What is albumin/globulin ratio?
Your blood protein consists of two halves that come from different corners. Albumin, more than half, is made by your liver; it keeps fluid in the vessels and carries hormones and fatty acids. Globulin is the rest: transport proteins, clotting proteins, inflammatory proteins and above all the antibodies, which your immune system makes. In a healthy person there is more albumin than globulin, and the albumin/globulin ratio, albumin divided by globulin, therefore comes out above one. The ratio does one thing that albumin and globulin cannot do separately: it is independent of how concentrated your blood was that day. If you arrive dehydrated at the draw, albumin and globulin both rise, and total protein with them; if you have drunk a lot, they both fall. The ratio between the two stays virtually the same in both cases. If the ratio does move, something has really shifted between what your liver makes and what your immune system makes. Your report usually does not print the ratio; you calculate it with the calculator on this page, from albumin and total protein in g/L from the same draw. The result has no unit. Because it is a calculation, nobody publishes a band for it; calculated from the middle of their bands a healthy adult comes out around 1.15 to 1.64. Below one the ratio is reversed, and that is always a reason to look further.
Why is albumin/globulin ratio relevant?
Albumin and globulin move against each other in most diseases. In an inflammation or infection that lasts for months your liver makes less albumin, because it shifts its protein production to inflammatory proteins, while your immune system makes more antibodies; the ratio then falls on two sides at once. In a liver with scars the same happens: less albumin, and more antibodies because the liver clears them less. The ratio catches that scissors in one number, and does so regardless of how much you drank. The second reason is that the ratio can unmask a normal total protein. A falling albumin that is filled up by a rising globulin leaves the total untouched; the ratio does show the shift. Anyone who has their blood tested yearly often sees a smouldering inflammation or a liver going downhill earlier in a falling ratio than in the separate numbers. The honest limitation is that the ratio is a pointer and not a verdict. It says that the distribution shifted, not why, and the cause lies in the two values it follows from. There is no published band, so your own course is the reference point, and a shift should always be read beside albumin, globulin, CRP and the liver values.
How albumin/globulin ratio is worked out
What counts beside the number:
- Your albumin and globulin themselves, because the ratio says which side shifted and the two numbers say why
- Your total protein, because a normal total can hide a shift the ratio does show
- Your CRP and ESR, because a long-standing inflammation lowers albumin and lifts globulin
- Your ALT and gamma-GT, because a liver making less albumin usually shows that there too
- Protein in your urine, because leaking kidneys let mainly albumin leak away
- Your earlier results, because without a published band your own course is the reference point
None of the four labs publishes a band for this ratio, and that follows from what it is: a calculation on two measured values. It can be calculated, though. Take per lab the middle of the band it publishes for albumin and divide that by the middle of the globulin fraction that follows from its own total protein: then the four labs come out between 1.15 and 1.64. That is not a published norm but our calculation on their figures, and it gives you something to set your own result against. Above one is healthy; if the ratio changes, the question is which of the two halves moved, and you read that from albumin and globulin themselves.
A/G ratio = albumin divided by globulin, both in g/l
There is no constant to account for: dividing is dividing. Because the units above and below the line are the same, the unit cancels and a bare number remains. That is its strength: the ratio stands apart from how concentrated your blood was that day, while albumin and globulin both move with it. Enter your albumin and your total protein below, the two figures your result carries; the globulin follows from that difference.
÷ ( − ) =
Albumin/globulin ratio high or low: what it means
A low ratio means there is proportionally less albumin or more globulin, and that is the side to take seriously. Usually it is the first and rarely the last: a liver making less albumin, through scars, alcohol or fatty change; protein loss through the kidneys, where albumin leaks away and the urine foams; a long-standing inflammation or infection, where albumin falls and the antibodies rise; and rarely an abnormal protein from a single cell line in the bone marrow, which lifts globulin without there being an inflammation. A high ratio means proportionally little globulin, and that is usually harmless: a globulin that sits on the low side with no clear cause, in someone who is healthy and drinks normally. Rarely the immune system makes too few antibodies, inborn or through medicines that suppress it, and then recurring infections are the hallmark. A high albumin on its own does not lift the ratio, because that comes from dehydration and then globulin rises with it. What you do about it: with a falling ratio you look for the cause in the two halves. If albumin falls, you look at your liver, with less alcohol, losing weight in fatty liver and the liver values beside it, and at your kidneys, with a urine test for protein. If globulin rises, you look at a smouldering inflammation, with CRP and ESR, and at a protein electrophoresis if it persists. Drink normally in the days before a draw, not because the ratio moves with it, but because the two separate numbers do. The ratio belongs beside albumin and globulin themselves, because the ratio says which side shifted and the two numbers say why, beside total protein and your fluid balance, and beside CRP, ALT and gamma-GT, which show whether an inflammation or your liver sits behind it.
What lowers it
Less albumin or more globulin, and that is the side to take seriously.
| Cause | How often |
|---|---|
| Reduced production by the liverA liver with scars, too much alcohol or fatty change makes less albumin, while the antibodies rise; the ratio falls on two sides | Sometimes |
| Protein loss through the kidneysWith leaking kidney filters mainly albumin leaves the body, and foaming urine is the clue | Sometimes |
| Lasting inflammation or infectionThe liver shifts its production to inflammatory proteins and makes less albumin, while the immune system makes more antibodies | Sometimes |
| An abnormal protein from a single cell lineOne cell line in the bone marrow makes one protein in large quantities, which lifts globulin without inflammation; the protein electrophoresis shows it | Rare |
What raises it
Proportionally little globulin, and that is usually harmless.
| Cause | How often |
|---|---|
| A lower globulin with no clear causeIn someone who is healthy and drinks normally, globulin sometimes just sits on the low side, and the ratio then comes out higher | Sometimes |
| Reduced antibody productionInborn or through medicines that suppress the immune system; the hallmark is recurring infections | Rare |
How does an albumin/globulin ratio blood test work?
- Referral
- Not needed, and there is no separate request: the ratio follows from albumin and total protein, two tests you get anyway. You calculate it with the calculator on this page.
- Fasting
- Not needed. Neither input value moves with what you ate.
- When
- On an ordinary day, not during or just after an infection, because then the inflammation lowers albumin temporarily and the ratio falls without anything lasting going on.
- The draw
- One tube of blood from a vein in your arm; albumin and total protein come from the same sample. Dehydration makes little difference here, because it lifts both halves together.
- Repeating
- Once a year at an ordinary check, and earlier if the ratio falls. Compare with your previous result, because without a published band your own course is the reference point.
- Which test
- Albumin/globulin ratio is in the comprehensive test (€229) and in .
- Where to draw
- You can draw at 250+ locations near you, no referral needed. See the locations
Frequently asked questions
What is the albumin/globulin ratio?
Your albumin divided by your globulin: the protein your liver makes against the protein mainly your immune system makes. In a healthy person there is more albumin than globulin, so the ratio comes out above one. It is calculated from albumin and total protein from the same draw; nothing extra is drawn for it.
What is a normal albumin/globulin ratio?
Above one, and calculated from the middle of the bands of the four labs around 1.15 to 1.64. There is no published band, because it is a calculation. More important than the number itself is the course: a ratio that falls year on year says more than one number against a limit.
What does a low ratio mean?
That there is proportionally less albumin or more globulin, and that is the side to take seriously. A liver making less albumin through scars, alcohol or fatty change, protein loss through the kidneys with foaming urine, or an inflammation or infection that has been smouldering for months and lets the antibodies rise. Rarely an abnormal protein from a single cell line in the bone marrow. Albumin, globulin, CRP and the liver values beside it say which of these it is.
What does a high ratio mean?
Proportionally little globulin, and that is usually harmless: in someone who is healthy, globulin sometimes just sits on the low side. Rarely the immune system makes too few antibodies, and then recurring infections are the hallmark. A high albumin from dehydration does not lift the ratio, because then globulin rises with it.
Why look at the ratio and not at the two numbers themselves?
Because the ratio is independent of how concentrated your blood was. Dehydration lifts albumin and globulin both, drinking a lot lowers them both, and the two separate numbers then move without anything being wrong. The ratio then stays the same and moves only when one half really shifts. After that you do look at the two numbers, because they say why.
What do I do about a falling ratio?
Look for the cause in the two halves. If albumin falls, you look at your liver, with less alcohol, losing weight in fatty liver and ALT and gamma-GT beside it, and at your kidneys with a urine test for protein. If globulin rises, you look at a smouldering inflammation with CRP and ESR, and at a protein electrophoresis if it persists. A ratio that falls during an infection and recovers afterwards belongs to the infection and not to you.
How do I calculate it myself?
Subtract your albumin from your total protein to get your globulin, then divide your albumin by that globulin, both in g/L and from the same draw. If your albumin is 42 and your total protein 72, your globulin is 30 and your ratio 1.4. The calculator on this page does the same sum.
Do I need to fast?
No. Neither input value moves with what you ate, and the ratio does not move with how much you drank either. Just do not have blood drawn during or just after an infection, because then the inflammation lowers albumin temporarily.
Which tests include albumin/globulin ratio?
Albumin/globulin ratio is in .
Related biomarkers
Sources
- 1.Unilabs, determination guide: total protein. 2026. bepalingenklapper.nl
- 2.Unilabs, determination guide: protein electrophoresis. 2026. bepalingenklapper.nl
- 3.Star-shl, determination guide: total protein. 2026. star-shl.nl
- 4.Certe, determination guide: total protein. 2026. bepalingenwijzer.certe.nl
- 5.Clinical Diagnostics, laboratory guide: total protein. 2026. clinicaldiagnostics.nl
Educational information only, not medical advice. Consult a healthcare professional for clinical decisions.
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