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Two blood test vials: Understanding A/G ratio results
Health Education

Understanding A/G ratio results

A high A/G ratio occurs when there are high levels of albumin in the blood or low levels of globulin
Medical reviewer and writer, Ashley Wong, Pharm. D.
By | Feb. 20, 2024

An albumin and globulin ratio (A/G ratio) test is a blood test that measures the ratio of albumin to globulin in the blood. Albumin and globulins are two major types of proteins in the blood. The A/ G ratio test helps screen for various health conditions and provides insight into one’s nutritional status. 

What is the significance of the A/G ratio in blood tests?

The serum of the blood contains albumin and globulin proteins. They each play vital roles in the body. Therefore, checking whether one has normal amounts of each protein or the “right” ratio can help healthcare professionals monitor your overall health. 

Healthcare providers may order the A/G ratio for routine blood work, such as a comprehensive metabolic panel (CMP). A CMP can also be ordered if you suffer from certain symptoms and your healthcare provider wants to screen for diseases. 

Role of albumin in the body

Albumin is a protein made in the liver. It keeps fluid from leaking out of blood vessels into other tissues. It also transports important substances throughout the body. 

The normal range of albumin is between 3.4 to 5.4 grams per deciliter (g/dL). High albumin levels may be a sign of dehydration. Low albumin levels can be a sign of kidney or liver disease.

Role of globulin in the body

The liver or immune system produces globulins. They support the immune system by helping fight infections. They also play a role in liver function and blood clotting.

The normal range of serum globulin is between 2.0 to 3.5 g/dL. High globulin levels can indicate potential problems like cancer, infection, or an autoimmune disease. Low globulin levels may indicate conditions such as kidney or liver disease.

A/G ratio results and ranges

In healthy individuals, the blood has slightly more albumin than globulin. If the ratio is high or low, the body produces too much or too little of either protein. Indications like these can suggest nutritional or health problems.

Normal A/G ratio results

Every lab has a slightly different range of a normal A/G ratio. Your test results may vary depending on age, medical history, and other factors. It’s best to discuss your test results with a healthcare provider. Generally, a normal A/G ratio falls between 1.1 and 2.5 because the blood has more albumin than globulin. 

Abnormal A/G ratio results

A low A/G ratio is below 1.1. These ratios can occur if your albumin levels are lower than normal or your globulin levels are too high. Infection, inflammation, autoimmune problems, or cancer may cause high globulin levels. Typically, decreased liver production or increased excretion of albumin through the kidneys causes low amounts of albumin.

A high A/G ratio is above 2.5. High ratios are less common than a low A/G ratio, but one may have a high A/G ratio if their albumin levels are high or globulin levels are low. Low globulin levels may indicate liver or kidney disease or nutritional deficiencies. High albumin levels can occur with severe dehydration, which can happen if you’re suffering from diarrhea.

Causes or conditions that increase A/G ratio

A high A/G ratio occurs when there are high levels of albumin in the blood or low levels of globulin. The most common cause of high albumin levels is severe dehydration. Low levels of serum globulin may allude to kidney or liver disease. 

Given these characteristics, a high A/G ratio can indicate certain medical problems. These conditions include, but are not limited to:

Causes or conditions that decrease A/G ratio

A low A/G ratio occurs when the blood has a low albumin level or a high globulin level. There are three leading causes of low albumin. These are:

  • Increased clearance of albumin from the body through the urine
  • Illness that increases albumin leakage from blood vessels into surrounding tissues
  • Low production of albumin in the liver

High globulin levels typically indicate an infection, inflammation, or elevated immune system activity. 

Certain medical conditions may cause these abnormalities. These conditions include, but are not limited to:

Symptoms of high A/G ratio

An abnormal A/G ratio doesn’t cause symptoms in and of itself. However, you may experience symptoms from the underlying medical condition causing a high A/G ratio. For example, if your A/G ratio is high due to dehydration, you may be having severe diarrhea or vomiting. If your A/G ratio is high due to kidney disease, you may experience swelling in your feet or ankles, tiredness, or frequent urination. 

Symptoms of low A/G ratio

Similar to if you had a high A/G ratio, a low A/G ratio doesn’t directly cause any symptoms. Instead, the underlying condition causing a low A/G ratio may cause symptoms. For instance, if multiple myeloma is causing your low A/G ratio, you may experience a loss of appetite, bone pain, or weight loss.

Management and treatment of A/G ratio

Although an abnormal A/G ratio can help a doctor gain insight into your health status, it cannot diagnose a medical condition independently. Your doctor may order follow-up tests so they can narrow down the potential causes. Once they come to a diagnosis, treatment will depend on the underlying condition.

Follow-up testing

Depending on your symptoms and the suspected underlying health condition, your healthcare provider might order follow-up tests. These tests will give them more information to help pinpoint what the cause is and to come to a diagnosis.

There isn’t one particular follow-up test your doctor will order. The tests will vary based on your symptoms and medical history. Some examples of tests include: 

Medical treatments 

Similar to follow-up testing, there isn’t one particular treatment for a high or low A/G ratio. Treatment will vary depending on the underlying condition, symptoms, and other test results.