Hypoalbuminemia

Overview

What is hypoalbuminemia?

Hypoalbuminemia happens when your body doesn’t produce enough of the albumin protein, or when you lose too much albumin in your urine or stool. Your liver makes albumin, which prevents fluid from leaking out of blood vessels into your tissues. Albumin is also responsible for transporting vitamins, enzymes and hormones throughout your body. Albumin makes up 50% of the proteins found in your plasma. When your albumin levels are low, hormones and other important compounds aren’t able to get to where they need to go in your body to fulfill their duties.

Who does hypoalbuminemia affect?

Hypoalbuminemia is very common in hospitalized individuals and among those with critical, life-threatening illnesses like heart failure, malnutrition, severe burns and kidney disease. There’s no age range as to who can have low levels of albumin in their blood, but the condition most often affects people over the age of 70.

How common is hypoalbuminemia?

A study indicated that over 70% of hospitalized individuals who were over the age of 70 had hypoalbuminemia. Hypoalbuminemia normally appears as a symptom of other conditions that leads to a specific diagnosis.

How does hypoalbuminemia affect my body?

Based on the cause of hypoalbuminemia, it can affect each person differently. If a child or adolescent has hypoalbuminemia, their albumin would delay the transportation of growth hormones throughout their body, and they could miss height development milestones for their age. For people over the age of 70, a symptom of hypoalbuminemia is weakness and fatigue, which could make people with this condition at risk of a fall or physical injury. The sudden onset of hypoalbuminemia symptoms could indicate an underlying medical condition. Treatment of the underlying condition can increase levels of albumin in your blood.

Symptoms and Causes

What are the symptoms of hypoalbuminemia?

Symptoms vary based on what causes your level of albumin to decrease. People with hypoalbuminemia may experience the following symptoms:

  • Fatigue.
  • Weak muscle tone.
  • Jaundice.
  • Swelling in their feet and legs.
  • Dark-colored urine and/or frequent urination.
  • Difficulty breathing.
  • Loss of appetite.

Symptoms of hypoalbuminemia are typically related to conditions affecting your liver, kidneys and heart, as well as nutritional deficiencies. Treatment to address the underlying condition can improve albumin protein levels.

What causes hypoalbuminemia?

An underlying medical condition causes hypoalbuminemia. The condition is ultimately a symptom of another condition. The most common causes of hypoalbuminemia include:

Other causes of hypoalbuminemia include:

Hypoalbuminemia can affect individuals who were recently hospitalized, especially if they:

  • Received fluids from an IV.
  • Had surgery.
  • Used a ventilator.
  • Needed a cardiopulmonary bypass machine (CBM).

Your healthcare provider will routinely check your albumin levels to verify whether or not the treatment for the underlying condition is progressing.

Diagnosis and Tests

How is hypoalbuminemia diagnosed?

Your healthcare provider will draw a sample of your blood for an albumin blood test to measure the amount of albumin in your body. The albumin blood test identifies whether the amount of albumin in your blood is too high, normal or too low. Results that are lower than normal can be a sign of an underlying medical condition.

Depending on your symptoms, your healthcare provider might test your albumin levels on their own or they’ll perform a panel test that assesses the health of your organs, like a metabolic panel that measures liver and kidney function and nutrient levels, or a liver panel that measures the function of your liver.

Your healthcare provider can also test a sample of your urine through a microalbuminuria test or an albumin-to-creatinine test to see whether or not you’re releasing albumin proteins when you urinate. These tests can also indicate whether or not your kidneys are functioning properly or if you have any kidney damage.

What is a normal albumin level?

A normal albumin level ranges from 3.5 to 5.5 grams per deciliter (g/dL) of blood. Albumin levels below that range are indications of an underlying medical condition.

Management and Treatment

How is hypoalbuminemia treated?

Treatment of hypoalbuminemia varies based on the cause of what lowered the levels of your albumin protein. Treatment of the underlying condition that caused hypoalbuminemia can increase your level of albumin back to normal. Treatment for hypoalbuminemia could include:

  • Eating a well-balanced diet to address malnutrition and heart disease.
  • Taking blood pressure medication to address kidney disease or heart failure.
  • Taking antibiotics to treat a severe burn.
  • Taking anti-inflammatory medicine to treat inflammation (NSAIDs).
  • Undergoing dialysis for kidney disease.

Treatment will be closely monitored by your healthcare provider to track your symptoms and make sure your body’s albumin protein level increases.

Can alcohol cause low albumin?

Drinking alcohol can make symptoms of hypoalbuminemia worse, so your healthcare provider may recommend avoiding alcoholic beverages with your hypoalbuminemia diagnosis.

What should I eat if I have low albumin?

Hypoalbuminemia could be the result of malnutrition or a vitamin deficiency. Taking vitamins (vitamin D) and eating a well-balanced diet full of protein like lean meats, fish, nuts (almonds, cashews, walnuts, etc.) and eggs, along with dairy products (milk, yogurt, cheese) and whole-grain carbohydrates (bread and rice) can increase the amount of albumin your body produces.

How soon after treatment will I feel better?

Treatment to address the underlying cause of hypoalbuminemia can take time, but making lifestyle changes, like improving your diet, can increase your albumin protein levels naturally. Your healthcare provider will offer a treatment plan that’s unique to your diagnosis to reduce your symptoms so you can feel better.

Prevention

How can I reduce my risk of hypoalbuminemia?

You can reduce your risk of hypoalbuminemia by:

  • Eating a balanced diet full of dairy, protein and whole-grain carbohydrates or taking supplements to increase the amount of protein and calories in your diet.
  • Removing foods high in sodium (salt) from your diet.
  • Taking medicine or receiving treatment to manage underlying health conditions.
  • Reducing how much alcohol you drink.

Outlook / Prognosis

What can I expect if I have hypoalbuminemia?

Depending on what caused your levels of albumin to decrease, treatment of the underlying condition can alleviate symptoms of hypoalbuminemia and increase your albumin proteins to a normal level.

If left untreated, hypoalbuminemia can be life-threatening. Untreated symptoms can lead to:

  • Malnutrition if you lose your appetite.
  • Liver or kidney disease.
  • Heart failure (circulatory collapse).

Persistent hypoalbuminemia, especially among people who are in the hospital and under intensive care, is a sign of an underlying health condition, and your healthcare provider will treat the underlying condition immediately to prevent life-threatening consequences.

Living With

When should I see my healthcare provider?

You should visit your healthcare provider if you experience symptoms of hypoalbuminemia, including:

  • Your surgical site isn’t healing, turns red or oozes a clear or yellow fluid (infection).
  • You’re urinating more frequently or your urine is a different color than what’s normal for you.
  • You lose your appetite and have trouble eating.
  • You experience swelling in your legs and feet.

Visit the emergency room or call 911 immediately if you have shortness of breath, difficulty breathing or if your heart starts beating fast or at an irregular pace.

What questions should I ask my doctor?

  • Are there side effects to the medicine you prescribed to treat the condition that caused hypoalbuminemia?
  • How often should I get my albumin levels checked if I have hypoalbuminemia?
  • What changes to my diet should I make to improve my albumin levels?

A note from Cleveland Clinic

Hypoalbuminemia is a warning sign for your healthcare provider to test for an underlying condition that’s responsible for lowering the amount of albumin proteins in your blood. Follow treatment advised by your healthcare provider to manage the condition that caused hypoalbuminemia and alleviate your symptoms so you can feel better.

Last reviewed by a Cleveland Clinic medical professional on 03/18/2022.

References

  • American Association for Clinical Chemistry/Lab Tests Online. Albumin Blood Test. (https://labtestsonline.org/tests/albumin) Accessed 3/18/2022.
  • National Kidney Foundation. Kidney Failure Risk Factor: Serum Albumin. (https://www.kidney.org/content/kidney-failure-risk-factor-serum-albumin) Accessed 3/18/2022.
  • StatPearls. Several pages reviewed for this article. (https://www.statpearls.com/ArticleLibrary/viewarticle/23253) Accessed 3/18/2022.
  • U.S. National Library of Medicine. Albumin Blood Test. (https://medlineplus.gov/lab-tests/albumin-blood-test/) Accessed 3/18/2022.

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