Lab Decoder: Optimal Ranges for Your Labs

Q: Why optimal ranges instead of the ranges on my lab report?

Lab reference ranges describe where most tested people fall, or where disease is diagnosed. Optimal ranges aim for where long-term risk is lowest. Each card says whether its target is a Sorrell MD optimization target or a published cutoff, and the table above lists the data behind each one.

Q: Is the Lab Decoder a diagnosis?

No. It shows where single numbers sit against optimal and guideline ranges. A diagnosis, and your personal targets, depend on your history, family risk, medications and how your markers relate to each other, which is why a physician should read the whole panel.

Q: Does Sorrell MD see the numbers I enter?

No. The decoder runs entirely in your browser. Nothing you type is stored, sent to a server or recorded in analytics; the page only counts that the tool was used.

Q: Why is LDL cholesterol not included?

ApoB counts the cholesterol-carrying particles directly and tracks risk better when the two disagree, so the decoder uses ApoB, the ApoB:ApoA1 ratio and Lp(a) instead. See ApoB vs LDL discordance.

Q: Why does the thyroid read depend on RMR?

Dr. Sorrell judges thyroid function by what it does, not only by lab ranges. A resting metabolic rate measured by indirect calorimetry, compared with the rate predicted for your size, age and sex, shows whether your metabolism is running as expected. A low rate with upper-normal TSH or low-normal free T3 is worth a conversation; a normal rate with in-range labs usually means thyroid output is adequate.

Q: My lab report uses different units. What do I do?

The decoder uses U.S. units. Common conversions: glucose mmol/L × 18 = mg/dL; HDL mmol/L × 38.67 = mg/dL; triglycerides mmol/L × 88.57 = mg/dL; ApoB or ApoA1 g/L × 100 = mg/dL; testosterone nmol/L × 28.84 = ng/dL; free testosterone pmol/L ÷ 3.47 = pg/mL; DHEA-S µmol/L × 36.8 = µg/dL; estradiol pmol/L ÷ 3.67 = pg/mL; vitamin D nmol/L ÷ 2.5 = ng/mL; ferritin µg/L = ng/mL. Free testosterone should be a calculated or equilibrium-dialysis result, not a "direct" assay.

Q: Why is FIB-4 not included?

FIB-4 is a liver-fibrosis triage score that needs clinical context to act on safely, so it is left out on purpose. The FIB-4 article explains how it is used.

Fill in only what you have. Sex and age matter for several markers, so start there.

About you

Sex Sets testosterone, DHEA-S, HDL and ratio targets Age years Used for predicted metabolic rate

Heart and cholesterol

ApoB mg/dL ApoA1 mg/dL Adds the ApoB:ApoA1 ratio Lp(a) Triglycerides mg/dL Fasting result HDL cholesterol mg/dL With triglycerides, adds TG:HDL hs-CRP mg/L Homocysteine µmol/L

Blood sugar and insulin

Fasting glucose mg/dL Fasting insulin µIU/mL With glucose, adds HOMA-IR HbA1c %

Hormones

Total testosterone ng/dL Free testosterone pg/mL Calculated or dialysis, not “direct” DHEA-S µg/dL Estradiol pg/mL Graded for postmenopausal women

Nutrients and iron

Vitamin D, 25-OH ng/mL Ferritin ng/mL Omega-3 index %

Thyroid and metabolism

Dr. Sorrell reads thyroid labs against a measured resting metabolic rate, not on their own. Add your RMR from indirect calorimetry with height and weight to see that read.

TSH mIU/L Free T4 ng/dL Free T3 pg/mL Measured RMR kcal/day Indirect calorimetry Height inches Weight lb

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Optimal ranges and sources

Optimal ranges are stricter than the reference ranges printed on lab reports: they aim for where long-term risk is lowest, not where disease is diagnosed. Where a target is Dr. Sorrell’s clinical call, it is labeled as a Sorrell MD target, with the published data it leans on. Updated September 22, 2026.

Marker	Unit	Optimal	Other categories	Basis
ApoB	mg/dL	<80	80–99 near optimal · 100–129 above target · ≥130 risk-enhancing	Sorrell MD target; ESC/EAS 2019, ACC/AHA 2018
ApoB : ApoA1	ratio	<0.7 men · <0.6 women	High-risk ≥0.9 men · ≥0.8 women	Sorrell MD target; Walldius & Jungner 2006
Lp(a)	mg/dL or nmol/L	<30 mg/dL (<75 nmol/L)	30–49 (75–124) gray zone · ≥50 (≥125) high	EAS 2022, ACC/AHA 2018
Triglycerides, fasting	mg/dL	<100	100–149 normal · 150–199 borderline · 200–499 high · ≥500 very high	AHA 2011, NCEP ATP III
Triglyceride : HDL	ratio (mg/dL)	<1.5	1.5–2.9 above optimal · ≥3.0 suggests insulin resistance	Sorrell MD target; McLaughlin 2003
HDL cholesterol	mg/dL	Not low	Low if <40 (men) or <50 (women)	NCEP ATP III
hs-CRP	mg/L	<1	1–3 average (≥2 is a U.S. risk enhancer) · >3 higher · >10 repeat	AHA/CDC 2003, ACC/AHA 2018
Homocysteine	µmol/L	<8	8–15 above optimal · >15 elevated	Sorrell MD target; Homocysteine Studies Collaboration 2002
Fasting glucose	mg/dL	70–84	85–99 above optimal · 100–125 prediabetes · ≥126 diabetes range	Sorrell MD target; Bjørnholt 1999, ADA 2025
Fasting insulin	µIU/mL	<6	6–14.9 above optimal · ≥15 well above	Sorrell MD target
HOMA-IR (calculated)	index	<1.5	1.5–2.4 above optimal · ≥2.5 suggests insulin resistance	Sorrell MD target; Matthews 1985
HbA1c	%	<5.7	5.7–6.4 prediabetes · ≥6.5 diabetes range	ADA 2025
Total testosterone, men	ng/dL	531–916 (≥ young-adult median)	<264 below normal · >916 above range	Sorrell MD target; Travison 2017
Free testosterone, men	pg/mL	134–230 (≥ young-adult median)	<70 below normal · >230 above range	Sorrell MD target; Bhasin 2011
Total testosterone, women	ng/dL	25–57 (upper half of premenopausal range)	<10 low · >57 above range	Sorrell MD target; Haring 2012, Global Consensus 2019
Free testosterone, women	pg/mL	2.5–7.3	<0.7 low · >7.3 above range	Sorrell MD target; Haring 2012
DHEA-S	µg/dL	300–500 men · 150–350 women	Below or above flagged to review	Sorrell MD target
Estradiol, postmenopausal	pg/mL	60–90	<60 below bone-protective level · >90 no added benefit	Sorrell MD target; Reginster 1992
Vitamin D (25-OH)	ng/mL	70–90	<20 deficient · 20–29 insufficient · 30–69 below optimal · >100 above safety limit	Sorrell MD target; Endocrine Society 2011
Ferritin	ng/mL	50–150	<30 low stores · 30–49 below optimal · 151–200 above optimal · >200 high	Sorrell MD target; DePalma 2021
Omega-3 index	%	>8	<4 low · 4–8 intermediate	Harris & von Schacky 2004
Resting metabolic rate	measured ÷ predicted	0.90–1.10	<0.90 low · >1.10 high	Sorrell MD approach; Mifflin 1990, Sterringer 2022
TSH · free T4 · free T3	mIU/L · ng/dL · pg/mL	Read with RMR	Typical ranges 0.45–4.5 · 0.8–1.8 · 2.3–4.2; low RMR with TSH >2.5 or free T3 <2.9 flagged	Sorrell MD approach; lab reference intervals

Grundy SM, Stone NJ, Bailey AL, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol. Circulation. 2019;139:e1082–e1143.
Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2020;41:111–188.
Walldius G, Jungner I. The apoB/apoA-I ratio: a strong, new risk factor for cardiovascular disease and a target for lipid-lowering therapy — a review of the evidence. J Intern Med. 2006;259:493–519.
Kronenberg F, Mora S, Stroes ESG, et al. Lipoprotein(a) in atherosclerotic cardiovascular disease and aortic stenosis: a European Atherosclerosis Society consensus statement. Eur Heart J. 2022;43:3925–3946.
Miller M, Stone NJ, Ballantyne C, et al. Triglycerides and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2011;123:2292–2333.
National Cholesterol Education Program Expert Panel. Third Report of the NCEP Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Circulation. 2002;106:3143–3421.
McLaughlin T, Abbasi F, Cheal K, et al. Use of metabolic markers to identify overweight individuals who are insulin resistant. Ann Intern Med. 2003;139:802–809.
Sumner AE, Finley KB, Genovese DJ, Criqui MH, Boston RC. Fasting triglyceride and the triglyceride-HDL cholesterol ratio are not markers of insulin resistance in African Americans. Arch Intern Med. 2005;165:1395–1400.
Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: a statement for healthcare professionals from the CDC and the AHA. Circulation. 2003;107:499–511.
Homocysteine Studies Collaboration. Homocysteine and risk of ischemic heart disease and stroke: a meta-analysis. JAMA. 2002;288:2015–2022.
Bjørnholt JV, Erikssen G, Aaser E, et al. Fasting blood glucose: an underestimated risk factor for cardiovascular death. Results from a 22-year follow-up of healthy nondiabetic men. Diabetes Care. 1999;22:45–49.
American Diabetes Association Professional Practice Committee. 2. Diagnosis and Classification of Diabetes: Standards of Care in Diabetes—2025. Diabetes Care. 2025;48(Suppl 1):S27–S49.
Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–419.
Travison TG, Vesper HW, Orwoll E, et al. Harmonized reference ranges for circulating testosterone levels in men of four cohort studies in the United States and Europe. J Clin Endocrinol Metab. 2017;102:1161–1173.
Bhasin S, Pencina M, Jasuja GK, et al. Reference ranges for testosterone in men generated using liquid chromatography tandem mass spectrometry in a community-based sample of healthy nonobese young men in the Framingham Heart Study. J Clin Endocrinol Metab. 2011;96:2430–2439.
Haring R, Hannemann A, John U, et al. Age-specific reference ranges for serum testosterone and androstenedione concentrations in women measured by liquid chromatography-tandem mass spectrometry. J Clin Endocrinol Metab. 2012;97:408–415.
Davis SR, Baber R, Panay N, et al. Global Consensus Position Statement on the Use of Testosterone Therapy for Women. J Clin Endocrinol Metab. 2019;104:4660–4666.
Reginster JY, Sarlet N, Deroisy R, et al. Minimal levels of serum estradiol prevent postmenopausal bone loss. Calcif Tissue Int. 1992;51:340–343.
Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96:1911–1930.
DePalma RG, Hayes VW, O'Leary TJ. Optimal serum ferritin level range: iron status measure and inflammatory biomarker. Metallomics. 2021;13(6):mfab030.
Harris WS, von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med. 2004;39:212–220.
Mifflin MD, St Jeor ST, Hill LA, et al. A new predictive equation for resting energy expenditure in healthy individuals. Am J Clin Nutr. 1990;51:241–247.
Sterringer T, et al. RMR ratio as a surrogate marker for low energy availability. Curr Nutr Rep. 2022.

Questions

Why optimal ranges instead of the ranges on my lab report?

Lab reference ranges describe where most tested people fall, or where disease is diagnosed. Optimal ranges aim for where long-term risk is lowest. Each card says whether its target is a Sorrell MD optimization target or a published cutoff, and the table above lists the data behind each one.

Is the Lab Decoder a diagnosis?

No. It shows where single numbers sit against optimal and guideline ranges. A diagnosis, and your personal targets, depend on your history, family risk, medications and how your markers relate to each other, which is why a physician should read the whole panel.

Does Sorrell MD see the numbers I enter?

No. The decoder runs entirely in your browser. Nothing you type is stored, sent to a server or recorded in analytics; the page only counts that the tool was used.

Why is LDL cholesterol not included?

ApoB counts the cholesterol-carrying particles directly and tracks risk better when the two disagree, so the decoder uses ApoB, the ApoB:ApoA1 ratio and Lp(a) instead. See ApoB vs LDL discordance.

Why does the thyroid read depend on RMR?

Dr. Sorrell judges thyroid function by what it does, not only by lab ranges. A resting metabolic rate measured by indirect calorimetry, compared with the rate predicted for your size, age and sex, shows whether your metabolism is running as expected. A low rate with upper-normal TSH or low-normal free T3 is worth a conversation; a normal rate with in-range labs usually means thyroid output is adequate.

My lab report uses different units. What do I do?

The decoder uses U.S. units. Common conversions: glucose mmol/L × 18 = mg/dL; HDL mmol/L × 38.67 = mg/dL; triglycerides mmol/L × 88.57 = mg/dL; ApoB or ApoA1 g/L × 100 = mg/dL; testosterone nmol/L × 28.84 = ng/dL; free testosterone pmol/L ÷ 3.47 = pg/mL; DHEA-S µmol/L × 36.8 = µg/dL; estradiol pmol/L ÷ 3.67 = pg/mL; vitamin D nmol/L ÷ 2.5 = ng/mL; ferritin µg/L = ng/mL. Free testosterone should be a calculated or equilibrium-dialysis result, not a "direct" assay.

Why is FIB-4 not included?

FIB-4 is a liver-fibrosis triage score that needs clinical context to act on safely, so it is left out on purpose. The FIB-4 article explains how it is used.

The Lab Decoder is educational and is not medical advice, a diagnosis or a substitute for a clinician who knows your history. Do not start, stop or change a medication or supplement based on it. If you have chest pain, trouble breathing or other urgent symptoms, call 911. Want the whole picture? Book a free call with Dr. Sorrell, or see how the Longevity Program includes Function Health labs twice a year.