Health education

Biomarker Reference Guide

Plain-language explanations of every biomarker we test — what it measures, why it matters, normal ranges, and which tests include it.

Showing 42 of 42 biomarkers

Blood Cells

Red Blood Cell Count (RBC)

What it measures

The total number of red blood cells per volume of blood. Red blood cells carry oxygen from your lungs to every tissue in your body.

Why it matters

Low RBC can indicate anemia, blood loss, or nutritional deficiencies. High RBC may signal dehydration or a bone marrow disorder.

Normal range: 4.5–5.9 million cells/µL (men); 4.1–5.1 million cells/µL (women)
Blood Cells

Hemoglobin (Hgb)

What it measures

The protein inside red blood cells that binds to oxygen and gives blood its red color.

Why it matters

Low hemoglobin is the hallmark of anemia and causes fatigue, shortness of breath, and weakness. High levels may indicate polycythemia.

Normal range: 13.5–17.5 g/dL (men); 12.0–15.5 g/dL (women)
Blood Cells

Hematocrit (Hct)

What it measures

The percentage of your blood volume that is made up of red blood cells.

Why it matters

A low hematocrit confirms anemia. A high hematocrit can thicken the blood and increase clotting risk.

Normal range: 41–53% (men); 36–46% (women)
Blood Cells

White Blood Cell Count (WBC)

What it measures

The total count of immune cells in your blood. White blood cells defend the body against infection and foreign invaders.

Why it matters

Elevated WBC often signals infection, inflammation, or immune activation. Very low WBC can indicate bone marrow suppression or autoimmune disease.

Normal range: 4,500–11,000 cells/µL
Blood Cells

Platelets (PLT)

What it measures

Tiny cell fragments that clump together to form clots and stop bleeding when a blood vessel is injured.

Why it matters

Low platelets (thrombocytopenia) increase bleeding risk. High platelets can raise the risk of abnormal clotting.

Normal range: 150,000–400,000 cells/µL
Blood Cells

MCV (Mean Corpuscular Volume)

What it measures

The average size of your red blood cells.

Why it matters

Small red blood cells (low MCV) suggest iron deficiency. Large red blood cells (high MCV) point to B12 or folate deficiency.

Normal range: 80–100 fL
Metabolic

Glucose (Blood Sugar)

What it measures

The primary sugar your body uses for energy, derived from the food you eat.

Why it matters

Persistently elevated glucose is the defining feature of diabetes and prediabetes. Low glucose (hypoglycemia) can cause dizziness, confusion, and fainting.

Normal range: 70–99 mg/dL (fasting)
Metabolic

Hemoglobin A1C (HbA1c)

What it measures

A measure of average blood sugar over the past 2–3 months, based on how much glucose has attached to hemoglobin.

Why it matters

The gold standard for diagnosing and monitoring diabetes and prediabetes. Unlike a fasting glucose test, it reflects long-term blood sugar control.

Normal range: Below 5.7% (normal); 5.7–6.4% (prediabetes); 6.5%+ (diabetes)
Metabolic

Creatinine

What it measures

A waste product produced by muscle metabolism, filtered out of the blood by the kidneys.

Why it matters

Elevated creatinine is a reliable indicator of reduced kidney function. It rises when the kidneys are not filtering waste efficiently.

Normal range: 0.7–1.3 mg/dL (men); 0.6–1.1 mg/dL (women)
Metabolic

eGFR (Estimated Glomerular Filtration Rate)

What it measures

An estimate of how well your kidneys are filtering waste from the blood, calculated from creatinine, age, and sex.

Why it matters

eGFR is the primary measure of kidney function. Values below 60 for more than 3 months indicate chronic kidney disease.

Normal range: 60 mL/min/1.73m² or higher
Metabolic

BUN (Blood Urea Nitrogen)

What it measures

A waste product from protein breakdown, filtered by the kidneys. BUN reflects both kidney function and protein metabolism.

Why it matters

High BUN can indicate kidney disease, dehydration, or high protein intake. Low BUN may suggest liver disease or malnutrition.

Normal range: 7–20 mg/dL
Metabolic

ALT (Alanine Aminotransferase)

What it measures

An enzyme found mainly in the liver. When liver cells are damaged, ALT leaks into the bloodstream.

Why it matters

Elevated ALT is one of the earliest signs of liver damage from fatty liver disease, hepatitis, alcohol use, or medications.

Normal range: 7–56 U/L
Metabolic

AST (Aspartate Aminotransferase)

What it measures

An enzyme found in the liver, heart, and muscles. Like ALT, it rises when these tissues are damaged.

Why it matters

Elevated AST alongside ALT strongly suggests liver disease. AST alone may indicate heart or muscle damage.

Normal range: 10–40 U/L
Metabolic

Alkaline Phosphatase (ALP)

What it measures

An enzyme produced by the liver, bile ducts, and bones.

Why it matters

High ALP can indicate bile duct obstruction, liver disease, or bone disorders. It is often elevated in gallbladder disease.

Normal range: 44–147 U/L
Metabolic

Total Bilirubin

What it measures

A yellow pigment produced when red blood cells break down, processed and excreted by the liver.

Why it matters

High bilirubin causes jaundice (yellowing of skin and eyes) and can indicate liver disease, bile duct obstruction, or hemolytic anemia.

Normal range: 0.1–1.2 mg/dL
Metabolic

Total Protein & Albumin

What it measures

Total protein measures all proteins in the blood. Albumin is the most abundant, made by the liver and responsible for maintaining fluid balance.

Why it matters

Low albumin is a sensitive marker of malnutrition, liver disease, or kidney disease (protein loss in urine).

Normal range: Total protein: 6.3–8.2 g/dL; Albumin: 3.5–5.0 g/dL
Electrolytes

Sodium

What it measures

The primary electrolyte in blood and fluid outside cells. It regulates fluid balance, blood pressure, and nerve and muscle function.

Why it matters

Abnormal sodium levels affect brain function. Low sodium (hyponatremia) can cause confusion and seizures. High sodium (hypernatremia) causes dehydration.

Normal range: 136–145 mEq/L
Electrolytes

Potassium

What it measures

An electrolyte critical for heart rhythm, muscle contraction, and nerve signaling.

Why it matters

Both high and low potassium can cause dangerous heart arrhythmias. It is closely monitored in patients on diuretics or with kidney disease.

Normal range: 3.5–5.0 mEq/L
Electrolytes

Calcium

What it measures

The most abundant mineral in the body, essential for bone strength, muscle contraction, nerve transmission, and blood clotting.

Why it matters

High calcium (hypercalcemia) can indicate hyperparathyroidism or cancer. Low calcium (hypocalcemia) causes muscle cramps and bone loss.

Normal range: 8.5–10.2 mg/dL
Lipids & Heart

Total Cholesterol

What it measures

The total amount of all cholesterol types in your blood, including LDL, HDL, and VLDL.

Why it matters

High total cholesterol is a major risk factor for heart disease and stroke, though the ratio of LDL to HDL matters more than the total alone.

Normal range: Below 200 mg/dL (desirable)
Lipids & Heart

LDL Cholesterol

What it measures

Low-density lipoprotein — often called "bad" cholesterol. LDL carries cholesterol to artery walls where it can build up as plaque.

Why it matters

High LDL is the primary driver of atherosclerosis (artery hardening) and is the main target of cholesterol-lowering medications.

Normal range: Below 100 mg/dL (optimal); below 130 mg/dL (near optimal)
Lipids & Heart

HDL Cholesterol

What it measures

High-density lipoprotein — often called "good" cholesterol. HDL carries cholesterol away from arteries back to the liver for removal.

Why it matters

Higher HDL is protective against heart disease. Low HDL is an independent risk factor for cardiovascular events.

Normal range: 40 mg/dL or higher (men); 50 mg/dL or higher (women)
Lipids & Heart

Triglycerides

What it measures

A type of fat (lipid) in the blood. After eating, your body converts unused calories into triglycerides and stores them in fat cells.

Why it matters

High triglycerides are linked to heart disease, metabolic syndrome, and pancreatitis. They are strongly influenced by diet, alcohol, and exercise.

Normal range: Below 150 mg/dL (normal)
Lipids & Heart

C-Reactive Protein (CRP)

What it measures

A protein produced by the liver in response to inflammation anywhere in the body.

Why it matters

Elevated CRP signals active inflammation from infection, injury, or chronic disease. High-sensitivity CRP (hs-CRP) is used to assess cardiovascular risk.

Normal range: Below 1.0 mg/L (low cardiovascular risk)
Lipids & Heart

Homocysteine

What it measures

An amino acid produced during protein metabolism. Elevated levels are associated with damage to blood vessel walls.

Why it matters

High homocysteine is an independent risk factor for heart attack, stroke, and blood clots — even when cholesterol levels appear normal.

Normal range: 5–15 µmol/L
Hormones

Total Testosterone

What it measures

The total amount of testosterone in the blood, including both bound and unbound forms.

Why it matters

Low testosterone in men causes fatigue, low libido, muscle loss, and mood changes. In women, abnormal levels can affect menstrual cycles and fertility.

Normal range: 300–1,000 ng/dL (men); 15–70 ng/dL (women)
Hormones

Free Testosterone

What it measures

The small fraction of testosterone not bound to proteins — the biologically active form that cells can actually use.

Why it matters

Free testosterone is a more accurate indicator of hormonal status than total testosterone. A man can have normal total testosterone but low free testosterone and still experience symptoms.

Normal range: 9–30 ng/dL (men); 0.3–1.9 ng/dL (women)
Hormones

SHBG (Sex Hormone Binding Globulin)

What it measures

A protein that binds to sex hormones (testosterone and estrogen) in the blood, controlling how much is available to tissues.

Why it matters

High SHBG reduces the amount of free testosterone available, which can cause low-T symptoms even when total testosterone is normal.

Normal range: 10–57 nmol/L (men); 18–144 nmol/L (women)
Hormones

TSH (Thyroid Stimulating Hormone)

What it measures

A hormone from the pituitary gland that signals the thyroid to produce thyroid hormones. TSH is the most sensitive indicator of thyroid function.

Why it matters

High TSH indicates an underactive thyroid (hypothyroidism). Low TSH indicates an overactive thyroid (hyperthyroidism). Both affect energy, weight, mood, and metabolism.

Normal range: 0.4–4.0 mIU/L
Hormones

Estradiol (E2)

What it measures

The primary form of estrogen in the body, produced mainly by the ovaries in women and in smaller amounts by the testes and adrenal glands in men.

Why it matters

In women, estradiol regulates the menstrual cycle, bone density, and cardiovascular health. In men, abnormally high estradiol can cause gynecomastia and low libido.

Normal range: 15–350 pg/mL (women, varies by cycle phase); 10–40 pg/mL (men)
Hormones

IGF-1 (Insulin-Like Growth Factor 1)

What it measures

A hormone produced by the liver in response to growth hormone (GH). IGF-1 is the primary mediator of growth hormone effects on the body.

Why it matters

Low IGF-1 can indicate growth hormone deficiency, causing fatigue, reduced muscle mass, and poor recovery. High levels may be associated with acromegaly.

Normal range: Varies by age; typically 115–307 ng/mL in adults
Hormones

AMH (Anti-Müllerian Hormone)

What it measures

A hormone produced by cells in ovarian follicles. AMH levels directly reflect the number of remaining eggs (ovarian reserve).

Why it matters

AMH is the most reliable marker of fertility potential in women. Low AMH indicates diminished ovarian reserve. It is also used to assess polycystic ovary syndrome (PCOS).

Normal range: 1.0–3.5 ng/mL (optimal fertility); below 0.5 ng/mL (low reserve)
Iron & Nutrients

Ferritin

What it measures

A protein that stores iron inside cells. Blood ferritin levels reflect total body iron stores.

Why it matters

Ferritin is the most sensitive test for iron deficiency — it falls before anemia develops. High ferritin can indicate iron overload, inflammation, or liver disease.

Normal range: 12–300 ng/mL (men); 12–150 ng/mL (women)
Iron & Nutrients

Serum Iron

What it measures

The amount of iron circulating in the blood bound to transferrin (the transport protein).

Why it matters

Low serum iron combined with low ferritin confirms iron deficiency. High serum iron may indicate iron overload (hemochromatosis).

Normal range: 60–170 µg/dL
Iron & Nutrients

TIBC (Total Iron Binding Capacity)

What it measures

A measure of how much iron the blood could carry if all transferrin proteins were fully loaded.

Why it matters

High TIBC with low iron and ferritin confirms iron deficiency anemia. Low TIBC may suggest iron overload or chronic disease.

Normal range: 240–450 µg/dL
Iron & Nutrients

Vitamin B12 (Cobalamin)

What it measures

An essential vitamin required for nerve function, DNA synthesis, and red blood cell formation. It is found almost exclusively in animal products.

Why it matters

B12 deficiency causes fatigue, nerve damage (tingling, numbness), memory problems, and megaloblastic anemia. It is common in vegans and older adults.

Normal range: 200–900 pg/mL
Iron & Nutrients

Folate (Folic Acid)

What it measures

A B vitamin essential for DNA synthesis, cell division, and red blood cell production. Critical during pregnancy for fetal neural tube development.

Why it matters

Folate deficiency causes megaloblastic anemia and, during pregnancy, significantly increases the risk of neural tube defects in the baby.

Normal range: 2.7–17.0 ng/mL
Inflammation

ESR (Erythrocyte Sedimentation Rate)

What it measures

A test that measures how quickly red blood cells settle to the bottom of a tube. Inflammation causes proteins to make cells clump and fall faster.

Why it matters

Elevated ESR is a non-specific marker of inflammation, infection, or autoimmune disease. It is used to monitor conditions like rheumatoid arthritis and lupus.

Normal range: 0–20 mm/hr (men); 0–30 mm/hr (women)

Included in

Inflammation

ANA (Antinuclear Antibody)

What it measures

Antibodies that mistakenly target proteins inside the cell nucleus. A positive ANA is the hallmark finding in many autoimmune diseases.

Why it matters

A positive ANA with a high titer strongly suggests an autoimmune condition such as lupus (SLE), Sjögren's syndrome, or rheumatoid arthritis.

Normal range: Negative (titer below 1:40)

Included in

Clotting

PT / INR (Prothrombin Time)

What it measures

PT measures how long blood takes to clot via the extrinsic pathway. INR is a standardized ratio that allows results to be compared across labs.

Why it matters

Elevated PT/INR means blood clots more slowly, increasing bleeding risk. It is used to monitor patients on blood thinners like warfarin and to assess liver function.

Normal range: PT: 11–13.5 seconds; INR: 0.8–1.1 (not on anticoagulants)
Diabetes

Fasting Insulin

What it measures

The level of insulin in the blood after an overnight fast. Insulin is the hormone that allows glucose to enter cells.

Why it matters

Elevated fasting insulin is the earliest sign of insulin resistance — often detectable years before blood sugar rises. It is a key marker of metabolic syndrome.

Normal range: 2–25 µIU/mL (fasting)

Included in

Diabetes

Microalbumin (Urine)

What it measures

A small amount of the protein albumin in the urine. Healthy kidneys do not allow albumin to pass into urine.

Why it matters

Microalbuminuria is the earliest detectable sign of diabetic kidney disease (nephropathy), often appearing years before kidney function declines.

Normal range: Below 30 mg/g creatinine

Included in

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