Serum Protein Electrophoresis
A specialized test that separates blood proteins to detect abnormal production patterns.
Table of contents
Basic data
Serum Protein Electrophoresis (SPEP) is a laboratory technique that separates proteins in the blood based on their size and electrical charge. It provides a visual distribution of protein fractions such as albumin, alpha, beta, and gamma globulins.
The test is primarily used in clinical contexts to help diagnose and monitor disorders like multiple myeloma, monoclonal gammopathy of undetermined significance (MGUS), and chronic inflammatory or liver conditions. While not typically part of general health screening, it can offer insights when abnormal immune or protein metabolism is suspected.
Category: Lab blood panel
Level: Advanced
Usefulness: Low
Level
Advanced
Usefulness
Low
Identifies monoclonal gammopathies
Detects M-protein bands in the gamma region, associated with multiple myeloma, MGUS, and other plasma cell disorders.
Assesses chronic inflammation or liver disease
Broad shifts in protein fractions may reflect long-term inflammation, immune dysfunction, or liver synthetic issues.
How it works
Electrophoretic separation
Proteins migrate through a gel or capillary medium under an electric current, forming identifiable bands.
Pattern interpretation
A trained technician or pathologist reviews the pattern — searching for characteristic spikes, gaps, or shifts.
Measures
Albumin
The most abundant serum protein — low levels may reflect liver dysfunction, malnutrition, or inflammation.
Alpha-1 and Alpha-2 Globulins
Elevated in acute inflammation or infection. May also be increased in steroid use or nephrotic syndrome.
Beta Globulins
Associated with iron transport and lipid metabolism — altered levels may indicate chronic disease.
Gamma Globulins
Elevated in chronic infections, autoimmune disease, or plasma cell dyscrasias. M-spikes here are a key red flag.
M-protein spike
A sharp peak in the gamma region suggests monoclonal protein production — further testing is often required.
Reliability
High analytical accuracy
Reliable for identifying monoclonal components and estimating globulin fractions with high reproducibility.
Requires expert interpretation
While results are objective, meaningful insights depend on clinical context and expert pattern recognition.
Limitations
Low specificity without context
Abnormal results may be seen in many non-specific conditions — requiring further testing to confirm diagnoses.
Not actionable for most users
Changes in protein fractions rarely lead to direct lifestyle or intervention changes without underlying disease.
Frequency
Suggested cadence
Only when clinically indicated. For users with abnormal findings (e.g., M-protein), typically monitored every 6–12 months.
Cost
Typical costs
$30–100 depending on location. Sometimes bundled with immunofixation or additional protein studies.
Availability
Where available
Available in most hospital labs and advanced diagnostic centers. Not typically offered via direct-to-consumer services.
Preparation
How to prepare
Fasting is not always required but may be recommended. Avoid high-protein meals or strenuous activity prior to testing.
Interpretation
M-spike detection
Sharp spike in gamma region suggests monoclonal gammopathy — follow-up includes immunofixation and bone marrow biopsy.
Broad changes
Decreased albumin or altered globulin fractions may reflect chronic inflammation, liver disease, or immune dysfunction.
Alternatives
Immunofixation electrophoresis (IFE)
Used in conjunction with SPEP to confirm and characterize monoclonal proteins. Provides higher resolution identification.
Total protein and albumin/globulin ratio
Less detailed but available in basic blood panels. A/G ratio shifts can hint at similar abnormalities.
FAQ
Should I include SPEP in my general health panel?
No. This is a targeted diagnostic test best reserved for evaluating specific symptoms or doctor-recommended follow-up.
What does a monoclonal spike mean?
It indicates that a single clone of plasma cells is producing large amounts of one antibody — further testing is required to determine if it’s benign (MGUS) or malignant (myeloma).