Values and Markers

Hematology Values

HEMATOCRIT (HCT)

HEMOGLOBIN (HGB)

Normal Adult Range: 80 100 f

Optimal Adult Reading: 90
Higher ranges are found in newborns and infants

MCHC (Mean Corpuscular Hemoglobin Concentration)

Normal Adult Range: 27 33 pg

Optimal Adult Reading: 30

MCV (Mean Corpuscular Volume)

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 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 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)

PLATELET COUNT

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: 18 48 %

Optimal Adult Reading: 33
Normal Childrens Range: 25 50 %
Optimal Childrens Reading: 37.5

MONOCYTES and MONOCYTE COUNT Elevated levels are seen in

tissue breakdown or chronic infections, carcinomas, leukemia
(monocytic) or lymphomas.

Normal Adult Range: 48 73 %

Optimal Adult Reading: 60.5
Normal Childrens Range: 30 60 %
Optimal Childrens Reading: 45

LYMPHOCYTES and LYMPHOCYTE COUNT Elevated levels may

indicate an active viral infections such as measles, rubella,
chickenpox, or infectious mononucleosis.

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 infection.

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: 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

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 (edema).

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

CALCIUM/PHOSPHORUS Ratio

Normal Adult Range: 2.3 3.3 (calculated)

Optimal Adult Reading: 2.8
Normal Childrens range: 1.3 3.3 (calculated)
Optimal Childrens Reading: 2.3

SODIUM/POTASSIUM

Normal Adult Range: 26 38 (calculated)

Optimal Adult Reading: 32

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

Normal Adult Range: 0 48 U/L

Optimal Adult Reading: 24

Normal Adult Range: 20 125 U/L

Optimal Adult Reading: 72.5
Normal Childrens Range: 40 400 U/L
Optimal Childrens Reading: 220

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

Normal Adult Range: 0 250 U/L

Optimal Adult Reading: 125

Normal Adult Range 0 1.3 mg/dl

Optimal Adult Reading: .65

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 infarction

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

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.

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 activity.

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
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

Normal Adult Range: .7 1.4 mg/dl

Optimal Adult Reading: 1.05

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

Normal Adult Range: 6 -25 (calculated)

Optimal Adult Reading: 15.5

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 function.

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.

BUN/CREATININE This calculation is a good measurement of kidney

and liver function.

Protein

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

Normal Adult Range: 3.2 5.0 g/dl

Optimal Adult Reading: 4.1

Normal Adult Range: 2.2 4.2 g/dl (calculated)

Optimal Adult Reading: 3.2

Normal Adult Range: 0.8 2.0 (calculated)

Optimal Adult Reading: 1.9

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

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.

A/G RATIO (Albumin/Globulin Ratio)

Lipids

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

Normal Adult Range: 62 130 mg/dl

Optimal Adult Reading: 81 mg/dl

Normal Adult Range: 35 135 mg/dl

Optimal Adult Reading: +85 mg/dl

Normal Adult Range: 0 200 mg/dl

Optimal Adult Reading: 100

Normal Adult Range: 1 6

Optimal Adult Reading: 3.5

LDL (Low Density Lipoprotein) studies correlate the association

between high levels of LDL and arterial artherosclerosis

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
intoxication.

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.

CHOLESTEROL/LDL RATIO

Thyroid

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

Normal Adult Range: 27 47%

Optimal Adult Reading: 37 %

Normal Adult Range: 4 12

Optimal Adult Reading: 8

Normal Adult Range: .5 6 milU/L

AACE (2003) target level: 0.3 to 3.04

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.

FREE T4 INDEX (T7)

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.

Cardiac

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

< 12 IU/L if total CK is <400 IU/L

<3.5% of total CK if total CK is >400 IU/L

140-280 U/L

LDH-1 18%-33%

LDH-2 28%-40%

10-42 U/L

<1

< 0.4

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.

(LDH) Lactate dehydrogenase Total LDH will begin to rise 2 to 5

days after an MI; the elevation can last 10 days.

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.

SGOT will begin to rise in 8-12 hours and peak in 18-30 hours

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.

Troponin Complex Peaks in 10-24 hours, begins to fall off after 1-2
weeks.

Table of Cardiac markers

Serum Markers of
Myocardial Injury
Detected

Peak

Falls

Myoglobin

1-3

1-8

12-18

CK/CK-MB

3-8

12-16

24-48

MB Isoforms

1-6

4-8

12-48

10-24

cTnI: 5-9 days

cTnT: 7-14 days

Troponin Complex

3-6