Labs Guide
Pamela C. Vickers
Candler Hospital/Georgia Southern University
February 23, 2015
Labs Guide
Lab
BUN
Creatinine
CO2 (Carbon
Dioxide)
Glucose
Hemoglobin A1C
Serum Chloride
Reference Range
8-23 mg/dL
0.6-1.2 mg/dL
20-29 mmol/L
70-110 mg/dL
≤ 6%
95-105 mmol/L
Causes for Elevation/Depletion
Elevation: congestive heart failure, excessive protein levels in the GI tract, GI
bleeding, dehydration, heart attack, kidney disease, kidney failure, shock, urinary
tract infection
Depletion: liver failure, low protein diet, malnutrition, and over-hydration
Elevation: blocked urinary tract, kidney damage/failure/infection/reduced blood flow,
dehydration, muscle breakdown, problems during pregnancy (eclampsia,
preeclampsia)
Depletion: myasthenia gravis (conditions involving muscles and nerves that control
them), muscular dystrophy: late stage muscle loss
Elevation: breathing disorders, crushing syndrome, hyperaldosteronism, vomiting
Depletion: Addison disease, diarrhea, ketoacidosis, kidney disease, lactic acidosis,
metabolic acidosis, salicylate toxicity (aspirin overdose)
Elevation: diabetes, overactive thyroid gland, pancreatic cancer, pancreatitis, stress
due to trauma/heart attack/surgery, tumors: pheochromocytoma, acromegaly,
Cushing syndrome, glucagonoma
Depletion: hypoglycemia, hypopituitarism, underactive thyroid gland, insulinoma,
too little food, too much insulin or diabetic medications, liver or kidney disease,
weight loss after surgery, vigorous exercise
Elevation: diabetes (new or poorly controlled), hyperglycemia, splenectomized
patients, pregnancy (gestational or pre-diabetes)
Depletion: chronic blood loss, chronic renal failure, hemolytic anemia
Elevation: hyperchloremia, bromide poisoning, carbonic anhydrase inhibitors,
diarrhea, metabolic acidosis, respiratory alkalosis, renal tubular acidosis
Serum Potassium
Serum Sodium
Serum Calcium
Serum Magnesium
3.5-5.0 mEq/L
135-145 mEp/L
9.0-10.5 mEq/L
1.5-2.0 mEq/L
Depletion: hypochloremia, Addison’s disease, burns, congestive heart failure,
dehydration, excessive sweating, gastric suction, hyperaldosteronism, metabolic
acidosis, respiratory acidosis, syndrome of inappropriate diuretic hormone secretion,
vomiting
Elevation: hyperkalemia, Addison’s disease, blood transfusion, certain medications,
crushed tissue injury, hyperkalemic periodic paralysis, hypoaldosteronism, kidney
failure, metabolic or respiratory acidosis, red blood cell destruction, too much
potassium in diet
Depletion: chronic diarrhea, Cushing syndrome, diuretics, hyperaldosteronism,
hypokalemic periodic paralysis, not enough potassium in diet, renal artery stenosis,
renal tubular acidosis, vomiting
Elevation: adrenal gland problems (Cushing syndrome/hyperaldosteronism), diabetes
insipidus, increased fluid loss due to excessive sweating, diarrhea, use of diuretics, or
burns, too much salt or sodium bicarbonate in the diet, use of certain medications
such as birth control pills, corticosteroids, laxatives, lithium, and NSAIDS
Depletion: adrenal glands not making enough hormones (Addison’s disease),
dehydration, vomiting, diarrhea, buildup in urine of waste products from fat
breakdown (ketonuria), increase in total body water seen in heart failure, kidney
diseases, or cirrhosis of the liver, syndrome of inappropriate antidiuretic hormone
secretion, too much vasopressin, use of medications such as diuretics, morphine, and
SSRI antidepressants
Elevation: Hyperparathyroidism, metastatic tumor to bone, Paget's disease
Depletion: Hypoparathyroidism, renal failure, vitamin D deficiency
Elevation: Addison’s disease, chronic renal failure, dehydration, diabetic acidosis,
oliguria
Depletion: alcoholism, chronic diarrhea, delirium tremens, hemodialysis, hepatic
cirrhosis, hyperaldosteronism, hypoparathyroidism, pancreatitis, too much inulin,
toxemia of pregnancy, ulcerative colitis
Serum
Phosphorous
pH
Serum Iron
Serum Ferritin
Serum Transferrin
Total Iron-Binding
Capacity
3.0-4.5 mg/dL
7.35-7.45
30-160 µ g/dL
13-150 ng/mL
204-360 mg/dL
280-400 g/dL
Elevation: diabetic ketoacidosis, hypoparathyroidism, kidney failure, liver disease,
too much vitamin D, too much phosphate in diet, use of certain medications such as
phosphate-containing laxatives
Depletion: alcoholism, hypercalcemia, hyperparathyroidism, too little dietary intake
of phosphate, very poor nutrition, too little vitamin D resulting in rickets or
osteomalacia
Elevation: alkalosis, kidneys do not properly remove acids (kidney tubular acidosis),
kidney failure, stomach pumping (gastric suction), urinary tract infection, vomiting
Depletion: acidosis, diabetic ketoacidosis, diarrhea, too much acid in the body fluids
(metabolic acidosis), starvation
Elevation: too much iron in the body (hemochromatosis), breakdown of red blood
cells (hemolysis), anemia due to red blood cells being destroyed too quickly
(hemolytic anemia), liver tissue death (hepatic necrosis), inflammation of the liver
(hepatitis), vitamin B-12 deficiency, vitamin B-6 deficiency, iron poisoning, many
blood transfusions
Depletion: long-term digestive tract bleeding, heavy menstrual bleeding, intestinal
conditions that cause poor absorption of iron, not enough dietary iron, pregnancy
Elevation: anemia (hemolytic and megaloblastic), advanced cancers,
alcoholic/inflammatory hepatocellular disease, chronic illnesses such as leukemia,
cirrhosis, chronic hepatitis or collagen vascular diseases, hemochromatosis,
hemosiderosis, inflammatory disease
Depletion: hemodialysis, iron deficiency anemia, severe protein deficiency
Elevation: anemia (iron deficiency and hemolytic), hemochromatosis, hemosiderosis,
increase iron intake, polycythemia vera, late pregnancy
Depletion: anemia (hemolytic, pernicious, sickle cell iron deficiency), cirrhosis,
hypoproteinemia, inflammatory diseases, malnutrition
Elevation: iron deficiency anemia, pregnancy (late)
Hemoglobin
Platelet Count
M: 13.2-16.2 gm/dL
F: 12.0-15.2 gm/dL
150,000-400,000 mcL
Depletion: anemia due to red blood cells being destroyed too quickly (hemolytic
anemia), lower-than-normal level of protein in the blood (hypoproteinemia),
inflammation, liver disease such as cirrhosis, malnutrition, decrease in red blood cells
from the intestines not properly absorbing vitamin B12 (pernicious anemia), sickle
cell anemia
Elevation: congestive heart failure, erythrocytosis, polycythemia vera, severe
dehydration, severe diarrhea, severe burns, severe COPD
Depletion: anemia, bone marrow failure, cirrhosis, dietary deficiency, hematologic
cancers, hemoglobinopathy, hemorrhage, lymphoma, normal pregnancy, prosthetic
valves, renal disease, rheumatoid/collagen vascular diseases
Elevation: thrombocytosis, a type of anemia in which red blood cells in the blood are
destroyed earlier than normal, certain infections, major surgery or trauma, allergic
reactions, cancer, chronic myelogenous leukemia, polycythemia vera, primary
thrombocythemia, recent spleen removal
Depletion: thrombocytopenia, not enough platelets made in the bone marrow,
platelets are being destroyed while in the bloodstream, platelets are being destroyed
while in the spleen or liver, cancer treatments with drugs, chemotherapy, radiation,
autoimmune disorders
Total Red Blood
Cell Count
M: 4.7-6.1 million
cells/mcL
W: 4.2-5.4 million
cells/mcL
Elevation: cigarette smoking, problem with heart’s structure and function that is
present at birth (congenital heart disease), failure of the right side of the heart,
dehydration, kidney tumor, low blood oxygen, scarring or thickening of the lungs,
bone marrow disease that causes abnormal increase in RBC’s (polycythemia vera),
gentamicin and methyldopa drugs
Depletion: anemia, bleeding, bone marrow failure, deficiency of erythropoietin
(kidney disease), RBC destruction (hemolysis) due to transfusion, blood vessel
injury, leukemia, malnutrition, bone marrow cancer, nutrition deficiencies of iron,
copper, folic acid, vitamin B6, or vitamin B12, over-hydration, pregnancy,
chemotherapy drugs, chloramphenicol, hydantoins, quinidine
Total White Blood
Cell Count
Total Protein
4,500-10,000 cells/mcL
5.9-8.4 g/dL
Elevation: anemia, drugs: beta adrenergic agonists, corticosteroids, epinephrine,
granulocyte colony stimulating factor, heparin, lithium, cigarette smoking, infections,
inflammatory disease, leukemia, severe mental or physical stress, tissue damage
(burns)
Depletion: bone marrow deficiency or failure, cancer treating drugs, drugs:
antibiotics, anticonvulsants, anti-thyroid drugs, arsenicals, captopril, chemotherapy
drugs, chlorpromazine, clozapine, diuretics, histamine-2 blockers, sulfonamides,
quinidine, terbinafie, ticlopidine, autoimmune diseases such as lupus, disease of the
liver or spleen, radiation treatment, viral illnesses such as mono, cancers that damage
bone marrow, very severe bacterial infections
Elevation: dehydration
Depletion: ascites, burns, increased capillary permeability, inflammatory diseases,
liver disease, malnutrition, protein-losing processes, over-hydration
Elevation: nephrotic syndrome, Hodgkin’s lymphoma, chronic kidney disease,
pregnancy
Albumin
3.5-5.2 g/dL
Prealbumin
20-40 mg/dL
Depletion: malnutrition, liver damage, burns, inflammation
Elevation: nephrotic syndrome, Hodgkin’s lymphoma, chronic kidney disease,
pregnancy
Bilirubin
0.2-1.0 mg/dL
Depletion: malnutrition, liver damage, burns, inflammation
Elevation: cirrhosis, hepatitis, liver disease, Gilberts disease, biliary stricture, cancer
of the pancreas or gallbladder, gallstones, newborns
Aspartate
Aminotransferase
(AST)
8-48 U/L
Depletion: usually not a concern
Elevation: cirrhosis, death of liver tissue, heart attack, hemochromatosis, hepatitis,
lack of blood flow to the liver (liver ischemia), liver cancer or tumor, medicines that
are toxic to the liver, mononucleosis, muscle disease or trauma, pancreatitis
Depletion: burns, heart procedures, seizure, surgery
Alanine
Aminotransferase
(ALT)
7-55 U/L
Total Cholesterol
120-200 mg/dL
Serum
Triglycerides
35-160 mg/dL
Elevation: viral or severe drug-induced hepatitis or other hepatic diseases with
extensive necrosis, mononucleosis, chronic hepatitis, intrahepatic cholestasis or
cholecystitis, early or improving acute viral hepatitis, or severe hepatic congestion
due to heart failure
Depletion: burns, heart procedures, seizure, surgery
Elevation: eating a diet high in fat, being overweight, lack of exercise, diabetes,
kidney disease, polycystic ovary syndrome, pregnancy, underactive thyroid gland
Elevation: cirrhosis or liver damage, diet low in protein and high in carbohydrates,
hypothyroidism, nephritic syndrome, poorly controlled diabetes
Depletion: low fat diet, hyperthyroidism, malabsorption, malnutrition