A common cause of a high total protein on a chemistry panel is which condition?

• A. Hypothyroidism
• B. Hemolysis
• C. Liver failure
• D. Dehydration or inflammation with hyperglobulinemia

Answer: (D)

Total protein equals albumin plus globulins, so a high reading comes from two main scenarios: concentration of proteins due to dehydration (which raises the measured amount of all proteins) or an increase in globulins from chronic inflammation or immune activity (hyperglobulinemia). In dehydration, the plasma becomes more concentrated, boosting the total protein; in inflammatory states, the immune system makes more immunoglobulins, raising the globulin portion and thus the total protein. Liver failure tends to lower total protein because albumin production drops, and hypothyroidism doesn’t typically cause a prominent rise in total protein. Hemolysis can interfere with some tests but isn’t a primary cause of truly elevated total protein. Hence, dehydration or inflammation with hyperglobulinemia best explains a high total protein.