Total Protein

Total amount of protein in blood

20/22Providers

Liver FunctionCategory

kidney diseaseReference

Widely Available

20 of 22 providers

Reference Range

kidney disease

What is Total Protein?

Total Protein measures the combined amount of all proteins in your blood serum, primarily consisting of albumin (55-60%) and globulins (40-45%). These proteins perform hundreds of essential functions:maintaining fluid balance, transporting substances throughout the body, supporting immune function, blood clotting, and serving as enzymes and hormones.

Total protein is calculated as Albumin + Globulin, or measured directly by laboratory methods. While total protein provides an overview of protein status, its components (albumin and globulin) are more diagnostically useful. Changes in total protein can result from changes in either fraction, and the albumin/globulin (A/G) ratio helps differentiate the underlying cause.

Total protein is affected by protein nutrition, liver synthetic function (albumin production), immune system activity (globulin production), kidney function (protein loss), and hydration status. Low total protein indicates malnutrition, liver disease, kidney disease, or protein loss. High total protein usually reflects dehydration or, less commonly, excessive globulin production from chronic infection or blood cancers.

Why Total Protein Is Your Protein Metabolism Overview

Broad health screening:Abnormal total protein prompts investigation of specific protein fractions and underlying causes
Nutritional assessment:Low total protein with low albumin suggests inadequate protein intake or malabsorption
Liver function indicator:Liver produces most blood proteins;low total protein may indicate chronic liver disease
Kidney health:Proteinuria (kidney protein loss) causes low total protein. Check urinalysis if low
Immune status:High total protein often reflects elevated globulins from infections, autoimmune disease, or malignancy
Hydration marker:Elevated total protein commonly indicates dehydration;low levels can indicate overhydration

Optimal vs Standard Ranges

Range Type	Level	Significance
Optimal	6.8-8.0 g/dL	Indicates adequate protein nutrition, normal liver synthetic function, balanced immune activity, and proper hydration. Optimal albumin (4.5-5.2 g/dL) combined with normal globulins (2.0-3.5 g/dL) yield total protein in this range. Associated with good health outcomes and longevity.
Borderline Low	6.0-6.8 g/dL	Below optimal but may be within lab reference range. Warrants investigation of albumin and globulin fractions to determine cause. May indicate marginal protein nutrition, mild liver dysfunction, early kidney disease with proteinuria, or chronic inflammation. Optimize protein intake (1.0-1.2 g/kg daily) and retest in 3-6 months with albumin and globulin.
Low (Hypoproteinemia)	<6.0 g/dL	Indicates significant underlying pathology. Check albumin and globulin to differentiate causes. Low albumin + normal/low globulin:Liver disease, malnutrition, protein loss (kidney, GI). Low albumin + high globulin:Chronic infection, autoimmune disease, liver cirrhosis (A/G ratio inverted). Low both:Severe malnutrition, protein-losing conditions. Requires comprehensive workup including liver panel, kidney function, urinalysis for protein, inflammatory markers.
High (Hyperproteinemia)	>8.0 g/dL	Most commonly indicates dehydration (concentrated blood). If properly hydrated, evaluate globulin fraction. High globulins:Chronic infections, autoimmune disease, multiple myeloma, lymphoma. Check SPEP if globulin >4.5 g/dL. High albumin is rare and usually reflects dehydration or laboratory error. Mild elevation (8.0-8.5 g/dL) often benign;marked elevation (>9.0 g/dL) requires investigation.

Standard lab range: kidney disease

How to Optimize Total Protein

1. Optimize Protein Nutrition (if Low Total Protein)

Adequate protein intake:1.0-1.5 g/kg body weight daily. Higher needs if elderly, ill, or recovering from illness. Example:70-105g for 70kg person

High-quality protein sources:Eggs (6-7g per egg), chicken breast (30g per 4oz), fish, Greek yogurt (15-20g per cup), cottage cheese, legumes, whey protein

Distribute throughout day:20-30g protein per meal for optimal synthesis. Don't consume all protein in one meal

Leucine-rich foods:Whey protein, eggs, chicken, dairy. Leucine triggers muscle protein synthesis

Consider supplementation:Whey protein (20-40g daily), essential amino acids (10-15g daily) if inadequate dietary intake

Address malabsorption:If celiac, Crohn's, pancreatic insufficiency present, treat underlying condition and ensure digestive enzyme adequacy

2. Address Underlying Liver Disease

Identify cause:Viral hepatitis (B/C), alcoholic liver disease, NAFLD, autoimmune hepatitis, cirrhosis

Specific treatments:Antiviral therapy for hepatitis, alcohol cessation, weight loss for NAFLD, immunosuppression for autoimmune hepatitis

Support liver function:Milk thistle (140-280 mg 2-3x daily), N-acetylcysteine (600-1200 mg daily), adequate protein intake

Avoid hepatotoxins:Eliminate alcohol, minimize acetaminophen (<2000 mg/day), review all medications

Monitor progression:Low total protein with low albumin in cirrhosis indicates advanced disease. Consider transplant evaluation if albumin <3.0 g/dL

3. Prevent and Treat Protein Loss

Nephrotic syndrome (kidney):ACE inhibitors or ARBs reduce proteinuria. Treat underlying glomerular disease with immunosuppression if indicated. Target <1g protein loss per day

Protein-losing enteropathy (GI):Treat inflammatory bowel disease, celiac disease, intestinal lymphangiectasia. High-protein diet (1.5-2.0 g/kg) to compensate

Increase protein intake:Compensate for losses with higher dietary protein while treating underlying cause

Monitor urine protein:24-hour urine collection or spot protein-to-creatinine ratio. Goal <150 mg/day (normal)

Albumin infusion:If severe hypoalbuminemia (<2.5 g/dL) with symptomatic edema, consider IV albumin while addressing cause

4. Address Immune and Inflammatory Causes (if High Globulins)

Investigate chronic infections:Test for hepatitis B/C, HIV, tuberculosis. Treat with appropriate antivirals or antibiotics

Manage autoimmune disease:Optimize treatment for lupus, rheumatoid arthritis, Sjögren's, inflammatory bowel disease

Anti-inflammatory interventions:Mediterranean diet, omega-3 fatty acids (2-4g EPA+DHA daily), minimize processed foods

Rule out malignancy:If globulin >4.5 g/dL, order SPEP to screen for multiple myeloma, lymphoma, chronic lymphocytic leukemia

Monitor treatment response:Total protein and globulins should decrease with successful treatment of infection or inflammation

5. Correct Hydration Status

If elevated total protein (>8.5 g/dL):Likely dehydration. Increase fluid intake to 2-3 liters daily. Retest after proper hydration—should normalize if dehydration was cause

If low total protein with edema:May reflect overhydration or dilution. Check albumin and globulin—low albumin causes fluid shifts and apparent dilution

Optimize hydration:30-35 ml/kg body weight daily for most adults. More if exercising, hot climate, or illness

Electrolyte balance:Ensure adequate sodium, potassium. Severe hyponatremia can dilute protein concentrations

Diuretics:If edema from low albumin, judicious use of diuretics (furosemide, spironolactone) can help but address underlying cause

Symptoms of Abnormal Total Protein

Low Total Protein

Edema:Swelling of legs, ankles, feet, or generalized edema (if albumin component is low)
Ascites:Abdominal swelling and fluid accumulation (severe cases)
Fatigue and weakness:Due to underlying disease and malnutrition
Recurrent infections:If low globulins causing immunodeficiency
Poor wound healing:Protein essential for tissue repair
Muscle wasting:Prolonged protein deficiency causes loss of muscle mass
Weight loss or failure to thrive:Despite adequate calorie intake if malabsorption present

High Total Protein

High total protein is often asymptomatic
Dehydration symptoms:Thirst, dry mouth, decreased urination, dizziness, dark urine (if dehydration is cause)
Symptoms of underlying condition:If high globulins are cause, may have symptoms of chronic infection (fever, night sweats), autoimmune disease (joint pain, rash), or multiple myeloma (bone pain, fatigue, recurrent infections)
Hyperviscosity syndrome:If extreme elevation (>10 g/dL from high globulins), blood becomes thick causing headaches, vision changes, bleeding, confusion—rare but medical emergency

Causes of Abnormal Total Protein

Low Levels

Malnutrition:Inadequate protein intake, eating disorders, extreme dieting, malabsorption (celiac, Crohn's, pancreatic insufficiency)
Liver disease:Chronic hepatitis, cirrhosis from any cause—reduces albumin synthesis. Advanced cirrhosis also elevates globulins (A/G ratio inverted)
Nephrotic syndrome:Massive urinary protein loss (>3g/day) from kidney disease. Check urinalysis and 24-hour urine protein
Protein-losing enteropathy:GI protein loss from inflammatory bowel disease, celiac disease, intestinal lymphangiectasia
Chronic inflammation:Cancer, chronic infections suppress albumin as negative acute-phase reactant
Burns and major trauma:Large wounds cause protein loss and increased catabolism
Overhydration:Dilutional effect from excess IV fluids or SIADH (syndrome of inappropriate ADH)
Combined causes:Often multiple factors contribute (e.g., cirrhosis causes low albumin + high globulins, partially offsetting total protein)

High Levels

Dehydration:Most common cause. Volume depletion concentrates proteins. Resolves with hydration
Chronic infections:Hepatitis B/C, HIV, tuberculosis, chronic osteomyelitis—elevate globulins
Autoimmune diseases:Lupus, rheumatoid arthritis, Sjögren's—polyclonal hyperglobulinemia
Multiple myeloma:Malignant plasma cells produce monoclonal immunoglobulin. Globulin often >5 g/dL. Requires SPEP for diagnosis
Lymphoma and chronic lymphocytic leukemia:Can elevate globulins
Monoclonal gammopathy (MGUS):Benign monoclonal protein production (requires monitoring)
Waldenström macroglobulinemia:Rare B-cell cancer producing IgM
Chronic liver disease:Cirrhosis elevates globulins despite low albumin;total protein may be normal or high

When to Retest

If borderline low (6.0-6.8 g/dL):Retest in 3-6 months with albumin and globulin fractions. Optimize protein nutrition. If downward trend, investigate urgently
If low (<6.0 g/dL):Urgent workup. Check albumin, globulin, liver enzymes, kidney function, urinalysis for protein, inflammatory markers (CRP, ESR). Retest every 4-8 weeks during treatment
If borderline high (8.0-8.5 g/dL):Ensure proper hydration and retest. If persistent, check albumin and globulin fractions
If high (>8.5 g/dL):Check hydration status. If properly hydrated, order SPEP to evaluate globulin fraction, especially if >9.0 g/dL or A/G ratio <1.0
During chronic disease:Monitor total protein along with albumin and globulin every 3-6 months in cirrhosis, chronic kidney disease, autoimmune disease, or MGUS
After nutritional intervention:Retest after 8-12 weeks of optimized protein intake. Should see gradual improvement if malnutrition was cause

Scientific Evidence

Total Protein as Health Status Indicator

Total protein serves as a broad indicator of health status, reflecting nutritional state, liver function, immune activity, and protein balance. While less specific than albumin or globulin individually, abnormal total protein prompts investigation of these fractions. Studies show low total protein independently predicts mortality and poor surgical outcomes, though this effect is driven primarily by the albumin component.

Source:Levitt DG, et al. Human serum albumin homeostasis:a new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. Int J Gen Med. 2016;9:229-255.

Protein Malnutrition in Elderly

Low total protein (<6.5 g/dL) is common in elderly populations and strongly associated with frailty, functional decline, and mortality. Often reflects inadequate protein intake (<0.8 g/kg daily) combined with age-related anabolic resistance. Increasing protein to 1.2-1.5 g/kg daily improves protein status, muscle mass, and physical function in older adults.

Source:Deutz NE, et al. Protein intake and exercise for optimal muscle function with aging:recommendations from the ESPEN Expert Group. Clin Nutr. 2014;33(6):929-936.

A/G Ratio in Disease Diagnosis

The albumin/globulin ratio (calculated from total protein and albumin) is diagnostically valuable. Normal ratio is 1.2-2.2. Ratio <1.0 indicates either low albumin (liver disease, malnutrition) or high globulins (chronic infection, autoimmune disease, malignancy). Inverted A/G ratio (<1.0) in cirrhosis correlates with advanced disease and poor prognosis.

Source:Duffy MJ, et al. Tumor markers in colorectal cancer, gastric cancer and gastrointestinal stromal cancers:European group on tumor markers 2014 guidelines update. Int J Cancer. 2014;134(11):2513-2522.

Nephrotic Syndrome and Protein Loss

Nephrotic syndrome causes massive urinary protein loss (>3g/day), predominantly albumin, leading to low total protein and characteristic edema. Total protein often <6.0 g/dL with albumin <3.0 g/dL. Treatment with ACE inhibitors/ARBs reduces proteinuria by 30-50%, while immunosuppression may be needed for underlying glomerular disease. Persistent heavy proteinuria requires nephrology management.

Source:Kodner C. Diagnosis and management of nephrotic syndrome in adults. Am Fam Physician. 2016;93(6):479-485.

Multiple Myeloma Screening

Multiple myeloma typically elevates total protein (often >8.5 g/dL) due to monoclonal immunoglobulin production. However, some myelomas produce light chains only without increasing total protein. Any unexplained elevation in total protein, especially with elevated globulins (>4.5 g/dL) or A/G ratio <1.0, warrants SPEP and immunofixation to screen for myeloma. Early diagnosis improves treatment outcomes.

Source:Rajkumar SV, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538-e548.

Which Providers Test Total Protein?

Full Provider Comparison

Provider	Includes	Annual Cost	Biomarkers
Superpower	✓	$199	100+ (150 with ratios)
WHOOP Advanced Labs	✓	$349	65
Labcorp OnDemand	✓	$398	30+
Life Extension	✓	$486	40+
Everlywell	✓	$468	83
Mito Health	✓	$349	100+
InsideTracker	—	$680	54
Function Health	✓	$365	100+
Marek Health Base	✓	$250	65
Marek Health Comprehensive	✓	$495	70+
Marek Health Complete	✓	$895	100+
Marek Health Executive	✓	$1950	150+
Blueprint	—	$399	100+
Quest Health	—	$Varies	75+
Empirical Health	✓	$190	100+
Oura Health Panels	✓	$99	50
SiPhox Health	✓	$125	60
Hims Labs Base	✓	$199	50
Hims Labs Advanced	✓	$499	120+
Healthspan	✓	$4188	80+
Vitality Blueprint Standard	✓	$375	85
Vitality Blueprint Elite	✓	$700	129

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Frequently Asked Questions

What does Total Protein test for?

Total Protein is a liver function biomarker. Total amount of protein in blood The normal reference range is kidney disease.

Which providers include Total Protein?

20 of 22 providers include this test:Superpower, Blueprint, Mito Health, WHOOP and others.

How often should I test Total Protein?

For most people, testing 2-4 times per year is recommended to establish baseline levels and track trends. Consult your healthcare provider for personalized recommendations.

What is the optimal range?

The standard reference range is kidney disease. Many functional medicine practitioners recommend tighter optimal ranges for peak health. Your ideal range may vary based on age, sex, and health goals.

Why is Total Protein important?

Combination of albumin and globulin. Abnormal levels indicate liver disease

Medical Disclaimer

This information is for educational purposes only and is not medical advice. Always consult with a qualified healthcare provider about your specific health needs.