What is total protein?
Your blood plasma is a small part protein, and that small part does a lot: it keeps fluid in your vessels, carries substances, clots your blood and defends you against infections. Total protein is the sum of all those proteins. Roughly sixty percent is albumin, one protein your liver makes. The remaining forty percent are the globulins, a group with your antibodies from the immune cells, the transport proteins for iron, copper and hormones, and the clotting factors. Because it is a sum, the number itself does not say which protein has changed. Two people with the same total can have a very different distribution. That is why total protein rarely stands alone on a report: albumin beside it, and the difference between the two, the globulin, carry the meaning. If the total rises while albumin stays the same, the rise sits in the globulins, usually in the antibodies. If they fall together, it is less production, more loss or dilution. Your report shows total protein in g/L. Normal is about 63 to 81 g/L, with limits that shift by a few units per lab. It is a concentration, so thickened blood gives a higher number and a large blood volume a lower one, without protein being added or lost.
Why is total protein relevant?
Total protein is rarely the value you read something from, and often the value that asks the question. In anyone healthy it mainly moves with fluid: too little drunk gives a higher number, drinking a lot or a large blood volume from endurance training a lower one. That is the first question with every deviation, and usually the answer. The second question is the distribution, and that is where it gets interesting. A total protein that rises while albumin stays the same or falls means more globulin, and that is usually more antibodies: with a long-standing inflammation or infection, with a liver disease in which the immune system works harder, or rarely with a proliferation of one kind of antibody cell that makes one protein in large amounts. That last one is the reason a persistently high total protein with a normal albumin is split out with a protein electrophoresis. A total protein that falls while albumin falls with it is the liver making less, kidneys letting protein through, or too little protein in the diet. The third reason is diet. Anyone who eats too little protein for a long time sees first albumin and then the total fall. A total protein at the low end in someone dieting, with little appetite or getting older, is the question of whether there is enough protein on the plate, and the answer is protein at every meal.
What Dutch labs actually use
66 – 79g/L
Between 61 and 66 and between 79 and 83 it depends on the lab, because each sets its limits on its own method and population. Above 83 every lab calls it abnormal.
every lab calls 66 – 79 g/L normal. Between 61 and 66 and between 79 and 83 it depends on the lab.
Every age, per lab
| Laboratory | Group | Reference range |
|---|---|---|
| Unilabs(Saltro, Medlon, SHO, Atalmedial)2026 | M/V: 6 tot 19 jr | 63 - 77 g/L |
| Vanaf 19 jaar | 63 - 81 g/L | |
| Star-shl2026 | >1 jaar | 61-79 g/L |
| Certe2026 | Alle > 18 jaar | 63 - 81 g/L |
| Clinical Diagnostics2026 | Volwassenen | 66-83 g/L |
Each band as the lab publishes it, retrieved in 2026, unless marked otherwise.
Total protein high or low: what it means
A low total protein means dilution, less production, more loss or too little supply. From common to rare: dilution by fluid, a liver making less, protein loss through the kidneys, and taking in or absorbing too little protein. Look at albumin: if that falls with it, it sits in the production, the loss or the diet, and CRP, the liver values and protein in the urine say which. If albumin stays the same, the fall sits in the globulins, and that is rare. A high total protein means thickened blood or more globulin. Dehydration is the most common reason; drink normally and have blood drawn again. If it stays high while albumin stays the same, the rise sits in the antibodies: a long-standing inflammation or infection, or rarely an abnormal protein from one cell line, and then a protein electrophoresis follows. What you do about it: with dilution or thickening nothing, except drinking normally and drawing again. With too little protein, protein is the lever, spread over the day and at every meal. With a shift in the distribution the split belongs, not a change in lifestyle. Set total protein beside albumin, and beyond that beside CRP, the liver values and creatinine. Have blood drawn normally hydrated, seated, and compare over time at the same lab.
What lowers it
Dilution, less production, more loss or too little supply.
| Cause | How often |
|---|---|
| Dilution by fluidDrinking a lot, a drip or the large blood volume of endurance athletes and pregnancy; the protein is there, but in more water | Often |
| Reduced production by the liverA liver making fewer proteins through disease; albumin falls first and the liver values are usually abnormal | Sometimes |
| Protein loss through the kidneysKidneys letting protein through into the urine; frothy urine and swollen ankles belong with it | Sometimes |
| Taking in or absorbing too littleOn a strict diet, with little appetite or getting older, and with a gut that absorbs protein poorly; recovers with protein at every meal | Sometimes |
What raises it
Thickened blood, or more globulin.
| Cause | How often |
|---|---|
| DehydrationToo little drunk or plenty sweated; the plasma shrinks and all proteins look higher, and drinking and drawing again settles it | Often |
| Long-standing inflammation or infectionThe immune system makes more antibodies and the globulins rise while albumin actually falls; CRP and the distribution show it | Sometimes |
| An abnormal protein from one cell lineOne kind of antibody cell proliferating and making one protein in large amounts; rare, and recognisable with a protein electrophoresis | Rare |
How does a total protein blood test work?
- Referral
- Not needed. Total protein is in the liver panel you can have measured yourself, together with albumin.
- Fasting
- Not needed. Proteins barely move with food, but they do with fluid, so drink normally.
- When
- Not during or just after an infection, and not after a day of drinking little or a long effort, if you want to know your usual value.
- The draw
- One tube of blood from a vein in your arm, seated and without a tourniquet that sits for long. Albumin and CRP come from the same draw.
- Repeating
- With a deviation first once more normally hydrated; if the total stays high with a normal albumin, a protein electrophoresis follows.
- Which test
- Total protein 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 total protein?
The sum of all the proteins in your blood. Roughly sixty percent is albumin, which your liver makes; the rest are the globulins, with your antibodies, transport proteins and clotting factors. The number says nothing about which protein, only how much there is altogether, and that is why it is always read beside albumin.
What is a normal total protein level?
About 63 to 81 g/L, with limits that shift by a few units at both ends per lab, so the range on your own report counts. More important than the band is how much you drank, because it is a concentration, and the distribution between albumin and globulin beside it.
What does a high total protein mean?
Usually that your blood was more concentrated: too little drunk, plenty sweated or a tourniquet that sat for long. Drink normally and have blood drawn again. If the value stays high while albumin stays the same, the rise sits in the globulins, usually the antibodies with a long-standing inflammation or infection, and rarely an abnormal protein from one cell line. Then a protein electrophoresis splits out where it comes from.
What does a low total protein mean?
Often that your blood was diluted, by drinking a lot, a drip or the large blood volume of endurance athletes and pregnancy. If it stays low and albumin falls with it, it is less production by the liver, protein loss through the kidneys, or too little protein in the diet; CRP, the liver values and protein in the urine say which. Without albumin beside it a low total protein says little.
What is the difference from albumin?
Albumin is one protein and the largest share of the total; total protein is albumin plus all the globulins together. Albumin says something about your liver, your diet and inflammation; the difference between the two, the globulin, says something about your immune system. That is why they are read side by side: if the total moves while albumin stays the same, it is the immune system; if they move together, it is production, loss or fluid.
Does a normal total protein mean nothing is wrong?
Not necessarily. A falling albumin and a rising globulin cancel each other out in the total, while underneath two things are moving, as in a long-standing inflammation or a liver disease. That is the reason albumin and the ratio between albumin and globulin exist as separate values.
What does total protein have to do with diet?
Anyone who eats too little protein for a long time sees first albumin and then the total fall. A total protein at the low end in someone dieting, with little appetite or getting older, is the question of whether there is enough protein on the plate. Protein at every meal, spread over the day, with meat, fish, dairy, eggs or legumes, brings it back in two to three months.
Do I need to fast for a total protein test?
No. Proteins barely move with food, but they do with fluid and posture: drink normally, have blood drawn seated and do not let the tourniquet sit for long. Albumin and CRP come from the same draw, and without albumin total protein cannot be read.
Which tests include total protein?
Total protein is in .
Related biomarkers
Sources
- 1.Unilabs, determination guide: total protein. 2026. bepalingenklapper.nl
- 2.Star-shl, determination guide: total protein. 2026. star-shl.nl
- 3.Certe, determination guide: total protein. 2026. bepalingenwijzer.certe.nl
- 4.Clinical Diagnostics, laboratory guide: total protein. 2026. clinicaldiagnostics.nl
- 5.Unilabs, determination guide: protein electrophoresis. 2026. bepalingenklapper.nl
Educational information only, not medical advice. Consult a healthcare professional for clinical decisions.
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