Total Protein and Albumin/Globulin (A/G) Ratio
Reviewed
Also called: Total Serum Protein, TP Albumin/Globulin Ratio, Total Protein with A/G Ratio, Total protein, Total protein test
A total protein and albumin/globulin (A/G) ratio test measures the total amount of protein in your blood.
Specimen: Blood
Why this test may be ordered
- As part of a routine checkup (often included in a comprehensive metabolic panel)
- To help diagnose kidney disease, liver disease, or nutritional problems
- To monitor a health condition that affects protein levels
- If you have symptoms such as swelling in the feet, ankles, legs, or abdomen, fatigue, unexplained weight loss, loss of appetite, nausea, vomiting, jaundice, or blood in the urine
Preparation and collection
You may need to stop taking certain medicines before this test, so tell your health care provider about everything you take. But don't stop taking any medicines unless your provider tells you to. If your total protein and A/G ratio test is part of another blood test, you may need to fast (not eat or drink) for several hours before the test.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
There is very little risk to having a blood test. There may be slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Understanding results
Your results will show whether you have normal, low, or high total protein levels. They will also show if you have a normal, low, or high albumin to globulin (A/G) ratio.
- Low total protein: If your total protein levels were low, it may be a sign of one of the following conditions: Liver disease, Kidney disease, Malnutrition, a condition in which your body does not get the calories, vitamins, and/or minerals needed for good health. Limitation: Your provider will consider your symptoms, medical history, and the results of other blood tests to understand the results of this test. Next step: If you have questions about your results, talk to your provider.
- High total protein: If your total protein levels were high, it may be a sign of one of the following conditions: An infection such as HIV or viral hepatitis, Multiple myeloma, a type of blood cancer. Limitation: Your provider will consider your symptoms, medical history, and the results of other blood tests to understand the results of this test. Next step: If you have questions about your results, talk to your provider.
- Low A/G ratio: If your A/G ratio was low, it may be caused by: An autoimmune disease, such as lupus, Liver disease, including cirrhosis, Kidney disease. Limitation: Your provider will consider your symptoms, medical history, and the results of other blood tests to understand the results of this test. Next step: In addition to total protein levels, your provider may order a separate blood test for albumin and/or a test for globulins.
- High A/G ratio: If your A/G ratio was high, it may be caused by: Certain types of genetic disorders, Leukemia (cancer of the blood cells). Limitation: Your provider will consider your symptoms, medical history, and the results of other blood tests to understand the results of this test. Next step: In addition to total protein levels, your provider may order a separate blood test for albumin and/or a test for globulins.
- Results are not diagnostic on their own; they must be interpreted by a healthcare professional in the context of your symptoms, medical history, and other test results.
- Low albumin levels can be normal during pregnancy.
- The test does not specify the exact cause of abnormal protein levels; further testing may be needed.
- Certain medicines can affect test results; tell your provider about everything you take.
What to do next
If you have questions about your results, talk to your provider.
- What do my total protein and A/G ratio results mean for my health?
- Do I need any additional tests based on these results?
- Should I be concerned about any specific symptoms I am having?
- Are there any medicines I am taking that could affect these results?
- How often should I have this test repeated?
Evidence source
Source: U.S. National Library of Medicine (MedlinePlus). Practices and reference ranges may differ in your country.
U.S. National Library of Medicine: Total Protein and Albumin/Globulin (A/G) Ratio