavier cell aggregates
fall faster than normal red cells. For healthy individuals, the normal rate is up
nid

to 20 millimeters in one hour. Inflammation increases the rate significantly.

Since inflammation can be caused by conditions other than arthritis, the
sedrate test alone is not diagnostic.

Rheumatoid Factor (RF)

Ma

Rheumatoid factor is an antibody found in unusually large amounts of

patients with rheumatoid arthritis. Rheumatoid factor was discovered in the
1940's and became a significant diagnostic tool in the field of rheumatology.
80% of RA patients have RF in their blood. Usually, the higher concentration
of RF, the more severe therheumatoid arthritis. RF can take many months to
show up in a patients blood. If tested too early in the course of the disease,
the result could be negative and retesting should be considered at a later
date. There are also patients with all the signs and symptoms of RA but are
seronegative for RF. Some doctors suspect another disease masquerading as
RA in these cases. RF can occur in response to inflammatory of infectious
diseases other than RA, though usually in these cases, the amount is lower.

HLA Typing

m
White blood cells may be typed for the presence of HLA-B27. This test is
common in medical centers because it is needed for transplants. What has
been found is that this genetic marker is present in some forms of arthritis,

ya
chiefly ankylosing spondylitis and Reiter's syndrome.

Antinuclear Antibody (ANA)

ANA (antinuclear antibody) test is performed to help detect

e
certain rheumatic diseases.Patients with certain diseases, especially lupus,
make antibodies to the nucleus, or command center, of the body's cells.
These antibodies are called antinuclear antibodies and are tested for by

Na
placing a patient's blood serum on a microscope slide containing cells with
visible nuclei. A substance containing fluorescent dye is added which binds to
the antibodies. Under a microscope the abnormal antibodies can be seen
binding to the nuclei.
 Over 95% of patients with lupus have a positive ANA test.
 50% of rheumatoid arthritis patients are positive for ANA.

Patients with other diseases also can have positive ANA tests. Other criteria
ha
must be involved in definitive diagnosis.

C-Reactive Protein (CRP)

C-Reactive Protein measures the concentration in blood serum of a special

nid

type of protein produced in the liver that is present during episodes of acute
inflammation or infection.

As a blood test, CRP is not specific. A high result serves as a general

indication of acute inflammation. In cases of inflammatory rheumatic
diseases, such as rheumatoid arthritis and lupus, doctors can utilize the CRP
test to assess the effectiveness of a specific arthritis treatment and monitor
Ma

periods of disease flareup.

Lupus Erythematosus (LE)

The LE cell test is not commonly performed anymore. Its initial discovery
opened up the whole field of antinuclear antibodies though. Only 50% of
lupus patients are found to have positive LE tests. Therefore the test does
not identify 50% of patients as having the disease.

Anti-CCP

m
Anti-CCP (anti-cyclic citrullinated peptide antibody) is a new and exciting
blood test to help doctors confirm a diagnosis of rheumatoid arthritis.

ya
Anti-DNA and Anti-Sm

Lupus patients have antibodies to the heredity material DNA

(deoxyribonucleic acid). It is a useful diagnostic tool since it is unusual to
find these antibodies in people who do not have lupus. The test is also a good
monitoring tool since the levels of anti-DNA rise and fall with disease

e
activity.

Na
Lupus patients also have antibodies to Sm, another substance in the cell's
nucleus. These antibodies also occur only in lupus patients. The test is not
particularly useful in monitoring disease activity however.

Complement

The complement system is a complex set of blood proteins which are part of
the body's defense system. These proteins are inactive until an antibody
ha
binds to an antigen and activates the complement system. The system
produces factors which help destroy bacteria, and combat invaders with
white cells. These reactions consume complement and leave depressed levels
indicative of immune complex formation. Lupus patients often show
decreased levels of total complement. The complement test may be helpful in
tracking the disease activity of a lupus patient.
nid

Related Resources - Blood Tests For Arthritis

 Laboratory Blood Tests / Diagnosis Of Arthritis

 Lab Tests - Test Your Knowledge
 Blood Tests Used To Monitor Arthritis Treatments
Ma