Quick Facts
- Sample: Serum (blood)
- Fasting: No fasting required
- Turn-around: 6 business days. May take longer based on weather, holiday, or lab delays.
Benefits
- Detect monoclonal proteins early to identify multiple myeloma and related disorders before complications arise
- Highly sensitive testing with over 90% accuracy in detecting abnormal immunoglobulins (Mayo Clinic 2024)
- Characterize protein types by identifying specific heavy and light chain components for precise diagnosis
- Support disease monitoring to track treatment response and progression in plasma cell disorders
- No referral delays with direct access to specialized hematology testing
Who Is This Test For?
- Individuals with abnormal protein electrophoresis results requiring further evaluation and characterization
- Those experiencing unexplained symptoms like bone pain, fatigue, recurrent infections, or anemia
- Patients monitoring known monoclonal gammopathies including MGUS or active multiple myeloma
- Anyone with a family history of plasma cell disorders seeking proactive health assessment
- People over 50 with elevated total protein levels needing specialized immunoglobulin analysis
- Individuals with suspected Waldenström's macroglobulinemia or other lymphoproliferative conditions
How It Works – Just 3 Steps
- Order online and visit a nearby lab for a simple blood draw at your convenience
- Lab analysis uses immunofixation electrophoresis to detect and identify monoclonal proteins in your serum
- Receive results in 6 business days.
FAQ
What does this test detect? It identifies monoclonal immunoglobulins (M-proteins) and characterizes their heavy chain type (IgG, IgA, IgM) and light chain type (kappa) to diagnose plasma cell disorders.
Is this test quantitative or qualitative? Primarily qualitative for identifying protein types, with some quantitation of major immunoglobulin classes to support clinical interpretation.
How accurate is immunofixation? Immunofixation has sensitivity greater than 90% for detecting monoclonal proteins compared to standard electrophoresis alone (Mayo Clinic 2024).
Can this test diagnose multiple myeloma alone? No, it indicates whether abnormal immunoglobulins are present but must be interpreted with clinical symptoms, imaging, and other tests for definitive diagnosis.
How long does it take to get results? Typical turnaround time is 6 business days from when the lab receives your sample.
Do I need a doctor's order? No, you can order this test directly online and access your results with included physician review.
More Details
What is the purpose of this test?
The Immunofixation (IFE) Serum Test detects and characterizes monoclonal proteins in your blood serum, which are abnormal immunoglobulins produced by plasma cell disorders. This specialized laboratory procedure combines protein electrophoresis to separate proteins by size and charge with immunofixation using specific antibodies to identify immunoglobulin types (IgG, IgA, IgM) and light chains (kappa). The test is critical for diagnosing monoclonal gammopathies such as multiple myeloma, Waldenström's macroglobulinemia, and other lymphoproliferative disorders (Mayo Clinic 2024). It helps distinguish between benign conditions like MGUS and malignant plasma cell diseases requiring treatment.
Who would benefit from this test?
You may benefit from this test if you have abnormal serum protein electrophoresis results requiring further characterization (Cleveland Clinic 2025). Individuals experiencing symptoms of plasma cell disorders—including bone pain in the back or ribs, unexplained fatigue and weakness, recurrent infections, or unexplained weight loss—should consider this evaluation. Those with elevated total protein levels, unexplained anemia, or kidney dysfunction may need IFE testing to rule out monoclonal gammopathies. If you're already diagnosed with a plasma cell disorder, this test helps monitor disease progression and treatment response. Adults over 50 have a 3-4% prevalence of monoclonal gammopathies, making screening valuable for this age group (American Society of Hematology 2023).
When should I order Immunofixation (IFE) Serum Test?
Order this test after receiving abnormal protein electrophoresis results showing possible M-protein spikes or bands. If you're experiencing symptoms suggestive of multiple myeloma—bone pain, weakness, broken bones, leg weakness, nausea, or recurrent infections—this test provides important diagnostic information. Symptoms of Waldenström's macroglobulinemia including severe fatigue, bleeding from nose or gums, bruising, blurred vision, or swollen lymph nodes also warrant testing. You should consider IFE if you have unexplained immune dysfunction, elevated serum viscosity, or peripheral neuropathy. For those with diagnosed MGUS or smoldering myeloma, periodic IFE testing helps monitor for progression to active disease.
How do I interpret the results?
Result Pattern: No monoclonal bands
- What it means: Normal polyclonal immunoglobulins present
- Typical action: No immediate concern; routine follow-up as needed
Result Pattern: Discrete M-spike with heavy/light chain
- What it means: Monoclonal gammopathy detected
- Typical action: Further evaluation with hematologist; additional testing
Result Pattern: IgG or IgA monoclonal protein
- What it means: Most common in multiple myeloma
- Typical action: Bone marrow biopsy, imaging, free light chain assay
Result Pattern: IgM monoclonal protein
- What it means: Suggests Waldenström's macroglobulinemia
- Typical action: Specialized hematology consultation and workup
Result Pattern: Light chain only (kappa or lambda)
- What it means: Light chain disease or AL amyloidosis
- Typical action: Urgent hematology referral; organ assessment
Result Pattern: Small M-spike with low concentration
- What it means: Possible MGUS (benign condition)
- Typical action: Monitoring every 6–12 months; watch for progression
Presence of monoclonal bands indicates abnormal plasma cell activity and requires interpretation alongside clinical symptoms, imaging, and additional laboratory tests for accurate diagnosis (UF Health 2024).
Disclaimer: Reference ranges may vary by laboratory. Listed ranges are general guidelines and may differ from those used by the performing lab. Always consult your healthcare provider for interpretation.
Pre-test preparation
No fasting is required for this test, and you can take your regular medications. Inform the lab of your clinical history, current symptoms, and any diagnosed conditions to support accurate interpretation. Blood is drawn into a serum separator tube during a routine venipuncture procedure. The serum is separated promptly and can be refrigerated for up to 7 days or frozen for longer storage during transport to the testing facility (UF Health 2024). No special dietary restrictions or activity limitations are necessary before or after the blood draw.
How often should I get tested?
Initial abnormal SPEP result
- Suggested interval: One-time IFE to characterize protein
Diagnosed MGUS (low-risk)
- Suggested interval: Every 6-12 months for monitoring
Diagnosed MGUS (high-risk)
- Suggested interval: Every 3-6 months with clinical assessment
Active multiple myeloma on treatment
- Suggested interval: Every 2-3 months to assess response
Multiple myeloma in remission
- Suggested interval: Every 3-6 months for surveillance
Waldenström's macroglobulinemia
- Suggested interval: Every 3-6 months depending on disease activity
Your healthcare provider will determine the optimal testing frequency based on your specific diagnosis, risk factors, and clinical course.
Why early detection matters
Early identification of monoclonal gammopathies through IFE testing significantly improves patient outcomes by enabling timely intervention before serious complications develop. Approximately 1% of the population has MGUS, which progresses to multiple myeloma at a rate of 1% per year—making regular monitoring essential (American Society of Hematology 2023). Early diagnosis of multiple myeloma reduces the risk of devastating complications including pathologic bone fractures, spinal cord compression, kidney failure, and severe infections (Cleveland Clinic 2025). When detected early, many plasma cell disorders can be managed effectively with targeted therapies, potentially delaying progression and preserving quality of life. For conditions like MGUS, early detection allows for appropriate surveillance protocols that catch transformation to malignancy at the most treatable stage.
Related tests you may consider
Immunofixation (IFE), Serum and Protein Electrophoresis Blood Test - Used to identify monoclonal immunoglobulin gammopathies. It may also indicate conditions such as multiple myeloma or Waldenstrom’s macroglobulinemia.
Complete Blood Count (CBC) with Differential and Platelets Blood Test - Evaluates blood cell types and levels to help diagnose health conditions and track treatment response.
Comprehensive Metabolic Panel (CMP-14) with eGFR Blood Test - Used to evaluate nutrient levels, liver, and kidney function.
Beta-2 Microglobulin, Urine Test - Measures a protein in urine to check for kidney problems, helping doctors detect early kidney damage in conditions like multiple myeloma or chronic infections.
