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Liver

LDH value: what the number says next to your liver values

LDH, in full lactate dehydrogenase, is an enzyme, a protein that speeds up a chemical conversion; in your cells that is the conversion of lactate. It sits in your liver, your muscles and your red blood cells, among other places, and most of it stays inside the cells themselves.

The LDH in your blood rises when cells break down, whether those are liver cells, muscle cells, red blood cells or cells of another tissue. Only a blood test can show that. According to the NVKC, ALT (alanine aminotransferase) sits mainly in the liver and leaks into the blood when liver cells are damaged.

From 19 up to and including 50, Star-SHL's normal range runs from 118 to 251 U/l, units per litre. For your liver, LDH on its own is not a targeted test, because it also comes from other tissues.

Doctor's Assessment Included

LDH is an enzyme that enters the blood when cells break down. For adults up to 50, the upper limit at the four laboratories lies between 247 and 251 U/l.

  • A raised value points to tissue damage but not to which tissue; other tests give that answer faster.
  • Blood damaged in the tube gives a falsely high result.
  • The limit is higher in older adults: Star-SHL uses 301 U/l from age 81.

Reference Ranges

See the value that applies to you:

Choose male or female — this range differs by sex.

Enter your age — this range changes with age.

This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.

Your reference range
u/l
116 329 u/l
Reference ranges by group, in u/l
Male · 1–5 years 197–329 u/l
197 329
Male · 6–12 years 168–307 u/l
168 307
Male · 13–18 years 127–273 u/l
127 273
Female · 6–12 years 148–313 u/l
148 313
Female · 13–18 years 116–234 u/l
116 234
Everyone · 19–50 years 118–251 u/l
118 251
Everyone · 51–65 years 128–274 u/l
128 274
Everyone · 66–80 years 130–282 u/l
130 282
Everyone · 81 years and older 136–301 u/l
136 301
116 329 u/l

Source: NVKC Reference population: Dutch general-practice population (NUMBER, n = 7,574,327)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

LDH (Lactate Dehydrogenase): what Dutch laboratories use

Reference ranges by group, in u/l
Star-shl · Male · 19–50 years 118–251 U/l
118 251
Star-shl · Female · 19–50 years 118–251 U/l
118 251
Star-shl · Male · 51–65 years 128–274 U/l
128 274
Star-shl · Female · 51–65 years 128–274 U/l
128 274
Star-shl · Male · 66–80 years 130–282 U/l
130 282
Star-shl · Female · 66–80 years 130–282 U/l
130 282
Star-shl · Male · 81–120 years 130–301 U/l
130 301
Star-shl · Female · 81–120 years 130–301 U/l
130 301
Unilabs · Everyone · 19–50 years · a limit, not a range < 251 U/l
251
Unilabs · Everyone · 51–65 years · a limit, not a range < 274 U/l
274
Unilabs · Everyone · 66–80 years · a limit, not a range < 282 U/l
282
Unilabs · Everyone · 81 years and older · a limit, not a range < 301 U/l
301
Certe · Male · 18 years and older · a limit, not a range < 248 U/L
248
Certe · Female · 18 years and older · a limit, not a range < 248 U/L
248
Diagnostiek voor U · Male · 13 years and older · a limit, not a range < 248 U/L
248
Diagnostiek voor U · Female · 13 years and older · a limit, not a range < 247 U/L
247
0 331.1 u/l

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

LDH (Lactate Dehydrogenase): what this test measures

In one number, in units per litre (U/l), the LDH test adds up the activity of lactate dehydrogenase from most tissues of your body. Which part of it comes from your liver cannot be read from that number.

LD4 and LD5 do not point only to your liver either: according to the NVKC, these two forms of the enzyme sit mainly in liver cells and in skeletal muscle.

LDH (Lactate Dehydrogenase): why this value matters

A raised LDH can point to tissue being damaged somewhere. According to the NVKC, the Dutch society for clinical chemistry, raised values occur in all diseases in which a tissue or organ is damaged. Which tissue that is has to come from other values.

For information about your liver, other tests are generally faster and more sensitive than LDH, according to the NVKC. According to the NVKC page on ALT, a doctor requests ALT (alanine aminotransferase) when liver damage is suspected.

LDH (Lactate Dehydrogenase): how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

LDH (Lactate Dehydrogenase): how to prepare

  1. No hard training beforehand

    Required

    No heavy training, long endurance sessions or anything that leaves you out of breath in the 48 hours before the draw. Normal walking is fine.

  • Water is always fine. Drink as usual beforehand, it makes the draw easier.
  • Take your usual medication, unless your own doctor told you otherwise.

LDH (Lactate Dehydrogenase): when is testing worthwhile?

An LDH measurement that you repeat after a while can follow the decline and recovery of tissue, according to the NVKC, the Dutch society for clinical chemistry. When LDH is repeated at the same moment as liver values such as ALT (alanine aminotransferase), both series can be laid side by side.

LDH (Lactate Dehydrogenase): symptoms of a high or low value

Low Levels

The explanation page of the NVKC, the Dutch professional society for clinical chemistry, gives no cause for an LDH result that is too low, so no liver cause either. According to the NVKC, other tests usually give faster and more sensitive information about affected tissues or organs than LDH.

High Levels

According to the NVKC, the Dutch professional society for clinical chemistry, a raised LDH points to damaged cells somewhere in the body, without singling out your liver. For your liver, tests other than LDH are as a rule faster and more sensitive, according to the NVKC. Discuss the result with a doctor, together with your liver values, your blood count and vitamin B12.

LDH (Lactate Dehydrogenase): causes of a low or high value

What raises the value

  • Tissue damage

    LDH sits in most tissues and enters the blood when cells break down, so any disease that damages a tissue or organ can raise the value.

  • Heart attack

    After a heart attack LDH can rise, but troponin and CK become measurable in the blood sooner after a heart attack.

  • Breakdown of red blood cells in the body (haemolysis)

    When red blood cells break down in the body, their LDH is released into the blood.

  • Internal bleeding

    LDH can be raised after bleeding inside the body.

  • Burst red blood cells in the tube

    The LDH concentration in a red blood cell is about 50 times higher than in serum, so blood damaged in the tube gives a falsely high result.

LDH (Lactate Dehydrogenase): lifestyle and this value

A vitamin B12 deficiency can raise your LDH, because it disturbs the production of red blood cells; with a raised LDH, have your vitamin B12 measured too.

Read LDH as a general sign that cells are breaking down, next to your liver values such as ALT (alanine aminotransferase).

LDH (Lactate Dehydrogenase): frequently asked questions

Is LDH a liver value?

LDH is not a true liver value: the enzyme also sits in muscle, the heart and red blood cells, and the ordinary test does not say which tissue it comes from. LD4 and LD5 do sit mainly in liver cells and muscle.

Can a vitamin B12 deficiency raise LDH?

Yes, a vitamin B12 deficiency can raise LDH. With such a deficiency, immature red blood cells are lost in the bone marrow, so LDH rises and haptoglobin, a protein that binds released haemoglobin, falls; the picture then resembles red-cell breakdown.

What is a normal LDH value?

A normal LDH value for adults lies below an upper limit that differs per laboratory: Certe uses 248 U/l and Diagnostiek voor U, above age 12, 247 U/l for women and 248 U/l for men. Star-SHL and Unilabs let the upper limit for adults rise with age, from 251 U/l from 19 up to and including 50 to 301 U/l from 81, and Star-SHL uses a lower limit of 118 U/l from 19 up to and including 50.

LDH (Lactate Dehydrogenase): sources

  1. den Elzen WPJ, Brouwer N, Thelen MH, Le Cessie S, Haagen I-A, Cobbaert CM. NUMBER: standardized reference intervals in the Netherlands using a 'big data' approach. Clin Chem Lab Med 2018;57(1):42-56. (retrieved 2026) doi.org
  2. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  3. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  4. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  5. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  6. NVKC, Alles over testen: LDH, allesovertesten.nl, geraadpleegd 2026-10-07 (retrieved 2026) allesovertesten.nl
  7. Star-SHL, Labbepalingen: LD(H), star-shl.nl, geraadpleegd 2026-10-07 (retrieved 2026) star-shl.nl

Tests with related values

These panels measure values from the same category as this marker.

GLP-1

GLP-1 Baseline Panel

Your starting point before the first injection: blood sugar, cholesterol, pancreas, liver, kidneys, thyroid and nutrients in one measurement.

Insulin (Fasting) ALT (Alanine Aminotransferase) TSH (Thyroid Stimulating Hormone) AST (Aspartate Aminotransferase) HDL Cholesterol HbA1c (Glycated Hemoglobin) Bilirubin (Total) ApoB (Apolipoprotein B) Vitamin B12 Ferritin Potassium Sodium Glucose (Fasting) Total Cholesterol Albumin Lipase Creatinine Vitamin D (25-OH) Triglycerides Bilirubin (Direct) Bilirubin (Indirect) HOMA-IR eGFR (Estimated Glomerular Filtration Rate) LDL Cholesterol Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€214,-
GLP-1

GLP-1 Extended Panel

The 6-month measurement: everything from the check-in plus insulin, ApoB and your nutrients — especially relevant if you have been eating much less for a while.

Insulin (Fasting) ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) HDL Cholesterol HbA1c (Glycated Hemoglobin) ApoB (Apolipoprotein B) Vitamin B12 Ferritin Potassium Sodium Glucose (Fasting) Total Cholesterol Albumin Lipase Creatinine Vitamin D (25-OH) Triglycerides HOMA-IR eGFR (Estimated Glomerular Filtration Rate) LDL Cholesterol Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€196,-
GLP-1

GLP-1 Check-in Panel

The 3-month safety and progress check clinics do: pancreas, liver, kidneys, salts and your metabolic progress on GLP-1 medication.

ALT (Alanine Aminotransferase) AST (Aspartate Aminotransferase) HDL Cholesterol HbA1c (Glycated Hemoglobin) Potassium Sodium Glucose (Fasting) Total Cholesterol Lipase Creatinine Triglycerides eGFR (Estimated Glomerular Filtration Rate) LDL Cholesterol Cholesterol/HDL Ratio Non-HDL Cholesterol LDL/HDL Ratio
€109,-

Medical reviewer

Medical standards

Dr. Naimi oversees the medical standards behind our content and assessments.

Medical policy
CIBG Ministerie van Volksgezondheid,
Welzijn en Sport Official BIG registration BIG 49928676701 Opens in a new tab

LDH (Lactate Dehydrogenase)

€10,-