<6% of total Hb AACE Guidelines (2011) Hemoglobin A1c, % (as a screening test)
≤5.4 – Normal
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5.5-6.4 – High risk/prediabetes; requires screening by glucose criteria
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≥6.5 -Diabetes, confirmed by repeating the test on a different day
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In general, therapy should target a A1C level of 6.5% or less for most nonpregnant adults.
Iron (mcg/dl)
65 – 150
Lactic acid (meq/L)
0.7 – 2.1
LDH (lactic dehydrogenase)
56 – 194 IU/L
Lipoproteins and triglycerides
Cholesterol, total
< 200 mg/dl
HDL cholesterol
≥ 35 mg/dL. Negative risk factor: ≥ 60 mg/dL
LDL cholesterol
65 – 180 mg/dl
Triglycerides
Normal: < 150 mg/dL. Borderline-high: 150 to 199 mg/dL High: 200 to 499 mg/dL Very High: >499 mg/dL
0.8 – 1.7 ng/dL (up to 2.7 ng/dL depending on the reference).
Free T4 Index (FT4I)
estimate of free T4
FT4I = TT4 x RT3U
1.0 -4.3 U
Total T3 (TT3)
bound and free T3
75 -200 ng/dL
Resin T3 Uptake (RT3U)
binding capacity of TBG
25 -35%
TRH
TRH
5 -25 mIu/mL
TSH
TSH
0.5 – 4.70 µIU/mL
American Association of Clinical Endocrinologists guidelines changed their normal range for TSH to
0.3 – 3.04 mIU/L.
Thyroglobulin
Thyroglobulin
5-25 ng/mL
Radioactive Iodine Uptake (RAIU)
Distribution of radiolabeled iodine in the thyroid
5 hr – 5 to 15%
24 hr – 15 to 35%
Notes:
Free T4 – much more useful then total T4 (e.g. interested in unbound or active form). Total T4 not commonly measured. Greatly affected by TBG.
Free T4 index: indirect measure of free T4. Corrects for high/low values of TBG.
Total T3: not as useful as free T3, however, may be useful in locating problems with TBG, or if looking for problems with peripheral conversion of T4 to T3.
Resin T3 Uptake: if low, then TBG binding capacity is high. Opposite if high.
TSH: best measure to determine thyroid function.
Thyroglobulin: nonspecific test that is elevated when the thyroid gland is inflamed or enlarged.
Free T3
2.3-4.2 pg/ml
Total iron binding capacity (TIBC)
250 – 420 mcg/dl
Transferrin
> 200 mg/dl
Uric acid (male)
2.0 – 8.0 mg/dl
(female)
2.0 – 7.5 mg/dl
WBC + differential
WBC (cells/ml)
4,500 – 10,000
Segmented neutrophils
54 – 62%
Band forms
3 – 5% (above 8% indicates left shift)
Basophils
0 – 1 (0 – 0.75%)
Eosinophils
0 – 3 (1 – 3%)
lymphocytes
24 – 44 (25 – 33%)
Monocytes
3 – 6 (3 – 7%)
Absolute Neutrophil Count (ANC) – Oncology
Equations: (1) Segs and bands reported as a percentage:
WBC * ((segs / 100) + (bands / 100))(2) Segs and bands reported in total numbers:
WBC * (segs + bands)
Neutrophils (aka polymorphonuclear cells, PMNs, granulocytes, segmented neutrophils, or segs) fight against infection and represent a subset of the white blood count. Neutropenia by definition is an ANC below 1800/mm3 (some sources use a lower value).
Absolute neutrophil count (ANC) of 1000-1800:
Most patients will be given chemotherapy in this range.
Risk of infection is considered low.
Mild neutropenia – Absolute neutrophil count (ANC) of 500-1000:
Carries with it a moderate risk of infection.
Absolute neutrophil count (ANC) of less than 500:
Severe neutropenia – high risk of infection. Remember that a reduced WBC is known as leukopenia.
The WBC consists of the following (differential):
Lymphocytes: 20-40%
Neutrophils: 50-60%
Basophils: 0.5-2%
Eosinophils: 1-4%
Monocytes: 2-9% (average: 4%).
ANC = Total WBC x (% “Segs” + % “Bands”)
Equivalent to: WBC x ((Segs/100) + (Bands/100))
The ANC refers to the total number of neutrophil granulocytes present in the blood.
Normal value: ≥ 1500 cells/mm3.
Mild neutropenia: ≥1000 – <1500/mm3.
Moderate neutropenia: ≥500 – <1000/mm3.
Severe neutropenia: < 500/mm3.
