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Cancer Screening

Protein Electrophoresis (SPEP)

Protein electrophoresis (SPEP) measures specific proteins in blood to detect abnormal protein patterns that may indicate multiple myeloma, immune disorders, or other conditions affecting protein production.


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What this test measures

Serum protein electrophoresis (SPEP) separates the proteins in a blood sample into distinct groups based on their electrical charge and size, producing a characteristic pattern that reveals the relative concentration of each protein fraction. The two major categories are albumin and globulins, with the globulins further divided into alpha-1, alpha-2, beta-1, beta-2, and gamma fractions.

The test is particularly valuable for detecting monoclonal proteins (M-proteins), abnormal antibodies produced by a single clone of plasma cells. M-proteins appear as a sharp, narrow spike in the electrophoresis pattern rather than the broad, smooth curve seen with normal polyclonal antibodies. Their detection is a hallmark of plasma cell disorders including multiple myeloma, Waldenstrom macroglobulinemia, and monoclonal gammopathy of undetermined significance (MGUS). Beyond M-protein detection, the overall protein pattern can also reveal chronic inflammation, liver disease, kidney protein loss, immune deficiency, and other systemic conditions. The test creates a visual and quantitative map of protein distribution that guides further diagnostic workup.

Who should consider this test

You might consider this test if you are experiencing any of the following:

  • Individuals with unexplained fatigue, bone pain, or frequent infections that may indicate multiple myeloma or other plasma cell disorders.
  • Those with elevated total protein levels on routine blood tests, as this may suggest abnormal protein production requiring further investigation.
  • Patients with a family history of multiple myeloma, plasma cell disorders, or other blood cancers who want screening for early detection.
  • People experiencing unexplained kidney problems, as abnormal proteins can affect kidney function and may indicate underlying conditions.
  • Individuals with autoimmune symptoms such as joint pain, inflammation, or immune dysfunction that could be related to abnormal protein patterns.
  • Those being monitored for progression from MGUS (monoclonal gammopathy of undetermined significance) to more serious conditions like multiple myeloma.
  • Patients with suspected immune system disorders or chronic inflammatory conditions that may cause changes in protein patterns.

What to expect

Preparation

No special preparation is needed. Individuals can eat normally and take medications as usual before the test.

Sample Type

A healthcare professional will draw a small blood sample from a vein in the arm using a standard needle and collection tube.

Collection

The blood draw takes only a few minutes and involves minimal discomfort. No doctor visit required --- simply visit any participating lab location.

Turnaround

Results are typically available within 1-3 business days after the lab receives the sample.

Understanding your results

Results are reported as both a visual electrophoresis pattern and numerical values for each protein fraction, expressed as a percentage of total serum protein. Healthcare providers look for deviations from the expected pattern: a sharp spike in the gamma region suggests a monoclonal protein warranting further investigation (immunofixation electrophoresis, free light chains), while a broadly depressed gamma fraction may indicate immunodeficiency. Elevated alpha-2 globulins can reflect inflammation or nephrotic syndrome. Each abnormality points in a different diagnostic direction, and healthcare providers use the pattern alongside clinical symptoms, complete blood count, kidney function, and additional specialized tests to determine the underlying cause.

PopulationReference RangeNotes
AdultsTotal protein: 6.4-8.3 g/dLNormal total protein levels in serum
AdultsAlbumin: 3.5-5.0 g/dLPrimary protein component maintaining blood volume
AdultsAlpha-1 globulin: 0.1-0.3 g/dLIncludes proteins involved in inflammation response
AdultsAlpha-2 globulin: 0.6-1.0 g/dLContains proteins for transport and inflammation
AdultsBeta globulin: 0.7-1.2 g/dLIncludes proteins for cholesterol transport and immune function
AdultsGamma globulin: 0.7-1.6 g/dLContains immunoglobulins (antibodies) for infection fighting

Reference ranges may vary by laboratory and individual factors. Results should be interpreted by a healthcare provider in the context of your overall health.

What does a “Low” result mean?

Low levels could mean malnutrition, kidney disease or liver disease. Low albumin: Poor nutrition; inflammation; liver disease; kidney disease are common causes of decreased albumin levels. Low total protein may indicate malnutrition, kidney or liver problems, or conditions that cause protein loss from the body. Decreased gamma globulins may suggest immune deficiency disorders or conditions affecting antibody production. Low alpha-1 globulin can be associated with genetic disorders affecting protein production, while decreased beta globulins may indicate certain metabolic conditions. These findings typically require additional testing to determine the underlying cause and appropriate treatment approach.

What does a “High” result mean?

High levels in certain protein groups could mean inflammation, cancer or immune system disorders. In people with multiple myeloma, you'll typically see: Elevated gamma globulins: Higher than normal levels in this region and possibly an M protein spike indicating abnormal protein production. Elevated alpha-2 globulins may suggest acute or chronic inflammation, while increased beta globulins can be associated with liver disease or immune conditions. High total protein levels may indicate dehydration, chronic infections, or certain blood disorders. In cases of elevated protein levels, such as higher gamma-globulin, doctors may suspect blood cancers like multiple myeloma, lymphoma, or inflammatory diseases. However, elevated protein levels can also occur in less serious conditions and require additional testing for proper diagnosis.

Privacy & confidentiality

All SPEP test results are completely confidential and HIPAA-compliant. Results are not shared with insurance companies, not added to medical records, and not sent to personal doctors unless specifically requested. No insurance billing or explanation of benefits is generated.

Frequently asked questions

Related tests

Last reviewed: April 2026

CPT Code: 84155, 84165

This test may not be available in: NY, NJ, RI

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