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Liver

Raised LDH value: tissue damage, training or red cells bursting in the tube

LDH, or lactate dehydrogenase, helps muscle cells, red blood cells and most other tissues convert lactate; it is an enzyme, a protein that speeds up such a conversion. It stays mostly inside the cell, so there is normally little of it in the blood.

Damaged muscle fibres, broken red blood cells or damage to another tissue let LDH leak into the blood, and then the value rises. Only a blood test shows whether that has happened.

Star-SHL lists 118 to 251 U/l (units per litre) for adults from 19 up to and including 50. A hard training session in the 24 hours before the draw can raise the value.

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 units per litre (U/l), the LDH measurement reflects how active lactate dehydrogenase is in the blood; LD and LDH both refer to this one test.

That number is the sum of five forms of the enzyme. According to the NVKC, LD1 and LD2 are found mostly in heart muscle and red blood cells, and LD4 and LD5 mostly in skeletal muscle and liver cells. A rise from muscle damage after training and a rise from broken red blood cells therefore look the same in the standard test.

For that reason CK, creatine kinase, an enzyme released with muscle damage, can be looked at alongside the LDH result.

LDH (Lactate Dehydrogenase): why this value matters

A raised LDH can come from muscle cells, for example after hard training, but also from red blood cells, and the number itself does not distinguish between those sources.

Haemolysis in the tube, the bursting of red blood cells during or after the draw, raises the LDH as well. Star-SHL puts the LDH concentration inside a red blood cell at about fifty times that of serum, the clear fluid left after blood has clotted.

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.
Which test
on its own €10,-
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 draw shortly after hard training can give a higher value than a draw on a rest day. Endurance exercise such as running can raise LDH activity for 12 to 24 hours, according to earlier research that Callegari and colleagues cited in 2017. A draw taken more than 24 hours after such an endurance session falls outside that window of 12 to 24 hours.

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

Low Levels

A low LDH is attributed to no cause at all by the NVKC (Dutch Society for Clinical Chemistry). Unilabs, Certe and Diagnostiek voor U give only an upper limit for LDH in adults, so at those three laboratories a result can only count as too high.

High Levels

According to the NVKC (Dutch Society for Clinical Chemistry), a raised LDH means that cells of a tissue have broken down, but the number does not name that tissue.

Baird and colleagues describe, in a 2012 article, research in which heavier strength training made LDH come out higher, together with CK (creatine kinase) and AST (aspartate aminotransferase). Training at 70 and 90 percent of the 10RM gave higher values there than training at 35 percent, with 150 repetitions each time. The 10RM is the heaviest weight a person can lift ten times.

Hard training beforehand does not settle the cause of a raised LDH, because damaged tissue elsewhere or broken red blood cells can give the same rise.

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

With an LDH measurement, note whether you trained hard in the 24 hours before the draw, so that the result can be read next to that training.

With a raised LDH, have CK, creatine kinase, an enzyme from muscle cells, measured too. When LDH and CK both rise after training, that can fit muscle damage.

LDH (Lactate Dehydrogenase): frequently asked questions

How long after training is LDH raised?

LDH can stay raised for 12 to 24 hours after endurance exercise such as running, according to earlier research that Callegari and colleagues cite in a 2017 article. That window was described for endurance exercise; after hard strength training LDH can also rise, together with CK (creatine kinase), as Baird and colleagues describe in 2012.

What is the normal LDH value for adults?

The normal LDH value for adults at Star-SHL is 118 to 251 U/l between 19 and 50, 128 to 274 U/l between 51 and 65, 130 to 282 U/l between 66 and 80, and 130 to 301 U/l from 81.

Why are AST and potassium raised along with my LDH?

The enzyme AST and potassium can come out falsely raised together with LDH when red blood cells break open in the blood sample, according to a 2019 teaching article by Krasowski. When they break open, those cells release AST, LDH and potassium, among other substances, into the sample. AST, aspartate aminotransferase, can also rise together with CK and LDH after hard strength training, as a 2012 article by Baird and colleagues describes.

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

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Medical standards

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Medical policy
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LDH (Lactate Dehydrogenase)

€10,-