Appendix: Normal Hormone Reference Ranges



Appendix: Normal Hormone Reference Ranges





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Normal Hormone Reference Rangesa,b































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Test Source Ages, Conditions, etc Conventional Units Conversion Factor SI Units Comments
Adrenocorticotropic hormone (ACTH) stimulation test (cosyntropin test): 0.25 mg of synthetic ACTH1-24 (cosyntropin) is administered IV or IM, and serum cortisol is measured at 0, 30, and 60 min. Normal response: peak cortisol >20 μg/dL (>540 nmol/L). A dose of 1 μg of ACTH will give a similar response in the normal individual (see Chapter 9).
ACTH Plasma Men 7-50 pg/mL 0.222 1.55-11.1 pmol/L Collect in silicone-coated EDTA-containing tubes. Keep iced. Avoid contact with glass during collection and separation. Process immediately. Separate and freeze plasma in plastic tube at −20°C.
Women 5-27 pg/mL 1.11-6 pmol/L
Children
Prepubertal 7-28 pg/mL 1.55-6.2 pmol/L
Postpubertal 2-49 pg/mL 0.44-10.78 pmol/L
Post-dexamethasone suppression 2-5 pg/mL 0.4-1.1 pmol/L
Aldosterone Serum (fasting) Sodium intake – 27.7
300 mmol/d:
Adult Levels in pregnant patients are three to four times higher.
Upright am <28 ng/dL <776 pmol/L
Upright pm <21 ng/dL <582 pmol/L
Supine am 3-16 ng/dL 83.1-443 pmol/L
Adrenal vein 200-400 ng/dL 5540-11,080 pmol/L
Urine Sodium diet – – Collect 24-h specimen in 10 g boric acid to maintain pH <7.5. Refrigerate during collection.
(100-300 mmol/d)
Children:
2-7 y ≤5.7 μg/d
8-11 y ≤10.2 μg/d
12-16 y ≤15.6 μg/d
Adult ≤2.3-21 μg/d
Post-fludrocortisone or intravenous saline infusion ≤5.0 μg/d
Alkaline phosphatase, bone specific Serum 2-24 mo 25.4-124.0 μg/L – – IRMA; collect following an overnight fast; useful in Paget disease and osteoporosis; assay also known as Ostase; increased levels seen in states of high bone turnover (Paget disease, hyperthyroidism, osteoporosis).
6-9 y 41-134.6 μg/L
10-13 y
Males 43.8-177.4 μg/L
Females 24.2-154.2 μg/L
14-17 y
Males 3.7-128 μg/L
Females 110.5-75.2 μg/L
Adult males
18-29 y 8.4-29.3 μg/L
30-39 y 7.7-21.3 μg/L
40-49 y 7.0-18.3 μg/L
60-68 y 7.6-14.9 μg/L
Adult females
18-29 y 4.7-17.8 μg/L
30-39 y 5.3-19.5 μg/L
40-49 y 5.0-18.8 μg/L
50-76 y 5.6-29 μg/L
Alpha subunit Serum Men <0.6 ng/mL – – RIA; used to assess gonadotropin hormone subunit secretion in pituitary adenomas.
Women
Premenopausal <1.5 ng/mL
Postmenopausal 0.9-3.3 ng/mL
Hypothyroid <3.7 ng/mL
Pregnant or hCG-producing tumor 1.8-360 ng/mL
3α-Androstenediol glucuronide Serum Prepubertal children 0.1-0.6 ng/mL 2.14 0.2-1.3 nmol/L Freeze serum and store at −20°C.
Tanner II-III
Male 0.19-1.64 ng/mL 0.41-3.51 nmol/L
Female 0.33-2.44 ng/mL 0.71-5.22 nmol/L
Adult
Male 2.6-15 ng/mL 5.6-32.1 nmol/L
Female 0.6-3.0 ng/mL 1.3-6.4 nmol/L
Androstenedione Serum Men 3.49
18-30 y 50-220 ng/dL 175-768 nmol/L
31-50 y 40-190 ng/dL 140-663 nmol/L
51-60 y 50-220 ng/dL 175-768 nmol/L
Women
Follicular 35-250 ng/dL 122-873 nmol/L
Midcycle 60-285 ng/dL 209-995 nmol/L
Luteal 30-235 ng/dL 105-820 nmol/L
Postmenopausal 20-75 ng/dL 70-262 nmol/L
Children
1-12 mo 6-78 ng/dL 21-272 nmol/L
1-4 y 5-51 ng/dL 17-178 nmol/L
5-9 y 6-115 ng/dL 21-401 nmol/L
10-13 y 12-221 ng/dL 42-771 nmol/L
14-17 y 22-225 ng/dL 77-785 nmol/L
Tanner II-III
Male 17-82 ng/dL 59-286 nmol/L
Female 43-180 ng/dL 150-628 nmol/L
Tanner IV-V
Male 57-150 ng/dL 199-523 nmol/L
Female 7-68 ng/dL 24-237 nmol/L
Antidiuretic hormone (ADH; vasopressin) Plasma If serum osmolality >290 mOsm/kg 1-13 pg/mL 0.925 0.9-12 pmol/L Collect in EDTA tubes. Keep iced. Centrifuge refrigerated. Store at −70°C within 2 h. 1 μU = 2.5 pg
If serum osmolality <290 mOsm/kg <2 pg/mL <1.85 pmol/L
Angiotensin II Plasma Adults 10-50 ng/L – – Collect in EDTA. Centrifuge refrigerated. Store frozen at −70°C.
C peptide of insulin Serum Fasting 0.8-3.1 ng/mL 0.331 0.26-1.03 nmol/L Freeze serum at −20°C; stable for 1 d at room temperature and 1 wk at −20°C.
Calcitonin Serum Male <10 pg/mL 0.293 <2.93 pmol/L Fasting, nonlipemic specimen. Refrigerate, spin down immediately. Store at −20°C.
Female <5 pg/mL <1.46 pmol/L
Child
<6 mo <41 pg/mL <12 pmol/L
6 mo-3 y <14 pg/mL <4.1 pmol/L
3-17 y <6 ng/mL <1.76 pmol/L
Calcitonin stimulation test utilizing calcium infusion: 2 mg/kg of calcium in the form of calcium gluconate is administered IV over 1 min. Blood samples for calcitonin are obtained at 1, 2, 5, and 10 min after the infusion. Normal peak values for calcitonin 2 min after calcium infusion: female; <70 ng/L (<20.5 pmol/L); male: <491 ng/L (<144 pmol/L).
Calcium, 24-h urinary Urine Calcium – – Collect in 25 mL of 6N HCl. Refrigerate during collection; elevated in primary hyperparathyroidism, Paget disease, multiple myeloma, vitamin D toxicity; reduced in rickets, osteomalacia, familial hypocalciuric hypercalcemia.
Men 50-300 mg/24 h
Women 50-250 mg/24 h
Calcium – –
Men 30-210 mg/g creatinine
Women 30-275 mg/g creatinine
Calcium, ionized Serum Adults 4.8-5.6 mg/dL – – Refrigerated serum must be collected anaerobically in gel barrier tube; elevated in primary hyperparathyroidism, vitamin D toxicity, cancer; reduced in pseudo-hypoparathyroidism, hypoparathyroidism, and severe vitamin D deficiency.
Children
8 mo-10 y 4.9-5.4 mg/dL
11-17 y 4.8-5.3 mg/dL
Calcium, total Serum Adults 8.6-10.2 mg/dL – – Overnight fasting preferred; used to diagnose parathyroid and vitamin D disorders; elevated in primary hyperparathyroidism, vitamin D toxicity; reduced in hypoparathyroidism and vitamin D deficiency.
Children
<1 mo 8.4-10.6 mg/dL
1-11 mo 8.7-10.5 mg/dL
1-3 y 8.5-10.6 mg/dL
4-19 y 8.9-10.4 mg/dL
Catecholamines (fractionated by HPLC) Plasma

Adults:





    • Norepinephrine
 – 0.00591 – Collect by intravenous catheter after patient has rested 30 min. Collect and centrifuge under refrigeration; freeze in plastic tube at −20°C.
Supine 112-658 pg/mL 0.66-3.89 nmol/L
Ambulatory 212-1109 pg/mL 1.28-6.55 nmol/L
Epinephrine – 0.00546 –
Supine <50 pg/mL <0.27 nmol/L
Ambulatory <95 pg/mL <0.52 nmol/L
Dopamine – 0.00654 –
Supine <10 ng/mL <0.065 nmol/L
Ambulatory <20 ng/mL <0.13 nmol/L
Total (N+E) Supine Upright 123-671 pg/mL 242-1125 pg/mL 0.00591 0.73-3.97 nmol/L 1.43-6.64 nmol/L
Children (age 3-15 y): – – –
Epinephrine – – –
Supine <464 pg/mL 0.00546 <2.54 nmol/L
Norepinephrine –
Supine < 1251pg/mL 0.00591 < 7.4 nmol/L
Dopamine <60 pg/mL 0.00654 0.39 nmol/L
Urine Norepinephrine – 5.91 – 24-h urine preservative: 25 mL of 6N HCl. Freeze aliquot promptly at −20°C.
3-8 y 5-41 μg/24 h – 29.5-242.3 nmol/24 h
9-12 y 5-50 μg/24 h 29.5-295.8 nmol/24 h
13-17 y 12-88 μg/24 h 70.9-526 nmol/24 h
>17 y 15-100 μg/24 h 89-591 nmol/24 h
Epinephrine – 5.46
3-8 y 1-7 μg/24 h – 5.46-38.2 nmol/24 h
9-12 y <8 μg/24 h <43.7 nmol/24 h
13-17 y <11 μg/24 h <60 nmol/24 h
>17 y 2-24 μg/24 h 11-131 nmol/24 h
Total (N + E) 5.91
3-8 y 9-51 μg/24 h 53-301 nmol/24 h
9-12 y 9-71 μg/24 h 53-420 nmol/24 h
13-17 y 13-90 μg/24 h 77-532 nmol/24 h
>17 y 26-121 μg/24 h 154-715 nmol/24 h
Dopamine 6.54
3-8 y 80-378 μg/24 h – 523-2472 nmol/24 h
9-12 y 51-474 μg/24 h 334-3100 nmol/24 h
13-17 y 51-645 μg/24 h 334-4218 nmol/24 h
>17 y 52-480 μg/24 h 340-3139 nmol/24 h
Cholecystokinin Plasma (fasting) 3.9 ng/mL 0.26 1 pmol/L –
Chorionic gonadotropin, beta subunit (β-hCG) Serum Men <5 mIU/mL 1.00 <5 mIU/mL See Chapter 16 for further details and interpretation.
Women
Premenopausal, Nonpregnant <5 mIU/mL <5 mIU/mL
Postmenopausal <10 mIU/mL <10 mIU/mL
Females postconception
<1 wk 5-50 mIU/mL 5-50 mIU/mL
1-2 wk 50-500 mIU/mL – 50-500 mIU/mL
2-3 wk 100-5000 mIU/mL – 100-5000 mIU/mL
3-4 wk 500-10,000 mIU/mL – 500-10,000 mIU/mL
4-5 wk 1000-50,000 mIU/mL 1000-50,000 mIU/mL
5-6 wk 10,000-100,000 mIU/mL 10,000-100,000 mIU/L
6-8 wk 15,000-200,000 mIU/mL 15,000-200,000 mIU/mL
2-3 mo 10,000-100,000 mIU/mL 10,000-100,000 mIU/mL
Chromogranin A Serum Adults <36.4 ng/mL 1.00 <36.4 μg/L –
Collagen type 1 C-telopeptide (CTx) Serum Adults – – – –
– Men – – Frozen serum, collected between 8 am and 10 am. Used to evaluate osteoporosis and Paget disease.
18-29 y 87-100 pg/mL
30-39 y 70-780 pg/mL
40-49 y 60-700 pg/mL
50-68 y 87-345 pg/mL
Women
18-29 y 64-640 pg/mL
30-39 y 60-650 pg/mL
40-49 y 40-465 pg/mL
Collagen cross-linked N-telopeptide (NTx), serum or urine 1.0 mL refrigerated serum; 2 mL refrigerated urine Men – – Monitor response to treatment in patients with osteoporosis; diagnose high bone turnover state; possibly elevated in Paget disease of bone, hyperthyroidism, osteoporosis.
Serum 10.7-22.9 nmol BCE/L
Second am voided urine
18-29 y 12-99 nmol BCE/mmol creatinine
30-59 y 9-60 nmol BCE/mmol creatinine
24-h urine 5-87 nmol BCE/mmol creatinine
Women
Premenopausal 8.7-19.8 nmol BCE/L
Serum
Second am 4-64 nmol BCE/mmolcreatinine
Urine
24-h urine 5-79 nmol BCE/mmol creatinine
Corticotropin-releasing hormone (CRH) test: Ovine CRH in a dose of 1 μg/kg is administered IV. Blood samples for ACTH and cortisol determinations are taken at 15, 30, and 60 min. The peak ACTH response of >10 pg/mL (>2.2 pmol/L) occurs at 15 min. The peak cortisol response of >10 μg/dL (>280 nmol/L) occurs at 30-60 min (see Chapter 4).
Corticotropin-releasing hormone Plasma Men and nonpregnant women <34 pg/mL 2.0 <68 pmol/L Markedly elevated at term pregnancy.
Pregnant women
1st trimester <40 pg/mL <80 pmol/L
2nd trimester <153 pg/mL <306 pmol/L
3rd trimester <847 pg/mL <1694 pmol/L
Cord blood <338 pg/mL <676 pmol/L
Cortisol Serum Adult 27.59 Collect and process under refrigeration. Spin down immediately. Salivary cortisol is in equilibrium with free cortisol and may be used as an index to free cortisol. Reference range may vary with method and laboratory.
Total
8-10 am 5-21 μg/dL 138-579.4 nmol/L
4-6 pm 2-14 μg/dL 55.2-386.3 nmol/L
Peak post-ACTH >20 μg/dL 551.8 nmol/L
Children
Premature (31-35 wk) <15 μg/dL <414 nmol/L
Term Infants (3 d) <14 μg/dL <386 nmol/L
1-17 y 2-17 μg/dL 55-469 nmol/L
Free
am 0.4-1.92 μg/dL 11-53 nmol/L
pm 0.2-0.9 μg/dL 5-25 nmol/L
Urine (free) 24-h specimen RIA 2.76 Collect 24-h specimen with 8 g of boric acid or 10 mL of 6N HCl as preservative. Liquid chromatography/tandem mass spectrometry.
Adults 4-50 μg/24 h 11-138 nmol/24 h
Children
1-4.9 y 0.9-8.2 μg/24 h 2.5-22.6 nmol/24 h
5-9.9 y 1-30 μg/024 h 2.8-82.8 nmol/24 h
10-13.9 y 1-45 μg/24 h 2.8-124.2 nmol/24 h
14-17.9 y 3-55 μg/24 h 8.3-151.8 nmol/24 h
Dehydroepiandrosterone (DHEA) Serum (fasting preferred) Men 180-1250 ng/dL 0.347 62.5-433.8 nmol/L Separate serum immediately and store at −20°C.
Women 130-980 ng/dL 45.1-340 nmol/L
Pregnancy 135-810 ng/dL 46.8-281 nmol/L
Post-ACTH stimulation in men and women 545-1845 ng/dL 189-640.2 nmol/L
Children
Premature (31-35 wk) <3343 ng/dL <1160 nmol/L
Term (1 wk) <761 ng/dL <246 nmol/L
Tanner II-III
Male 25-300 ng/dL 8.7-104 nmol/L
Female 69-605 ng/dL 23.9-209.9 nmol/L
Tanner IV-V
Male 100-400 ng/dL 34.7-138.8 nmol/L
Female 165-690 ng/dL 57.3-239.4 nmol/L
Dehydroepiandrosterone sulfate (DHEAS) Serum (fasting preferred) Male 0.0272 Stable 72 h at 40°C. Store at −20 °C.
0-1 mo <316 μg/dL <8.6 μmol/L
1-6 mo <58 μg/dL <1.6 μmol/L
7-12 mo <26 μg/dL <0.7 μmol/L
1-3 y <15 μg/dL <0.4 μmol/L
4-6 y <27 μg/dL <0.7 μmol/L
7-9 y <91 μg/dL <2.4 μmol/L
10-13 y <138 μg/dL <0.6 μmol/L
14-17 y 38-340 μg/dL 1.0-9.2 μmol/L
18-29 y 110-510 μg/dL 3.0-13.9 μmol/L
30-39 y 110-370 μg/dL 3.0-10.1 μmol/L
40-49 y 45-345 μg/dL 1.2-9.4 μmol/L
50-59 y 25-240 μg/dL 0.7-6.5 μmol/L
60-69 y 25-95 μg/dL 0.7-2.6 μmol/L
70-90 y <75 μg/dL <2.0 μmol/L
Female 0.0272
0-1 mo 15-261 μg/dL 0.4-7.1 μmol/L
1-6 mo <74 μg/dL <2.0 μmol/L
7-12 mo <26 μg/dL <0.7 μmol/L
1-3 y <22 μg/dL <0.6 μmol/L
4-6 y <34 μg/dL <0.9 μmol/L
7-9 y <92 μg/dL <2.5 μmol/L
10-13 y <148 μg/dL <4.0 μmol/L
14-17 y 37-307 μg/dL 1.0-10.1 μmol/L
18-29 y 45-320 μg/dL 1.2-8.7 μmol/L
30-39 y 40-325 μg/dL 1.1-8.8 μmol/L
40-49 y 25-220 μg/dL 0.7-6.0 μmol/L
50-59 y 15-170 μg/dL 0.4-4.6 μmol/L
60-69 y <185 μg/dL <5.0 μmol/L
70-90 y <90 μg/dL <2.5 μmol/L
Deoxycorticosterone (DOC) Serum (fasting preferred) Male 30.26 Process immediately. Store at −20 °C.
Adult 3.5-11.5 ng/dL 106-333 pmol/L
Female
Follicular phase 1.5-8.5 ng/dL 45-257 pmol/L
Luteal phase 3.5-13 ng/dL 91-393
Pregnancy
1st trimester 5-25 ng/dL 151-757 pmol/L
2nd trimester 10-75 ng/dL 303-2270 pmol/L
3rd trimester 30-110 ng/dL 908-3329 pmol/L
Children
<1 y 7-57 ng/dL 212-1725 pmol/L
1-5 y 4-49 ng/dL 121-1483 pmol/L
6-12 y
Male 9-34 ng/dL 272-1029 pmol/L
Female 2-13 ng/dL 61-393 pmol/L
11-Deoxycortisol Serum Male 0.02887 Process immediately. Store at −20°C. Early morning specimen preferred.
18-29 y <119 ng/dL <3.4 nmol/L
30-39 y <135 ng/dL <3.9 nmol/L
40-49 y <76 ng/dL <2.2 nmol/L
50-59 y <42 ng/dL <1.2 nmol/L
Female
18-29 y <107 ng/dL <3.1 nmol/L
30-39 y <51 ng/dL <1.5 nmol/L
40-49 y <62 ng/dL <1.8 nmol/L
50-66 y <37 ng/dL <1.1 nmol/L
Children
Cord blood 295-554 ng/dL 8.5-16 nmol/L
Premature infants <235 ng/dL <6.8 nmol/L
Full-term infants <170 ng/dL <4.9 nmol/L
1-12 mo 10-200 ng/dL 0.3-5.8 nmol/L
1-4 y 7-210 ng/dL 0.2-6.1 nmol/L
5-9 y <122 ng/dL <3.5 nmol/L
10-13 y <245 ng/dL <7.1 nmol/L
14-17 y <302 ng/dL <8.7 nmol/L
Dexamethasone suppression test (low dose) for the diagnosis of Cushing syndrome (see Chapter 9):

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Jun 11, 2016 | Posted by in ENDOCRINOLOGY | Comments Off on Appendix: Normal Hormone Reference Ranges

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