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Total Protein Test

What is a total protein test?


  1. The total protein test measures the amount of the proteins albumin and globulin in your body.
  2. It’s usually done as a part of a regular checkup. Your doctor may also order it if you have symptoms like weight loss or fatigue or if you’re showing signs of kidney or liver disease.
  3. You’ll need to have blood drawn so a sample can be analyzed in a lab. You should discuss your results with your doctor.

Albumin and globulin are two types of protein in your body. The total protein test measures the total amount albumin and globulin in your body. It’s used as part of your routine health checkup. It may also be used if you have unexpected weight loss, fatigue, or the symptoms of a kidney or liver disease.

What are proteins?

Proteins are important building blocks of all cells and tissues. Proteins are necessary for your body’s growth, development, and health. Blood contains albumin and globulin. Albumin proteins keep fluid from leaking out of your blood vessels. Globulin proteins play an important role in your immune system.

Purpose of the total protein test

A total protein test is completed as part of your routine health checkup. It’s one of the tests that make up your comprehensive medical panel (CMP). It may be ordered if you have:

  • unexplained weight loss
  • fatigue
  • edema, which is swelling caused by extra fluid in your tissues
  • symptoms of kidney or liver disease

The total protein test measures the total amount of protein in your blood and specifically looks for the amount of albumin and globulin.

This test will also look at the ratio of albumin to globulin in your blood. This is known as the “A/G ratio.”

How is the total protein test performed?

The test uses a blood sample that’s analyzed in the laboratory. To get a blood sample, the lab technician will draw blood from a vein in your arm or the back of your hand. First, they’ll clean the site with an antiseptic wipe. They’ll wrap a band around your arm to apply pressure to the area and gently insert the needle into the vein. The blood will collect into a tube attached to the needle. Once the tube is full, the band and the needle will be removed from your arm. They’ll put pressure on the puncture site to stop any bleeding.

In infants or small children, a lancet is used to puncture the skin and the blood collects in a small glass pipette, test strip, or onto a slide. A bandage may be placed over the area if there’s any bleeding.

Preparing for the total protein test

You don’t need to make any special preparations before the test is done. Your doctor will let you know if you should avoid food or drinks before the test.

Many medications can affect the total protein test results. Talk to your doctor about your current medication use before you take this test.

Medications that can affect the test results include:

  • steroids
  • androgens
  • corticosteroids
  • dextran
  • growth hormone
  • insulin
  • phenazopyridine
  • progesterone
  • ammonium ions
  • estrogen
  • birth control pills

Test risks

You may feel moderate pain or discomfort from the blood test. The risks associated with having a blood test are minimal. In some cases, you may experience:

  • excessive bleeding
  • fainting or feeling light-headed
  • developing a hematoma, which occurs when blood gathers under your skin

There is a risk of infection any time your skin is broken.

What do the results mean?

Total protein range

The normal range for total protein is between 6 and 8.3 grams per deciliter (g/dL). This range may vary slightly among laboratories. These ranges are also due to other factors such as:

  • age
  • gender
  • population
  • test method

Your total protein measurement may increase during pregnancy.

If total protein is abnormal, additional tests must be performed to identify which specific protein is low or high before a diagnosis can be made.

Elevated total protein may indicate:

  • inflammation or infections, such as viral hepatitis B or C, or HIV
  • bone marrow disorders, such as multiple myeloma or Waldenstrom’s disease

Low total protein may indicate:

  • bleeding
  • liver disorder
  • kidney disorder, such as a nephrotic disorder or glomerulonephritis
  • malnutrition
  • malabsorption conditions, such as celiac disease or inflammatory bowel disease
  • extensive burns
  • agammaglobulinemia, which is an inherited condition in which your blood doesn’t have enough of a type of globulin, affecting the strength of your immune system
  • inflammatory conditions
  • delayed post-surgery recovery

Low albumin is considered albumin below 3.4 g/dL. It’s associated with decreased effectiveness of medications used for ulcerative colitis. Low albumin levels may result in complications during or after surgery.

A/G ratio

Normally, the A/G (albumin to globulin) ratio is slightly higher than 1. If the ratio is too low or too high, additional testing must be done to determine the cause and diagnosis. If the ratio is low, it can suggest:

  • autoimmune disease
  • multiple myeloma
  • cirrhosis
  • kidney disease

A high A/G ratio can indicate genetic deficiencies or leukemia. Make sure to discuss your results with your doctor. They may want to do follow-up testing.

Diet and lifestyle: Q&A

You asked, we answered

  • Can changes in my diet or lifestyle help me balance an abnormal total protein level?
  • There is no specific diet or lifestyle change you can make to bring down your total protein. High levels of total protein can mean that either albumin and globulin are high. Albumin helps prevent blood from leaking out of blood vessels and carries medicines through the blood. Globulins have different purposes. One of the main ones is helping fight infections. High levels of albumin are usually because a person is dehydrated. High globulin levels can be from blood diseases such as multiple myeloma or autoimmune diseases such as lupus, kidney disease, or liver disease.

    - Suzanne Falck, MD, FACP
  • Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

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