The letters on a German lab report can look like a secret code. Ery, Leuko, Thrombo, MCV, MCH, MCHC, and next to each one a number and a range.
Almost all of those letters belong to one single test: the großes Blutbild. It is one of the most requested tests in German practices, it comes up in almost every health conversation, and it is also the test people misunderstand most often. The name suggests the big, complete check. The content is much narrower than that.
The short answer. A großes Blutbild contains around 18 values, and every single one of them describes your blood cells: your red blood cells, your platelets, and a detailed count of your white blood cells. It does not contain cholesterol, blood sugar, vitamins, iron stores, hormones, or liver and kidney values. Those are separate tests, even though they can come from the same blood draw.
What is a großes Blutbild
A großes Blutbild is two tests in one. The first part is the kleines Blutbild, the small blood count. It counts your red blood cells, your platelets and your white blood cells as one total number, and it measures how much oxygen-carrying pigment your red cells hold.
The second part is the Differentialblutbild. Your white blood cells are not one single cell type but five, and each type has its own job in your immune system. The Differentialblutbild splits the total white cell count into those five groups, as described by AOK's guide to blood count values.
So the formula is simple: kleines Blutbild + Differentialblutbild = großes Blutbild. Everything in it is about cells. Nothing in it is about the substances that float between the cells, like fats, sugar, vitamins or hormones.
Which values are in the kleines Blutbild
These are the values the first part of the test contains, in the order most lab reports show them.
The values in the kleines Blutbild
| Value |
What it is |
What a value outside the range can go along with |
| Erythrozyten (Ery) |
Your red blood cells. They pick up oxygen in the lungs and carry it through the body |
Low counts often go along with anaemia, high counts with fluid loss or smoking |
| Hämoglobin (Hb) |
The red pigment inside those cells. It is the part that actually binds the oxygen |
A low value is the classic sign doctors check when someone feels weak and pale |
| Hämatokrit (Hkt) |
The share of your blood that is made of cells rather than fluid |
High values can mean the blood is thick, for example after too little drinking |
| MCV, MCH, MCHC |
Three calculated values that describe the size of your red cells and how well they are filled with pigment |
They help narrow down the type of anaemia, for example small pale cells versus large ones |
| Thrombozyten (Thrombo) |
Your platelets. They seal small wounds and start the clotting process |
Low counts can go along with easier bruising, high counts sometimes follow infections |
| Leukozyten (Leuko) |
All your white blood cells counted as one total number, your immune cells |
High totals often go along with infections, low totals with some infections and medicines |
One important reading rule: a single value slightly outside the range is common and usually means little on its own. Doctors read these values as a pattern, not one by one.
What does the Differentialblutbild add
The Differentialblutbild is the part that turns a kleines Blutbild into a großes Blutbild. It takes the one total Leukozyten number and splits it into the five types of white blood cells.
The five white blood cell types in the Differentialblutbild
| Cell type |
What it does |
When it typically rises |
| Neutrophile |
The largest group. They are the first defence against bacteria and swallow them whole |
Bacterial infections, stress on the body, some medicines |
| Lymphozyten |
The memory of your immune system. They recognise germs and build antibodies |
Many viral infections, for example flu-like illnesses |
| Monozyten |
The cleanup crew. They leave the blood, become macrophages and clear away debris |
Longer-running infections and recovery phases |
| Eosinophile |
Specialists for allergies and parasites |
Allergic reactions, asthma, parasite infections |
| Basophile |
The smallest group. They release histamine and play a role in allergic reactions |
Rarely, sometimes in allergic and inflammatory conditions |
Some reports also show Retikulozyten, which are very young red blood cells, but most standard reports stop at the values above. Counted together, the kleines Blutbild and the five white cell types add up to around 15 to 18 numbers, depending on how your laboratory reports them.
What is not in a großes Blutbild
This is the part that surprises most people. Because the test is called "groß", many expect it to be the complete picture of their health. It is not.
A großes Blutbild does not contain cholesterol or any other blood fat. It does not contain blood sugar or HbA1c. It does not contain ferritin, the value that shows your iron stores, even though it can hint at iron problems through the red cell values. It does not contain vitamin D or B12, no thyroid values, no hormones, no liver or kidney values, and no inflammation marker like hs-CRP.
All of those come from the same tube family but need to be ordered as extra tests. If you want the full story of what the großes Blutbild leaves out and why, our pillar guide covers it in depth: Großes Blutbild, what it actually tests and what it misses.
When do doctors order a großes Blutbild and who pays
A doctor typically orders a großes Blutbild when there is a concrete reason to look at your blood cells: a suspected infection, tiredness that could point to anaemia, unexplained bruising, or a check before an operation. When a doctor orders the test for a medical reason, your Krankenkasse pays for it.
Without a concrete suspicion, the test is usually an IGeL service you pay yourself, and it then costs roughly 25 to 40 euros at most practices. If you want a blood test without waiting for symptoms, you can also book one directly: we explain the options in how to get a blood count done yourself in Germany.
How do you read your own values
Three simple rules make a lab report much less scary.
First, the reference range printed next to each value belongs to the laboratory that ran your test. Ranges differ slightly between labs, so compare your value against the range on your own report, not against a table from the internet.
Second, one value slightly outside the range is normal life, not a diagnosis. Values move with infections, sport, stress and even the time of day. Doctors look at the pattern across values and at the trend over time.
Third, a normal großes Blutbild does not mean everything is fine, and an abnormal one does not mean something is wrong. It means exactly what it measures: your blood cells, on that day. Questions about energy, metabolism, hormones or vitamins need their own values.
How can you see what the großes Blutbild leaves out
If your reason for wanting a blood test is a question like "why am I always tired" or "how is my metabolism doing", the großes Blutbild alone will rarely answer it, because the values that answer those questions are not part of it.
An Aniva membership costs 199 euros per year and measures 100+ biomarkers across 10 physiological systems, including the complete großes Blutbild plus the values it leaves out, like ferritin, vitamin D, thyroid values, blood fats and hs-CRP. Blood is drawn by licensed physicians at over 25 partner locations in Germany, results arrive in the app usually within 10 days with a personalised action plan, and your personal health concierge can answer questions about every single value. Membership is up to 100% reimbursable via German private health insurance (PKV), depending on your plan.
Frequently asked questions
How many values does a großes Blutbild contain?
Around 15 to 18, depending on how the laboratory reports them. Eight values come from the kleines Blutbild: Erythrozyten, Hämoglobin, Hämatokrit, MCV, MCH, MCHC, Thrombozyten and Leukozyten. The Differentialblutbild adds the five white blood cell types, and some labs split or add single values on top.
Is cholesterol part of a großes Blutbild?
No. A großes Blutbild only counts and describes blood cells. Cholesterol, blood sugar, vitamins, hormones, iron stores and liver or kidney values are all separate tests that a doctor has to order in addition, even though they can come from the same blood draw.
What is the difference between a kleines and a großes Blutbild?
The Differentialblutbild. A kleines Blutbild counts red blood cells, platelets and all white blood cells as one total number. A großes Blutbild takes that same test and splits the white blood cells into their five types: Neutrophile, Lymphozyten, Monozyten, Eosinophile and Basophile.
Do I need to fast before a großes Blutbild?
Usually not. The blood count itself is not affected by breakfast. Fasting matters for values that are often ordered together with it, like blood sugar and blood fats, so ask your practice beforehand whether you should come without eating.
How much does a großes Blutbild cost?
If a doctor orders it for a medical reason, your Krankenkasse pays. If you ask for it yourself without a concrete suspicion, it is an IGeL service and usually costs roughly 25 to 40 euros. Larger panels that include the values a Blutbild leaves out cost more and are priced per provider.
This article is general information about laboratory tests, not medical advice, and it is not intended to diagnose, treat or rule out any condition. Reference ranges belong to the analysing laboratory and vary between labs. If a value on your report worries you, discuss it with a clinician who knows your history.
