Low albumin levels mean the blood may not be able to transport essential materials, such as hormones, effectively. This can lead to various symptoms, including fatigue, jaundice, and fluid retention.

Albumin binds substances, including hormones and some drugs, to help them travel through the body.

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.

Hypoalbuminemia occurs when albumin levels in the blood are very low. In adults, albumin concentration is typically between 35–50 grams per liter (g/L). Albumin levels below 35 g/L indicate hypoalbuminemia.

This article explores the causes and effects of low albumin levels.

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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 enteropathy that 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.

Less frequently, people can develop hypoalbuminemia due to a serious burn, a blood infection called sepsis, allergic reactions, lupus, hypothyroidism, or diabetes.

While a doctor tries to find out the reason for hypoalbuminemia and start treatment, some strategies can reduce the risk of serious complications.

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

Critically ill patients may require intravenous albumin to raise their levels. It is currently unclear how intravenous administration may benefit other patients.

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:

  • 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 similar to other conditions.

Albumin is present in many food products. These include:

  • beef
  • milk
  • cottage cheese
  • eggs
  • fish
  • Greek yogurt

Some nutritional supplements and meat substitutes may also contain albumin.

People who consume enough protein will usually also get sufficient albumin. Adults should aim to make proteins 10–35% of their daily calorie intake.

It is important to note that many cases of hypoalbuminemia occur in people who 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 2015 study found that people with chronic obstructive pulmonary disease (COPD) and hypoalbuminemia were more likely to experience respiratory failure.

Other complications include:

  • the buildup of fluid, including around the lungs and stomach
  • pneumonia
  • muscle damage

Hypoalbuminemia may also decrease the effectiveness of certain medications that need to bind to albumin.

The outlook for people diagnosed with low albumin levels in the blood depends on the cause.

Prompt diagnosis and treatment can improve long-term outlooks. The right treatments can be lifesaving.

Low albumin levels may predict worse outcomes in hospitalized patients, regardless of underlying conditions.

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, albumin levels can recover.