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THE PURSER WELLNESS REFERENCE

Understand your lab vocabulary.

205 approved laboratory references. Explore the exact ranges, units and context from Dr. Purser’s adult baseline.

205 entries

Vitamins, Minerals, and Nutrient Status

1,25-dihydroxyvitamin D — lab reference

Not a routine vitamin D status test. Interpret with calcium, phosphorus, kidney function, and PTH.

Reproductive and Sex Hormones

17-hydroxyprogesterone — lab reference

Female follicular <80; luteal <285; postmeno <51. Morning timing and stimulation testing may be needed.

Glucose, Insulin, and Glycemic Control

2-hour glucose, 75 g OGTT — lab reference

Normal <140; prediabetes 140-199; diabetes ≥200.

Urinalysis and Urine Kidney Markers

24-hour urine protein — lab reference

Collection completeness must be assessed.

Vitamins, Minerals, and Nutrient Status

25-hydroxyvitamin D, total — lab reference

<10 severe deficiency; 10-19 mild-moderate deficiency. Toxicity assessment requires clinical context.

Specialty Wellness, Oxidative Stress, and Functional Testing

8-hydroxy-2-deoxyguanosine (8-OHdG) — lab reference

Urine/plasma method, creatinine correction, collection timing, and assay matter.

Complete Blood Count and Differential

Absolute basophils — lab reference

Lab-specific.

Complete Blood Count and Differential

Absolute eosinophils — lab reference

Allergy, parasitic disease, medication reaction, and adrenal status may matter.

Complete Blood Count and Differential

Absolute lymphocyte count (ALC) — lab reference

Age, infection, immune status, and medications affect interpretation.

Complete Blood Count and Differential

Absolute monocytes — lab reference

Lab-specific.

Complete Blood Count and Differential

Absolute neutrophil count (ANC) — lab reference

Clinical action thresholds differ from statistical reference intervals.

Adrenal, Pituitary, and Calcium-Regulating Hormones

ACTH, morning — lab reference

Collect 7-10 AM with proper chilled handling. Interpret with concurrent cortisol.

Coagulation and Thrombosis Markers

Activated partial thromboplastin time (aPTT) — lab reference

Reagent-specific. Heparin monitoring may use different targets or anti-Xa.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Albumin — lab reference

Inflammation, hydration, liver synthesis, renal loss, and nutrition affect result.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Albumin/globulin ratio — lab reference

Calculated; interpret component values.

Adrenal, Pituitary, and Calcium-Regulating Hormones

Aldosterone — lab reference

Sodium intake, posture, potassium, time, medications, and renin method are essential.

Adrenal, Pituitary, and Calcium-Regulating Hormones

Aldosterone-renin ratio — lab reference

Screening cutoff depends on units, method, medications, potassium, and collection protocol.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Alkaline phosphatase (ALP) — lab reference

Age, bone turnover, liver source, pregnancy, and isoenzymes affect interpretation.

Liver, Pancreas, Protein Status, and Muscle Enzymes

ALT — lab reference

Assay-specific. Healthy-population upper limits may be lower than many commercial ranges.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Amylase — lab reference

Not pancreas-specific; interpret with lipase and clinical presentation.

Inflammation, Autoimmunity, and Immunoglobulins

ANA screen — lab reference

A positive ANA requires titer, pattern, symptoms, and disease-specific antibody interpretation.

Reproductive and Sex Hormones

Androstenedione — lab reference

Assay-specific and age-dependent.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Anion gap — lab reference

Formula and albumin correction vary by laboratory. Confirm whether potassium is included.

Inflammation, Autoimmunity, and Immunoglobulins

Anti-CCP — lab reference

Assay-specific; higher values may carry greater specificity.

Female Cycle, Menopause, and Ovarian Reserve Addendum

Anti-Müllerian hormone (AMH) — lab reference

Ovarian reserve marker, not egg quality. PCOS and hormonal treatments may affect interpretation.

Specialty Wellness, Oxidative Stress, and Functional Testing

Antioxidant Protection Assay (APA) — lab reference

Use report-defined protection categories and Purser Wellness clinical prioritization.

Lipids and Cardiovascular Risk Markers

ApoB/ApoA-I ratio — lab reference

Approximate risk strata are sex-specific and assay-dependent.

Lipids and Cardiovascular Risk Markers

Apolipoprotein A-I — lab reference

Assay-specific. Interpret with HDL and ApoB.

Lipids and Cardiovascular Risk Markers

Apolipoprotein B — lab reference

90-99 above desirable; 100-119 borderline high; 120-139 high; ≥140 very high. Risk goals may be lower.

Liver, Pancreas, Protein Status, and Muscle Enzymes

AST — lab reference

Muscle, liver, hemolysis, alcohol, exercise, and medication context matter.

Glucose, Insulin, and Glycemic Control

Beta-hydroxybutyrate — lab reference

Fasting, ketogenic diets, illness, and diabetes context materially affect interpretation.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Bilirubin, direct — lab reference

Review direct and indirect fractions together.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Bilirubin, total — lab reference

Fasting, Gilbert syndrome, hemolysis, and liver disease may alter result.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Blood urea nitrogen (BUN) — lab reference

Protein intake, hydration, catabolism, GI bleeding, and kidney function affect result.

Urinalysis and Urine Kidney Markers

Blood/hemoglobin, urine — lab reference

Confirm with microscopy; exercise, menstruation, myoglobin, and hemolysis may interfere.

Lipids and Cardiovascular Risk Markers

BNP — lab reference

Age, kidney function, obesity, rhythm, and clinical setting affect interpretation.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

BUN/creatinine ratio — lab reference

Calculated and context-dependent. Not a stand-alone diagnostic marker.

Glucose, Insulin, and Glycemic Control

C-peptide, fasting — lab reference

Interpret with concurrent glucose, kidney function, and exogenous insulin use.

Inflammation, Autoimmunity, and Immunoglobulins

C-reactive protein (standard CRP) — lab reference

Assay-specific. Acute infection, injury, and chronic inflammation may elevate.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Calcium, ionized — lab reference

pH and specimen handling materially affect results.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Calcium, total — lab reference

Correct for albumin when appropriate or measure ionized calcium.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Carbon dioxide / bicarbonate — lab reference

Serum chemistry value. Do not substitute arterial blood-gas bicarbonate ranges.

Specialty Wellness, Oxidative Stress, and Functional Testing

Catalase activity — lab reference

Method-specific; establish clinical use and repeatability.

Vitamins, Minerals, and Nutrient Status

Ceruloplasmin — lab reference

Acute-phase reactant; interpret with serum/urine copper and clinical context.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Chloride — lab reference

Interpret with sodium, bicarbonate, and anion gap.

Specialty Wellness, Oxidative Stress, and Functional Testing

CMA intracellular micronutrient panel — lab reference

Use Cell Science Systems method-specific categories. Dr. Purser to approve clinic severity and target language.

Vitamins, Minerals, and Nutrient Status

Coenzyme Q10 — lab reference

Interpret with lipid level, supplementation, and performing-lab interval.

Inflammation, Autoimmunity, and Immunoglobulins

Complement C3 — lab reference

Use performing-lab range and trend with C4/CH50 and disease activity.

Inflammation, Autoimmunity, and Immunoglobulins

Complement C4 — lab reference

Use performing-lab range and trend.

Vitamins, Minerals, and Nutrient Status

Copper, serum — lab reference

Estrogen, pregnancy, inflammation, liver function, and ceruloplasmin affect values.

Adrenal, Pituitary, and Calcium-Regulating Hormones

Cortisol, serum, afternoon/evening — lab reference

Time-specific and assay-specific.

Adrenal, Pituitary, and Calcium-Regulating Hormones

Cortisol, serum, morning — lab reference

Collect at a defined time. Assay-specific; dynamic testing may be required.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Creatine kinase (CK) — lab reference

Exercise, muscle mass, sex, race, trauma, injections, and statins affect values.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Creatinine — lab reference

Muscle mass, age, diet, medications, and assay matter. Review with eGFR, not alone.

Specialty Wellness, Oxidative Stress, and Functional Testing

Cytokine panel — lab reference

Define genes/analytes, specimen, assay, repeatability, and how results change management.

Inflammation, Autoimmunity, and Immunoglobulins

Cytokines, including IL-6 and TNF-α — lab reference

Preanalytic and assay variability is high. Use exact laboratory intervals and a defined clinical use case.

Coagulation and Thrombosis Markers

D-dimer — lab reference

Age-adjusted and assay-specific diagnostic strategies may apply. Not a stand-alone thrombosis diagnosis.

Reproductive and Sex Hormones

DHEA-S — lab reference

M 18-30: 105-728; F 18-30: 83-377. Values decline substantially with age.

Reproductive and Sex Hormones

Dihydrotestosterone (DHT) — lab reference

Method and units vary. Define clinical use before adopting a clinic target.

Male-Specific Screening and Gonadal Addendum

Dihydrotestosterone (DHT) — lab reference

Method-specific. Clarify its role in hair, prostate, androgen therapy, or enzyme questions.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

eGFR, 2021 CKD-EPI — lab reference

G2 60-89; G3a 45-59; G3b 30-44; G4 15-29; G5 <15. G1/G2 alone do not establish CKD without kidney damage.

Inflammation, Autoimmunity, and Immunoglobulins

Erythrocyte sedimentation rate (ESR) — lab reference

Age, anemia, pregnancy, immunoglobulins, and technical factors affect result.

Iron Status, Anemia Workup, and Methylation-Related Markers

Erythropoietin — lab reference

Interpret relative to hemoglobin, oxygenation, and kidney function.

Reproductive and Sex Hormones

Estradiol — lab reference

Female cycle-phase detail is on the next section. LC-MS/MS is preferred at low concentrations.

Female Cycle, Menopause, and Ovarian Reserve Addendum

Estradiol, follicular phase — lab reference

Ranges vary across the follicular phase and by assay.

Female Cycle, Menopause, and Ovarian Reserve Addendum

Estradiol, luteal phase — lab reference

Interpret with cycle timing and ovulation status.

Female Cycle, Menopause, and Ovarian Reserve Addendum

Estradiol, postmenopausal — lab reference

Method-dependent; LC-MS/MS is preferred at very low values.

Reproductive and Sex Hormones

Estrone — lab reference

Assay-specific, especially at low concentrations.

Specialty Wellness, Oxidative Stress, and Functional Testing

F2-isoprostanes — lab reference

Urine/plasma and mass-spec/immunoassay results are not interchangeable.

Glucose, Insulin, and Glycemic Control

Fasting insulin — lab reference

No universal reference or treatment target. Standardize fasting duration and collection time.

Glucose, Insulin, and Glycemic Control

Fasting plasma glucose — lab reference

Normal <100; prediabetes 100-125; diabetes ≥126 on confirmatory testing unless unequivocal hyperglycemia.

Iron Status, Anemia Workup, and Methylation-Related Markers

Ferritin — lab reference

Acute-phase reactant. Menstruation, menopause, inflammation, liver disease, and iron therapy matter.

Inflammation, Autoimmunity, and Immunoglobulins

Fibrinogen — lab reference

Coagulation factor and acute-phase reactant. Duplicate review with coagulation section if preferred.

Coagulation and Thrombosis Markers

Fibrinogen — lab reference

Acute-phase reactant; functional and antigenic assays differ.

Iron Status, Anemia Workup, and Methylation-Related Markers

Folate, serum — lab reference

<4.0 suggests deficiency. Recent intake or supplementation may raise serum values.

Reproductive and Sex Hormones

Follicle-stimulating hormone (FSH) — lab reference

Interpret with age, ovarian status, testosterone/estradiol, and pituitary context.

Male-Specific Screening and Gonadal Addendum

Free PSA / total PSA — lab reference

Often used when total PSA is in an indeterminate zone. Use the performing-lab risk table.

Thyroid Function and Thyroid Autoimmunity

Free T3 — lab reference

Useful in selected hyperthyroid states; not a sensitive stand-alone test for hypothyroidism.

Thyroid Function and Thyroid Autoimmunity

Free T4 — lab reference

Binding abnormalities and severe illness may affect some free-hormone assays.

Glucose, Insulin, and Glycemic Control

Fructosamine — lab reference

Assay-specific; reflects approximately 2-3 weeks and is affected by protein turnover.

Female Cycle, Menopause, and Ovarian Reserve Addendum

FSH, follicular — lab reference

Interpret with estradiol, age, and cycle day.

Female Cycle, Menopause, and Ovarian Reserve Addendum

FSH, luteal — lab reference

Assay-specific.

Female Cycle, Menopause, and Ovarian Reserve Addendum

FSH, midcycle — lab reference

Assay-specific.

Female Cycle, Menopause, and Ovarian Reserve Addendum

FSH, postmenopausal — lab reference

Wide range; hormone therapy may suppress.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Gamma-glutamyl transferase (GGT) — lab reference

Alcohol, medications, metabolic disease, and cholestasis may elevate.

Specialty Wellness, Oxidative Stress, and Functional Testing

Genetic variants / SNP findings — lab reference

Classify by evidence, zygosity, phenotype, and clinical actionability rather than a numeric range.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Globulin — lab reference

Often calculated. Consider SPEP/IFE for unexplained abnormalities.

Urinalysis and Urine Kidney Markers

Glucose, urine — lab reference

Renal threshold, SGLT2 inhibitors, pregnancy, and hyperglycemia matter.

Adrenal, Pituitary, and Calcium-Regulating Hormones

Growth hormone, random — lab reference

Pulsatile secretion makes random GH difficult to interpret; stimulation/suppression testing may be needed.

Specialty Wellness, Oxidative Stress, and Functional Testing

GSH/GSSG ratio — lab reference

Only meaningful when both analytes use a validated paired method.

Iron Status, Anemia Workup, and Methylation-Related Markers

Haptoglobin — lab reference

Acute-phase reactant; used in hemolysis evaluation with LDH, bilirubin, and reticulocytes.

Male-Specific Screening and Gonadal Addendum

hCG, quantitative — lab reference

Use exact assay cutoff and clinical indication.

Female Cycle, Menopause, and Ovarian Reserve Addendum

hCG, quantitative, nonpregnant — lab reference

Pregnancy interpretation is gestational-age-specific; low-level positives require clinical follow-up.

Lipids and Cardiovascular Risk Markers

HDL cholesterol — lab reference

Higher HDL is not always protective; interpret within the entire risk profile.

Specialty Wellness, Oxidative Stress, and Functional Testing

Heavy metals, blood or urine — lab reference

Specimen choice, timing, recent seafood/supplements, provoked vs unprovoked collection, and public-health thresholds matter.

Complete Blood Count and Differential

Hematocrit — lab reference

Hydration and altitude are major modifiers. Review alongside hemoglobin and RBC indices.

Complete Blood Count and Differential

Hemoglobin — lab reference

Consider altitude and iron/B12/folate status. Pregnancy requires trimester-specific ranges.

Glucose, Insulin, and Glycemic Control

Hemoglobin A1C — lab reference

Normal <5.7; prediabetes 5.7-6.4; diabetes ≥6.5. Altered RBC turnover can make A1C unreliable.

Lipids and Cardiovascular Risk Markers

High-sensitivity CRP — lab reference

≥2 suggests higher cardiovascular risk; >10 may reflect acute inflammation and should generally be repeated when well.

Glucose, Insulin, and Glycemic Control

HOMA-IR — lab reference

Formula-dependent and population-dependent. Dr. Purser to define clinic interpretation, if used.

Iron Status, Anemia Workup, and Methylation-Related Markers

Homocysteine, total — lab reference

No universal wellness target. Interpret with B12, folate, B6, kidney, thyroid, genetics, and medications.

Urinalysis and Urine Kidney Markers

Hyaline casts — lab reference

Small numbers may be nonspecific; other cast types require context.

Adrenal, Pituitary, and Calcium-Regulating Hormones

IGF-1 — lab reference

Age, sex, nutrition, liver disease, diabetes, and assay matter.

Inflammation, Autoimmunity, and Immunoglobulins

Immunoglobulin A (IgA) — lab reference

Age and assay-specific. Important when interpreting IgA-based celiac testing.

Inflammation, Autoimmunity, and Immunoglobulins

Immunoglobulin G (IgG) — lab reference

Age and assay-specific. Consider subclasses or electrophoresis when indicated.

Inflammation, Autoimmunity, and Immunoglobulins

Immunoglobulin M (IgM) — lab reference

Age and assay-specific.

Male-Specific Screening and Gonadal Addendum

Inhibin B — lab reference

May assist selected fertility evaluations; not a routine wellness marker.

Coagulation and Thrombosis Markers

INR — lab reference

Normal range only. Warfarin therapeutic targets are indication-specific.

Vitamins, Minerals, and Nutrient Status

Iodine, urine — lab reference

Spot urine is useful mainly for populations; individual status requires careful collection and interpretation.

Urinalysis and Urine Kidney Markers

Ketones, urine — lab reference

Fasting, ketogenic diet, vomiting, and diabetes context matter.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Lactate, venous — lab reference

Collection method, tourniquet time, exercise, and timing affect result.

Liver, Pancreas, Protein Status, and Muscle Enzymes

LDH — lab reference

Broad tissue marker; hemolysis can cause false elevation.

Lipids and Cardiovascular Risk Markers

LDL cholesterol — lab reference

Risk-based goals may be <100, <70, or <55 depending on primary/secondary prevention risk.

Lipids and Cardiovascular Risk Markers

LDL particle number (LDL-P) — lab reference

Advanced lipoprotein testing. Use the performing laboratory classification.

Urinalysis and Urine Kidney Markers

Leukocyte esterase — lab reference

Interpret with microscopy, symptoms, nitrite, and culture.

Female Cycle, Menopause, and Ovarian Reserve Addendum

LH, follicular — lab reference

Interpret with cycle day and symptoms.

Female Cycle, Menopause, and Ovarian Reserve Addendum

LH, luteal — lab reference

Assay-specific.

Female Cycle, Menopause, and Ovarian Reserve Addendum

LH, midcycle — lab reference

Surge timing produces a very wide range.

Female Cycle, Menopause, and Ovarian Reserve Addendum

LH, postmenopausal — lab reference

Hormone therapy may suppress.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Lipase — lab reference

Assay-specific; diagnostic thresholds for pancreatitis are separate.

Lipids and Cardiovascular Risk Markers

Lipoprotein-associated phospholipase A2 — lab reference

Method, units, and cutoffs vary. Dr. Purser to decide whether to retain.

Lipids and Cardiovascular Risk Markers

Lipoprotein(a) — lab reference

≥75 increased; ≥125 commonly treated as a risk-enhancing level. Units are not directly interchangeable with mg/dL.

Reproductive and Sex Hormones

Luteinizing hormone (LH) — lab reference

Interpret with testosterone or estradiol, FSH, cycle phase, and pituitary context.

Complete Blood Count and Differential

Lymphocytes — lab reference

Review absolute count and clinical context.

Vitamins, Minerals, and Nutrient Status

Magnesium, RBC — lab reference

No universal interval across methods. Record exact performing-lab method and range.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Magnesium, serum — lab reference

Normal serum magnesium does not exclude tissue depletion.

Complete Blood Count and Differential

Mean corpuscular hemoglobin (MCH) — lab reference

Analyzer-specific. Review with MCV and MCHC.

Complete Blood Count and Differential

Mean corpuscular hemoglobin concentration (MCHC) — lab reference

Analyzer-specific; hemolysis and cold agglutinins may interfere.

Complete Blood Count and Differential

Mean corpuscular volume (MCV) — lab reference

Macrocytosis and microcytosis require cause-specific interpretation.

Complete Blood Count and Differential

Mean platelet volume (MPV) — lab reference

Highly analyzer- and handling-specific. Consider trend rather than isolated value.

Iron Status, Anemia Workup, and Methylation-Related Markers

Methylmalonic acid — lab reference

More specific for cellular B12 deficiency; kidney impairment can elevate.

Specialty Wellness, Oxidative Stress, and Functional Testing

Myeloperoxidase (MPO) — lab reference

Assay and indication-specific.

Complete Blood Count and Differential

Neutrophils — lab reference

Relative percentage can mislead; review absolute count.

Urinalysis and Urine Kidney Markers

Nitrite — lab reference

A negative result does not exclude UTI.

Lipids and Cardiovascular Risk Markers

Non-HDL cholesterol — lab reference

Risk-based goals may be lower; useful when triglycerides are elevated.

Lipids and Cardiovascular Risk Markers

NT-proBNP — lab reference

Use assay- and indication-specific rule-out/rule-in thresholds.

Vitamins, Minerals, and Nutrient Status

Omega-3 index / RBC fatty acids — lab reference

Method-specific. Any clinic target should identify the exact assay.

Specialty Wellness, Oxidative Stress, and Functional Testing

Oxidized glutathione (GSSG) — lab reference

Specify method and stabilization protocol.

Specialty Wellness, Oxidative Stress, and Functional Testing

Oxidized LDL — lab reference

Use exact laboratory interval. Clinical utility and treatment targets are not universally standardized.

Adrenal, Pituitary, and Calcium-Regulating Hormones

Parathyroid hormone (intact PTH) — lab reference

Interpret with calcium, phosphorus, magnesium, vitamin D, and kidney function.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Phosphorus — lab reference

Interpret with kidney function, calcium, vitamin D, and PTH.

Adrenal, Pituitary, and Calcium-Regulating Hormones

Plasma free metanephrines — lab reference

Supine collection and stress control improve specificity; use exact lab cutoffs.

Complete Blood Count and Differential

Platelet count — lab reference

Local analyzer range governs. Review trends and collection artifacts.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Potassium — lab reference

Hemolysis can falsely elevate. Review kidney function and acid-base status.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Prealbumin — lab reference

Negative acute-phase reactant; not a stand-alone nutrition marker.

Reproductive and Sex Hormones

Pregnenolone — lab reference

No broadly accepted wellness target. Use exact assay and clinical indication.

Reproductive and Sex Hormones

Progesterone — lab reference

Female phase detail is on the next section. Exogenous progesterone route/timing matters.

Female Cycle, Menopause, and Ovarian Reserve Addendum

Progesterone, follicular — lab reference

Cycle day and exogenous progesterone timing matter.

Female Cycle, Menopause, and Ovarian Reserve Addendum

Progesterone, luteal — lab reference

Single values are pulse- and timing-sensitive; confirm the clinical question.

Female Cycle, Menopause, and Ovarian Reserve Addendum

Progesterone, ovulatory window — lab reference

Wide physiologic variation.

Female Cycle, Menopause, and Ovarian Reserve Addendum

Progesterone, postmenopausal — lab reference

Exogenous hormone use changes interpretation.

Reproductive and Sex Hormones

Prolactin — lab reference

Stress, sleep, nipple stimulation, medications, pregnancy, and macroprolactin matter.

Urinalysis and Urine Kidney Markers

Protein, dipstick — lab reference

Dipstick is albumin-biased. Confirm persistent findings with quantitative ratio.

Coagulation and Thrombosis Markers

Prothrombin time (PT) — lab reference

Reagent-specific. Interpret with INR, liver function, vitamin K, and anticoagulants.

Male-Specific Screening and Gonadal Addendum

PSA, total — lab reference

No single normal cutoff fits every patient. Use age, baseline, trend, prostate size, risk factors, and shared decision-making.

Glucose, Insulin, and Glycemic Control

Random plasma glucose — lab reference

Diabetes may be diagnosed at ≥200 with classic symptoms or hyperglycemic crisis.

Urinalysis and Urine Kidney Markers

RBC, microscopy — lab reference

Persistent microscopic hematuria requires risk-based evaluation.

Complete Blood Count and Differential

Red blood cell count (RBC) — lab reference

Altitude, smoking, hydration, androgen therapy, and pregnancy may shift values.

Complete Blood Count and Differential

Red cell distribution width (RDW-CV) — lab reference

Useful with MCV for mixed nutrient deficiencies and evolving anemia.

Specialty Wellness, Oxidative Stress, and Functional Testing

Reduced glutathione (GSH) — lab reference

Specify whole blood, RBC, plasma, or intracellular method. Preanalytic handling is critical.

Adrenal, Pituitary, and Calcium-Regulating Hormones

Renin / plasma renin activity — lab reference

Direct renin and plasma renin activity are not interchangeable.

Complete Blood Count and Differential

Reticulocyte count — lab reference

Use corrected reticulocyte count or production index when anemic.

Thyroid Function and Thyroid Autoimmunity

Reverse T3 — lab reference

No broadly accepted treatment target. Dr. Purser to define whether and how this is used.

Inflammation, Autoimmunity, and Immunoglobulins

Rheumatoid factor — lab reference

Assay-specific and nonspecific. Interpret with symptoms and anti-CCP.

Vitamins, Minerals, and Nutrient Status

Selenium, serum — lab reference

Trace-metal collection and geographic/dietary context matter.

Iron Status, Anemia Workup, and Methylation-Related Markers

Serum iron — lab reference

Morning fasting collection is preferred when practical. Day-to-day variation is substantial.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Serum osmolality — lab reference

Measured and calculated values may differ. Review osmolal gap when indicated.

Reproductive and Sex Hormones

Sex hormone-binding globulin (SHBG) — lab reference

Estrogen, thyroid, liver disease, insulin resistance, age, and medications affect SHBG.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Sodium — lab reference

Volume status, glucose, osmolality, and medications may alter interpretation.

Iron Status, Anemia Workup, and Methylation-Related Markers

Soluble transferrin receptor — lab reference

Can help distinguish iron deficiency from inflammation; use performing-lab interval.

Urinalysis and Urine Kidney Markers

Specific gravity — lab reference

Hydration and concentrating ability affect result.

Specialty Wellness, Oxidative Stress, and Functional Testing

Superoxide dismutase activity — lab reference

RBC, plasma, and cellular assays are not interchangeable.

Reproductive and Sex Hormones

Testosterone, bioavailable — lab reference

Depends on total testosterone, SHBG, albumin, calculation, and assay.

Reproductive and Sex Hormones

Testosterone, free — lab reference

Mayo example age 20-24: M 5.25-20.7; F <0.13-1.08. Declines with age and is method-dependent.

Reproductive and Sex Hormones

Testosterone, total — lab reference

Morning collection preferred for men. Method and age matter; confirm unexpected low values.

Coagulation and Thrombosis Markers

Thrombin time — lab reference

Reagent-specific; affected by heparin, direct thrombin inhibitors, and fibrinogen abnormalities.

Thyroid Function and Thyroid Autoimmunity

Thyroglobulin — lab reference

Not a general thyroid wellness target. Use tumor follow-up, thyroid anatomy, and antibody status.

Thyroid Function and Thyroid Autoimmunity

Thyroglobulin antibody (Tg Ab) — lab reference

Assay-specific. Also affects thyroglobulin tumor-marker interpretation.

Thyroid Function and Thyroid Autoimmunity

Thyroperoxidase antibody (TPO Ab) — lab reference

Assay-specific. Positive result supports thyroid autoimmunity but does not determine treatment alone.

Specialty Wellness, Oxidative Stress, and Functional Testing

TMAO — lab reference

Diet, kidney function, microbiome, timing, and assay affect results.

Lipids and Cardiovascular Risk Markers

Total cholesterol — lab reference

Screening measure, not a stand-alone treatment target.

Iron Status, Anemia Workup, and Methylation-Related Markers

Total iron-binding capacity (TIBC) — lab reference

Interpret with iron, transferrin saturation, and ferritin.

Liver, Pancreas, Protein Status, and Muscle Enzymes

Total protein — lab reference

Review albumin, globulin, and electrophoresis when indicated.

Thyroid Function and Thyroid Autoimmunity

Total T3 — lab reference

Affected by binding proteins and nonthyroidal illness.

Thyroid Function and Thyroid Autoimmunity

Total T4 — lab reference

Affected by thyroid-binding globulin, pregnancy, estrogen, and medications.

Iron Status, Anemia Workup, and Methylation-Related Markers

Transferrin — lab reference

Negative acute-phase reactant; affected by liver function and nutrition.

Iron Status, Anemia Workup, and Methylation-Related Markers

Transferrin saturation — lab reference

Calculated from iron and TIBC. Fasting and timing improve consistency.

Lipids and Cardiovascular Risk Markers

Triglycerides — lab reference

150-199 borderline high; 200-499 high; ≥500 severe and pancreatitis-relevant.

Thyroid Function and Thyroid Autoimmunity

TSH — lab reference

Adult interval. Pregnancy and pituitary disease require different interpretation.

Thyroid Function and Thyroid Autoimmunity

TSI / TRAb — lab reference

Use the exact assay cutoff. Helpful in selected Graves disease questions.

Electrolytes, Renal Chemistry, and Core Metabolic Markers

Uric acid — lab reference

A gout treatment target is not the same as the healthy-population interval.

Urinalysis and Urine Kidney Markers

Urine albumin/creatinine ratio — lab reference

A1 <30; A2 30-300; A3 >300. Persistence ≥3 months matters for CKD classification.

Urinalysis and Urine Kidney Markers

Urine appearance — lab reference

Color and clarity are nonspecific; review medications, hydration, and sediment.

Urinalysis and Urine Kidney Markers

Urine pH — lab reference

Diet, infection, medications, and specimen age affect result.

Urinalysis and Urine Kidney Markers

Urine protein/creatinine ratio — lab reference

Use laboratory and indication-specific thresholds; consider timed collection when needed.

Vitamins, Minerals, and Nutrient Status

Vitamin A, retinol — lab reference

Fasting, liver function, inflammation, and carrier proteins matter.

Vitamins, Minerals, and Nutrient Status

Vitamin B1, whole blood TDP — lab reference

Fasting and supplement abstention improve interpretability.

Iron Status, Anemia Workup, and Methylation-Related Markers

Vitamin B12 — lab reference

<150 supports deficiency; 150-400 is often treated as borderline and may warrant MMA/homocysteine review.

Vitamins, Minerals, and Nutrient Status

Vitamin B6, plasma PLP — lab reference

Recent supplementation can elevate; very high values may be clinically relevant.

Vitamins, Minerals, and Nutrient Status

Vitamin C, plasma — lab reference

Highly preanalytic-sensitive. Fasting, processing, and recent intake matter.

Vitamins, Minerals, and Nutrient Status

Vitamin E, alpha-tocopherol — lab reference

Interpret relative to lipids when appropriate; assay-specific.

Lipids and Cardiovascular Risk Markers

VLDL cholesterol — lab reference

Often calculated. Less reliable when triglycerides are markedly elevated.

Urinalysis and Urine Kidney Markers

WBC, microscopy — lab reference

Interpret with symptoms, culture, contamination, and other sediment findings.

Complete Blood Count and Differential

White blood cell count (WBC) — lab reference

Lab-specific. Interpret with symptoms, medication effects, and differential.

Vitamins, Minerals, and Nutrient Status

Zinc, serum — lab reference

Fasting, time of day, inflammation, albumin, and trace-metal collection technique matter.

These pages adapt the Purser educational materials into plain language. They are educational summaries, not individualized assessments or a claim of independent medical review.