Hi, everyone. Abby here with nursing.com. In this lesson, we’ll talk about total protein. It’s a measurement of both albumin and globulin in the bloodstream. We’ll talk about when values might be increased or decreased, and what’s normal, and when we would draw this lab. Let’s dive in!

Total protein, abbreviated PROT, measures for two proteins in the blood; albumin and globulin. Protein, man, what an integral part of every cell and all the tissues in our bodies. Proteins are responsible for transport through the body, signaling, building, immunity, and even oncotic pressure, especially in the case of albumin. Albumin and globulins are both synthesized by the liver. Globulins are also indicated, uh, in, or, uh, excuse me, incited for production from the immune system. And, I included this image here because what do we get out of all of this RNA and DNA situation? What contributes to making those bits in our bodies that are so important? Protein. So, when is it indicated to draw this lab? Well, with nephrotic syndrome. We might see elevated protein in the urine, and we wanna know what the protein in the body is doing. It could also be in times of nutritional deficiency, we need to know how much protein there is, because someone might not be healing or failing to thrive right? And then, we also will take this lab in kidney and liver disease because we want to know, is the liver able to synthesize proteins? Is the kidney clearing them or filtering? Is it staying in the system? Right? All sorts of indications. 

Now, normal therapeutic values are between 6 and 8 grams per deciliter. We’ll use a plasma separator tube and you’ll see this lab value reported on a CMP. When lab values are increased, that could mean chronic illness and inflammation, and even from a disease process or infection like HIV, also in viral hepatitis. Multiple myeloma ends up making the body produce all of these short chain proteins, and that increase is major. It’s also evident in pregnancy. Now, we’ll also see globulins, of course, being produced as we talked about with illness and inflammation. Isn’t it interesting, what they look like, these proteins? Did you know that insulin is actually a protein? Well, protein levels will be decreased in the case of liver disease, kidney disease, malnutrition, or malabsorption like we see with autoimmune disorders like celiac and Crohn’s. They could also be decreased in bleeding, nephrotic syndrome, and in the case of extensive burns, where there’s lots of tissue damage. 

Linchpins for this lesson are that the protein lab, PROT, measures for albumin and globulin in the blood. It helps us to evaluate nutritional status and liver and kidney disease. Normal values will be between 6 and 8 grams per deciliter, and we’ll see it increased in the case of viral infections like HIV, or hepatitis B and C. And also during pregnancy. Can you imagine the amount of, uh, production and building that happens during pregnancy? Lots of protein. It will be decreased in cases of malnutrition, in the face of kidney and liver disease, and malabsorptive disorders in the gut. 

This wraps it up our lesson for total protein. Remember, we love you guys and we know you can do it now. Go out, be your best self today, and as always happy nursing.

References:

• https://www.mountsinai.org/health-library/tests/total-protein
• https://medlineplus.gov/lab-tests/total-protein-and-albumin-globulin-a-g-ratio/
• https://www.uptodate.com/contents/evaluation-of-proteinuria-in-pregnancy-and-management-of-nephrotic-syndrome?search=total%20protein%20measure&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
• https://ltd.aruplab.com/Tests/Pub/0020029