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Liver health

Albumin/Globulin (A/G) Ratio

Also known as: A/G ratio, Albumin-to-globulin ratio, Serum protein ratio

The albumin/globulin (A/G) ratio is a simple blood test that compares two types of proteins in your blood: albumin (the most abundant protein in human plasma) and globulin. 

These proteins play key roles in maintaining fluid balance, carrying nutrients and hormones, and supporting immune function. The ratio can provide useful information about your overall health and help your healthcare provider evaluate how well your liver and kidneys are working.

Because this test is typically part of the comprehensive metabolic panel (CMP), it’s often ordered during routine physicals or checkups.

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Key takeaways

  • Sample required: Blood (serum)

  • Tests for: Balance of major blood proteins; may help evaluate liver function, kidney function, and immune system health

  • Reference range: Typically between 1.0 and 2.0, but ranges may vary by lab

What can an A/G Ratio test tell you?

An A/G ratio test helps evaluate the balance between albumin and globulins, which can reflect how well your body is producing, using, and losing protein. An abnormal ratio doesn’t diagnose a specific condition on its own, but it can help identify patterns that may point toward issues with liver function, kidney disease, malnutrition, or chronic inflammation.

  • A low A/G ratio may suggest that albumin levels are low or globulin levels are high. This can happen in the presence of liver disease, kidney disease (especially nephrotic syndrome), or autoimmune and inflammatory disorders.

  • A high A/G ratio usually indicates relatively low globulin levels or relatively higher albumin, which can be seen in some inherited immune deficiencies or in certain blood and bone marrow disorders. Dehydration can also change protein concentrations and may temporarily affect the ratio. Your provider will interpret this finding together with other labs and your history.

Because albumin and total protein are commonly included in the comprehensive metabolic panel (CMP), the A/G ratio is often calculated or reported as part of routine blood work ordered during physicals or checkups.

What is being tested?

Your blood contains hundreds of proteins, but albumin and globulins make up most of the total. The A/G ratio compares these two:

The test works by dividing the albumin concentration by the globulin concentration to produce a numerical ratio. For example, if albumin is 4.0 grams per deciliter (g/dL) and globulin is 2.0 g/dL, the A/G ratio is 2.0.

Where is the Albumin/Globulin ratio test typically included?

The A/G ratio is usually part of the comprehensive metabolic panel (CMP), the total protein test, and serum protein electrophoresis (SPEP) (to investigate abnormal globulin patterns, such as in multiple myeloma). Providers may also order an A/G ratio test alongside:

  • Liver panel tests (to assess liver damage or cirrhosis)

  • Kidney function tests (to evaluate protein loss in urine)

Who should get an A/G ratio test?

Because the A/G ratio is commonly included in routine metabolic testing, most adults get it checked periodically. A provider may order or review this test if you:

  • Have symptoms of liver disease, such as jaundice, fatigue, dark urine, or swelling

  • Show signs of kidney problems, like foamy urine or swelling in your legs or ankles

  • Experience unexplained weight loss, bone pain, or signs of chronic inflammation

  • Are being monitored for a chronic condition such as hepatitis, lupus, or multiple myeloma

  • Are undergoing a general health checkup or pre-surgical evaluation

No formal screening guideline exists specifically for the A/G ratio; it’s used as a supportive marker within broader panels.

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Not available in all 50 states. Eligibility and provider order required. Lab results alone are not intended to diagnose, treat, or cure any condition. A provider will reach out about critical results and plans include access to 24/7 provider messaging.

Images for illustrative purposes only.

Frequently asked questions

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Can this test be done at home?

Yes, some mail-in blood collection kits measure total protein and A/G ratio. However, professional lab testing may be more standardized and accurate. It’s also important for a provider to interpret your results within your overall health picture.

What is the reference range for a normal A/G ratio?

The normal range for albumin/globulin ratio is between 1.0 and 2.0, but it may vary among labs.

What can cause changes in my A/G ratio?

Your A/G ratio can shift for several reasons. Genetic immune deficiencies or low globulin production may raise the ratio, while liver or kidney disease, autoimmune disorders, chronic inflammation, or malnutrition can lower it. Temporary factors — like illness or hydration levels — can also cause short-term changes in your results.

Is fasting required?

Not always. Fasting may be required if the A/G ratio is part of a comprehensive metabolic panel (CMP), which measures blood sugar and other chemistry values. Always follow test-preparation directions from your provider and the lab.

How long do results take?

Results are usually available within one to three business days, depending on the lab.

How often should I get tested?

If included in your annual checkup or CMP, your provider may review your A/G ratio once a year. You may get more frequent testing if you’re being monitored for liver or kidney conditions.

Does insurance cover it?

Yes, insurance typically covers this test when deemed medically necessary. However, insurance is not required for lab testing available through the Hims platform.

What affects A/G ratio accuracy?

Recent illness, dehydration, or certain medications can affect results. Always tell your provider about your current health and any supplements you take.

What tests are related to this biomarker?

• Comprehensive metabolic panel (CMP)

• Albumin

• Globulin

• Total protein 

• Liver Panel 

• Kidney function tests

• Serum Protein Electrophoresis (SPEP)

The information provided here is for informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always talk to a qualified healthcare provider about your specific health concerns.

Related biomarkers

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Alanine Transaminase (ALT)

Alanine transaminase (ALT) is an enzyme found in liver cells that helps process amino acids. This enzyme is a key marker that shows if your liver cells are healthy and working normally.

Learn more about Alanine Transaminase (ALT)

Aspartate Aminotransferase (AST)

Aspartate aminotransferase (AST) is an enzyme in the liver and muscles that helps to process amino acids. Healthy levels mean your liver and muscles are not under stress or injured.

Learn more about Aspartate Aminotransferase (AST)

Alkaline Phosphatase (ALP)

Alkaline phosphatase (ALP) is an enzyme that reflects bile flow and liver function. A healthy level indicates proper bone metabolism and that your liver and gallbladder are functioning without signs of stress.

Learn more about Alkaline Phosphatase (ALP)

Albumin

Albumin is a protein made by the liver that helps carry hormones, vitamins, and nutrients through the blood. It also helps to keep fluid in your blood vessels.

Learn more about Albumin

Total Bilirubin

Bilirubin is a waste product made when old red blood cells break down. Your liver helps remove bilirubin from your blood, so normal levels usually mean your liver is clearing waste efficiently.

Learn more about Total Bilirubin

Total Protein

Total protein measures the combined levels of albumin and globulin proteins that support fluid balance, hormone and drug transport, and the immune system. Healthy levels mean that your body is currently maintaining a good balance of these important proteins.

Learn more about Total Protein

Globulin

Globulins are a group of proteins in your blood that include antibodies, which help your body fight infection, and other proteins that carry hormones and nutrients. Healthy levels suggest your immune system and liver are working well.

Learn more about Globulin

De Ritis Ratio

This ratio compares aspartate aminotransferase (AST) to alanine transaminase (ALT), two enzymes released when liver or muscle cells are stressed. A normal ratio suggests your liver is functioning well and not showing signs of chronic damage or stress.

Learn more about De Ritis Ratio

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Reviewed by Felix Gussone, MD

Published 11/19/2025