Understanding Low or High A/G Ratio Results (2024)

This simple blood test measures the two main proteins in your blood. A high reading may indicate issues such as severe hydration or a weakened immune system.

A serum albumin and globulin (A/G) ratio test is a type of blood test. It measures the ratio of albumin to globulin, the two main proteins in your blood.

Typically, an A/G ratio test is done as part of a routine protein blood test. It’s used to check your general health, including nutritional status and immune function.

This blood test is also used to screen and monitor various health conditions, including kidney disease, chronic infections, various cancers, and more.

In this article, we’ll explain the purposes of an A/G ratio blood test, what the process of getting tested is like, and how results are interpreted.

Serum is the clear fluid part of blood that contains no blood cells and clotting components. This serum contains proteins, which are known as serum protein.

Serum protein consists of two main proteins:

  • Albumin proteins. Albumin, which makes up 50 percent of serum protein, reflects your nutritional status. Albumin proteins transport substances like hormones, fatty acids, and drugs throughout your body.
  • Globulin proteins. Globulin proteins, which are made by your immune system, make up around 48 percent of serum protein. These proteins indicate the state of your immune function and the severity of any inflammation.

The purpose of an A/G ratio test is to measure the ratio of albumins to globulins.

Since its results give insight into your nutritional status and immune function, this blood test is also useful for diagnosing and monitoring many health conditions.

The normal range for albumin/globulin ratio is over 1, usually around 1 to 2. That’s because there’s a bit more albumin than globulin in serum protein.

If your body is producing too much or too little of either protein, your A/G ratio will be classified as high or low.

A low A/G ratio could indicate your albumin levels are too low (hypoalbuminemia), or your globulin levels are too high. High globulin indicates inflammation and immune system activity.

Overall, a low A/G ratio result is associated with:

  • kidney disease (nephrotic syndrome)
  • liver disease, and indicator of overall liver function
  • chronic infections (including HIV, tuberculosis, and hepatitis)
  • malnutrition
  • pancreatitis
  • autoimmune diseases (such as rheumatoid arthritis)
  • certain cancers, including:
    • liver cancer
    • multiple myeloma and other blood (hematologic) cancers
    • colorectal cancer
    • pancreatic cancer
    • lung cancer
  • type 2 diabetes (low albumin can indicate insulin deficiency)

A 2010 research overview found low albumin levels were partially predictive of increased mortality rates for those with gastrointestinal, lung, and breast cancers among others.

High albumin concentration can be caused either by overproduction of albumin by the liver, or when fluid (serum) levels are too low.

When a high A/G ratio is caused by high albumin levels, this can be due to severe dehydration or diarrhea, but can also occur during pregnancy. As the National Institutes of Health (NIH) explains, healthy kidneys don’t allow albumin to pass from blood into urine. High albumin in urine (albuminuria) can be an indicator of kidney disease.

A high A/G result might also indicate low levels of globulin, which are found in people with antibody deficiencies, meaning a weakened immune system.

Low globulin levels can also occur due to malnutrition. Malnutrition can be caused by inflammatory bowel or other gastrointestinal diseases, eating disorders, and not eating a balanced diet.

The A/G ratio blood test is sometimes, but not always, done as part of a comprehensive metabolic panel (CMP). A CMP is typically done at routine health checkups.

When done as part of a CMP, you’ll likely need to fast before the test, meaning you can’t eat or drink for a certain period of time leading up to your blood draw. This doesn’t have anything to do with the A/G ratio component specifically but is relevant for other parts of the CMP. If you are just having an A/G test you will not have to fast.

The procedure is a simple blood test, which can take place in a doctor’s office. It usually involves the following steps:

  1. A phlebotomy technician (expert in blood drawing) will locate a vein in your arm.
  2. They will clean the area of skin with an antiseptic wipe.
  3. The technician will insert a thin needle into the vein, drawing blood out from the needle into a plastic hose that fills a test tube. The tube is marked with your patient information.
  4. If multiple samples are needed, the technician will replace the test tubes multiple times as they fill up.
  5. After the samples are collected, the technician will remove the needle and apply pressure to the site. You’ll receive a small bandage.

You may have an elastic band tied around your arm above the vein, or be asked to squeeze a stress ball, to increase blood flow. Once the blood draw process begins, it usually only takes several seconds to complete.

There is also a protein urine test. Depending on the reasons for checking your A/G ratio, and your results, your doctor might also order this test.

Your doctor might order an A/G ratio test if you have certain symptoms that are cause for concern. This is particularly likely if your symptoms suggest kidney or liver problems.

These include:

  • unexplained weight loss
  • fluid accumulation (edema)
  • yellowing of the skin or eyes (jaundice)
  • blood in the urine
  • nausea
  • vomiting
  • fatigue
  • poor appetite

The A/G ratio test often is used to assess the severity of disease progression, and even predict mortality rates. You may receive this blood test if you are being treated for an illness in the hospital, or if you live with a chronic condition like liver or kidney disease.

In some cases, you might not need a specific reason to get your A/G ratio checked. Depending on your doctor and lab, your A/G ratio might be measured during your routine CMP.

Treatment after A/G ratio test results

There is no single treatment for a high or low A/G result, as this will vary depending on the underlying health condition. Treatment will also depend on any other exams or tests your doctor performs regarding your symptoms.

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An A/G ratio test measures albumin and globulin, the two main proteins in your blood. This simple blood test is used to monitor your nutritional status, immune function, and overall health.

High or low A/G ratios are particularly associated with kidney and liver disease. A low A/G ratio can also indicate chronic infections, cancers, and more. A high A/G ratio is associated with dehydration, malnutrition, and other gastrointestinal conditions.

Your doctor might check your A/G ratio if you’re experiencing unexplained weight loss, extreme fatigue, or swelling. Additionally, if you’ve been diagnosed with a chronic condition, they might use the test to monitor your progress.

Understanding Low or High A/G Ratio Results (2024)


Understanding Low or High A/G Ratio Results? ›

A high A/G ratio may indicate kidney disease, antibody deficiencies, or severe dehydration. A low A/G ratio can also indicate kidney disease as well as liver disease, chronic infections like human immunodeficiency virus (HIV), autoimmune diseases like lupus, and certain cancers.

What does it mean if your A G ratio is a little high? ›

High A/G ratio: This can be a sign of disease in your liver, kidney, or intestines. It's also linked to low thyroid activity and leukemia. If your doctor feels any of your levels are too high or low, you may need to have more precise blood or urine tests.

What happens if a G ratio is low? ›

If your A/G ratio was low, it may be caused by:

An autoimmune disease, such as lupus. Liver disease, including cirrhosis. Kidney disease.

What does it mean if your globulin is too low? ›

Globulin and albumin are proteins found in the blood. Levels that are too high can indicate autoimmune disease, infections or cancers. Low levels may be a sign of liver or kidney problems. Your provider will order additional tests to make a diagnosis.

Can you improve a G ratio? ›

How can I influence my A/G ratio for improved wellness? Maintaining a balanced diet with adequate protein intake can support both albumin and globulin levels. Regular exercise and healthy lifestyle habits can also positively impact the A/G ratio.

What are the symptoms of too much protein in your blood? ›

Common symptoms associated with High Blood Protein may include the following.
  • Fatigue and weakness.
  • Unexplained weight loss.
  • Swelling in the extremities.
  • Changes in urine colour or frequency.
  • Abdominal pain or discomfort.
  • Loss of appetite.
Jan 17, 2024

What is a concerning globulin level? ›

Results more than 3.5 g/dL for globulin and more than 2.5 for an albumin/globulin ratio are considered high. But being on bed rest for too long, dehydration, and problems during the blood draw can also cause a high reading. Your healthcare provider will likely order additional tests.

What is the Ag ratio in a liver function test? ›

Another kind of protein called globulin has other functions in your body. This test provides information about the amount of albumin you have compared with globulin. This comparison is called the A/G ratio. This test is useful when your healthcare provider suspects you have liver or kidney disease.

Is albumin globulin ratio important? ›

High albumin in urine (albuminuria) can be an indicator of kidney disease. A high A/G result might also indicate low levels of globulin, which are found in people with antibody deficiencies , meaning a weakened immune system. Low globulin levels can also occur due to malnutrition.

How do you treat low albumin globulin ratio? ›

Treatment of the underlying condition that caused hypoalbuminemia can increase your level of albumin back to normal. Treatment for hypoalbuminemia could include: Eating a well-balanced diet to address malnutrition and heart disease. Taking blood pressure medication to address kidney disease or heart failure.

Is a G ratio 2.8 bad? ›

A test result with a ratio less than 1 or more than 2.5 is considered bad. A bad ratio means the presence of an ongoing disease or pathology in the body. What does the AG ratio indicate? The AG ratio indicates the concentration of albumin and globulins in the blood serum of an individual.

Can diet cause low globulin? ›

Malnutrition and congenital immune deficiency can cause a decrease in total globulins due to decreased synthesis, and nephrotic syndrome can cause a decrease due to protein loss through the kidney.

Does low globulin cause fatigue? ›

Corticosteroid-binding globulin deficiency is a condition with subtle signs and symptoms, the most frequent being extreme tiredness (fatigue), especially after physical exertion. Many people with this condition have unusually low blood pressure (hypotension).

What is ideal a G ratio? ›

A normal A/G ratio is between 1.1 and 2.5, although this can vary by lab. A low A/G ratio may be due to kidney disease, liver disease, chronic infections, type 2 diabetes, malnutrition, certain autoimmune diseases, and cancers.

What is a low A/G ratio? ›

A low A/G ratio has been associated with many illnesses, which may be related to inflammation or certain cancer such as myeloma. The A/G ratio can be decreased with short-term problems that cause inflammation, such as tissue trauma or infection, chronic inflammatory conditions, and nutritional problems.

Is 3.8 globulin normal? ›

Normal value ranges are: Serum globulin: 2.0 to 3.5 grams per deciliter (g/dL) or 20 to 35 grams per liter (g/L)

Why is my albumin ratio high? ›

An albumin blood test checks levels of albumin in your blood. Low albumin levels might indicate a problem with your liver, kidneys or other health conditions. High albumin levels are typically the result of dehydration or severe dehydration. The test is very quick and doesn't carry any serious risks.

What are symptoms of high albumin levels? ›

Weakness. Jaundice, a condition that causes your skin and eyes to turn yellow. Swelling and/or pain in your abdomen (belly) Swelling in your ankles and legs.

Is the 3.8 globulin level high? ›

Normal value ranges are: Serum globulin: 2.0 to 3.5 grams per deciliter (g/dL) or 20 to 35 grams per liter (g/L)

What are the side effects of high globulin levels? ›

What are the symptoms of high globulin? Elevated globulin levels, often associated with liver injury, may present with common symptoms such as jaundice (yellowing of the skin and eyes), itching, nausea, fatigue, unexpected weight loss, and swelling around the eyes, stomach, or legs.


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