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VitalDecades Guides & Explainers

Labs and biomarkers 7 min

What your A1C means, and the conditions that make it wrong

An A1C below 5.7 percent is normal, 5.7 to 6.4 is prediabetes and 6.5 or above is diabetes. The test measures glucose stuck to hemoglobin over about three months, which means anything that changes the life of a red blood cell changes the result, and several common conditions do.

Labs and biomarkers 6 min

Vitamin B12 levels: the gray zone between 200 and 400, and how to settle it

The NIH Office of Dietary Supplements treats serum B12 below 200 or 250 pg/mL as subnormal, and names methylmalonic acid as the most sensitive marker, able to confirm deficiency when serum B12 sits anywhere between 150 and 399 pg/mL. That range is wide, it covers many results reported as normal, and it is the whole reason B12 testing confuses people.

Labs and biomarkers 7 min

Normal hemoglobin levels: the cutoff is a percentile, not a verdict

WHO's 2024 guideline defines anemia at a hemoglobin below 130 g/L in men and below 120 g/L in non-pregnant women aged 15 to 65. Those cutoffs are the 5th percentile of a healthy population, which means one healthy adult in twenty sits below the line by construction, and WHO itself treats anemia as a sign of something else rather than a diagnosis.

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Labs and biomarkers 7 min

High uric acid without gout: what the rheumatology guideline says to do

The American College of Rheumatology defines asymptomatic hyperuricemia as a serum urate of 6.8 mg/dL or above with no prior gout flare and no tophi, and conditionally recommends against starting any urate-lowering drug for it. That recommendation rests on high certainty evidence, which is rare in this guideline.

Labs and biomarkers 10 min

High ALT on a blood test: what the number means and what to do next

The American College of Gastroenterology puts the true healthy upper limit for ALT at 29 to 33 IU/L for men and 19 to 25 IU/L for women, below what many laboratories flag. The commonest cause of a mildly high result is fat in the liver, and the question that actually matters is not the enzyme, it is whether the liver has scarred.

Labs and biomarkers 5 min

TSH normal range: 0.45 to 4.12, and why that is too tight after 70

The standard adult TSH interval is 0.45 to 4.12 mIU/L. But the 97.5th centile rises from 3.56 in your twenties to 7.49 after 80, and 70 percent of older people flagged with a TSH above 4.5 are inside their own age group's range.

Labs and biomarkers 6 min

eGFR by age: what is normal, and why 60 is not age-adjusted

The National Kidney Foundation publishes an average eGFR for every age band, and it falls from 116 in your 20s to 75 after 70. The threshold that defines kidney disease does not move with it. Both facts are true, and the gap between them is an open argument in nephrology.

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Labs and biomarkers 4 min

Blood tests for men over 50, and what they cost

The yearly core after 35: glucose or A1C (USPSTF screens adults 35 to 70 with overweight every 3 years), a lipid panel feeding the age-40 statin discussion, and blood pressure at every visit. Kidney (eGFR) and liver (ALT) numbers ride along on standard panels and have published healthy limits. Worth doing once, not yearly: ApoB and Lp(a). Usually not worth ordering without a reason: routine vitamin D, per the 2024 Endocrine Society guideline.