Medical Council of Canada

Normal Values

Clinical Laboratory Tests - Adult Normal Values

This table lists reference values for the interpretation of laboratory results provided in the Medical Council of Canada exams.
All values apply to adults.

Normal values were obtained primarily from the University of Ottawa’s laboratory (Eastern Ontario Regional Laboratory Association [EORLA]), the AMA Manual of Style, and Ottawa Hospital Laboratory Services.

ARTERIAL BLOOD GASESa

Clinical Laboratory Test Normal Value
pH, arterial blood 7.38–7.46
Pco2, arterial blood 32–45 mm Hg
Po2, arterial blood 83–116 mm Hg
Bicarbonate (HCO3), arterial blood 22–27 mmol/L
Base excess, arterial blood −2.5 to 2.5 mmol/L


a
Eastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Blood Gas & Oximetry. Last updated June 28, 2019.

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BLOOD

HEMOGRAM
Clinical Laboratory Test Normal Value
Erythrocyte sedimentation rate (ESR), blooda  
    Female 0–20 mm/h
    Male 0–10 mm/h
Hematocrit (Hct), blooda 0.38–0.50 L/L
Hemoglobin (Hgb), blooda
    Female 115–155 g/L
    Male 125–170 g/L
Mean corpuscular volume (MCV), blooda 80–100 fL
Mean corpuscular hemoglobin (MCH), blooda
    Female 25–34 pg
    Male 27–34 pg
Mean corpuscular hemoglobin concentration (MCHC), blooda 315–355 g/L
Mean platelet volume (MPV), blooda 9.0–14.0 fL
Platelet count, blooda 130–380 × 109/L
Red blood cell (RBC) count, blooda
    Female 3.50–5.00 × 1012/L
    Male 4.00–5.50 × 1012/L
Red cell distribution width (RDW), blooda 11.5%–15.5%
Reticulocyte count, absolute, bloodb 23–90 × 109/L
Reticulocyte percentage, bloodc 0.5%–1.5%

aEastern Ontario Regional Laboratory Association. Hematology reference ranges. Glengarry Memorial Hospital. Effective date June 25, 2019.

bFrom The Ottawa Hospital laboratory (2019).

cSzigeti, R. G. (2014, September 5). Reticulocyte count and reticulocyte hemoglobin content. Retrieved April 27, 2020, from https://emedicine.medscape.com/article/2086146-overview.

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COAGULATION (HEMOSTASIS)
Clinical Laboratory Test Normal Value
Bleeding time (Ivy method), bloodd 1–9 min
International normalized ratio (INR), nonanticoagulated, blooda 0.9–1.2
Activated partial thromboplastin time (APTT), nonanticoagulated, blooda 22–30 s
Prothrombin time (PT), bloode 10–14 s

aEastern Ontario Regional Laboratory Association. Hematology reference ranges. Glengarry Memorial Hospital. Effective date June 25, 2019.

dCharbek, E. (2016, March 2). Bleeding time. Retrieved April 15, 2020, from https://emedicine.medscape.com/article/2085022-overview.

eGamma Dynacare.

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WHITE BLOOD CELLS AND DIFFERENTIAL
Clinical Laboratory Test Normal Value
White blood cell (WBC) count, blooda 3.5–10.5 × 109/L
    Neutrophils, absolute, blooda 2.0–7.5 × 109/L
    Basophils, blooda 0–0.1 × 109/L
    Eosinophils, blooda 0–0.5 × 109/L
    Lymphocytes, blooda
      Female 0.8–3.3 × 109/L
      Male 0.8–3.5 × 109/L
    Monocytes, blooda 0.1–1.0 × 109/L

aEastern Ontario Regional Laboratory Association. Hematology reference ranges. Glengarry Memorial Hospital. Effective date June 25, 2019.

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IRON STUDIES
Clinical Laboratory Test Normal Value
Ferritin, bloodf  
    Female 11–307 µg/L
    Male 24–336 µg/L
Iron, bloodg
    Female 9–30 µmol/L
    Male 12–31 µmol/L
Iron-binding capacity, total (TIBC), bloodg 45–81 µmol/L
Transferrin, bloodg 2.0–3.6 g/L
Transferrin saturation, bloode 0.20%–0.50%

eGamma Dynacare.

fEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Beckman DXI. Last updated June 28, 2019.

gEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Siemens Vista. Last updated June 28, 2019.

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THYROID
Clinical Laboratory Test Normal Value
Thyroid peroxidase antibody, bloodh < 35 IU/mL
Thyrotropin (thyroid-stimulating hormone), bloodf 0.34–5.60 mIU/L
Thyroxine, free (FT4), bloodf 7.0–17.0 pmol/L
Triiodothyronine, free (FT3), bloodf 3.3–6.0 pmol/L

fEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Beckman DXI. Last updated June 28, 2019.

hElhomsy, G. (2014, December 4). Antithyroid antibody. Retrieved April 15, 2020, from https://emedicine.medscape.com/article/2086819-overview.

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CHEMICAL CONSTITUENTS
Clinical Laboratory Test Normal Value
Adrenocorticotropic hormone (ACTH), bloodi  
    At 8 a.m. 2.2–13.3 pmol/L
    At 4 p.m. < 4.5 pmol/L
Albumin, bloodg 34–50 g/L
Aldosterone, bloodj 61–978 pmol/L
Alkaline phosphatase, bloodg 50–136 IU/L
Transaminaseg
    Alanine aminotransferase (ALT), blood 17–63 IU/L
    Aspartate aminotransferase (AST), blood 15–37 IU/L
    γ-Glutamyltransferase (GGT), blood
        Female 5.0–55.0 IU/L
        Male 15.0–85.0 IU/L
Ammonia, bloodg ≤ 35 µmol/L
Amylase, bloodg 25–115 IU/L
Anion gap, bloodg 5–12 mmol/L
Bicarbonate (HCO3), bloodb 21–32 mmol/L
Bilirubin, bloodg
    Direct (conjugated) 2–9 µmol/L
    Total 3–17 µmol/L
Brain-type natriuretic peptide (BNP)k
    BNP, blood ≤ 50 pg/mL
    𝘕-terminal pro–brain-type natriuretic peptide (NT-proBNP), blood ≤ 125 pg/mL
CD4 T-cell count, bloodl 500–2000 cells/μL
C-reactive protein, bloodg ≤ 10 mg/L
Calcium (Ca), blood
    Totalg 2.12–2.52 mmol/L
    Ionizedm 1.14–1.28 mmol/L
Cancer antigen (CA) 125, bloodf < 35 kIU/L
Cancer antigen (CA) 19-9, bloodf < 35 kIU/L
Carbamazepine, bloodn 17–51 µmol/L
Carcinoembryonic antigen (CEA), bloodf < 3.0 µg/L
Chloride (Cl), bloodg 98–107 mmol/L
Cortisol, bloodf
    a.m. 185–624 nmol/L
    p.m. ≤ 276 nmol/L
Creatine kinase (CK), bloodg
    Female 30–190 IU/L
    Male 30–250 IU/L
Creatinine, bloodg
    Female 22–75 µmol/L
    Male 49–93 µmol/L
D-dimer, blooda < 600 µg/L
Estimated glomerular filtration rate (eGFR), bloodb ≥ 60 mL/min/1.73 m2
α1-Fetoprotein, bloodf ≤ 9.0 µg/L
Folate (folic acid), bloodf ≥ 10.0 nmol/L
Glucose, bloodg
    Fasting 4.0–6.0 mmol/L
    Random 4.0–11.0 mmol/L
Hemoglobin A1c (HbA1c), bloodg 4.8%–6.0%
Hepatitis B surface antibodies, bloodo ≥ 10 mIU/mL (Positive)

< 10 mIU/mL (Negative)

Lactate, bloodm 0.5–2.5 mmol/L
Lactate dehydrogenase (LDH), bloodg 100–205 IU/L
Lipase, bloodg 73–393 IU/L
Lithium (Li), bloodn
      Age 18–65 y 0.6–1.2 mmol/L
      Age > 65 y 0.4–0.8 mmol/L
Magnesium (Mg), bloodg 0.74–1.03 mmol/L
Osmolality, bloodp 275–295 mmol/kg
Parathyroid hormone (PTH), bloodf 1.6–9.3 pmol/L
Phosphate (PO4), bloodg 0.81–1.58 mmol/L
Potassium (K), bloodg 3.5–5.1 mmol/L
Prostate-specific antigen (PSA), bloodf < 3.1 µg/L
Protein, total, bloodq
      Age 18–<30 y 65–83 g/L
      Age ≥30 y 65–78 g/L
Rheumatoid factor (RF), bloodg ≤ 20 kIU/L
Sodium (Na), bloodg 136–146 mmol/L
Troponin I, bloodg ≤ 45 ng/L
Troponin T (TnT), bloodp ≤ 0.1 µg/L
Uric acid, bloodg
    Female 155–400 µmol/L
    Male 208–400 µmol/L
Urea, bloodg 2.1–8.0 mmol/L
Valproic acid, bloodn 350–700 µmol/L
Vitamin B12, bloodf 133–675 pmol/L
Vitamin D (25-hydroxyvitamin D), bloodf 75–250 nmol/L

aEastern Ontario Regional Laboratory Association. Hematology reference ranges. Glengarry Memorial Hospital. Effective date June 25, 2019.

bFrom The Ottawa Hospital laboratory (2019).

fEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Beckman DXI. Last updated June 28, 2019.

gEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Siemens Vista. Last updated June 28, 2019.

iNieman, L. K., Lacroix, A., Martin, K. A. (2019, September 9). Measurement of ACTH, CRH, and other hypothalamic and pituitary peptides. Retrieved April 14, 2020, from https://www.uptodate.com/contents/measurement-of-acth-crh-and-other-hypothalamic-and-pituitary-peptides.

jEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Liaison XL. Last updated June 28, 2019.

kEzekowitz, J. A., O’Meara, E., McDonald, M. A., Abrams, H., Chan, M., Ducharme, A., et al. (2017). 2017 comprehensive update of the Canadian Cardiovascular Society guidelines for the management of heart failure. Canadian Journal of Cardiology, 33, 1342–1433. Retrieved April 14, 2020, from https://www.onlinecjc.ca/article/S0828-282X(17)30973-X/fulltext.

lGilroy, S. A. (2020, March 5). HIV infection and AIDS. Retrieved April 15, 2020, from https://emedicine.medscape.com/article/211316-overview.

mEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Blood Gas & Oximetry. Last updated June 28, 2019.

nEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: TDM. Last updated June 28, 2019.

oPublic Health Ontario. (2018, May 7). Hepatitis B surface antibody serologic testing updated – Changes to screening test. Retrieved April 14, 2020, from https://www.publichealthontario.ca/-/media/documents/lab/lab-sd-129-hepb-surface-ab-update.pdf?la=en.

pIverson, C. (Chair). (2007). AMA manual of style: A guide for authors and editors (11th ed.). Chicago: American Medical Association.

qEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Ortho Vitros. Last updated June 28, 2019.

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LIPIDSa

Clinical Laboratory Test Normal Value
Cholesterol, total, blood 3.5–5.2 mmol/L
Cholesterol, high-density lipoprotein (HDL), blood
    Female > 1.3 mmol/L
    Male > 1.0 mmol/L
Cholesterol, low-density lipoprotein (LDL), bloodb See table below
Non–high-density lipoprotein (non-HDL), blood ≤ 4.5 mmol/L
Triglycerides, blood ≤ 1.7 mmol/L

aEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Siemens Vista. Last updated June 28, 2019.

bInterpretation of normal values for LDL varies depending on risk factors. Authors can decide if they want to include the LDL analysis table (see below).

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LOW-DENSITY LIPOPROTEIN (LDL) ANALYSIS

Category When to Consider Initiating Therapy Treatment Target
Primary prevention High (≥ 20%) or intermediate (10%–19%) Framingham risk score and LDL of ≥ 3.5 mmol/L, non–high-density lipoprotein (non-HDL) of ≥ 4.30 mmol/L, apolipoprotein B-100 (ApoB) of ≥ 1.20 g/L, or men (age, ≥ 50 y) and women (age, ≥ 60 y) with ≥ 1 additional risk factor for cardiovascular disease LDL of < 2 mmol/L or with > 50% decrease; or ApoB of < 0.80 g/L or non-HDL of < 2.60 mmol/L
Statin-indicated conditions Clinical atherosclerosisb; abdominal aortic aneurysm; diabetes and age ≥ 40 y or ≥ 30 y with 15-y duration of type 1 diabetes; diabetes with microvascular disease; chronic kidney disease in patients aged ≥ 50 y LDL of < 2 mmol/L or with > 50% decrease; or ApoB of < 0.80 g/L or non-HDL of < 2.60 mmol/L
Low-risk LDL of ≥ 5 mmol/L LDL with > 50% decrease

aFrom The Ottawa Hospital laboratory (2019).

bConsider target LDL of less than 1.8 mmol/L for patients with acute coronary syndrome of 3 months’ duration or less.

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URINEa

URINALYSIS (NOT DIPSTICK)b
Clinical Laboratory Test Normal Value
Specific gravity, urine 1.005–1.030
pH, urine 5.0–8.5
Urobilinogen, urine ≤ 16.0 µmol/L
Albumin to creatinine ratio, urinec ≤ 2.0 g/mol Cr
Osmolality, urined 38–1400 mOsm/kg H2O

aAll items refer to a random specimen unless specified otherwise (e.g., 24-h specimen).

bEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Urinalysis. Last updated June 28, 2019.

cEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Vista Urine Biochemistry. Last updated June 28, 2019.

dPadillo, O. (2018, September). Normal laboratory values: Urine. In Merck manual professional edition. Retrieved April 14, 2020, from https://www.merckmanuals.com/en-ca/professional/resources/normal-laboratory-values/urine-tests-normal-values#v8511272.

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24-H SPECIMEN
Clinical Laboratory Test Normal Value
Urine calcium (Ca), unrestricted diet, 24-h specimenc 2.5–7.5 mmol/24 h
Urine chloride (Cl), 24-h specimenc 110.0–250.0 mmol/24 h
Urine creatinine, weight-based, 24-h specimenc
    Female 5.3–15.9 mmol/24 h
    Male 7.1–17.7 mmol/24 h
Urine metanephrine, 24-h specimene
    Female 0.2–1.3 µmol/24 h
    Male 0.3–2.0 µmol/24 h
Urine protein, 24-h specimen < 0.2 g/24 h
Urine potassium (K), 24-h specimenc 25.0–125.0 mmol/24 h
Urinary free cortisol, 24-h specimenc 58.0–306.0 µg/24 h
Urine sodium (Na), 24-h specimenc 40.0–220.0 mmol/24 h

cEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Vista Urine Biochemistry. Last updated June 28, 2019.

eEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: HPLC. Last updated June 28, 2019.

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REPRODUCTIVE HORMONES

Clinical Laboratory Test Normal Value
Dehydroepiandrosterone sulfate (DHEA-S), blooda
  Female
      18–20 y 1.4–8.7 µmol/L
      21–29 y 0.5–10.6 µmol/L
      30–39 y 0.6–7.2 µmol/L
      40–49 y 0.5–6.3 µmol/L
      50–59 y 0.2–5.1 µmol/L
      60–69 y 0.3–3.6 µmol/L
      70–118 y 0.2–4.8 µmol/L
  Male
      18–20 y 0.7–14.6 µmol/L
      21–29 y 2.3–18.7 µmol/L
      30–39 y 2.9–12.6 µmol/L
      40–49 y 1.9–13.4 µmol/L
      50–59 y 1.0–8.5 µmol/L
      60–69 y 0.7–6.6 µmol/L
      70–118 y 0.1–6.9 µmol/L
Estrogens, total, bloodb 60–400 ng/L
Estradiol (E2) [report the phase of the menstrual cycle], bloodc,d
    Female
        Follicular phase 50–100 pmol/L
        Midcycle peak 50–200 pmol/L
        Luteal phase 70–150 pmol/L
    Male 37–110 pmol/L
Follicle-stimulating hormone (FSH) [report the phase of the menstrual cycle], blooda,d
    Female
      Midfollicular phase 3.9–8.8 IU/L
      Midcycle peak 4.5–22.5 IU/L
      Midluteal phase 1.8–5.1 IU/L
      Postmenopausal 16.7–113.6 IU/L
    Male 1.0–19.0 IU/L
Human chorionic gonadotropin (β-hCG), nonpregnant, blooda < 5 IU/L
Luteinizing hormone (LH) [report the phase of the menstrual cycle], blooda.d
    Female
        Midfollicular phase 2.1–10.8 IU/L
        Midcycle peak 19.2–103.0 IU/L
        Midluteal phase 1.2–12.9 IU/L
        Postmenopausal 10.9–58.6 IU/L
    Male 1.0–9.0 IU/L
Progesterone [report the phase of the menstrual cycle], blooda.d
    Female
      Midfollicular phase 1.0–4.8 nmol/L
      Midluteal phase 16.4–59.0 nmol/L
    Male 0.5–6.6 nmol/L
Prolactin, blooda
    Female
        Premenopausal 3–27 µg/L
        Postmenopausal 3–20 µg/L
    Male 3–13 µg/L
Testosterone, blooda
    Female ≤ 2.6 nmol/L
    Male 6.1–27.1 nmol/L

aEastern Ontario Regional Laboratory Association. EORLA regional biochemistry recommended reference intervals by instrumentation/analyzer: Beckman DXI. Last updated June 28, 2019.

bIverson, C. (Chair). (2007). AMA manual of style: A guide for authors and editors (11th ed.). Chicago: American Medical Association.

cPadillo, O. (2018, September). Normal laboratory values: Blood, plasma, serum. In Merck manual professional edition. Retrieved April 14, 2020, from https://www.merckmanuals.com/en-ca/professional/resources/normal-laboratory-values/blood-tests-normal-values#v8508814

dFor phase of the menstrual cycle, generally, follicular phase is 0–10 days, midcycle peak is day 11–20, and luteal phase is day 21–30.

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SEMEN ANALYSISa

Clinical Laboratory Test Normal Value
Ejaculate volume, semen ≥ 1.5 mL
pH, semen ≥ 7.2
Sperm concentration, semen ≥ 15 × 106 spermatozoa/mL
Total sperm number, semen ≥ 39 × 106 spermatozoa/ejaculate
Motility, semen ≥ 40%
Forward progression, semen ≥ 32%
Normal morphology, semen ≥ 4% normal
Sperm agglutination, semen Absent
Viscosity, semen ≤ 2-cm thread after liquefaction

aPractice Committee of the American Society for Reproductive Medicine. (2015). Diagnostic evaluation of the infertile male: a committee opinion. Fertility and Sterility, 103, e18–e125. Retrieved April 14, 2020, from https://www.fertstert.org/article/S0015-0282(14)02528-X/fulltext

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STOOLa

Clinical Laboratory Test Normal Value
Fecal fat < 5 g/day in patients on a 100-g fat diet

aPadillo, O. (2018, September). Normal laboratory values: Stool. In Merck manual professional edition. Retrieved April 14, 2020, from https://www.merckmanuals.com/en-ca/professional/resources/normal-laboratory-values/stool-tests-normal-values

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TESTS AND ANALYSES THAT DO NOT REQUIRE A NORMAL VALUE

Clinical Laboratory Tests
Urine (not dipstick)
Eosinophils, urine
Sodium (Na), urine
Glucose, urine
Bilirubin, urine
Ketone, urine
Blood, urine
Protein, urine
Nitrite, urine
Leukocytes, urine
Urinalysis, dipstick testing
Bilirubin, urine
Blood, urine
Glucose, urine
Ketones, urine
Leukocyte esterase, urine
Nitrite, urine
Protein, urine
Chemical Constituents
Ethanol (ethyl alcohol)
Hepatitis A IgM antibody
Hepatitis A IgG antibody
Hepatitis C antibody
HIV viral load
Stool
Stool culture
Analyses
Pleural fluid
Cerebrospinal fluid
Synovial fluid
Ascitic fluid
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Last updated: May 2020