Total Serum Protein

A total serum protein test measures the total amount of protein in the blood. It also measures the amounts of two major groups of proteins in the blood: albumin and globulin.

• Albumin is made mainly in the liver. It helps keep the blood from leaking out of blood vessels. Albumin also helps carry some medicines and other substances through the blood and is important for tissue growth and healing.
• Globulin is made up of different proteins called alpha, beta, and gamma types. Some globulins are made by the liver, while others are made by the immune system. Certain globulins bind with hemoglobin. Other globulins transport metals, such as iron, in the blood and help fight infection. Serum globulin can be separated into several subgroups by serum protein electrophoresis. For more information, see the medical test Serum Protein Electrophoresis.

A test for total serum protein reports separate values for total protein, albumin, and globulin. The amounts of albumin and globulin also are compared (albumin/globulin ratio). Normally, there is a little more albumin than globulin and the ratio is greater than 1. A ratio less than 1 or much greater than 1 can give clues about problems in the body.

Albumin is tested to:

• Check how well the liver and kidney are working.
• Find out if your diet contains enough protein.
• Help determine the cause of swelling of the ankles (edema) or abdomen (ascites) or of fluid collection in the lungs that may cause shortness of breath (pulmonary edema).

Globulin is tested to:

• Determine your chances of developing an infection.
• See if you have a rare blood disease, such as multiple myeloma or macroglobulinemia.

No special preparation is required before having a total serum protein test.

Talk to your health professional about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results may mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).

The health professional taking a sample of your blood will:

• Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
• Clean the needle site with alcohol.
• Put the needle into the vein. More than one needle stick may be needed.
• Attach a tube to the needle to fill it with blood.
• Remove the band from your arm when enough blood is collected.
• Put a gauze pad or cotton ball over the needle site as the needle is removed.
• Put pressure on the site and then put on a bandage.

The blood sample is taken from a vein in your arm. An elastic band is wrapped around your upper arm. It may feel tight. You may feel nothing at all from the needle, or you may feel a quick sting or pinch.

There is very little chance of a problem from having blood sample taken from a vein.

• You may get a small bruise at the site. You can lower the chance of bruising by keeping pressure on the site for several minutes.
• In rare cases, the vein may become swollen after the blood sample is taken. This problem is called phlebitis. A warm compress can be used several times a day to treat this.
• Ongoing bleeding can be a problem for people with bleeding disorders. Aspirin, warfarin (Coumadin), and other blood-thinning medicines can make bleeding more likely. If you have bleeding or clotting problems, or if you take blood-thinning medicine, tell your doctor before your blood sample is taken.

A total serum protein test is a blood test that measures the amounts of total protein, albumin, and globulin in the blood. Results are usually available within 12 hours.

Normal

Normal values may vary from lab to lab.

High values

High albumin levels may be caused by:

• Severe dehydration.

High globulin levels may be caused by:

• Diseases of the blood, such as multiple myeloma, Hodgkin's lymphoma, leukemia, macroglobulinemia, or hemolytic anemia.
• An autoimmune disease, such as rheumatoid arthritis, lupus, autoimmune hepatitis, or sarcoidosis.
• Kidney disease.
• Liver disease.
• Tuberculosis.

Low values

Low albumin levels may be caused by:

• A poor diet (malnutrition).
• Severe burns.
• Kidney disease.
• Liver disease.
• An autoimmune disease, such as systemic lupus erythematosus (SLE) or rheumatoid arthritis.
• Gastrointestinal malabsorption syndromes, such as sprue or Crohn's disease.
• Hodgkin's lymphoma.
• Uncontrolled diabetes.
• Hyperthyroidism.
• Heart failure.

Reasons you may not be able to have the test or why the results may not be helpful include:

• Taking medicines, such as corticosteroids, estrogens, male sex hormones (called androgens), growth hormone, or insulin.
• Injuries or infections.
• Prolonged bed rest, such as during a hospital stay.
• A long-term (chronic) illness, especially if the disease interferes with what you are able to eat or drink.
• Being pregnant.

• If you have abnormal globulin levels, another test called serum protein electrophoresis is often done. This test measures specific groups of proteins in the blood. For more information, see the medical test Serum Protein Electrophoresis.
• Damaged liver cells lose their ability to make protein. But previously produced protein may stay in the blood for 12 to 18 days, so it takes about 2 weeks for damage to the liver to show up as decreased serum protein levels. The liver's ability to make protein may be used to predict the course of certain liver diseases.
• Unlike carbohydrates and fats, proteins are not stored in the body. They are continuously broken down (metabolized) into amino acids that can be used to make new proteins, hormones, enzymes, and other compounds needed by the body.
• Protein also can be measured in the urine. For more information, see the medical test Urine Test.

Other Works Consulted

• Chernecky CC, Berger BJ, eds. (2004). Laboratory Tests and Diagnostic Procedures, 4th ed. Philadelphia: Saunders.

• Fischbach FT, Dunning MB III, eds. (2004). Manual of Laboratory and Diagnostic Tests, 7th ed. Philadelphia: Lippincott Williams and Wilkins.

• Handbook of Diagnostic Tests (2003). 3rd ed. Philadelphia: Lippincott Williams and Wilkins.

• Pagana KD, Pagana TJ (2002). Mosby’s Manual of Diagnostic and Laboratory Tests, 2nd ed. St. Louis: Mosby.