Optimal Lab Interpretation - Blood Chemistry
The ranges and information contained within this sheet are for informational and educational purposes
only. Please see a licensed healthcare practitioner before making any changes to your current lifestyle.
The ranges contained within this sheet are nutritional ranges, they are not designed to diagnose, treat, or
cure any disease. Acceptance of these ranges varies among practitioners.
Lab
CBC w/Differential
HGB
Optimal
F=Female
M=Male
F:
13.5-14.5g
/dL M:
14-15
g/dL
High Levels
Low Levels
Cardiac dysfunction,
excessive RBC, immune
suppression, lung
dysfunction, hemoglobin
production abnormality,
bleeding, hemolysis, liver
dysfunction, kidney
dysfunction
Shock, immune suppression,
excessive RBC
Decreased levels of RBC, RBC
abnormality, hemoglobin
production abnormality,
bleeding, hemolysis, liver
dysfunction, kidney
dysfunction, bone marrow
dysfunction
HCT
F:37-44
M:40-48
RBC
F:3.9-4.5 Excessive RBC, dehydration,
M:4.2-4.9 renal dysfunction, high
altitude, lung dysfunction,
immune suppression,
cardiovascular dysfunction
MCV
85-92
fL/red
cell
MCH
27-32
pg/cell
B12/folate need, high
altitude, increased
methylmalonic acid and
homocysteine
B12/folate need, new born
infants, RBC abnormality
MCHC
32-35
g/dL
B12/folate need, new born
infants, RBC abnormality
Decreased levels of RBC,
abnormal breakdown of RBC,
immune suppression,
increased levels of WBC,
adrenal dysfuntion, acute
blood loss
Decreased levels of RBC,
immune suppression,
hemorrhage, adrenal
dysfunction & cortisol
production dysfunction,
chronic bacterial infections
B6 need, bleeding, decreased
levels of RBC, free radicals,
parasites
B6 need, RBC abnormality
Decreased levels of RBC, B6
need, abnormal hemoglobin
production
1
Lab
RDW
Optimal
High Levels
Neut.
B12 and iron need, immune
suppression, abdnormal
hemoglobin
150,000- Over production of platelets,
450,000 excessive RBC production,
increased immature WBC,
splenectomy
5.0-8.0
billion /L
40%-60% Bacteria
Lymph​.
25%-40% Virus
Mono​.
<7
Infections, heavy metals
Eos.
<3%
Allerigies, parasites
Baso.
0%-1%
Platelets
WBC
Low Levels
<13
Use sesame seed oil
Adrenal dysfunction
Thyroid
TSH
1.8-3.0
uU/mL
Total T4
6-12
mcg/Dl
Free T4
1.0 - 1.5
ng/dL
100-180
ng/dL
Total T3
FTI
1.2-4.9
Free T3
3.0-4.0
pg/ml
T3 Uptake
28-38 %
Rev. T3
9-35ng/
mL
20+
T3:RT3 Ratio
Decreased thyroid hormone
levels
Pituitary dysfunction, gut
infections, excessive
production of thyroid
hormone
Increased thyroid hormone
Overly high protein levels in
levels, increase in thyroid
the blood, decreased thyroid
binding globulin,
hormone levels, decreased
hepatitis/liver, acute
thyroid binding globulin,
thyroditis, thyroid medication thyroid medication
Increased thyroid hormone
levels
High cortisol levels,
inflammation, third trimester
pregnancy, pituitary
dysfunction
Decreased thyroid hormone
levels, need selenium
High cortisol levels,
inflammation, third trimester
pregnancy, pituitary
dysfunction
TSI
TPO AB
0
Autoimmune / GI
TGB AB
0
Autoimmune / GI
2
Lab
Optimal
High Levels
Low Levels
CMP
Glucose
85-100
mg/dL
Sodium
135-140
mEq/L
Potasium
4-4.5
mEq/L
Chloride
100-106
mmol/L
25-30
mmol/L
Co2
Calcium
9.2-10.1
mg/dL
Excess glucose in the
low blood glucose levels,
bloodstream, blood sugar adrenal dysfunction & cortisol
issues, pituitary dysfunction, production dysfunction, liver
pregnancy, increased blood
dysfunction, pituitary
iron levels, inflammation of dysfunction, decreased levels
the pancreas, thiamin need
of thyroid hormone
dehydration, renal
Low salt diet, diarrhea,
dysfunction, water softners,
cardiac dysfunction, burns,
excessive aldosterone
adrenal dysfunction & cortisol
production, pituitary
production dysfunction,
dysfunction, blood sugar
malabsorption, edema
issues
Low adrenal function, renal
Diurtetic use, excessive
dysfunction, tissue
adrenal function, renal
destruction, dehydration,
dysfunction, blood sugar
blood sugar issues, acidosis issues, excessive alcohol use,
starvation, alkalosis
Alkalosis, excessive secretion
Acidosis, asprin use, renal
of aldosterone, lung &
dysfunction, use of diuretics,
alveolar dysfunction,
starvation, diarrhea
vomiting
hyperthyroid/parathyroid,
Pregnancy, bone weakening
excessive Vit. D, bone cell
issues, thyroid/parathyroid
remodeling/deformity issues,
dysfunction, magnesium
immune suppression,
need, Vit. D need,
increased immature WBC,
inflammation of the pancreas
malabsorption, alcohol
BUN
Creatinine
0.7-1.1
mg/dL
Alk Phos
27-90
iU/L
Dehydration, renal
dysfunction, enlarged
prostate, uterine problems,
increased growth hormone,
neuromuskuloskeletal
conditions, autoimmune
issues
Gut inflammation, liver
dysfuntion, increased bone
growth, gastric inflammation,
cardiovascular issues,
immune suppression,
excessive production of
Pregnancy, bone growth,
protein need, liver
dysfunction, glutathione
need, methylation
3
thyroid hormone, lung
dysfunction
Lab
Optimal
SGOT (AST)
10-26
iU/L
SGPT(ALT)
10-26
iU/L
Albumin
Globulin
4.0-5.0
g/dL
2.4-2.8
A/G Ratio
1.5-2.0
High Levels
Low Levels
Cardiac/muscle/liver
B6 need
dysfunction, virus,
inflammation of the pancreas,
parasitic activity, mushroom
poisoning
Liver dysfunction, bile duct Malnutrition, infections of the
dysfunction, inflammation of
urinary tract
the pancreas
Dehydration
Liver dysfunction, Vit. C need,
free radicals
Increased need for HCL,
Liver dysfunction, digestive
Typhoid fever, parasites,
inflammation, HCL Need,
immune suppression,
Severe hemorrhage, severe
lymphatic infection
decrease in RBC levels
Dehydration
Burns, kidney dysfunction,
lung & alveolar dysfunction,
viral infections, excessive
production of thyroid
hormone, inflammation of the
peritoneum, intestial
obstruction
Lipid Panel
Cholesterol
150-200
mg/dL
Triglycerides
75-100
mg/dL
LDL
<120
HDL
>55
Type 4 Diabetes, thyroid,
carbs, chronic renal failure,
Type 2 Diabetes, gallbladder
dysfunction,
liver/alcohol/pancreatic
dysfunction
Insulin resistance, alcohol,
high carb intake, estrogen,
defect/deficient LPL or
APO-C2, blood sugar issues,
thyroid dysfunction
high carb intake, alcohol use,
Type 2 Diabetes, high fat diet,
blood sugar issues, eating
disorders, renal dysfunction
Vegetarianism, autoimmunity,
free radicals, excessive
production of thyroid
hormone, abnormal RBC
production, liver dysfunction
Autoimmune issues, liver
dysfunction, lung dysfunction,
Cystic Fibrosis
abnormally low levels of lipid
in the blood, severe reduction
in HDL in the blood, excessive
production of thyroid
hormone
Autoimmunity, liver
blood sugar issues, obesity,
dysfunction, increased lipid
high carb intake, lack of
levels in the blood, long term
exercise, high levels of
exercise
lipoproteins in the blood, Apo
4
C-3 dificency, cardiac
dysfunction
Lab
Optimal
Chol/HDL Ratio
<3.1
HDL/LDL Ratio
>.4
High Levels
Low Levels
Cardiovascular issues, Type 2 Liver dysfunction, excessive
Diabetes, increased lipid in
production of thyroid
the blood, diabetes, renal
hormone, long-term exercise,
dysfunction
inflammation, infections
Additional Labs
Homocysteine
5.5-8
umol/L
HgBA1c
<5.2
Uric Acid
F:3.2-5.5
mg/dL
M:3.7-6.0
mg/dl
<1.0
mg/L
Lab
ranges
HS-CRP
RBC Folate
MMA
% Free Copper
Lab
ranges
>6.0
mg/dl
80-100
ug/dl
25-40
mg/dL
100-140
ug/dL
0.53-0.91
mg/L
9-14.7
mg/L
40-70
ng/mL
<15
Zinc/CU ratio
1.3:1
Magnesium RBC
Copper, Serum
Ceruloplasmin
Zinc, Serum
Copper, RBC
Zinc, RBC
Histamine
Cardiovascular issues,
hypo-methylation, oxidative
stress, mood dissorders, and
numerous other issues.
Blood sugar issues, insulin
resistance
Low glutathione and CoQ10
need.
Low Glutathione, Toxic
exposure, or SNP
upregulation
Inflammation/ gut/
infection/ poor diet
MTHFR, FOL, SLC19A1 SNPs.
Folate is unable to get into
the cell.
Adeno-B12 Need
Magnesium need
5
Lab
Vit. D 1,25 (OH)
Vit. D 25(OH)
Ratio 1,25D:25D
Ionized Ca
Optimal
High Levels
Low Levels
22-75
ng/mL
35-80
ng/mL
1.5-2.0
Lab
Ranges
Iron
Ferritin
TIBC
% Sat
Fibrinogen
Galectin-3
20-50
ng/mL
250-350
mcg/dL
25%-30%
250-350
(mg/dl)
<12.9
Inflammatory marker that,
(ng/ml) when elevated, systemic
enzymes (Vitalzym XE) and
modified citrus pectin
(MCP-Pectasol) often are
needed until the root
cause of elevation is
found.
Hormones
IGF-1
220+
Estriol (E3)
EQ (E3 / (E1+E2)
Pregnenolone
130+
Progesterone (Pg)
Pg/E2 Ratio
Testosterone, Free
Testosterone
DHEA
300-500
DHEAS
200-400
LH
FSH
6
Lab
Optimal
High Levels
Low Levels
Infectious / Autoimmune / Inflammatory
Panels
Immunoglobulin G
Immunoglobulin M
EBV VCA AB (IGM)
EBV EA AB (IGG)
EBV VCA AB (IGG)
EBV EBNA AB (IGG)
Complete Cytokine Assay
Candida Antibodies
Helicobacter IgG panel
Hep A, B, and C titers
Breakout of Cytokine
panel
ESR
RA factor
SLE screen
T Lymphocite Helpter
supporessor assay
IL 8, IL1 B or TNF alpha
analysis
Cancer history of colon, breast and ovary
CEA for colon cancer
CA 125 for ovarian cancer
CA 27.9 for breast cancer
AFP blood test
CA125, 15-2, 27.29, 19.9
BRCA 1 and 2 screen
Previous Heart Disease
Apo A-1 and B
B Natriurietic Factor
LpA status, Lp-PLA2
CIMT
7
Calcium Index Score
Lab
Optimal
High Levels
Low Levels
Bonus: Optimal Hormone Levels from
StopTheThyroidMadness.com
This information comes from
https://stopthethyroidmadness.com/lab-values/
Iron / Total Iron
% Iron Saturation
US: Close
to 110 for
women,
upper
130s for
men; UK
/ AU:
lower to
mid-20s
for
women;
CAN:
Mid-20s
for
women,
higher for
men
close to
35% for
women,
40-45%
for men
If you are considerably higher
than optimal, you could have
the MTHFR mutation which
will need testing and
treatment. The MTHFR
mutation also drives the
ferritin low with normal or
high iron is many of us, we’ve
noted. If all three iron labs are
high (serum iron, % saturation,
and ferritin, you may have the
genetic hemochromatosis
and you can ask your doctor
for testing for that.
Measures your serum iron
divided by your TIBC. Like all
iron labs, you should be off
all iron for at least 12 hours
before testing to see how
your supplementation is
doing, or up to 5 days to see
what your natural levels are.
The latter may be best.
NOTE: % Saturation can look
falsely good or high if your
TIBC is too low!!
8
Lab
TIBC
Optimal
High Levels
Low 300s
(ref
range:
250-450)
- for
other
ranges, a
little
more
than
1/4th
above
the
bottom
number
in the
range
provided.
CAN:
when
range is
umol/L >45-77=lo
w 60s;
range us
50-70
umol/L=
bottom
1/4th
above
bottom of
range
TIBC measures whether a
protein called transferrin,
produced by the liver, is
enough to carry iron in the
blood. Used to determine
anemia or low body iron. If
your result is high in the
range and in the absence of
chronic disease, you may be
anemic. NOTE we do NOT
treat the TIBC. We treat the
iron and % Sat. The TIBC just
gives us interesting
information as explained.
Low Levels
9
Lab
Optimal
High Levels
Low Levels
10
Ferritin
Lab
70-90 for
women;
slightly
above
100 for
men
Measures your levels of
storage iron. NOTE THAT WE
DO NOT TREAT the FERRITIN
LEVEL. A mistake. We treat
iron and % saturation and let
ferritin follow in its own
accord. But ferritin is
interesting to watch, and can
also point to INFLAMMATION
if it goes high without serum
iron being high. i.e.
inflammation causes iron to
be thrust into storage, and
inflammation is common with
certain thyroid patients for a
variety of reasons. In less
common cases, higher ferritin
can be from liver disease,
alcoholism, diabetes, asthma,
or some types of cancer. But
for most of us, it’s just about
inflammation from
hypothyroidism, or gluten
issues, or unknown. So we
need to lower the
inflammation before taking
iron supplements. If ferritin is
high along with a high % Sat
and Serum iron, you may
have hemochromatosis, an
inherited condition. Time to
get tested in working with
your doctor.
If your ferritin is low along
with inadequate/lower levels
of iron and % saturation, that
usually points to simply low
iron, which is common with
those on T4-only meds, or
undiagnosed, or
under-treated. But we do
NOT treat that low ferritin. We
treat the inadequate iron and
% saturation, and over time,
the ferritin moves up by itself
if it’s too low. If your ferritin is
low with very good or high
iron, plus a TIBC in the middle
300s or higher, that usually
points to having high heavy
metals and an active MTHFR
mutation.
Optimal
High Levels
Low Levels
11
FEMALE HORMONES
20-22
Progesterone (Pg) ng/mL
cycling women
Progesterone (Pg) non-cycling women
Lab
(US)
serum 64-70
nmol/L(
UK)
serum 250-300
pg/mL
(US)
saliva 1100-130
0 pmol/L
(UK)
saliva
8-10
ng/mL
(US)
serum 25-32
nmol/L
(UK)
serum 100-125
pg/mL
(US)
saliva 440-585
pmol/L
(UK)
saliva
Optimal
High Levels
Low Levels
12
Estradiol - cycling
women with normal
SHBG
80-100
pg/mL
(US)
serum 294-367
pmol/L
(UK)
serum 1.30-1.50
pg/mL
(US)
saliva 3.70-6.50
pmol/L
(UK)
saliva
20-40
Estradiol non-cycling women pg/mL
(US)
with normal SHBG
serum 73-147
pmol/L
(UK)
serum 0.40-0.60
pg/mL
(US)
saliva 1.50-3.00
pmol/L
(UK)
saliva
NOTE: Women with high SHBG can have slightly higher estradiol. i.e. when SHBG is high (>160 or so),
some need a level of 150-160 blood to feel well. As a noncycling woman with higher SHBG, some might
need a level of 50-80.
FSH
LH
<10 mIU/mL good/healthy
egg reserve (nowhere close
to meno–chance of
conception, <3 excellent, 3-6
good, 6-9 fair)
FSH/LH 10-15 conception
difficult but not impossible
FSH/LH 15-20
perimenopause (probably not
ovulating every month)
FSH/LH 20-30 menopause
almost certainly in progress
(ovulation rare if at all
regardless of bleeding)
FSH/LH > 30
noncycling/postmenopause
13
NOTE: FSH and LH for cycling women should be 1:1 ratio. If LH is higher, that typically means PCOS.
Labs must be taken day 2-4 of the cycle while bleeding.
2.10-3.20
Free testosterone
pg/mL
(US)
serum 7.30-11.00
pmol/L
(UK)
serum 108-149
pmol/L
(UK)
saliva 36-47
pg/mL
(US)
saliva 0.04-0.05
nmol/L
serum
1.10-1.50
ng/dL
serum
28-38
Total testosterone
ng/dL
(US)
serum 1.00-1.32
nmol/L
(UK)
serum 36-47
pg/mL
(US)
saliva 108-149
pmol/L
(UK)
saliva
75-95
SHBG
nmol/L
Lab
Optimal
High Levels
Low Levels
14
DHEA (in the absense
of adrenal fatigue or
PCOS)
B-12
Serum
175-225
ug/dL
Saliva >
13ng/mL
upper
quartile
We noticed repeatedly that
an optimal B12 lab result is in
the upper quarter of the
range. Mid-range can present
symptoms of inadequate
levels, such as legs falling
asleep too easily, or the same
with little fingers or other
fingers. It has been shown in
studies that patients with labs
under 350 are likely to have
symptoms, which means the
deficiency is very serious and
has gone on for a few years
undetected. Even mid-range
has shown to be in adequate.
Lab ranges are much too low
for B12…in Japan the bottom of
the range is 500. The urine
test Urinary Methylmalonic
Acid, also called the UMMA,
can be added since it is a very
sensitive detection and if high,
will reveal a true B12
deficiency.
NOTE: Measures an essential vitamin, B12, which can be low in hypothyroid patients due to low stomach
acid. It is NOT optimal to simply be “in range”. For example, if your range is similar to 180-900, a healthy
level appears to be 800 or higher. In the 500-800 range, you can benefit from taking B12 lozenges,
specifically Methylcobalamin. The exception to the latter for some may be if they have both an MTHFR
and COMT mutation–the methyl version of B12 can sometimes send out B12 levels way too high.
Folate
Top third
of
standard
range
(3-17);
higher for
MTHFR
15
Also sometimes called “folic acid”, this is a b-vitamin which can be low in hypothyroid patients. Folate is
important for prenatal development, as well as your blood cell health. Folate works with B12 in the use
and creation of proteins. It’s “folate” thats needed instead of “folic acid”, especially if you have MTHFR.
We don’t start too high, as for some of us, it can start the methylation process too strongly.
Lab
Optimal
ALT
AST
Magnesium
teens
Vit D (25 hydroxy)
60-80
High Levels
Low Levels
teens
mid-rang
e or
higher
Thyroid patients can be chronically low in the electrolyte magnesium, which causes a multitude of
problems ranging from worsened Mitral Valve Prolapse, less cancer protection, poor muscle
development, too much calcium, cramping, and many other chronic conditions. See Janie’s blog post
on magnesium.
Close to
Sodium
142
Can also be strongly related to your adrenals and aldosterone: Measures the levels of the electrolyte
sodium, which is outside cells, and has a balance with potassium, which is within cells. Sodium
regulates bodily fluid and plays role in major bodily functions. This can be strongly related to whether
you have low aldosterone or not.
4.2 or
Potassium
higher;
upper
70-95%
of the
range
Measures the electrolyte mineral Potassium, which is within cells, and has a balance with sodium, which
is outside cells. Potassium plays a role in healthy kidney, heart and nervous system function. When
potassium is too high, it’s called hyperkalemia; when too low, hypokalemia. It can rise in the presence of
low aldosterone (see above under Adrenals), then fall. Best to do an RBC potassium–red blood
cell—which measures it in your cells.Tell the lab tech NOT to use the tourniquet for drawing blood. It can
falsely raise your potassium result.
Measures the enzyme
If both hormones are low in
Renin
hormone that regulates the
the range, you ‘may’ a
release of aldosterone and is pituitary problem. Always
done in conjunction with the tested along with Aldosterone
aldosterone test. If renin is
to see if your problem is due
high in the range along with a to the adrenals (primary
low aldosterone, you have an adrenal insufficiency) or your
adrenal cause.
pituitary (secondary adrenal
insufficiency).
16
Vitamin D plays a role in your immune system and other important actions. Many thyroid patients are
low in D due to digestive issues from being undiagnosed or undertreated, plus problems with Celiac or
gluten intolerance. When someone overreacts to Vit D supplementation, it seems to point to a
parathyroid problem.
Lab
Optimal
High Levels
Low Levels
Zinc
Top third
of the
range
Also important to test your RBC Zinc to see your cellular levels, because you have good-looking serum
zinc and low RBC zinc!
17