Finding the right tests…
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Finding the right tests…
Biochemistry
Your blood carries two broad families of protein: albumin, made only by the liver, and a mixed group called globulins, made by the liver and by immune cells. The albumin/globulin, or A/G, ratio compares the two, and it isn't ordered as a stand-alone test — it's calculated from a total protein result and an albumin result drawn from the same blood sample, then reported alongside them. In a healthy person, albumin normally outweighs globulin by a modest margin. When it doesn't, the shift can come from either side, either the liver making too little albumin or something driving globulin levels up, and the ratio alone doesn't say which.
The ratio itself is a simple calculation: albumin divided by globulin, where globulin is worked out by subtracting the albumin result from total protein. No separate blood draw or extra step is needed beyond what a total protein and albumin test already provide. The result is reported alongside those two underlying numbers, since the ratio on its own, without them, doesn't show whether an abnormal reading came from a shift in albumin, a shift in globulin, or both moving at once.
A single A/G ratio can look identical whether the underlying cause is low albumin, high globulin, or some combination of both, which is why it's never read in isolation from the total protein and albumin figures it's built from.
A low A/G ratio can come from reduced albumin production, seen in chronic liver disease or malnutrition, from albumin loss through damaged kidneys or the gut, or from a rise in globulins, the immune proteins that increase in some autoimmune diseases such as lupus, in chronic inflammation, or in certain blood cancers that overproduce a single type of antibody protein.
A high ratio is less common and less specifically linked to disease, though it has been associated with some genetic disorders and with leukemia. Because it's the rarer finding, it tends to prompt a broader look at the total protein and albumin results rather than a fixed interpretation on its own.
Because this ratio is a byproduct of two other tests rather than its own separate measurement, it's almost always seen on a report next to total protein, albumin, and often liver enzymes, as part of a wider liver or general health panel. It's this fuller picture your doctor reads, not the ratio in isolation.
Not really — it's calculated from a total protein and an albumin result taken from the same blood sample, so it's always reported alongside those two underlying numbers.
It can point toward reduced albumin from liver or kidney disease, or toward raised globulins from conditions like chronic inflammation or certain autoimmune diseases, so it's read together with the individual results.
It's less common and less specifically linked to a particular condition, but it can prompt further review of your total protein and albumin results.
Globulin is worked out by subtracting your albumin result from your total protein result, and the ratio is albumin divided by that globulin figure.
This page is general information about the test, not medical advice. Your own report's reference ranges apply — please discuss your results with your doctor.
The same ratio can result from very different underlying changes — low albumin, high globulin, or both — so the individual numbers are needed to tell which one is actually happening.
Yes. Since albumin is made only by the liver, chronic liver disease can reduce albumin production and pull the A/G ratio down.