This document provides normal ranges and significance of various laboratory investigations including: 1. Complete blood count tests such as hemoglobin, white blood cell count, neutrophils, lymphocytes, and platelets. 2. Liver function tests including ALT, AST, alkaline phosphatase, bilirubin, albumin and globulin. 3. Renal function tests including creatinine, urea, sodium, potassium and chloride. 4. Thyroid function tests including TSH, free thyroxine and triiodothyronine. 5. Antigen tests, ELISA tests, Widal tests and Montaux tests which are used to detect presence of viruses or bacteria.

1. “LABORATORY INVESTIGATIONS”
NIMS INSTITUTE OF PHARMACY
Subject: Pharmacotherapeutics
Pharm D
(2023-2024)
SUBMITTED TO: SUBMITTED BY:
DR. AKHILESH PATEL BHAVYA JINDAL
ASSISTANT PROFESSOR ROLL NO. 06
DEPARTMENT OF PHARMACY PHARM D 2nd
YEAR
NIMS UNIVERSITY RAJASTHAN, JAIPUR
PIN CODE: 303121
AUGUST, 2023

2. LAB INVESTIGATION WITH THEIR
SIGNIFICANCE AND NORMAL RANGE
1. CBC: -
 HEMOGLOBIN
NORMAL VALUE LOW HIGH
13-18 mg/dL (male) Anemia Clots, heart attack,
Polycythemia vera,
Cancer, Kidney, or
Liver disease.
11.5-16.5 mg/dL
(female)
 TLC (TOTAL LEUKOCYTE COUNT) / WBC
NORMAL VALUE LOW HIGH
4,000-11,00 cells per
cubic millions of
blood
More vulnerable to
develop infection
Infection, Leukemia,
and other immune
system disease
 NEUTROPHILS
NORMAL VALUE LOW HIGH
2,500-7,000 per
microliter of blood
Neutropenia (swelling
and repeated
infection)
Leukocytosis
 LYMPHOCYTES
NORMAL VALUE LOW HIGH
1,000-4,800 per
microliter of blood
(ADULT)
Higher risk of
infection
Infection (bacterial,
viral, other), Blood
cancer, Autoimmune
disorder
3,000-4,000 per
microliter of blood
(CHILDREN)

3.  MONOCYTES
NORMAL VALUE LOW HIGH
200-800 per
microliter of blood or
2-8% of WBC count
More susceptible to
infection.
Mononucleosis or an
autoimmune disease
like lupus
 TRBC (TOTAL RED BLOOD CELLS)
NORMAL VALUE LOW HIGH
4.7-6.1 million cells
per microliter (MALE)
Anemia Blood will be thicker
than it should be and
it increase risk for
blood clots
4.2-5.4 million cells
per microliter
(FEMALE)
 PCV (PACKED CELL VOLUME)
NORMAL VALUE LOW HIGH
38.3-48.6% (MALE) Anemia or
Hemodilution
Cardiovascular events
such as a stroke, mini-
stroke, or heart attack
35.5-44.9%
(FEMALE)
 MCV (MEAN CORPUSCULAR VOLUME)
NORMAL VALUE LOW HIGH
80-100 femtoliter (ft) RBC are smaller than
normal and may
indicate microcytic
anemia
Anemia, liver disease
and thyroid
 MCHC (MEAN CORPUSCULAR HEMOGLOBIN
CONCENTRATION)
NORMAL VALUE LOW HIGH

4. 32-36 gram per
deciliter (gm/dL)
Hypochromic anemia Hyperchromic anemia
 PLATELET COUNT
NORMAL VALUE LOW HIGH
150,000-450,000
platelets per
microliter of blood
Thrombocytopenia Blood clots in blood
vessels
2. LFT
 ALT (ALANINE AMINOTRANSFERASE)
NORMAL VALUE LOW HIGH
4-36 U/L (UNIT PER
LITER)
Increased risk of long-
term morality
Sign of liver injury or
disease
 AST (ASPARTATE AMINOTRANSFERASE)
NORMAL VALUE LOW HIGH
14-20 units/L
(MALE)
Deficiency of
vitamin B6 and cause
kidney disease
Sign of hepatitis,
cirrhosis,
mononucleosis, or
liver disease
10-36 units/L
(FEMALE)
 ALP (ALKAINE PHOSPHATE)
NORMAL VALUE LOW HIGH
30-130 unit/L Protein deficiency or
Wilson’s disease
Liver damage or bone
disorder
 BILIRUBIN TOTAL
NORMAL VALUE LOW HIGH
0.1-1.2 mg/dL Risk factor of
coronary artery
disease (CAD) or
phenomenon
Jaundice

5.  BILIRUBIN DIRECT
NORMAL VALUE LOW HIGH
>0.3 mg/dL Generally, not a
concern
Indicate your liver is
not clearing bilirubin
properly
 BILIRUBIN INDIERCT
NORMAL VALUE LOW HIGH
0.2-1.3 mg/dL Increase risk of
developing deep
white matter lesions in
brain
Hemolytic disease
 ALBUMIN
NORMAL VALUE LOW HIGH
3.4-5.4 gm/dL Malnutrition, liver
disease or kidney
disease or an
inflammatory disease
Dehydration
 GLOBULIN
NORMAL VALUE LOW HIGH
2.0-3.5 gm/dL Liver or kidney
disease
Autoimmune disease,
infection, or cancer
3. RFT
 SERUM CREATININE
NORMAL VALUE LOW HIGH
0.7-1.35 mg/dL
(MALE)
Muscle loss, sever
liver disease
May lead to
permanent kidney
damage
0.6-1.04 mg/dL
(FEMALE)

6.  SERUM UREA
NORMAL VALUE LOW HIGH
10-50 mg/dL Not usually a cause of
concern
Kidney is not working
well
 SODIUM
NORMAL VALUE LOW HIGH
135-145 millimole
per lite (mmole/L)
Nausea, vomiting,
headache, confusion,
and fatigue
Hypernatremia
 POTASSIUM
NORMAL VALUE LOW HIGH
3.5-5.2 mmole/L Abnormal heart
rhythms
Irregular heart beat in
worst case it can
cause heart attack
 CHLORIDE
NORMAL VALUE LOW HIGH
96-106 mmole/L Dehydration and you
become sick
Dehydration, kidney
disease, and metabolic
acidosis
4. TFT (THYROID FUNCTION TEST)
 TSH (THYROID STIMULATING HORMONE)
NORMAL VALUE LOW HIGH
0.5-5.0 milli-
international unit per
liter (mlU/L)
Hyperthyroidism Hypothyroidism
 FREE THYROXINE (FT4)
NORMAL VALUE LOW HIGH
0.8-1.8 nanograms
per deciliter (ng/dL)
Hypothyroidism An overactive
thyroid gland

7.  TRIIODOTHRONINE (T3)
NORMAL VALUE LOW HIGH
80-220 ng/dL Hypothyroidism Hyperthyroidism
5. ANTIGEN TEST
NORMAL VALUE NEGATIVE POSITIVE
0-2.5 ng/dl Not detected with
antibody of virus
Detected with
antibody of virus
0-5 ng/dl (for smoker
it is slightly high)
6. ELISA TEST
ELISA test has a positive or negative result, but some might be invalid
Significance
 Negative result: - A negative result means that the test did not
detect any of the substance it was checked for.
 Positive result: - A positive result means that the test detected the
7. WIDAL TEST
There are 2 types of antigens in widal test: -
 Flagellar (H) antigen
 Somatic (O) antigen
Normal value
< 1:160
Significance
 If Salmonella O is positive, then you have an active fever.
 If Salmonella H is positive, then fever is a past infection.
 Negative Result: - A tire of O and H lower than 1:160 is considered
negative, it indicates that the person is unlikely to have an enteric
fever, and their symptom may be due to a different infection.

8.  Positive Result: - A tire of O and H greater than 1:160 to 1:320 is
considered positive. A positive widal test means there is a presence of
Salmonella typhi in the blood.
8. MONTAUX TEST
NORMAL VALUE NEGATIVE POSITIVE
0-15 mm
(micrometer)
Induration less than 5
mm diameter
More than 15 mm
diameter shows you
probably have TB
(TUBERCULOSIS)
germs in your body