The total protein test measures the total amount of two classes of proteins found in the fluid portion of your blood. These are albumin and globulin. Proteins are an important part of cells and tissues. Albumin helps prevent fluid from leaking out of the blood vessels. Globulin is an important part of your immune system. A total protein test is routinely included in the panels of tests performed as a part of a general health examination, such as a comprehensive metabolic panel. Typically, a total protein test is used to diagnose nutritional problems, kidney disease, or liver disease. However, protein levels can become abnormal in many different diseases and disorders; therefore, the total protein test is frequently run in tandem with several other tests to determine the exact cause of a problem. Some laboratories report total protein, albumin, and the calculated ratio of albumin to globulins, called A/G ratio. Because disease states affect the relative amounts of albumin and globulin, the A/G ratio may provide a clue as to the cause of the change in protein levels.
A low total protein level can suggest:
- Liver disease
- Kidney disorder
- Malabsorption (celiac disease or inflammatory bowel disease)
- Malnutrition
- Extensive burns
- Bleeding
A low A/G ratio may indicate:
- Overproduction of globulins (e.g., autoimmune disease)
- Underproduction of albumin (e.g., cirrhosis)
- Selective loss of albumin from circulation (e.g., kidney disease)
A high total protein may be seen with:
- Chronic inflammation or infection (viral hepatitis or HIV)
- Bone marrow disorders (multiple myeloma)
A high A/G ratio may be due to:
- Underproduction of immunoglobulins (e.g., leukemia)
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