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Protein C and Protein S Tests
URL of this page: https://medlineplus.gov/lab-tests/protein-c-and-protein-s-tests/

Protein C and Protein S Tests

What are protein C and protein S tests?

Protein C and protein S are proteins in your blood that work together to prevent your blood from clotting too much. Tests of protein C and S use a sample of your blood to measure how much of these proteins you have and how well they're working.

Problems with proteins C and S are called "deficiencies." Normally, your body makes blood clots to stop bleeding when you have an injury. If you have a protein C or a protein S deficiency, your blood may clot even when you don't have an injury.

The clots usually form in the veins in your legs or pelvis. This condition is called deep vein thrombosis (DVT). If part of a blood clot breaks loose and travels to your lungs, it's called a pulmonary embolism. This condition can be life-threatening.

Most protein C and protein S deficiencies are acquired. That means that the deficiency is caused by another health condition or certain medicines. Acquired protein C and S deficiencies may develop with:

  • Infections
  • Liver or kidney disease
  • A lack of vitamin K
  • Cancer and chemotherapy
  • Certain medicines, including birth control pills and warfarin, a blood-thinner
  • Pregnancy
  • Disseminated intravascular coagulopathy (DIC), a rare condition that causes blood clotting throughout the body, followed by bleeding

In rare cases, protein C or protein S deficiencies are inherited. That means that your condition is caused by a change in a gene that one or both of your parents passed down to you.

There are separate tests for protein C and S. But they are often done at the same time.

Other names: protein C antigen, protein S antigen, PC, PS, free PS, autoprothrombin IIA

What are they used for?

Protein C and protein S tests are used to:

  • Find the cause of a blood clot that can't be explained and check your risk for developing more blood clots in the future.
  • Check for a protein C or S deficiency.
  • Check your protein C or S levels to see if they've gotten better or worse. This is done if you have had a change in the health condition that is causing a protein C or S deficiency.

Why do I need protein C and protein S tests?

You may need to test protein C and S if you:

  • Had a blood clot before the age of 50 without a known reason
  • Had a blood clot in an unusual location, such as in the veins of your kidneys, liver, or brain
  • Have had several blood clots

In certain cases, you may need testing if you have a family member who has a serious inherited protein C or S deficiency or who had a clot at a young age. Testing may also be needed for a newborn with a clotting disorder.

What happens during protein C and protein S testing?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

If you are having protein C and S tests because you had a blood clot, you must wait until you have fully recovered to have this test. If you have the test too soon, the results will not be accurate. Your provider will let you know when you're ready to be tested.

Your provider may tell you to not to take blood thinners (medicine that helps prevents blood clots) for several days or longer before your test. But never stop any prescription medicine without talking with your provider first.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Higher than normal levels of protein C or S are not known to cause any health problems.

Lower than normal levels of protein C or S, or proteins that aren't working well, mean that you have a higher risk of developing a blood clot. Your level of risk depends on how abnormal your test results are.

If your provider thinks your protein C or S deficiency is inherited, you may need a genetic test to find out for sure. Having an inherited deficiency doesn't mean that you'll develop a blood clot. But it does mean that your risk for developing a clot will be increased for the rest of your life.

If your protein C or S deficiency is acquired, the deficiency may be temporary or long-lasting. In certain cases, acquired deficiencies may get worse over time.

With both inherited and acquired deficiencies, treatment may help reduce your risk of developing blood clots. Your provider may recommend treatment depending on your test results and health history. You may be able to lower your risk of blood clots by:

  • Taking medicines (blood thinners, also called "anticoagulants") to help prevent too much clotting
  • Treating the condition that caused an acquired deficiency
  • Avoiding other things that can increase your risk of blood clots, including:
    • Smoking
    • Birth control pills

If you have questions about your results or how to manage a protein C or S deficiency, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about protein C and protein S tests?

If you have been diagnosed with a protein C or S deficiency, it's important to talk with your provider whenever you face situations that can trigger blood clots, such as:

  • Surgery
  • Pregnancy
  • Broken bones or other trauma injuries
  • Not moving for long periods of time due to:
    • Bedrest
    • Long car rides or airplane trips

Your provider can help you reduce your risk of getting a clot during those higher-risk times.

References

  1. Cleveland Clinic: Health Library: Protein S Deficiency [Internet]. Cleveland (OH): Cleveland Clinic; c2022. Protein C Deficiency; [reviewed 2021 Sept 21; cited 2022 Aug 7]; [about 13 screens]. Available from: https://my.clevelandclinic.org/health/diseases/21880-protein-c-deficiency#symptoms-and-causes
  2. Cleveland Clinic: Health Library: Protein S Deficiency [Internet]. Cleveland (OH): Cleveland Clinic; c2022. Protein S Deficiency [reviewed 2021 Sept 28; cited 2022 Aug 7]; [about 14 screens]. Available from: https://my.clevelandclinic.org/health/diseases/21877-protein-s-deficiency#diagnosis-and-tests
  3. Gupta A, Patibandla S. Protein C Deficiency. [Updated 2022 Jul 4; cited 2022 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542222/
  4. Gupta A, Tun AM, Gupta K, et al. Protein S Deficiency. [Updated 2021 Aug 29; cited 2022 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544344/
  5. March of Dimes [Internet]. White Plains (NY): March of Dimes; c2022. Blood Clots and Pregnancy; [updated 2020 February; cited 2022 Aug 1]; [about 7 screens]. Available from: https://www.marchofdimes.org/complications/blood-clots-and-pregnancy.aspx
  6. Mayo Clinic: Mayo Medical Laboratories [Internet]. Mayo Foundation for Medical Education and Research; c1995–2022. Test ID: PSTF Protein S Antigen, Plasma; Clinical and Interpretive; [cited 2022 Aug 1]; [about 4 screens]. Available from: https://www.mayocliniclabs.com/test-catalog/overview/83049#Clinical-and-Interpretive
  7. Merck Manual Consumer Version [Internet]. Kenilworth (NJ): Merck & Co., Inc.; c2022. Excessive Clotting (Thrombophilia); [updated 2021 Jan; cited 2022 Aug 1]; [about 3 screens]. Available from: https://www.merckmanuals.com/home/blood-disorders/excessive-clotting/excessive-clotting
  8. National Blood Clot Alliance [Internet]. Vienna (VA): National Blood Clot Alliance; Protein S and Protein C Deficiency Resources; [cited 2022 Aug 1]; [about 6 screens]. Available from: https://www.stoptheclot.org/congenital-protein-s-and-protein-c-deficiency.htm
  9. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [updated 2022 Mar 24; cited 2022 Aug 1]; [about screens]. Available from: https://www.nhlbi.nih.gov/health/blood-tests
  10. NIH U.S. National Library of Medicine: MedlinePlus [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Protein C deficiency; [updated 2013 May 1; cited 2022 Aug 1]; [about 5 screens]. Available from: https://medlineplus.gov/genetics/condition/protein-c-deficiency/
  11. NIH U.S. National Library of Medicine: MedlinePlus [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Protein C deficiency; [updated 2009 Oct 1; cited 2022 Aug 1]; [about 5 screens]. Available from: https://medlineplus.gov/genetics/condition/protein-s-deficiency/
  12. NORD: National Organization for Rare Disorders [Internet]. Danbury (CT): NORD: National Organization for Rare Disorders; c2021. Protein C Deficiency; [cited 2022 Aug 1]; [about 11 screens]. Available from: https://rarediseases.org/rare-diseases/protein-c-deficiency
  13. Padda IS, Patel P, Citla Sridhar D. Protein S and C. [Updated 2022 May 8; cited 2022 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557814/
  14. Pathology Tests Explained [Internet]. Alexandria (Australia): Australasian Association for Clinical Biochemistry and Laboratory Medicine; c2022. Protein C and Protein S; [Reviewed 2021 Mar 24; cited 2022 Aug 7]; [about 4 screens]. Available from: https://pathologytestsexplained.org.au/ptests-pro.php?q=Protein%20C%20and%20S
  15. Testing.com [Internet]. Seattle (WA): OneCare Media; c2022. Protein C and Protein S; [modified 2020 Sep 22; cited 2022 Aug 1]; [about 14 screens]. Available from: https://www.testing.com/tests/protein-c-and-protein-s/
  16. UF Health: University of Florida Health [Internet]. University of Florida; c2022. Protein C blood test: Overview; [updated 2021 Jan 19; cited 2022 Aug 1]; [about 2 screens]. Available from: https://ufhealth.org/protein-c-blood-test
  17. UF Health: University of Florida Health [Internet]. University of Florida; c2022. Protein S blood test: Overview; [updated 2021 Jan 19; cited 2022 Aug 1]; [about 2 screens]. Available from: https://ufhealth.org/protein-s-blood-test
  18. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: Protein C (Blood); [cited 2022 Aug 1]; [about 4 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=protein_c_blood
  19. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: Protein S (Blood); [cited 2022 Aug 1]; [about 3 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=protein_s_blood
  20. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2022. Health Information: Deep Vein Thrombosis: Topic Overview; [updated 2022 Mar 28; cited 2022 Aug 1]; [about 7 screens]. Available from: https://patient.uwhealth.org/healthwise/article/en-us/aa68134

Related Health Topics

  • Blood Thinners
  • Deep Vein Thrombosis
  • Genetic Disorders
  • Pulmonary Embolism
  • Vascular Diseases

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  • What You Need to Know About Blood Testing

The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

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