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Blood tests from a laboratory provide both results of the specific tests as well as tabular “Reference" ranges, sometimes referred to as “Normal" values. The latter is a bit of a misnomer because values considered “Normal" are based on an average collected from large scale tests. Normal is not necessarily “Optimal." A second, very important factor in interpreting results comes from understanding these ranges may vary somewhat from laboratory to laboratory. Therefore, in considering abnormal blood tests and hormones, or any other blood test, both the actual result and the specific range used by the laboratory must be taken into account. The reference ranges used in this article are based on Disease Management and Treatment except where noted.
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Cortisol levels provide a check on adrenal function and whether there is too little or too much of the hormone. Several types of tests measure this hormone: saliva or blood or a 24-hour urine collection. Testing blood or saliva usually is done in the morning and evening with the normal ranges as noted below. Urine results have a different range. Normal results are:
- Morning = 4.3–22.4 mcg/dL and evening = 3.1–16.7 mcg/dL.
- 24-hour urine = 10–100 mcg/24H.
An abnormally high result could indicate Cushing ’s syndrome, Cushing’s Disease, Pseudo-Cushing’s or an ACTH releasing tumor. Amounts below normal might suggest Addison ’s disease, Hypopituitarism or Congenital adrenal hyperplasia.
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Dehydroepiandrosterone Sulfate (DHEA)
This test is used for suspected female infertility, amenorrhea, hirsuitism, excess androgen or adrenocortical disease.
- 18–30: 125-619 mcg/dL
- 31–50: 59–452 mcg/dL
- 51–60: 20–413 mcg/dL
- 60–83: 10–285 mcg/dL
- 19–30: 29–781 mcg/dL
- 31–50: 12–285 mcg/dL
- Postmenopausal: 30–260 mcg/dL
Abnormal blood tests and hormones in this area might indicate congenital adrenal hyperplasia, adrenal carcinoma or an adrenal gland tumor
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Normal Ranges: Male: 30–85 mg/dl; Female: 4–22 mg/dl
Abnormal amounts occur with hypergonadism or prostate malfunction. In women with high levels, there may be hair loss.
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This test is used to assess hypothalamic and pituitary function, menopausal status, sexual maturity and other conditions. It can screen for problems with ovaries, placenta, or adrenal glands.
- Male (adult): 3–70 pg/ml
- Female (adult): Follicular phase, 9—175 pg/ml
- Midcycle peak: 150–750 pg/ml
- Luteal phase: 44–196 pg/ml
- Postmenopausal: <20 pg/ml
Abnormal results in males suggests several possibilities—gynecomastia or feminization syndromes.
In females, when greater than normal, there is a possibility of an ovarian tumor. When results are less than normal, there may be a condition called Turner Syndrome
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This blood test evaluates sexual maturity, menstrual problems, fertility issues in females, and fetal/placental health in pregnancy.
Males: 12-72 mg/dl
- Follicular phase: 37–138 mg/dl
- Midcycle peak: 37–60-229 mg/dl
- Luteal phase: 50–114 mg/dl
In males an abnormal result may be from gynecomastia or feminization syndrome. An abnormal value can be a marker in estrogen-producing tumors.
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Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH)
Used in determining menstrual irregularities, menopause, pituitary problems, suspected gonadal failure and infertility tests.
FSH normal ranges:
Males (Adult, >15 years) = 1.4–18.1 mIU/ml
- Follicular phase: 2.5–mIU/ml
- Ovulatory peak: 3.4–33.4 mIU/ml
- Luteal phase: 1.5–1.5–9.1 mIU/ml
- Postmenopausal: 23.0–116.3 mIU/ml.
LH normal ranges:
Males (adult, 20-70 years) = 0.5–9.3 mIU/ml; >70 years = 3.1–34.6 mIU/ml
- 20–70 years = 0.0–76.3, greater than 70 years = 5.0–52.3 mIU/ml
- Follicular phase: 1.9–12.5 mIU/ml
- Ovulatory peak: 8.7–76.3 mIU/ml
- Luteal phase: 0.5–16.9 mIU/ml
- Postmenopausal phase: 5.0–52.3 mIU/ml
In fertility testing, low levels suggest secondary ovarian failure. For men, high levels come from testicular failure. High levels also may occur in the young from secondary sexual marks developing unusually early .
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Free Testosterone (LabCorp values)
Used in cases of hirsuitism and masculinization in women; testicular function in men. Sometimes it is used as a cross-check with elevated PSA (Prostate Specific Antigen).
- 20-29 years: 9.3–26.6 pg/ml
- 30–39 years: 8.7–25.1 pg/ml
- 40-49 years: 6.8–21.3 pg/ml
- 50-59 years: 7.2–24.0 pg/ml
- 60+ years: 18–26.5 pg/mL (aging men without prostate cancer)
Females: 20–59 years: 0.0–2.2 pg/ml; older than 60 years: 0.0–2.8 pg/ml
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Total Testosterone (LabCorp values)
Used to test either early or late development of puberty in boys, excess hair growth, and male characteristics in women or irregular menstrual periods.
Males: 241–827 ng/Dl; Females 14–76 ng/Dl
Decreased values in men could come from hypothalamic or pituitary disease, genetic disease, or testicle damage. Increased levels might indicate a tumor in the testicles, and adrenal tumor, or hyperthyroidism. While testosterone levels are normally low in females, an increased amount could indicate an ovarian or adrenal tumor or polycystic ovarian syndrome.
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Thyroid Stimulating Hormone (TSH)
Used in detecting abnormality in the thyroid including thyroid disease. Normal ranges are 0.35–5.50 mcIU/ml. According to the University of Southern California Medical Center, above normal results might indicate:
- Congenital hypothyroidism (cretinism)
- Exposure to mice (lab workers or veterinarians)
- Primary hypothyroidism
- Thyroid hormone resistance
- TSH-dependent hyperthyroidism
Results below the normal range could be caused by:
- TSH deficiency
- Use of certain medications including dopamine agonists, glucocorticoids, somatostatin analogues, and bexarotene
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Disease Management and Treatment, 4th ed., 2003
UCSF Medical Center: Medical Tests http://www.ucsfhealth.org/adult/adam/index.html#E
The Hormone Foundation: The Endocrine System & Types of Hormones: http://www.hormone.org/endocrine_system.cfm
Lab Tests Online: http://www.labtestsonline.org/understanding/analytes/fsh/test.html
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