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Liver

How high can the LDH value be?

Skeletal muscle, the liver, the heart and the red blood cells all contain lactate dehydrogenase, LDH for short. This enzyme, a protein that hastens the conversion of lactate, stays mostly inside the cells. Normally, therefore, there is only a little of it in the blood.

After a hard strength session, damaged muscle tissue can release LDH into the blood, and damage to another tissue or broken red blood cells do the same. Only a blood test reveals a rise in LDH.

At Star-SHL the normal range for men moves up with age, starting at 118 to 251 U/l (units per litre) from 19 up to and including 50. From 51 up to and including 65 that is 128 to 274 U/l, and from 66 up to and including 80 it is 130 to 282 U/l. Whether a raised LDH shortly after strength training comes from the muscles, the number itself does not show.

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
118 329 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
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
118 329 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 · Male · 51–65 years 128–274 U/l
128 274
Star-shl · Male · 66–80 years 130–282 U/l
130 282
Star-shl · Male · 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
Diagnostiek voor U · Male · 13 years and older · a limit, not a range < 248 U/L
248
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

An LDH result gives the activity of lactate dehydrogenase in units per litre (U/l); Star-SHL calls the test LD(H).

LD4 and LD5, two of the five forms of LDH, occur according to the NVKC mainly in striated muscle tissue, such as skeletal muscle, and in liver cells. The standard test measures all forms together, so the share from the muscles does not appear separately in the result.

LDH (Lactate Dehydrogenase): why this value matters

Damaged skeletal muscle, the muscles attached to the skeleton, is one possible source of a raised LDH. A damaged heart, red blood cells breaking down or injury to another tissue can give the same rise too.

According to Star-SHL, red cells bursting in the tube give a falsely raised LDH. When red blood cells break down in the body, the LDH rises too, and haptoglobin, a protein that captures freed haemoglobin, is then lowered, according to Phillips and Henderson (2018).

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 shortly after hard training can come out higher, and how long that effect lasted depended on the type of session in the study by Callegari and colleagues (2017). With the strength sessions, LDH was already coming down within a day from its value straight after the session. After endurance work at 80 percent of maximal oxygen uptake (VO2max), the largest amount of oxygen the body can take up during exercise, LDH stayed raised for up to 24 hours.

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

Low Levels

No cause of an LDH that is too low appears in the explanation of the NVKC, the association of Dutch clinical chemists. At Star-SHL the lower limit is higher from age 51, at 128 U/l for ages 51 up to and including 65 and at 130 U/l from age 66.

High Levels

With a raised LDH, cells of a tissue have broken down, according to the NVKC, the association of Dutch clinical chemists; the number does not show which tissue. After a strength session, that can be muscle tissue. In the study by Callegari and colleagues (2017), LDH appeared to climb higher straight after strength sessions than after endurance exercise. That held for bi-sets, two exercises straight after each other, and for sessions with multiple sets, compared with endurance work at 60 and 80 percent of maximal oxygen uptake.

A recent strength session does not make other sources of a raised LDH impossible, such as damage to the heart or breakdown of red blood cells.

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

When the question with a raised LDH is whether red cells are being destroyed inside the body, a doctor can also have haptoglobin measured. That protein binds released haemoglobin and falls with such breakdown, according to an article in American Family Physician from 2018.

LDH (Lactate Dehydrogenase): frequently asked questions

How high can the LDH value be in a man?

The LDH value in a man aged 19 up to and including 50 can be up to 251 U/l according to Star-SHL, up to 274 U/l between 51 and 65, up to 282 U/l between 66 and 80, and up to 301 U/l from 81. Certe uses 248 U/l for adults, and Diagnostiek voor U also 248 U/l for men above age 12. Look at the limit on your own result.

Does strength training raise the LDH value?

Yes, strength training can raise the LDH value. In 2017, Callegari and colleagues cited earlier research in which both strength training and endurance training changed CK and LDH, in line with muscle damage after a session. CK, creatine kinase, is an enzyme that enters the blood with muscle damage.

Is LDH used in germ cell tumours?

Yes, according to the National Cancer Institute (NCI), LDH is used in germ cell tumours, growths from the cells that sperm and eggs develop from. There, LDH helps to assess the stage and the outlook and to follow the response to treatment. The NCI also writes that noncancerous conditions can sometimes raise the level of a tumour marker.

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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LDH (Lactate Dehydrogenase)

€10,-