Total Protein Test

The total protein test is used to diagnose, screen and monitor the condition of people showing abnormal levels of proteins in their bodies.

The primary misconception about blood, plasma and serum is that they are similar to each other. The whole blood contains formed elements and plasma proteins. Formed elements are red blood cells, white blood cells and platelets. Thus, the 'whole blood' minus formed elements is the plasma proteins or the base for our blood. Plasma fosters clotting with the clotting proteins, namely fibrinogen.

Types of plasma proteins can be depicted as follows:

• Albumin: Accounts for 80% of authority for controlling the body's osmotic pressure to prevent fluid from leaking.
• Globulin: Plays a vital role in maintaining the body's immune system.

These proteins have various functions:

• Maintains viscosity and osmotic pressure
• Ensures acid-base balance
• Promotes blood clotting.
• Plays a crucial role in the defence mechanism
• Transports nutrients and respiratory gases
• Removes waste products from the body to the kidney

Any abnormality or deviation of protein from their normal ranges can be reflected using a protein test. The total protein test also measures the total protein levels (as a summation of albumin and globulin) as well as individual levels. Further, by means of protein tests, one can also measure the values of several types of globulin in the blood.

Abnormality in the protein levels is the primary cause behind India facing malnutrition at a higher rate. Some contributory risk factors behind protein malnutrition are:

• Lack of food, poverty and poor hygiene
• Large family sizes
• Poor mother health
• Breastfeeding for less than five months

With the Mid-Day Meal Scheme (MDM) and Integrated Child Development Services (ICDS), the Government of India aims to provide a safety net for youth, adolescent girls and pregnant women, especially as they are at a higher level risk of developing malnutrition.

According to the Indian Council of Medical Research (ICMR), an average Indian adult needs to consume 1 gram of protein per kilogram of their body weight per day. For example, if a person weighs 50 kg, they must consume at least 50 grams of protein per day to meet the body's requirement. In the practical world, nearly 73% of Indians have a protein deficiency and above 90% are unaware of the recommended daily intake.

Other names for protein test

• Albumin to Globulin Ratio Test
• Total Protein Test
• Serum Protein Test
• A/G Ratio Test

What does the protein test detect or measure and whom is this prescribed for?

The total protein test detects total plasma protein, albumin and globulin levels in the blood. The protein test results are based on the blood sample collected from the patient's arm. It can help diagnose the following:

• Severe dehydration
• Malnutrition
• Kidney Disease
• Liver Disease
• Blood diseases
• Malabsorption syndromes

A total protein blood test is prescribed:

• To detect the cause behind swelling of ankles and abdomen.
• To determine your susceptibility to infection.
• To diagnose blood diseases, like leukaemia.
• If you are facing symptoms like nausea, vomiting, jaundice, fluid build-ups, or abdominal pains.
• To high-risk group individuals, like adolescent girls, pregnant women, infants, preschool children, lactating mothers and the elderly.

Total serum protein normal ranges can vary with age.

1. In adults and the elderly population

Reference: Pagana KD, Pagana TJ, Pagana TN. Mosby’s Diagnostic & Laboratory Test Reference. 14th ed. St. Louis, Mo: Elsevier; 2019.

2. In children population

Reference: Pagana KD, Pagana TJ, Pagana TN. Mosby’s Diagnostic & Laboratory Test Reference. 14th ed. St. Louis, Mo: Elsevier; 2019.

What are the symptoms of too much protein?

The body accumulated with too much protein commonly shows symptoms of gastrointestinal problems, inflammation and cancer. They are:

• Indigestion and abdominal discomfort
• Severe dehydration
• Marked exertion and exhaustion even after slight exercise/walking
• Diarrhoea, headache, nausea, vomiting
• Bad breath

What foods reduce protein in the body?

Here is a brief list of food items you can opt to reduce high protein or maintain an adequate amount of protein in your body:

• Fruits and vegetables, like apples, bananas, grapes, broccoli, and green leafy vegetables.
• Grain products, like rice, barley, and bread.
• Healthy fat, like avocados, olive oil

These are healthy low-protein foods.

The results of the total protein test can yield information about abnormal levels of total protein, albumin and globulin. They are as follows:

Your test interpretation can vary depending on age, gender, body status, history and family inheritance. You must discuss your total protein test results with your doctor before jumping to any conclusion.

The total protein test results are based on analysing a blood sample collected from the arm's vein.

Test Preparation

1. Before the test

No specific preparation, like fasting, is needed before the total protein test. Let your doctor know about over-the-counter medicines, prescription-based drugs and herbal supplements.

2. During the test

A nurse or sample collector will use your arm's vein to collect the blood sample. Preferably, wear a short sleeve for convenience during sample collection.

3. After the test

When done hygienically and according to protocol, the total protein test procedure poses no serious threats to an individual. There might be slight soreness due to needle insertion and lightheadedness.

Test inclusions: What parameters are included?

A total protein test includes a total of four parameters:

1. Measurement of Total Protein in Blood: The protein test measures the summation of all proteins. It indicates hyperproteinemia or hypoproteinemia.
2. Measurement of Albumin in Blood: Albumin is the protein that keeps fluid (blood) from escaping the blood vessels and accumulating outside. It is an important parameter to determine the cause of oedema. It indicated hypoalbuminemia or hyperalbuminemia.
3. Measurement of Globulin in blood: Globulin protein is linked with the immunological function of the body. It indicates hyperglobulinemia or hypoalbuminemia.
4. Albumin/Globulin Ratio in blood: It is essential to determine whether the patient has liver or kidney diseases.

How frequently should you take this test?

A total protein test is commonly a part of a comprehensive liver function test that is advised to be given at least once annually. Otherwise, your doctor will only prescribe a protein test if they suspect concerning signs and symptoms of kidney dysfunction, liver abnormalities or immediate weight loss, etc.

Severe dehydration, Malnutrition, Kidney disease, Liver disease