Digitalis-like immunoreactive factors (DLIF) are special types of steroids with lactone rings in their structures. Clinically, this type of compound can be used as medicine for heart failure; thus, the elevated endogenous DLIF found under certain pathological conditions are interferent substances in digoxin immunoassay. Endogenous DLIF with biological and immunological properties similar to cardiotonic drugs, such as digoxin, have been found in several tissues and body fluids of animals and humans. Since these endogenous Na+, K(+)-ATPase inhibitors can be considered hormones in nature, immunoassays must be selected detection of them to achieve the required sensitivity and specificity. In this study, we used three sets of in-house formulated immunoassays for DLIF and ouabain-like factors (OLF) detection. Using a polyclonal antibody-based ouabain enzyme immunoassay, the mean +/- S.E.M. of OLF in the sera of 10 healthy individuals were determined to be (9.1 +/- 0.9) x 10(-11) M. Using a monoclonal antibody-based ouabain enzyme immunoassay, the mean +/- S.E.M of OLF in the sera of 10 healthy individuals was (8.2 +/- 1.2) x 10(-11) M while using a antibody fragment Fab-based enzyme immunoassay for digoxin, the mean +/- S.E.M of DLIF in 11 healthy individuals was (4.0 +/- 1.2) x 10(-10) M. In conclusion, our immunological data indicate that DLIFs are normal constituents of human blood. Although DLIF is the major component, coexistence of OLF with DLIF in healthy individuals can not be excluded.