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Back to Endocrinology Lab tests
Serum proteins
Total proteins
Total protein represents the sum of albumin and globulins.
Causes of elevated total protein
- Chronic infection (including tuberculosis)
- Adrenal cortical hypofunction
- Liver dysfunction
- Collagen Vascular Disease (Rheumatoid Arthritis, Systemic
Lupus, Scleroderma)
- Hypersensitivity States
- Sarcoidosis
- Dehydration (diabetic acidosis, chronic diarrhea, etc.)
- Respiratory distress
- Hemolysis
- Cryoglobulinemia
- Alcoholism
- Leukemia
Causes of decreased total protein
- Malnutrition and malabsorption
- Liver disease
- Diarrhea
- Severe burns
- Loss through the urine in severe kidney disease
- Low albumin
- Low globulins
- Pregnancy
Reference range
Range: 6.5-8.0 g/100ml
Albumin
Causes of increased albumin levels
- Dehydration - actual
- Congestive heart failure
- Possibly poor protein utilization
- Glucocorticoid excess (can result from taking medications
with cortisone effect, the adrenal gland overproducing cortisol,
or a tumor that produces extra cortisol like compounds)
- Congenital
Causes of decreased albumin levels
- Dehydration
- Hypothyroidism
- Chronic debilitating diseases (ex: RA)
- Malnutrition - Protein deficiency
- Dilution by excess H2O (drinking too much water, which is
termed “polydipsia,” or excess administration of IV fluids)
- Kidney losses (Nephrotic Syndrome)
- Protein losing-enteropathy (protein is lost from the
gastrointestinal tract during diarrhea)
- Skin losses (burns, exfoliative dermatitis)
- Liver dysfunction (the body is not synthesizing enough
albumin and indicates very poor liver function)
Reference Range: 4.0-4.8 g/100ml
Globulins
Causes of increased albumin levels
- Chronic infections (parasites, some cases of viral and
bacterial infection)
- Liver disease (biliary cirrhosis, obstructive jaundice)
- Carcinoid syndrome
- Rheumatoid arthritis
- Ulcerative colitis
- Multiple myelomas, leukemias, Waldenstrom's
macroglobulinemia
- Autoimmunity (Systemic lupus, collagen diseases
- Kidney dysfunction (Nephrosis)
Causes of decreased albumin levels
- Nephrosis (A Condition in which the kidney does not filter
the protein from the blood and it leaks into the urine)
- Alpha-1 Antitrypsin Deficiency (Emphysema)
- Acute hemolytic anemia
- Liver dysfunction
- Hypogammaglobulinemia/Agammaglobulinemia
Reference Range: 2.8-3.2 g/dL
A/G ratio
A reversed A/G Ratio may be a helpful indicator of early liver
failure.
The proper albumin to globulin ratio is 2:1
Causes of elevated AG ratio
- Hypothyroidism
- High protein/high carbohydrate diet with poor nitrogen
retention
- Hypogammaglobulinemia (low globulin)
- Glucocorticoid excess (can be from taking medications with
cortisone effect, the adrenal gland overproducing cortisol, or a
tumor that produces extra cortisol like compounds, low globulin)
Causes of decreased AG ratio
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