A-Z TESTS BIOCHEMISTRY

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DLM User Guide 2008 Page 42 of 90

A-Z TESTS BIOCHEMISTRY

Specimen requirements and reference ranges for blood analyses (Adults)

Analyte Reference range Turnaround time Specimen notes 11-deoxy cortisol 5.0-12.1 nmol/L 4 weeks Yellow top tube (Serum)

Must be sent to the laboratory on ice for immediate separation

17 a OH Progesterone

0-10 nmol/L 1 – 2 weeks Yellow top tube (Serum) 18 hydroxy cortisol Supine 0.7-6.5 nmol/L

Ambulant 1.6-10.7 nmol/L 4-8 weeks Purple Top Tube (EDTA plasma) or Yellow top tube (Serum)

Acid - Base status

pH pCO2 - arterial pO2 - arterial pO2-capillary actual bicarbonate base excess male female 7.36 - 7.44 4.5 - 6.0 kPa 12.0-14.7 kPa 6.7 - 10.7 kPa 24 - 30 mmol/L -2.3 to + 2.3 mmol/L -3.0 to + 1.6 mmol/L

Urgent; 30 mins Blood gas syringe. Remove needle, cap syringe.

Additional:

Do not send this specimen by pneumatic tube

ACTH

09.00 hr 0-46 ng/L 2-4 weeks Green top tube (plasma) Additional:

Do not use glass tube. Send to lab in ice immediately. Requires rapid separation

Adrenaline – see Catecholamines ADH (Argenine

vasopressin) 2 x Green top tubes (plasma) Send on ice for immediate separtation, 5 ml of plasma is required

AFP - as tumour marker < 10 KU/L 1 week Yellow top tube (serum)

Albumin Adult >18 years

0-4 days 4 days – 14 yrs 14 – 18 yrs 34 – 48 g/L 28 – 44 g/L 38 – 54 g/L 32 – 45g/L Urgent; 2 hours

Routine; 4 hours Yellow top tube (serum) Green top microtainer (Paeds)

Aldosterone Random 100-850 pmol/L Overnight recumbent 100/450 pmol/L

4 weeks Green top tube (Plasma) Must be sent to the laboratory immediate separation but must

not be sent in ice. Aldosterone / Renin Ratio >1000 suggests primary

hyperaldosteronism >2000 indicated that the patient almost certainly has hyperaldosteronism

4 weeks Green top tube (Plasma) Must be sent to the laboratory immediate separation but must

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Analyte Reference range Turnaround time Specimen notes Alkaline phosphatase

(U/L) Age Female Male 1-5d <231 <231 6d -1y <449 <449 1y-6y <269 <269 7y-12y <300 <300 13y-17y <187 <390 Adults 35-104 40-129 Urgent; 2 hours

Alpha – 1 Antitrypsin 1.0 – 2.0 g/L

Phenyotyping will be done if results are;

Adult <1.28 g/L Children <1.5 g/l

1 week Yellow top tube (serum)

Alcohol - See ethanol and methanol in Toxicology section

ALT 5 – 40 U/L Urgent; 2 hours

Ammonia

Premature neonates; <150 umol/L Term neonates; <100 umol/L

Infants , Children, Adults; <40umol/L.

Urgent; 2 hours

Routine; 4 hours Purple top tube. (EDTA) Additional:

Contact lab on 4697 prior to collection. Sample must be fresh – send to lab in ice immediately.

Amylase < 100 U/L Urgent; 2 hours

Routine; 4 hours Yellow top tube (serum) Green top microtainer (Paeds) Androstenedione male female 2.1-10.8 nmol/L

1.0-11.5 nmol/L 2-4 weeks Yellow top tube (serum)

Anion-Gap 10-18 mmol/L Urgent; 2 hours

Routine; 4 hours Yellow top tube (Serum)

Angeotensin converting

enzyme (ACE) 15-55 IU/L 1 – 2 weeks Yellow top tube (Serum)

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Analyte Reference range Turnaround time Specimen notes

AST 5 – 45 U/L Urgent; 2 hours

Bicarbonate 24-30 mmol/L Urgent; 2 hours

Routine; 4 hours Yellow top tube (Serum) Green top microtainer(Paeds)

Bile Acids < 14 umol/L Next day Mon-Fri Yellow top tube (Serum)

Bilirubin (total) adult >18yrs

neonate 0 – 12 hr neonate 12hr – 5 days 5 days -18 years Bilirubin (Conjugated/direct) < 22 µmol/L < 115 µmol/l < 170 µmol/L 2 – 14 µmol/L No range Urgent; 2 hours

Routine; 4 hours Yellow top tube, Serum (Adults) Green top micrtoainer (Paeds)

Bone Markers; CTX P1NP 0.1 – 0.5 ng/L 20 -76 ug/L 2-4 weeks

Purple top tube (plasma) Yellow top tube (serum)

Ca-125,Ca19-9,Ca15-3,CEA see tumour markers

Caeruloplasmin 0.25 – 0.63 g/L 1 week Yellow top tube (serum)

Carbohydrate deficient

transferrin Negative <2.6% of total transferrin Positive >2.6% of total transferrin

2-4 weeks Yellow top tube (serum )

Carboxyhaemoglobin <2% non smokers <10% for smokers (approximate)

Urgent; 30 mins If sent with blood gas;

Blood gas syringe. Remove needle, cap syringe.

Additional:

If separate sample; Green Top tube (Plasma)

Calcitonin < 5.5ng/L Female

< 18.9 ng/L Male 4 weeks Yellow top tube (serum) Send to lab in ice immediately. Requires rapid separation

Calcium (total

Calcium (corrected) 2.10 – 2.55 mmol/L 2.15 – 2.65 mmol/L Urgent; 2 hours Routine; 4 hours Yellow top tube (serum) Green top microtainer (Paeds)

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Analyte Reference range Turnaround time Specimen notes Catecholamine (Plasma) Adrenaline 0-1.0 nmol/L

Noradenaline 1.0-6.0 nmol/l

4 weeks Purple top tube ( EDTA plasma)Send to lab in ice immediately. Requires rapid separation

Chloride 95 -110 mmol/L Urgent; 2 hours

Chromogranin A < 60 pmol/L 8 weeks Purple top tube ( EDTA plasma)

Chromogranin B < 150 pmol/L 8 weeks Purple top tube ( EDTA plasma)

Cholesterol total HDL male HDL female JBS 2 Dec 2005 treatment targets; <4.0 mmol/l >1.0 mmol/l >1.2 mmol/l

Routine; 4 hours Yellow top tube (serum) Additional:

See European Arthrosclerosis Society Guidelines

Cholinesterase total

phenotype 0.62 – 1.37 kU/L See interpretive result report issued

4 weeks Yellow top tube (serum)

Additional:

Apnoea investigations should wait until patient is fully recovered.

CK total male

female up to 190 U/L up to 165 U/L Urgent; 2 hours Routine; 4 hours Yellow top tube (serum) Green top microtainer (Paeds)

CKMBmass Less than 5 ng/mL Urgent; 2 hours Yellow top tube (serum)

Test only available for A&E Chest Pain Assessment Unit @ MRI

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Analyte Reference range Turnaround time Specimen notes Copper 11-20 umol/L 2-4 weeks Blue top tube (serum)

Cortisol midnight

09.00 hr 60-250 nmol/L 200 – 650 nmol/L Next day Mon-Fri Yellow top tube (serum) All samples taken as part of a Synactehn test should be sent to the laboratory in a single batch.

C-peptide Level depends on

glucose concentration 4 weeks Yellow top tube (Serum) Must be sent to the laboratory on ice for immediate separation

C-reactive protein (CRP) 0.3-5.0 mg/L Urgent; 2 hours

Creatinine Adults Male

Female

Children’s

Neonates (full term) 2-12 months 1-<3 years 3- <5 years 5-< 7 years 7- < 9 years 9-< 11 years 11- <13 years 13-< 15 years 62-106 µmol/l 44-80 µmol/l 21 – 75 µmol/l 15 – 37 µmol/l 21 – 36 µmol/l 27 – 42 µmol/l 28 – 52 µmol/l 35 – 53 µmol/l 34 – 65 µmol/l 46 – 70 µmol/l 50 – 77 µmol/l Urgent; 2 hours

CTX- See Bone Markers DHEA sulphate male

female 2.2 – 15.2 µmol/L 1.0 -12.0 µmol/L 2-4 weeks Yellow top tube (serum)

FSH male female pre-menopause post menopause 2 -15 IU/L 2 -15 IU/L > 20 IU/L Urgent; 2 hours

Routine; 4 hours Yellow top tube (serum)

Fructosamine 2.55 – 3.60 mmoL/L 2-3 weeks Yellow top tube (serum)

Gamma-GT < 65 U/L Routine; 4 hours Yellow top tube (serum)

GHRH 4-8 weeks Red Top (serum)

Glucose fasting adult

newborn prem/SFD 3.0 – 6.0 mmol/L 2.0 – 5.0 mmol/L 1.1 – 4.5 mmol/L Urgent; 2 hours

Routine; 4 hours Grey top tube (plasma)

Glycated non-diabetic Haemoglobin diabetic HbA1c (well controlled)

4.5– 6.5%

up to 7% Next day , Mon-Fri Purple top top tube (EDTA plasma)

GTT Interpretation of results is provided with each report following WHO guidelines.

Analysed same day as test carried out on ward

Contact Programmed Investigation Unit

extn 4697 to arrange ward appointment

Growth Hormone Level dependant on age, sex and clinical

circumstance

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Analyte Reference range Turnaround time Specimen notes Gut hormones; Gastrin Glucagon Neurotensin Pancreatic polypeptide Somatostatin VIP <40 pmol/L <50 pmol/L <100 pmol/l <300 pmol/L <150 pmol/L <30 pmol/L

4 weeks Must sent in ice and collected in special tube provided by the laboratory.

HCG ( as tumour marker) 0- 2 IU/L 1 week Yellow top tube (serum)

Homocysteine <15 umol/L 2-4 weeks Grey Top (Fl.ox. plasma) Must be sent to the laboratory for immediate separation Fasting sample preferred

Immuno-reactive trypsin See report 2-4 weeks Green top tube , whole blood or preferably blood spots

Inhibin B 80-150 pg/mL 2-4 weeks Yellow top tube (serum)

Insulin 1.0 – 10.0 U/L

(fasting) 1 week Yellow top tube (Serum) Must be sent to the laboratory on ice for immediate separation

Insulin Like Growth Factor 1

IGF-1 Complex age related ranges , these are listed in a separate table on page 30

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Analyte Reference range Turnaround time Specimen notes Iron

Total iron binding capacity (TIBC) % iron saturation 7 – 29 µmol/L 45 – 70 µmol/L 15%-45% Urgent; 2 hours

Routine; 4 hours Yellow top tube (serum) Additional:

For investigation of iron deficiency Ferritin assay (Haematlogy)

Lactate adult

neonates 0.7 – 2.1 mmol/L 0.7 – 2.1 mmol/L Urgent; 2 hours Grey top tube (plasma) Additional:

Specimen to be sent to laboratory immediately

Lead

Enviroment exposure guidlines adult child < 250 ug/L < 100 ug/L Routine 5 working

days Purple top tube ( EDTA Plasma)

LDH 240 – 480 U/L Routine; 4 hours Yellow top tube (serum)

Additional:

By special arrangement

LH female/male

female mid cycle post menopause

2 – 14 IU/L 15 – 50 IU/L > 15 IU/L

Next day , Mon-Fri Yellow top tube (serum)

Magnesium adults

Neonates 0.6 – 1.0 mmol/L 0.7 – 0.9 mmol/L Urgent; 2 hours Routine; 4 hours Yellow top tube. (serum) Green top microtainer (Paeds)

Manganese <1 year 7-18 ug/L

> 1yr 4-12 ug/ 2-4 weeks Purple top tube ( EDTA Plasma) Special tube from Toxicology for paediatrics

Met-haemoglobin < 1.5% Urgent; 2 hours

Routine; 4 hours If sent with blood gas; Blood gas syringe. Remove needle, cap syringe. Additional:

If separate sample; Green Top tube (Plasma)

Noradrenalin – see Catecholamines Oestradiol male female follicular mid cycle luteal 50 - 165 pmol/L 110 - 183 pmol/L 550 - 1650 pmol/L 550 – 845 pmol/L

Next day , Mon-Fri Yellow top top tube Additional:

Discuss with Biochemistry for monitoring H.R.T.

Orosomucoid 300 – 1200 mg/L 2-4 weeks Yellow top tube

Osmolality (serum) 275 – 295 mmol/kg Urgent; 2 hours

Osmoalar Gap <10 mmol/L Urgent; 2 hours

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Analyte Reference ranges Turnaround time Specimen notes

Oxalate 2-4 weeks Purple top ( EDTA Plasma)

Must be separated and frozen within 1h minutes of collection

P1NP – See Bone Markers

PIIINP 1.7 – 4.2 ug/L 2-3 weeks Yellow top tube (serum)

Phosphate

Neonates up to 28 days Children 28 days-1 year 1 year -12 years

Adult and over 12 years

1.4 mmol/L-2.8mmol/L 1.2 mmol/L- 2.2mmol/l 1.0 mmol/L-1.8mmol/L 0.7 mmol/L-1.4mmol/L Urgent; 2 hours Routine; 4 hours

Yellow top tube (serum) Green top microtainer (Paeds)

Potassium adults

neonates 3.5 - 5.5 mmol/L 3.5 - 6.5 mmol/L Urgent; 2 hours Routine; 4 hours Yellow top tube (serum) Green top microtainer (Paeds)

Pregnancy test; see Quantitative HCG

Progesterone follicular

luteal peak < 3 nmol/L 20 - 70 nmol/L Next day , Mon-Fri Yellow top tube (serum)

Prostate Specific Antigen (PSA) 50-59 yrs 60-69 yrs 70 and over <3.0 ng/ml <4.0 ng/ml <5.0 ng/ml ( Department of Health Referral Guidelines 2002)

Prolactin

Males

Females 86-324 mU/L 102 – 496 mU/l

Protein (total) > 12 months

<1 month 1-12 months 60 – 80 g/L 51 – 68 g/L 56 – 72 g/L Urgent; 2 hours

PTH 10 – 60 pg/ml Same day Purple top (EDTA plasma)

PTHrp Set report 2-4 weeks Special tube from Liverpool, must be sent on ice for rapid

separtation

Quantitative HCG

If used for Ectopic Pregnancy see Clinical Guildline

Quantitive HCG used as a pregnancy test; A result of >25 U/L would normally inducate a positive test. But, a result of <25 U/L does not exclude early pregnancy.

Urgent; 2 hours

Same Day Yellow top tube (serum)

Renin

Over night recumbent 30 minutes upright Random 1.1-2.7 nmol/L/hr 2.8 – 4.5 nmol/L/hr 0.5- 3.5 nmol/L/hr

2-4 weeks Green top tube (Plasma) Must be sent to the laboratory immediate separation but must

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Analyte Reference range Turnaround time Specimen notes

Selenium See report

umol/L 2-4 weeks Special tube from Toxicology

SHBG male

female 15 – 47 nmol/L 20 – 110 nmol/L 1-2 weeks Yellow top tube (serum)

Sodium 132 – 144 mmol/L Urgent; 2 hours

Routine; 4 hours Yellow top tube (serum). Green top microtainer (Paeds) Additional: Hyponatraemia Guidelines Available Tri-oidothinoine – Free (free T3) not routinely available

Tri-iodothinoine –Total (T3) 1.3 – 3.1 nmol/L 1-2 weeks Yellow top tube (serum) Additional:

Not standard part of Thyroid Function Test

Testosterone male

female 10 – 35 nmol/L < 2.4 nmol/L Yellow top tube (serum)

Thiopurine methyl

transferase (TPMT) 1-2 weeks Yellow top tube (serum) Thyroglogulin (Thyro) < 55 ug/L 1-2 weeks Yellow top tube (serum)

Thyroid Binding Globulin

(TBG) 1-2 weeks Yellow top tube (serum)

Thyroxine- Free (free T4) 9 – 24 pmol/L 1-2 weeks Yellow top tube (serum)

Total Protein <1 month 51-68g/l 1m – 12 m 56-72 g/L >12m 60-80g/L

Routine ; same day Yellow top tube (serum)

Transferrin 2.0 – 3.60 g/L Routine ; same day Yellow top tube (serum)

Triglycerides fasting JBS 2 Dec 2005

treatment targets; <1.7 mmol/l

Same day Yellow top tube (serum)

Troponin T < 0.01ng/mL Urgent; 1 hour

Routine; 4 hours Yellow top tube

TSH 0.2 – 5.0 mU/L Same day Yellow top tube

Tumour Markers; CA 15- 3 CA 19 – 9 CA 125 CEA <32 KU/L <31 U/mL <30 U/mL 0-3.0 ug/L (non-smoker)

All 1-2 weeks Yellow top tube (serum)

Urate males

females 0.17 – 0.48 mmol/L 0.14 – 0.39 mmol/L Routine; 4 hours Yellow top tube

Urea

3.5 – 7.4 mmol/L Urgent; 2 hours Routine; 4 hours Yellow top tube Green top microtainer (Paeds)

VLCFA (Very long chain fatty

acids) See individual reports 1-2 weeks Purple top (EDTA plasma) Vitamins; Vitamin A Vitamin B1 Vitamin B2 Vitamin B6 Vitamin E

See individual reports 1-2 weeks Vit A & E ;Yellow top tube B Vitamins; Purple top (EDTA plasma)

White cell enymes See individual reports 1-2 weeks Purple top (EDTA plasma)

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IGF-1 reference ranges

Age

Male range (ug/l)

Female Range (ug/l)

0-7d <25 <25 7-14 days <40 <40 <4 years 40-195 40-250 >4y <9y 55-280 9 years 55-320 >4y <10y 55-240 10 years 55-310 70-460 11 years 65-400 95-540 12 years 95-610 170-650 13 years 135-690 170-740 14-16years 135-830 180-830 17 years 135-630 17-20 years 135-545 18-20 years 135-490 20-30 years 108-320 30-40 years 100-275 40-50 years 90-240 50-60 years 75-215 60-70 years 68-190 70-80 years 60-160