Complement Test: Types, Procedure, And Results - Healthline

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SubscribeWhat to Know About a Complement Blood TestMedically reviewed by Kelsey Nank, PA-CWritten by Ann Pietrangelo Updated on May 2, 2025
  • What is it?
  • Purpose
  • Types
  • Preparation
  • Procedure
  • Risks
  • Results
  • Takeaway

A complement blood test checks for autoimmune diseases or other issues with your immune system. Your doctor might test you if you have a family history of certain conditions, such as rheumatoid arthritis or kidney disease.

What is a complement test?

A complement test is a blood test that measures the activity of a group of proteins in the bloodstream. These proteins make up the complement system, which is one part of the immune system.

The complement system helps antibodies fight infections and destroy foreign substances in the body, such as viruses, bacteria, and other germs.

The complement system is also involved in the functioning of autoimmune diseases and other inflammatory conditions. When a person has an autoimmune disease, the body views its own tissues as foreign and makes antibodies against them.

There are nine major complement proteins, labeled C1 through C9. However, this system is very complex. Currently, dozens of known substances in the immune system combine with complement proteins when activated.

A total complement measurement checks the activity of the main complement components by gauging the total amount of complement protein in your blood. One of the more common tests is known as a total hemolytic complement, or a CH50 measurement.

Complement levels that are too low or too high can cause problems.

What is the purpose of a complement test?

A complement test is commonly used to diagnose autoimmune diseases or other immune function conditions. Certain diseases can have abnormal levels of a particular complement.

A doctor can use a complement test to monitor the progress of a person undergoing treatment for an autoimmune disease such as systemic lupus (SLE) or rheumatoid arthritis (RA). It can also gauge the effectiveness of ongoing treatments for autoimmune disorders and certain kidney conditions. The test can also identify individuals at high risk of complications in certain diseases.

What are the types of complement tests?

A total complement measurement checks how well the complement system is functioning.

A doctor often orders total complement tests for people with a family history of complement deficiency and those who have symptoms of:

  • RA
  • hemolytic uremic syndrome (HUS)
  • kidney disease
  • SLE
  • myasthenia gravis, a neuromuscular disorder
  • an infectious disease, such as bacterial meningitis
  • cryoglobulinemia, which is the presence of abnormal proteins in the blood

Specific complement tests, such as C2, C3, and C4 tests, may help evaluate the course of certain diseases. Depending on your symptoms and history, your doctor will order either a total complement measurement, one of the more targeted tests, or all three. A blood draw is all that’s necessary.

How do you prepare for a complement test?

A complement test requires a routine blood draw. No preparation or fasting is necessary.

How is a complement test performed?

A healthcare professional will follow these steps to perform the blood draw:

  • They disinfect an area of skin on your arm or hand.
  • They wrap an elastic band around your upper arm to allow more blood to fill the vein.
  • They insert a small needle into your vein and draw the blood into a small vial. You may feel a pricking or stinging sensation from the needle.
  • When the vial is full, they remove the elastic band and needle and place a small bandage over the puncture site.

There may be some soreness in the arm where the needle entered the skin. You may also experience some mild bruising or throbbing after the blood draw.

What are the risks of a complement test?

The blood draw carries few risks. Rare risks from a blood draw include:

  • excessive bleeding
  • swelling
  • lightheadedness
  • fainting
  • infection, which can happen any time the skin is broken

Notify your doctor right away if you have any of these symptoms.

What do the test results mean?

Results of a total complement measurement are usually expressed in units per milliliter. Tests that measure specific complement proteins, including C3 and C4, are typically reported in milligrams per deciliter (mg/dL).

According to Mayo Medical Laboratories, the following are typical complement readings for people ages 16 years and older. Values can vary between laboratories. Sex and age can also affect expected levels.

  • total blood complement: 30 to 75 units per mL (U/mL)
  • C2: 25 to 47 mg/dL
  • C3: 75 to 175 mg/dL
  • C4: 14 to 40 mg/dL

Higher-than-normal results

Values that are higher than usual may indicate a wide variety of conditions. Often, these are related to inflammation. Some conditions associated with elevated complement can include:

  • cancer
  • viral infections
  • metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcohol-related fatty liver disease (NAFLD)
  • metabolic syndrome
  • obesity
  • diabetes
  • heart disease
  • chronic skin conditions like psoriasis
  • ulcerative colitis (UC)

Complement activity in the bloodstream is characteristically low in people with active autoimmune diseases such as lupus. However, blood complement levels may be healthy or high with RA.

Lower-than-usual results

Certain complement levels that are lower than usual may occur with:

  • lupus
  • cirrhosis with severe liver damage or liver failure
  • glomerulonephritis, a type of kidney disease
  • hereditary angioedema, which is episodic swelling of the face, hands, feet, and some internal organs
  • malnutrition
  • a flare-up of an autoimmune disease
  • sepsis, an infection in the bloodstream
  • septic shock
  • fungal infection
  • some parasitic infections

In some people with infectious and autoimmune diseases, complement levels may be so low that they are undetectable.

People who lack certain complement proteins may be more prone to infections. Complement deficiency may also be a factor in the development of autoimmune diseases.

What happens after a complement test?

After the blood draw, your healthcare professional will send the blood sample to a laboratory for analysis.

Keep in mind that your total complement test results can be normal even if you’re deficient in several specific complement proteins.

Talk with your doctor about how the results apply to you. They may recommend more testing to make a final diagnosis.

 

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
  • Bardhan M, et al. (2023). Physiology, complement cascade.https://www.ncbi.nlm.nih.gov/books/NBK551511/
  • Blood tests. (2022).https://www.cancerresearchuk.org/about-cancer/tests-and-scans/blood-tests
  • Complement blood test. (2024).https://medlineplus.gov/lab-tests/complement-blood-test/
  • Coss SL, et al. (2023). The complement system and human autoimmune diseases.https://www.sciencedirect.com/science/article/pii/S0896841122001871
  • Cserhalmi M, et al. (2019). Regulation of regulators: Role of the complement factor H-related proteins.https://www.sciencedirect.com/science/article/pii/S1044532319300247
  • Ghias MH, et al. (2020). Role of the complement pathway in inflammatory skin diseases: A focus on hidradenitis suppurativa.https://www.sciencedirect.com/science/article/pii/S0022202X19333019
  • Heggi MT, et al. (2024). Microbial evasion of the complement system: A continuous and evolving story.https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2023.1281096/full
  • Killeen RB, et al. (2025). Cryoglobulinemia.https://www.ncbi.nlm.nih.gov/books/NBK557606/
  • Kolev M, et al. (2022). Inside-out of complement in cancer.https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.931273/full
  • Mollah F, et al. (2023). Complement deficiency.https://www.ncbi.nlm.nih.gov/books/NBK557581/
  • Signs of hemolytic uremic syndrome. (2024).https://www.cdc.gov/ecoli/signs-symptoms/hus.html
  • Test ID: C1Q. Complement C1q, serum: Clinical and interpretive. (n.d.).https://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8851
  • Test ID: C2FXN. C2 complement, functional, serum: Clinical and interpretive.https://www.mayocliniclabs.com/test-catalog/overview/32137#Clinical-and-Interpretive
  • Test ID: C3. Complement C3, serum: Clinical andinterpretive. (n.d.).https://www.mayocliniclabs.com/test-catalog/overview/8174#Clinical-and-Interpretive
  • Test ID: C4. Complement C4, serum: Clinical andinterpretive. (n.d.).https://www.mayocliniclabs.com/test-catalog/overview/8171#Clinical-and-Interpretive
  • Test ID: COM. Complement, total, serum: Clinicaland interpretive. (n.d.).https://www.mayocliniclabs.com/test-catalog/overview/8167#Clinical-and-Interpretive

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Medically reviewed by Kelsey Nank, PA-CWritten by Ann Pietrangelo Updated on May 2, 2025

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