Lab result explainedMetabolic panelLast updated November 8, 2026

Lipase blood test: what high and low lipase levels mean, and when it points to pancreatitis

Lipase · Ordered alone or with amylase; sometimes part of a hepatic or abdominal pain panel · reported in U/L (units per litre); ranges differ widely between laboratories

Lipase is an enzyme made almost entirely by the pancreas and released into the small intestine to digest fat. A small amount normally leaks into the blood, and a lipase blood test measures it. Most US labs quote a normal range somewhere between about 10 and 140 U/L, though the limits differ markedly between assays (some labs use 13 to 60), so the only safe comparison is with the range printed on your own report. The test's main job is to diagnose acute pancreatitis: a lipase more than three times the upper limit of normal, with typical upper abdominal pain, is one of the two findings needed to make the diagnosis.

Lipase has replaced amylase as the preferred test because it is more specific to the pancreas and stays raised for longer. It rises within 4 to 8 hours of the onset of pancreatitis, peaks at about 24 hours and stays elevated for 8 to 14 days, compared with 3 to 5 days for amylase, which means it still catches people who come in late. Gallstones and alcohol account for about 70 percent of acute pancreatitis; very high triglycerides, certain drugs, ERCP procedures and high calcium make up most of the rest.

Many raised lipase results are not pancreatitis. Mild elevations, under three times the upper limit, occur in kidney disease, bowel obstruction or inflammation, gallbladder disease, peptic ulcer, coeliac disease, diabetic ketoacidosis, with some medicines (notably GLP-1 drugs such as semaglutide) and in a proportion of healthy people. The height of the lipase does not predict how severe pancreatitis will be, and a low lipase is usually of no consequence, though a persistently very low value can hint at a pancreas that has lost much of its enzyme-producing tissue.

Lipase at a glance

  • What it is: a fat-digesting enzyme from the pancreas; blood levels rise when pancreatic cells are inflamed or the duct is blocked.
  • Normal: varies widely by lab, roughly 10–140 U/L on many assays, 13–60 on others. Always use the printed range.
  • High: above the upper limit. More than 3 times the upper limit with upper abdominal pain radiating to the back indicates acute pancreatitis. Under 3 times is non-specific and often not pancreatitis.
  • Timing: rises 4–8 hours after pain begins, peaks at about 24 hours, stays up 8–14 days. The level does not predict severity.
  • Low: below the lab's lower limit (if it has one) is usually not significant; persistently very low values can reflect chronic pancreatitis, cystic fibrosis or pancreatic surgery.
  • Next step: with pain, same-day assessment, repeat lipase, liver tests, calcium, triglycerides and an ultrasound; without pain, check kidney function, medicines and repeat in a few weeks.

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What Lipase measures

Serum lipase is measured by an enzymatic colorimetric or turbidimetric assay that detects the breakdown of a fat substrate, reported in units per litre (U/L). Different manufacturers use different substrates and calibrators, which is why the upper limit of normal ranges from about 50 to 160 U/L depending on the lab, and why results from two labs cannot be compared directly. The clinically important thresholds are therefore expressed as multiples of each lab's upper limit, with three times the upper limit the agreed cut-off for pancreatitis.

In health, pancreatic acinar cells secrete lipase into ducts leading to the duodenum, and only a trickle enters the blood. When the pancreas is inflamed, obstructed or injured, enzymes spill from damaged cells and blocked ducts into the circulation. Lipase is cleared by the kidneys and reabsorbed in the tubules, so reduced kidney function raises the baseline, typically to under two or three times the upper limit. Small amounts of lipase are also produced by the stomach, tongue, intestine and liver, which explains some of the mild, non-pancreatic elevations.

Lipase is not affected by eating and does not need fasting, though some clinicians prefer a fasting sample when it is drawn with triglycerides. It is not raised by salivary gland disease or ectopic pregnancy, both of which can elevate amylase, which is part of why it is more specific. Very rarely, lipase binds to immunoglobulins to form macrolipase, giving a persistently raised result with no disease, analogous to macroamylasemia.

Normal range for Lipase

Reference ranges vary between labs and by age, sex and pregnancy. Use the range printed on your own report.

GroupTypical range (U/L (units per litre); ranges differ widely between laboratories)Notes
Adults, typical reference rangeAbout 10–140 U/L (varies by assay)Other common ranges are 0–160, 13–60 and 7–60 U/L. The upper limit on your report is the number that matters.
Mild elevationUp to 3 times the upper limit of normalNon-specific: kidney disease, bowel disorders, gallbladder disease, peptic ulcer, DKA, GLP-1 drugs, coeliac disease, or early or mild pancreatitis. Repeated and interpreted with symptoms.
Diagnostic threshold for acute pancreatitisAbove 3 times the upper limit of normalWith typical pain, meets the Atlanta criteria for acute pancreatitis without imaging. Sensitivity and specificity are each around 80 to 90 percent at this cut-off.
Marked elevationAbove 5–10 times the upper limit of normalAlmost always pancreatitis, but the height does not predict severity; a lipase of 5,000 can accompany mild disease and a lipase of 600 severe disease.
Time course in acute pancreatitisRises at 4–8 hours, peaks at 24 hours, normal by 8–14 daysA normal lipase in the first hours of pain does not exclude pancreatitis; a repeat at 24 hours does.
Kidney disease (eGFR below 30–45)Often 1–3 times the upper limitReduced clearance raises the baseline. Pancreatitis in someone with kidney disease still usually exceeds 3 times the upper limit.
Low lipaseBelow the lower limit of the printed rangeMany labs have no meaningful lower limit. Persistently very low values are seen in advanced chronic pancreatitis, cystic fibrosis and after pancreatic surgery; fecal elastase is the proper test for exocrine insufficiency.

High lipase

A high lipase means the pancreas is releasing more enzyme into the blood than usual or the kidneys are clearing less of it. How high, and whether there is pain, determine what it means. A lipase more than three times the upper limit of normal in someone with severe, constant upper abdominal pain that often bores through to the back, with nausea and vomiting, is acute pancreatitis until proven otherwise, and the person needs hospital assessment. Gallstones blocking the pancreatic duct and alcohol are the two main causes; triglycerides above about 1,000 mg/dL, a recent ERCP, high calcium, certain medicines (azathioprine, valproate, thiazides, oestrogens, some HIV drugs) and, in children, viral infections and trauma account for most of the remainder. Around 10 to 20 percent of cases have no cause found.

A lipase that is raised but less than three times the upper limit, particularly without typical pain, is a different and more common situation. Mild elevations occur in up to a quarter of people with chronic kidney disease, in bowel obstruction, ischaemia or perforation, appendicitis, cholecystitis, peptic ulcer disease, inflammatory bowel disease, coeliac disease, diabetic ketoacidosis, after head injury and in critical illness. GLP-1 receptor agonists (semaglutide, liraglutide, dulaglutide) raise lipase by about 20 to 30 percent in trials, usually without pancreatitis, and routine monitoring is not recommended. Opioids can cause a mild rise by tightening the sphincter of Oddi. Some people simply run high with no disease.

In a person without symptoms, a mildly raised lipase found incidentally is generally repeated after a few weeks, with kidney function, calcium, triglycerides and liver tests. A persistent elevation without explanation may lead to imaging of the pancreas, since pancreatic cancer or a cyst can block the duct and raise lipase, but the great majority of incidental mild elevations turn out to be benign. In established pancreatitis, the lipase level is not used to judge severity or progress; that is done with clinical scores, CRP, kidney function and imaging.

Common causes

  1. Acute pancreatitis from gallstones

    A stone lodging where the bile and pancreatic ducts join blocks drainage and triggers inflammation. The most common cause (about 40 percent), more often in women and over 50. ALT more than three times normal alongside high lipase points strongly to a gallstone cause.

  2. Acute pancreatitis from alcohol

    Years of heavy drinking, often with a recent binge, cause about 30 percent of acute pancreatitis and most chronic pancreatitis. The pancreas can be damaged enough that lipase rises only modestly in later attacks.

  3. Very high triglycerides

    Triglycerides above about 1,000 mg/dL (11 mmol/L) can precipitate pancreatitis, with risk rising steeply above 2,000; this accounts for 2 to 10 percent of cases and is more common in uncontrolled diabetes, pregnancy, heavy alcohol use and inherited lipid disorders.

  4. ERCP, surgery and abdominal trauma

    Lipase rises after ERCP in a majority of patients and about 5 percent develop clinical pancreatitis; blunt abdominal trauma (bicycle handlebars in children, seatbelts) and abdominal surgery can injure the pancreas directly.

  5. Medicines

    Azathioprine and mercaptopurine, valproate, thiazides, furosemide, oestrogens, didanosine, pentamidine, sulfonamides, tetracyclines, mesalamine and some cancer immunotherapies cause pancreatitis occasionally. GLP-1 receptor agonists and DPP-4 inhibitors raise lipase modestly in most users without disease.

  6. Kidney disease

    Lipase is cleared by the kidneys, so chronic kidney disease and acute kidney injury raise it, usually to under two or three times the upper limit, in people with no pancreatic disease.

  7. Other abdominal conditions

    Bowel obstruction, intestinal ischaemia or perforation, appendicitis, cholecystitis, peptic ulcer, inflammatory bowel disease, coeliac disease and hepatitis all produce mild elevations through irritation of the pancreas or release of intestinal lipase.

  8. High calcium and hyperparathyroidism

    Hypercalcaemia activates digestive enzymes inside the pancreas; a calcium level is part of every pancreatitis work-up.

  9. Pancreatic cancer, cysts and chronic pancreatitis

    Tumours or cysts blocking the pancreatic duct, and flares of chronic pancreatitis, cause mild to moderate elevations. A persistent unexplained rise in someone over 50 with weight loss or new diabetes is a reason for imaging.

  10. Diabetic ketoacidosis, critical illness, head injury and macrolipase

    Lipase exceeds three times normal in 10 to 15 percent of people with DKA without pancreatitis. Severe illness, brain injury and the rare macrolipase complex all raise it without pancreatic disease.

Symptoms that can go with it

  • Severe, constant pain in the upper abdomen, often spreading through to the back, worse lying flat and eased by sitting forward (acute pancreatitis)
  • Nausea and vomiting
  • Fever, fast heartbeat and a tender, distended abdomen
  • Yellowing of the skin or eyes, pale stools and dark urine if a gallstone is also blocking the bile duct
  • Oily, pale, foul-smelling stools and weight loss with chronic pancreatitis
  • No symptoms at all with the mild elevations caused by kidney disease, medicines or incidental findings

Low lipase

Most lipase reference ranges start at or near zero, so a 'low' lipase is often not a meaningful result; the assay is designed to detect elevations, not deficiency. A value at the bottom of the range in a healthy person who eats and digests normally needs no action.

A lipase that is consistently very low can, however, reflect loss of pancreatic enzyme-producing tissue. In advanced chronic pancreatitis, cystic fibrosis, after pancreatic surgery and in some people with long-standing type 1 or type 2 diabetes, there is simply less pancreas making lipase, and studies have found that low serum lipase is associated with exocrine pancreatic insufficiency and with a small, fatty pancreas. In one of these conditions a low value fits the picture, but it is not used to make the diagnosis.

If you have symptoms of fat malabsorption, such as pale, greasy, floating stools, weight loss despite eating, bloating and deficiencies of the fat-soluble vitamins A, D, E and K, the test that matters is a fecal elastase (below 200 micrograms per gram suggests insufficiency), not the serum lipase. Treatment is with prescribed pancreatic enzyme replacement taken with meals.

Common causes

  1. Advanced chronic pancreatitis

    Repeated inflammation, most often from alcohol or smoking, replaces enzyme-producing tissue with scar; by the time fat malabsorption appears, 90 percent of function may be lost and serum lipase can be low or fail to rise during flares.

  2. Cystic fibrosis

    Thick secretions block pancreatic ducts from infancy and about 85 percent of people with CF have exocrine insufficiency; serum lipase is low in most of them.

  3. Pancreatic surgery or pancreatic cancer

    Removing part or all of the pancreas, or a tumour replacing it, reduces the amount of lipase made.

  4. Long-standing diabetes

    Both type 1 and type 2 diabetes are associated with a smaller pancreas and reduced exocrine function; low-normal serum lipase has been observed in these groups, though it is not clinically used.

  5. Fatty replacement of the pancreas and age-related atrophy

    Fat infiltration of the pancreas (pancreatic lipomatosis), common with obesity and metabolic syndrome, and the gradual shrinkage of the gland with age both reduce enzyme output; imaging studies have linked a fatty pancreas to lower serum lipase and reduced fecal elastase.

  6. Laboratory and sampling factors

    Different assays have different lower limits and some simply report values below detection as 'low'; a result at the bottom of the range usually carries no meaning.

Symptoms that can go with it

  • Usually none; a low lipase by itself does not cause symptoms
  • Pale, bulky, greasy or floating stools that are hard to flush (steatorrhoea) if exocrine insufficiency is present
  • Weight loss despite a normal appetite
  • Bloating, cramping and frequent loose stools after fatty meals
  • Signs of fat-soluble vitamin deficiency such as night blindness, easy bruising or bone pain

Read it alongside

  • Amylase — rises and falls faster than lipase and is raised by salivary gland disease; a lipase-to-amylase ratio above 2 to 3 has been suggested to favour an alcohol cause, though it is unreliable.
  • ALT and AST — an ALT more than three times normal with a high lipase strongly suggests a gallstone cause of pancreatitis; an AST/ALT ratio above 2 suggests alcohol.
  • Bilirubin, alkaline phosphatase and GGT — raised when a gallstone is blocking the common bile duct, which may need ERCP.
  • Triglycerides — above about 1,000 mg/dL identifies hypertriglyceridaemic pancreatitis, which changes treatment.
  • Calcium — high calcium is a cause of pancreatitis; low calcium during an attack is a marker of severity.
  • Creatinine and eGFR — kidney disease raises baseline lipase and is also a marker of severe pancreatitis when it rises during an attack.
  • CRP and white blood cell count — a CRP above 150 mg/L at 48 hours predicts severe pancreatitis; the lipase level itself does not.
  • Glucose and A1C — pancreatitis can cause temporary or permanent diabetes, and new diabetes with a raised lipase in an older adult prompts imaging.

What usually happens next

  1. If you have upper abdominal pain and a lipase more than three times the upper limit, the diagnosis of acute pancreatitis is made and the next steps are hospital fluids, pain relief, early feeding when tolerated, an ultrasound to look for gallstones, and triglyceride, calcium and liver tests to find the cause.
  2. A lipase less than three times the upper limit with pain is repeated after 12 to 24 hours; if pain persists and the lipase stays modest, a CT or MRI is used to look for pancreatitis and for other causes such as perforation, obstruction or ischaemia.
  3. A mildly raised lipase with no symptoms is usually repeated in 2 to 6 weeks alongside kidney function, calcium, triglycerides and a review of medicines (particularly GLP-1 drugs, azathioprine and valproate); a stable mild elevation with a normal work-up is often simply monitored.
  4. A persistent unexplained elevation, especially with weight loss, new diabetes, back pain or an age over 50, usually leads to a CT or MRI of the pancreas.
  5. After an attack of pancreatitis, expect a conversation about the cause: gallbladder removal is advised during or soon after the same admission for gallstone pancreatitis, and stopping alcohol and smoking is the main protection against recurrence in alcohol-related disease.
  6. If malabsorption symptoms are present, ask for a fecal elastase rather than relying on a low serum lipase.

Diet, lifestyle and natural levers with evidence

What can move Lipase once the cause is known. Nothing here replaces finding the cause.

Stop drinking alcohol after alcohol-related pancreatitis

Strong evidence

Alcohol causes about 30 percent of acute and most chronic pancreatitis, and continued drinking is the main driver of recurrent attacks and progression to chronic disease. In a Finnish randomised trial, repeated brief interventions about drinking every six months after a first alcohol-related attack reduced recurrence over two years to about 8 percent, compared with about 21 percent after a single conversation at discharge. Abstinence also slows the progression of chronic pancreatitis and reduces pain.

Stop smoking

Strong evidence

Smoking is an independent risk factor for both acute and chronic pancreatitis, not just a marker of drinking. In a Swedish cohort of 84,000 adults, current smokers with 20 or more pack-years had more than double the risk of non-gallstone acute pancreatitis, with risk returning to that of never-smokers about 20 years after quitting, and a meta-analysis found smokers have roughly double the risk of chronic pancreatitis. Smoking and alcohol multiply each other's effects on the pancreas.

Lower triglycerides with diet and omega-3 fats

Strong evidence

Triglycerides above about 1,000 mg/dL carry a 5 percent or greater risk of pancreatitis and the risk rises further above 2,000. A diet low in refined carbohydrate, sugar and alcohol, with total fat under about 15 to 20 percent of calories during acute management, lowers triglycerides within days; weight loss and glucose control lower them further. Prescription-strength omega-3 (about 4 g a day of EPA and DHA) reduces triglycerides by 20 to 30 percent in randomised trials and is a standard part of preventing hypertriglyceridaemic pancreatitis alongside fibrates.

People with triglycerides above 500 mg/dL usually need medication as well as diet. High-dose omega-3 can increase bleeding tendency and, in some trials, atrial fibrillation.

Maintain a healthy weight and avoid very rapid weight loss

Moderate evidence

Obesity roughly doubles the risk of gallstones and is associated with more severe acute pancreatitis and higher mortality when it occurs, while a meta-analysis of cohort studies found each 5-unit increase in BMI associated with about 20 percent higher risk of acute pancreatitis. Rapid weight loss of more than about 1.5 kg a week, as with very-low-calorie diets or after bariatric surgery, increases gallstone formation and therefore gallstone pancreatitis; gradual loss and regular meals containing some fat (to keep the gallbladder emptying) reduce this risk.

Eat more vegetables

Preliminary evidence

In a Swedish prospective cohort of 80,000 adults followed for 11 years, those eating four or more servings of vegetables a day had a 44 percent lower risk of non-gallstone-related acute pancreatitis than those eating one or fewer, with the strongest protection among people who drank more alcohol; fruit intake was not protective. The proposed mechanism is antioxidant protection of acinar cells. This is observational evidence from a single population and has not been tested in trials.

Antioxidant supplementation in chronic pancreatitis

Preliminary evidence

An Indian randomised trial of a combined antioxidant mixture (selenium, vitamin C, beta-carotene, vitamin E and methionine) in 127 people with chronic pancreatitis reduced painful days per month by about a third more than placebo over six months, but a UK trial in a largely alcohol-related population found no benefit, and a Cochrane review judged the overall evidence low quality with only a small reduction in pain. It does not change lipase levels or the course of disease.

High-dose vitamin E and beta-carotene have their own risks (bleeding; lung cancer in smokers). Discuss with the team managing your pancreatitis rather than self-prescribing.

When to see a clinician promptly

  • Severe upper abdominal pain, especially spreading to the back, with vomiting, whether or not you know your lipase result: possible acute pancreatitis, which needs same-day hospital assessment.
  • A lipase more than three times the upper limit of normal, at any time.
  • A raised lipase with yellow skin or eyes, dark urine, pale stools or fever: a gallstone may be blocking the bile duct and infection can follow.
  • A raised lipase with confusion, breathlessness, a very fast heartbeat, passing little urine or a bruised-looking abdomen: signs of severe pancreatitis.
  • A persistently raised lipase with unexplained weight loss, new diabetes, back pain or age over 50, so the pancreas can be imaged.
  • Greasy, pale, floating stools and weight loss, which suggest exocrine insufficiency and should prompt a fecal elastase test.

Frequently asked questions

What is a normal lipase level?

It depends on the lab's assay more than for almost any other common test. Many US labs quote roughly 10 to 140 U/L, others 0 to 160, 13 to 60 or 7 to 60. Because of this, the important thresholds are expressed as multiples of your lab's upper limit: more than three times the upper limit, with typical pain, indicates acute pancreatitis. Compare your result only with the range printed next to it.

What does a slightly elevated lipase mean?

A lipase raised to less than three times the upper limit of normal, especially without abdominal pain, is usually not pancreatitis. Common explanations are reduced kidney function, GLP-1 diabetes or weight-loss drugs, bowel or gallbladder conditions, peptic ulcer, coeliac disease, or simply being at the high end of normal for you. It is typically repeated after a few weeks with kidney function, calcium and triglycerides, and imaging is reserved for persistent unexplained elevation or symptoms.

What lipase level indicates pancreatitis?

A lipase more than three times the upper limit of normal for the lab (for example above 420 U/L where the upper limit is 140, or above 180 where it is 60), together with characteristic upper abdominal pain, meets the diagnostic criteria for acute pancreatitis without needing a scan. The sensitivity and specificity at that cut-off are each around 80 to 90 percent. Lower values with pain are repeated at 24 hours or followed by CT or MRI.

Does a very high lipase mean severe pancreatitis?

No. The height of the lipase reflects how much enzyme leaked out, not how much damage is being done, and studies consistently find no correlation between the level and the outcome. A lipase of 5,000 U/L can accompany a mild attack that settles in two days, and a lipase of 500 can occur with severe necrotising pancreatitis. Severity is judged by clinical scores, CRP at 48 hours, kidney function, blood pressure, oxygen levels and imaging.

What is the difference between lipase and amylase?

Both are pancreatic digestive enzymes, but lipase is more specific to the pancreas (amylase also comes from the salivary glands and rises with mumps, ectopic pregnancy and some tumours) and stays raised for 8 to 14 days versus 3 to 5 for amylase, so it catches people who present late. Guidelines recommend lipase alone; ordering both adds cost and little information. Neither predicts severity.

Can Ozempic, Wegovy or Mounjaro raise lipase?

Yes. GLP-1 receptor agonists such as semaglutide, liraglutide and dulaglutide, and the dual agonist tirzepatide, raise lipase by about 20 to 30 percent on average in trials, and some people exceed the upper limit while feeling well. These elevations have not been shown to predict pancreatitis, which remains uncommon on these drugs, and guidelines do not recommend routine lipase monitoring. The drug should be stopped and you should be assessed if you develop persistent severe abdominal pain.

How long does lipase stay elevated after pancreatitis?

Lipase rises within 4 to 8 hours of the onset of pain, peaks at around 24 hours and usually returns to normal within 8 to 14 days, though it can stay mildly raised for weeks if a pseudocyst forms or the duct remains partly blocked. Because it falls relatively slowly, a normal lipase a week after an attack is reassuring, but a persistently high one does not by itself mean the pancreatitis is still active.

Do I need to fast for a lipase test?

Usually not. Lipase is not affected by a recent meal, and in an emergency it is drawn whenever you arrive. Some clinicians ask for 8 to 12 hours of fasting when lipase is ordered alongside triglycerides or glucose, which are affected by food. Tell the clinician about alcohol, GLP-1 drugs, azathioprine, valproate, thiazides and opioids, all of which can affect the result.

References

  1. Lipase tests. MedlinePlus, US National Library of Medicine (2023)View source
  2. Pancreatitis. Mayo Clinic (2023)View source
  3. Acute pancreatitis. Merck Manual Professional Version (2024)
  4. Banks PA, Bollen TL, Dervenis C, et al.. Classification of acute pancreatitis 2012: revision of the Atlanta classification and definitions by international consensus. Gut (2013)
  5. Tenner S, Vege SS, Sheth SG, et al.. American College of Gastroenterology guidelines: management of acute pancreatitis. American Journal of Gastroenterology (2024)
  6. Rompianesi G, Hann A, Komolafe O, Pereira SP, Davidson BR, Gurusamy KS. Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis. Cochrane Database of Systematic Reviews (2017)
  7. Hameed AM, Lam VW, Pleass HC. Significant elevations of serum lipase not caused by pancreatitis: a systematic review. HPB (Oxford) (2015)
  8. Nordback I, Pelli H, Lappalainen-Lehto R, Järvinen S, Räty S, Sand J. The recurrence of acute alcohol-associated pancreatitis can be reduced: a randomized controlled trial. Gastroenterology (2009)
  9. Sadr-Azodi O, Andrén-Sandberg Å, Orsini N, Wolk A. Cigarette smoking, smoking cessation and acute pancreatitis: a prospective population-based study. Gut (2012)
  10. Oskarsson V, Sadr-Azodi O, Orsini N, Andrén-Sandberg Å, Wolk A. Vegetables, fruit and risk of non-gallstone-related acute pancreatitis: a population-based prospective cohort study. Gut (2013)
  11. Scherer J, Singh VP, Pitchumoni CS, Yadav D. Issues in hypertriglyceridemic pancreatitis: an update. Journal of Clinical Gastroenterology (2014)
  12. Steinberg WM, Buse JB, Ghorbani MLM, Ørsted DD, Nauck MA. Amylase, lipase, and acute pancreatitis in people with type 2 diabetes treated with liraglutide: results from the LEADER randomized trial. Diabetes Care (2017)

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This page is educational and is not medical advice or a diagnosis. Lab results have to be interpreted together with your history, symptoms and other results by a clinician who knows you. Do not start or stop a supplement to change a lab value before the cause is known.