What is Albumin? Causes, Symptoms, and Treatment of High and Low Albumin

What is Albumin?

Albumin is one of the most abundant proteins in blood plasma, produced by the liver. It plays a critical role in maintaining the body's fluid balance by ensuring sufficient pressure within the blood vessels, thereby preventing fluid from leaking out of the vessels. It also helps transport important substances such as hormones, vitamins, enzymes, and certain medications to different parts of the body. Various health issues, primarily chronic conditions such as liver diseases, kidney problems, malnutrition, diabetes, heart failure, or severe infections, can cause a decrease in the amount of albumin in the blood serum. Low albumin, or hypoalbuminemia, can lead to complications such as edema, fatigue, shortness of breath, and a weakened immune system. Albumin is a type of protein produced in the liver that plays an active role in many processes, most notably preventing fluid leakage from blood vessels. In healthy individuals, albumin makes up approximately half of the proteins found in blood plasma. Hepatocytes, the primary cells of the liver, secrete approximately 10-15 grams of albumin into the bloodstream daily. About 30-40% of the albumin in the body is found within the blood vessels. The remaining albumin is located in the muscles and skin. Small amounts of albumin can also be found in body fluids such as sweat, tears, gastric juice, and bile. The primary function of albumin is to maintain oncotic pressure in the blood vessels, which is the pressure that keeps fluid within the vessels. If oncotic pressure drops due to reasons such as low albumin, the fluid in the plasma passes from the blood vessel walls into the space between tissues. In this case, the body's fluid balance may be disrupted, and problems such as edema may occur.

Another function of albumin is the transport of substances such as vitamins, enzymes, hormones, fatty acids, and medications to tissues and organs in the body. In other words, albumin acts as a binder and carrier for these substances. Although it varies by laboratory, the normal albumin value in an adult is between 3.5 and 5.5 grams per deciliter (g/dL). If the albumin level in the blood is found to be outside the normal range after tests, specialists may resort to additional examinations to investigate whether the patient has a health problem such as liver or kidney disease. The albumin test, a type of liver function test, can be used in patients showing symptoms of liver or kidney disease. Some of these symptoms include:

Unexplained bruising on the body,

Changes in urinary habits such as dark urine, frequent urination, or a decrease in urine volume,

Fatigue,

Loss of appetite,

Edema in the body,

Unexplained weight loss,

Itching or dryness of the skin,

Muscle cramps.

Additionally, in cases of nutritional deficiencies that can lead to inadequate protein intake, such as vegan or vegetarian diets, specialists may resort to a blood test to investigate whether there is low albumin.

What is High Albumin?

High albumin means that there is more than 5.5 grams of albumin protein per deciliter in the blood plasma. While high albumin in the blood can occur due to reasons such as excessive consumption of high-protein foods, other health problems can also cause an increase in the amount of albumin. The main causes of high albumin are:

Severe dehydration,

Severe diarrhea or vomiting,

Chronic inflammation,

Viral infectious diseases such as hepatitis B and hepatitis C.

Symptoms of high albumin are often not noticed by patients. Specialists may diagnose high albumin in a patient during routine blood tests. In this case, ensuring the patient consumes fluids or, if necessary, providing intravenous fluid supplementation can often help bring albumin levels back to the normal range. However, if excess albumin occurs due to health problems such as viral infectious diseases, the underlying health issue must be treated first.

What is Low Albumin?

Low albumin, known in medical literature as hypoalbuminemia, means that there is not enough albumin protein in the blood. Under normal conditions, a healthy adult's blood contains 3.5 to 5.5 grams of albumin per deciliter. If the amount of albumin in the blood falls below 3.5 grams per deciliter for various reasons, albumin deficiency occurs. If there is not enough albumin in the blood, the oncotic pressure—the pressure that keeps blood fluid within the vessels—decreases, and fluid leaks out of the vessels. As a result, various symptoms, especially edema (swelling), may develop.

Low albumin occurs when the body does not produce enough albumin protein due to reasons such as liver disease, or when too much albumin is lost through urine or stool. The main health problems that can cause low albumin are listed as follows:

Liver diseases such as cirrhosis,

Heart failure,

Inflammatory bowel disease,

Kidney disease,

Infectious diseases such as hepatitis and HIV,

Stress,

Thyroid gland diseases,

Diabetes,

Autoimmune diseases such as lupus.

In cases of low albumin, specialists may also resort to tests such as ALT and AST tests, which help evaluate liver functions. In addition, a type of urine test known as the albumin-creatinine ratio can be applied to evaluate kidney function. Under normal conditions, the albumin-creatinine ratio in urine is expected to be less than 30 mg/g. High albumin-creatinine in urine usually occurs if the kidneys cannot prevent albumin and creatinine (a type of waste product) in the blood from leaking into the urine. In this case, additional blood tests such as the eGFR test (glomerular filtration rate) can be used to evaluate kidney function.

Symptoms of low albumin may vary depending on the factor causing the deficiency. However, some commonly encountered symptoms are:

Muscle weakness,

Yellowing of the skin and eyes,

Swelling in the feet and legs,

Dark urine color,

Shortness of breath,

Unexplained weight gain,

Irregular heart rhythm,

Nausea and vomiting.

If albumin abnormality is not noticed in the early stages, serious complications such as fluid accumulation in the abdomen may occur in later stages.

What is an Albumin Test and Why is it Done?

The albumin test is a simple and safe blood test performed to determine the level of the protein called albumin in the blood. Performed as part of kidney and liver function tests, the albumin test is generally used to evaluate liver and kidney functions. In addition, an albumin test may be requested in cases where health problems such as chronic inflammation or malnutrition are suspected. For example, if the CRP value is high and the albumin value is low in the test result, it may suggest an infectious disease or serious tissue damage to specialists.

In most cases, no special preparation is required before an albumin test. However, in cases where other blood tests will be performed alongside the albumin test, specialists may recommend fasting for a certain period. The procedure is performed by taking a small blood sample from the arm. First, the area where blood will be drawn is cleaned with an antiseptic liquid. Then, a bandage is applied to the upper arm to make the veins more visible. Specialists take a blood sample from a suitable vein and send it to the laboratory for examination.

How is Albumin Treated?

With albumin treatment, specialists aim to return albumin levels in the blood to normal by eliminating the underlying cause. In patients with low albumin due to inflammation, immunosuppressive drugs may be prescribed. In cases where kidney diseases cause albumin abnormalities, medications that help regulate blood pressure may be given to prevent albumin loss through urine.

In addition to these, making changes to dietary habits is also important in albumin treatment. In cases of low albumin, foods rich in protein such as meat, eggs, dairy products, nuts, and legumes can be prioritized. Also, since alcohol consumption can impair liver functions and negatively affect albumin production, it is important to reduce or completely stop alcohol consumption. In cases of high albumin, it may be necessary to limit protein intake.

Frequently Asked Questions

In a healthy adult, the albumin level in the blood is generally in the range of 3.5 - 5 g/dL. Low albumin levels may indicate conditions such as kidney or liver diseases, or nutritional deficiencies. Low albumin can be caused by many reasons such as chronic liver diseases, kidney diseases like nephrotic syndrome, inflammation, inadequate protein intake, and intestinal diseases. Additionally, severe burns, infections, recent intravenous fluid supplementation, or having undergone surgery can lower albumin levels. High albumin levels usually occur due to dehydration (fluid loss). When fluid in the body decreases, the concentration of albumin in the blood increases. Also, some chronic diseases and excessive protein consumption can temporarily increase albumin levels. The albumin test is a laboratory test performed to measure albumin levels in the blood or urine. It can be used to evaluate liver functions, examine nutritional status, and diagnose kidney diseases. The albumin-globulin (A/G) ratio is a test that measures the ratio of albumin to globulin, the two main proteins in the blood. Since there is more albumin than globulin protein in the blood, an albumin-globulin ratio between 1 and 2 is considered normal. A low A/G ratio can occur due to reasons such as kidney and liver diseases, chronic infections, and autoimmune diseases, while a high A/G ratio can occur due to health problems such as severe fluid loss (dehydration) and a weakened immune system. Quality protein sources such as eggs, milk and dairy products, meat, fish, chicken, dried legumes, nuts, and whole grains are considered rich in albumin. Albumin is not a vitamin but a protein synthesized in the liver. One of the primary functions of albumin is the transport of substances like vitamins in the blood. The spot urine albumin/creatinine ratio is generally performed to evaluate kidney functions. Normally, this ratio should be below 30 mg/g. High values may indicate kidney damage or kidney diseases such as diabetic nephropathy.

If you are concerned about your health or if an abnormality has been detected in your albumin values, do not neglect to make an appointment with our specialist doctors in the Department of Nephrology. Regular check-ups are critical for the early diagnosis of many health problems.