Normal values for alpha-hydroxybutyrate dehydrogenase range from 90-182 U/L. Alpha-hydroxybutyrate dehydrogenase is found primarily in the human myocardium and can be detected in the blood in the presence of myocardial injury. If myoglobin, troponin, and creatine kinase isoenzymes are also elevated, this may be secondary to myocardial infarction, myocarditis, severe shock, or iron deficiency anemia. α-hydroxybutyrate dehydrogenase is also found in the liver, although the elevation of α-hydroxybutyrate dehydrogenase in the liver is generally not significant. The amount in the myocardium is twice as high as that in the liver, so generally speaking, an increase in the index is considered first for myocardial damage.