Blood test results explained: FBC, CRP, ESR, liver and kidney tests, and what a check-up includes
A routine blood test can pick up anaemia, infection, liver and kidney problems, diabetes and high cholesterol before you feel unwell. But the report can be hard to read. Here is what the common tests measure and what high or low results can mean. Always go by the reference range printed on your own report, as it varies between labs, and ask a doctor to explain your results.
Key points
- Reference ranges differ between labs. A result slightly outside the range is often normal for you, so look at the whole picture with a doctor.
- Small red blood cells (low MCV) are common in Malaysia and can mean iron deficiency or thalassaemia trait, which need different treatment.
- Raised liver enzymes (ALT) are most often caused by fatty liver, which affects about 3 in 10 Malaysian adults.
- About 1 in 7 Malaysian adults has chronic kidney disease, and only 1 in 20 of them knows. People with diabetes or high blood pressure should have yearly kidney tests.
- STR recipients aged 40 and over can get free blood tests through PeKa B40, and eligible PERKESO contributors aged 40 to 59 through its health screening programme.
Full blood count (FBC)
The full blood count (FBC, or full blood picture) measures the cells in your blood.
| Test | Typical adult range | What it can mean |
|---|---|---|
| Haemoglobin (Hb) | Men about 130–180 g/L; women about 115–165 g/L | Low: anaemia, for example from iron deficiency, heavy periods, blood loss or thalassaemia |
| MCV and MCH (red cell size) | MCV about 80–100 fL; MCH about 27–32 pg | Low: iron deficiency or thalassaemia trait. High: low vitamin B12 or folate, alcohol, liver disease |
| White cells (WBC) | About 4–11 ×10⁹/L | High: infection, inflammation, steroids, rarely leukaemia. Low: some viral infections (such as dengue), medicines |
| Platelets | About 150–400 ×10⁹/L | Low: higher bleeding risk, for example in dengue. High: inflammation, iron deficiency |
Haemoglobin is sometimes reported in g/dL: divide g/L by 10 (so 130 g/L is 13.0 g/dL).
Small red cells are common in Malaysia. They can mean iron deficiency, which is treated with iron, or thalassaemia trait, which isn’t, and iron tablets don’t help. A doctor can check your iron levels and arrange a thalassaemia test. See our guide to thalassaemia screening.
CRP and ESR: inflammation markers
- CRP (C-reactive protein) is made by the liver when there is inflammation or infection, and rises within hours. A normal result is usually below about 5 to 10 mg/L, depending on the lab. Very high levels often point to a bacterial infection.
- ESR (erythrocyte sedimentation rate) measures how fast red cells settle in a tube in an hour. It rises more slowly than CRP and is naturally higher in women, older people, pregnancy and anaemia. Typical upper limits are around 15 to 20 mm/hr for men and 20 to 30 mm/hr for women, depending on age.
Both are signals, not diagnoses: they show that inflammation is present, but not where or why. Doctors use them alongside your symptoms and other tests, and to check whether a condition is improving.
A high-sensitivity CRP (hs-CRP) is a different test sometimes used to assess heart disease risk.
Liver function tests (LFT)
| Test | What it shows |
|---|---|
| ALT and AST | Enzymes released when liver cells are damaged. ALT is the more liver-specific of the two |
| ALP and GGT | Raised in bile duct problems. GGT also rises with alcohol and some medicines. ALP also comes from bone |
| Bilirubin | A yellow pigment. High levels cause jaundice. Mildly raised bilirubin on its own is often harmless (Gilbert’s syndrome) |
| Albumin | A protein made by the liver. Low levels can mean long-term liver disease, kidney problems or poor nutrition |
Common causes of raised ALT in Malaysia:
- fatty liver (now called MASLD or MAFLD). A 2023 Ministry of Health survey found it in 28.2% of adults, about 6.7 million people, including 1 in 5 adults aged 18 to 29. It is linked to excess weight, diabetes and high cholesterol. See our BMI calculator.
- alcohol
- hepatitis B and C. See our guide to hepatitis B.
- medicines, and herbal or slimming supplements
- a recent illness or very hard exercise, which can cause short-lived rises
Mildly raised results are often rechecked after a few weeks, and the doctor may arrange a liver ultrasound.
Kidney function tests
- Creatinine is a waste product from muscles, cleared by the kidneys. A high level suggests the kidneys aren’t filtering well.
- eGFR (estimated glomerular filtration rate) is calculated from creatinine, age and sex. It estimates how well your kidneys filter, in mL/min/1.73m².
- Urea is another waste product, affected by dehydration and diet as well as kidney function.
- Urine albumin-to-creatinine ratio (ACR or UACR) detects protein leaking into the urine, an early sign of kidney damage, especially in diabetes.
| Stage | eGFR | Meaning |
|---|---|---|
| G1 | 90 or more | Normal filtering. Counts as kidney disease only with other signs of damage, such as protein in the urine |
| G2 | 60–89 | Mildly reduced. Common with age. Kidney disease only with other signs of damage |
| G3a / G3b | 45–59 / 30–44 | Moderately reduced |
| G4 | 15–29 | Severely reduced |
| G5 | Below 15 | Kidney failure |
Chronic kidney disease (CKD) is diagnosed when results stay abnormal for more than 3 months. In Malaysia, a national survey found CKD in 15.5% of adults in 2018, up from 9.1% in 2011, but only about 5% of those affected knew. About 50,000 people were on dialysis in 2023, with more than 10,000 starting each year. High blood pressure and diabetes are the main causes, so people with either should have their kidney blood and urine tests at least once a year.
Other common tests
| Test | What it checks | Read more |
|---|---|---|
| Fasting glucose and HbA1c | Diabetes and prediabetes | Normal blood sugar levels |
| Lipid profile (cholesterol, LDL, HDL, triglycerides) | Heart disease and stroke risk | Blood pressure and cholesterol |
| Uric acid | Gout and kidney stones | Gout |
| TSH (thyroid-stimulating hormone) | Overactive or underactive thyroid | Thyroid problems |
| Urine test (urine FEME) | Sugar, protein, blood and signs of infection | UTI |
Do I need to fast before a blood test?
- Fasting glucose needs a fast of at least 8 hours, usually overnight.
- Cholesterol tests often don’t need fasting now, but some labs and doctors still ask for a 10 to 12 hour fast, mainly because triglycerides rise after eating. Follow the instructions you are given.
- HbA1c, the full blood count, and liver and kidney tests usually don’t need fasting.
- When fasting, you can drink plain water. Avoid tea, coffee, sweet drinks and chewing gum.
- Take your usual medicines unless told otherwise, but ask about diabetes medicines and insulin, which may need adjusting while you fast.
- Stop biotin supplements (often in hair and nail products) 2 days before, as they can distort some results, including thyroid tests.
What a medical check-up includes, and free options
A typical health screening includes a consultation, blood pressure, weight and waist measurement, and blood and urine tests such as:
- full blood count
- fasting glucose or HbA1c
- lipid profile
- kidney function (creatinine, eGFR) and urine test
- liver function, and sometimes uric acid, thyroid and hepatitis B tests
Free and low-cost options:
- PeKa B40: STR recipients and their spouses aged 40 and over get free tests at panel clinics: full blood count, kidney profile with eGFR, HbA1c, lipid profile and urine tests, with no fasting needed and a second visit to explain the results. See our PeKa B40 guide.
- PERKESO Health Screening Programme: eligible Malaysian contributors aged 40 to 59 get free blood and urine tests at panel clinics.
- Klinik Kesihatan: basic screening for a minimal fee.
- Private clinics and labs: packages range from under RM100 to several hundred ringgit, depending on the tests included.
See our guide to free health screening in Malaysia. Whichever you choose, have a doctor go through your results, especially any flagged as high or low, rather than relying on the report alone.
Where to get a blood test
Most GP clinics can take blood for a check-up or specific tests and explain the results. Our directory lists GP clinics across Kuala Lumpur, Selangor and other states, including PeKa B40 panel clinics and clinics open early on Saturdays for fasting tests.
Browse the clinic directoryFrequently asked questions
What does a full blood count check?
Your red cells (including haemoglobin and cell size), white cells and platelets. It can show anaemia, infection, inflammation and bleeding risks.
What is a normal CRP level?
Usually below about 5 to 10 mg/L, depending on the lab. A raised CRP shows inflammation or infection but not the cause.
What does a high ALT mean?
Liver cells may be inflamed or damaged. In Malaysia the most common cause is fatty liver, but alcohol, hepatitis B or C and medicines are also possible. A doctor may repeat the test and arrange an ultrasound.
What is a normal eGFR?
90 or above is normal, and 60 to 89 can be normal, especially with age. Below 60 for more than 3 months means chronic kidney disease.
Do I need to fast before a blood test?
Only for some tests, mainly fasting glucose and sometimes cholesterol. Drink plain water and take your usual medicines unless told otherwise.
Why does my report show results outside the normal range?
Ranges cover about 95% of healthy people, so slightly abnormal results are common and often not significant. A doctor will look at the whole picture.
Where can I get a free blood test in Malaysia?
Through PeKa B40 if you receive STR and are 40 or over, and through PERKESO’s screening programme if you are an eligible contributor aged 40 to 59. Klinik Kesihatan offer basic screening for a minimal fee.
How often should I have a blood test?
It depends on your age and health. Adults are generally advised to screen for diabetes, cholesterol and kidney problems regularly from 30 or 40, and every year if you have diabetes or high blood pressure. Ask your doctor.
Sources
- Institute for Public Health — Metabolic dysfunction-associated fatty liver disease in Malaysia (2023)
- BMC Nephrology — Prevalence of chronic kidney disease in Malaysia (Aug 2020)
- The Star — Bid to reduce kidney cases among Malaysians (24 Feb 2025)
- ProtectHealth — PeKa B40
- MyGOV — PeKa B40 (Mar 2026)
- CodeBlue — The silent surge: why Malaysians keep postponing health screening (Sep 2026)
- Gloucestershire Hospitals NHS Trust — Haematology reference ranges
- Testing.com — C-reactive protein (Aug 2026)
- Testing.com — Liver panel (Aug 2026)
- NHS — Chronic kidney disease: diagnosis
- NHS — Blood tests
