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Factor V

Coagulation

F5Factor V activityFVLabile factorProaccelerin

Review status

Currently under review

Pending specialist review and validation.

What it shows

Factor V is a blood-clotting protein made mainly in the liver. It acts as a cofactor that helps an enzyme complex convert prothrombin to thrombin, a key step in forming a stable blood clot. The Factor V test most often measures functional activity in your plasma using a clot-based assay, which reflects how well Factor V is working rather than just how much is present.

This test is different from genetic testing for the Factor V Leiden variant. The activity assay does not diagnose Factor V Leiden; it evaluates overall Factor V function, which can be reduced in inherited deficiency or in several acquired conditions.

Why it matters

Your clinician may order a Factor V test if you have easy bruising, nosebleeds, heavy menstrual bleeding, bleeding after surgery or dental work, or if screening tests like the PT or aPTT are prolonged. It helps identify whether a clotting factor problem is contributing to bleeding and can point to specific causes, such as a rare inherited deficiency, liver-related production issues, or clotting factor consumption during serious illness.

The result can also help distinguish between different medical conditions that look similar on routine tests. For example, Factor V is not dependent on vitamin K, so patterns that include a low Factor V level suggest causes other than simple vitamin K deficiency. The test can also help detect rare inhibitors to Factor V that may develop after exposure to certain surgical materials.

Understanding your results

If your Factor V activity is lower than expected, it may reflect an inherited deficiency or an acquired problem such as reduced production in liver disease, increased consumption during severe infection or disseminated intravascular coagulation, dilution after large-volume transfusion, or an antibody that interferes with Factor V. Your care team may repeat the test, review other clotting tests, or perform mixing studies to clarify the cause and guide treatment.

If your result is within the expected range, Factor V deficiency is unlikely, and your clinician may look for other reasons for bleeding symptoms, such as platelet disorders or deficiencies of other clotting factors. A higher-than-expected Factor V activity is uncommon and usually not clinically significant by itself, but results are always interpreted in the context of your history, medications, and other labs. If there is concern about a genetic variant such as Factor V Leiden, a separate resistance assay or genetic test would be considered.

Reference ranges

0.51.5 U/mL
All sexes
0 days – 150 years

Reference intervals vary by laboratory, analyzer, methodology, population, and units. The ranges shown here are for education only. Always interpret your results against the reference interval printed on your own lab report.

Factors that could impact Factor V

  • Sample collection and handling

    Clotting tests require a correctly filled citrate tube, gentle mixing, and prompt processing. Underfilled tubes, delays in centrifugation, or storage at improper temperatures can falsely alter Factor V activity.

  • Anticoagulant medications

    Heparin and direct oral anticoagulants can interfere with clot-based activity assays and may make Factor V appear lower than it truly is. Tell your clinician about all blood thinners and supplements before testing.

  • Liver function and severe illness

    Because Factor V is made in the liver, liver disease can reduce its level. Severe infections, disseminated intravascular coagulation, or massive trauma can consume clotting factors and lower Factor V activity.

  • Transfusions and volume resuscitation

    Recent transfusion of plasma or large volumes of intravenous fluids can temporarily change measured activity by adding or diluting clotting proteins. Your team may time testing to avoid misleading results.

  • Inhibitors to Factor V

    Rare autoantibodies can neutralize Factor V, sometimes after exposure to bovine thrombin in surgical materials. In these cases, mixing studies often fail to correct the clotting time, suggesting an inhibitor.

  • Genetic testing differences

    This activity test does not diagnose Factor V Leiden. If your doctor suspects that genetic variant, they may order an activated protein C resistance assay or a DNA test instead.

2026

References

  1. McGill University Health Centre. (2015, March 01). Factor V (Task CD 701480). Laboratory reference ranges.
  2. Clinical and Laboratory Standards Institute. (2008). Collection, transport, and processing of blood specimens for testing plasma-based coagulation assays and molecular hemostasis assays; approved guideline (H21-A5). Wayne, PA: CLSI.
  3. World Federation of Hemophilia. (2013). Diagnosis of hemophilia and other bleeding disorders: A laboratory manual (2nd ed.). Montreal, QC: WFH.