Hypoalbuminemia occurs when albumin levels in the blood are very low. Albumin is a blood protein that makes up a significant portion of the blood plasma. Plasma is the liquid portion of the blood that holds the proteins and blood cells.
As the main protein in blood plasma, albumin plays a role in many functions, including maintaining pressure in the blood vessels and transporting substances, such as hormones and medications.
Albumin binds to many of these substances, including hormones and some drugs, to help them travel through the body. So when albumin levels are low, the blood may not be able to transport essential materials effectively.
Albumin levels below 3.4 grams per deciliter (g/dL) are considered low.
A range of health issues can cause hypoalbuminemia.
Determining the cause of hypoalbuminemia is vital for effective treatment.
Some of the most common causes of the syndrome include:
- Liver failure: The liver manufactures albumin. So albumin tests are often a part of liver-functioning checks. Many diseases can cause liver failure, including cirrhosis, liver cancer, hepatitis, alcohol-related liver disease, and fatty liver disease.
- Heart failure: Some people with acute heart failure develop low albumin levels, though the reason for this phenomenon is not well understood.
- Kidney damage: Problems with the kidneys may cause them to release large amounts of protein into the urine. This can take albumin from the blood, leading to hypoalbuminemia.
- Protein losing enteropathy: Some stomach and gastrointestinal conditions, including celiac disease and inflammatory bowel disease, can cause the digestive system to lose a lot of protein. This causes a syndrome called
protein losing enteropathythat can lead to low albumin levels.
- Malnutrition: People may develop hypoalbuminemia when they do not eat enough key nutrients, or medical conditions make it hard for their bodies to absorb nutrients. Some undergoing chemotherapy may be malnourished.
While a doctor tries to find out the reason for hypoalbuminemia and start treatment, some strategies can reduce the risk of serious complications.
Some people may need medications to raise their albumin levels. This can include albumin administered via an intravenous needle.
The best option for treating hypoalbuminemia is to address the underlying cause. So people may need to have a variety of tests to determine why there is not enough albumin in their blood.
Treatment may include:
- blood pressure medication for people with kidney disease or heart failure
- lifestyle changes, particularly avoiding alcohol in people with liver disease
- medications to manage chronic gastrointestinal disease or reduce inflammation in the body
- medications, such as antibiotics, if a person has hypoalbuminemia after a severe burn
- dietary changes to reduce the severity of heart or kidney disease
People experiencing hypoalbuminemia due to organ failure may need an organ transplant. People with kidney disease may need dialysis as they await a kidney transplant.
People with hypoalbuminemia may need to be hospitalized and monitored until the condition is corrected.
A person may experience a wide range of symptoms, such as confusion, dizziness, and low energy if they are malnourished, for example.
Some common symptoms of hypoalbuminemia include:
- excess protein in the urine shown by a urine test
- fluid retention that causes swelling, especially of the feet or hands
- signs of jaundice, including yellow skin or eyes
- feelings of weakness or exhaustion
- rapid heartbeat
- vomiting, diarrhea, and nausea
- appetite changes
- thinning hair
- very dry or itchy skin
It is impossible to diagnose low albumin by some of the symptoms alone, and many symptoms associated with low albumin are also linked to other conditions.
Albumin is present in many animal products. These include:
- cottage cheese
- Greek yogurt
Some nutritional supplements and meat substitutes may also contain albumin.
It is important to note that many cases of hypoalbuminemia occur in people who do eat enough albumin. Even in people who eat a healthy diet, underlying diseases can make it difficult to absorb and use albumin and other nutrients.
Hypoalbuminemia can worsen the effects of other diseases. A
Other complications include:
- buildup of fluid, including around the lungs and stomach
- muscle damage
Hypoalbuminemia may also decrease the effectiveness of certain medications that need to bind to albumin.
The outlook for people diagnosed with low levels of albumin in the blood depends on the cause.
Prompt diagnosis and treatment can improve long-term outlooks.
The right treatments can be lifesaving.
Some research suggests that low albumin levels may predict worse outcomes in people who have to be hospitalized.
Overall, 16.3 percent of people with low albumin died in a 30-day period, compared to just 4.3 percent of people with normal albumin.
This suggests that measuring albumin levels and diagnosing the cause of low albumin could improve outcomes in people admitted to the hospital.
Low albumin suggests a person may have a specific health problem but, on its own, it does not provide much information about the reason.
People with low albumin or those who suspect their albumin might be low should work with their doctor to find out what is causing the condition. When someone receives the correct treatment, their low albumin can be reversed.