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Albumin – Serum Test

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Human serum albumin is the most abundant protein in human blood plasma. It is produced in the liver. Albumin constitutes about half of the blood serum protein. It is soluble and monomeric.
Albumin transports hormones, fatty acids, and other compounds, buffers pH, and maintains osmotic pressure, among other functions.

Albumin – Serum Test

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Albumin – Serum

Introduction:

Human serum albumin is the most abundant protein in human blood plasma. It is produced in the liver. Albumin constitutes about half of the blood serum protein. It is soluble and monomeric.
Albumin transports hormones, fatty acids, and other compounds, buffers pH, and maintains osmotic pressure, among other functions.
Albumin is synthesized in the liver as preproalbumin, which has an N-terminal peptide that is removed before the nascent protein is released from the rough endoplasmic reticulum. The product, proalbumin, is in turn cleaved in the Golgi vesicles to produce the secreted albumin.
The reference range for albumin concentrations in blood is 3.4 to 5.4 g/dL.[1] It has a serum half-life of approximately 20 days. It has a molecular mass of 67 kDa.
The gene for albumin is located on chromosome 4 and mutations in this gene can result in anomalous proteins. The human albumin gene is 16,961 nucleotides long from the putative 'cap' site to the first poly(A) addition site. It is split into 15 exons that are symmetrically placed within the 3 domains thought to have arisen by triplication of a single primordial domain.

The structure of human serum albumin

Function of albumin serum :

  • Maintains oncotic pressure
  • Transports thyroid hormones
  • Transports other hormones, in particular, ones that are fat-soluble
  • Transports fatty acids ("free" fatty acids) to the liver and to myocytes for utilization of energy
  • Transports unconjugated bilirubin
  • Transports many drugs; serum albumin levels can affect the half-life of drugs
  • Competitively binds calcium ions (Ca2+)
  • Buffers pH
  • Serum albumin, as a negative acute-phase protein, is down-regulated in inflammatory states. As such, it is not a valid marker of nutritional status; rather, it is a marker in inflammatory states
  • Prevents photodegradation of folic acid

Albumin is a protein made by the liver. A serum albumin test measures the amount of this protein in the clear liquid portion of the blood.
Blood has two basic components cells and fluid. The fluid called serum has many different proteins the biggest of which is albumin. It is a protein that is negatively charged and is responsible to carring other proteins and elements like Calcium, potassium and sodium throughout the body.
Albumin is the most abundant protein in the blood. It helps move many small molecules through the blood, including bilirubin, calcium, progesterone, and medications and keeps fluids from leaking out of blood vessels; nourishes tissues, and transports hormones, vitamins, and ions like calcium throughout the body and plays a vital role in tissue growth and healing. Albumin is made in the liver and extremely sensitive to liver damage. The concentration of albumin drops when the liver is damaged, when a person has a kidney disease that causes nephrotic syndrome, when a person is malnourished, has inflammation or is in a shock. Albumin levels are high when a person is dehydrated. Checking the level of albumin in the blood helps assess kidney and liver function. When the albumin levels drop in the blood, the person develops swelling in the ankles (pedal enema) or abdomen (ascites), fluid accumulation takes place in the lungs (pulmonary edema), leading to shortness of breath. Albumin plays an important role in keeping the fluid from the blood from leaking out into the tissues. Since albumin is made by the liver, decreased albumin is a sign of liver disease.
The liver produces a protein known as albumin. This protein plays an important role in moving many small molecules such as bilirubin, progesterone, calcium, and others into the bloodstream. Albumin also ensures that fluid from the blood does not leak out into the body's tissues. Since, albumin is manufactured by the liver; an abnormal level of albumin could point to liver damage or disease. It could also be a sign of kidney damage, because the kidneys keep check on large molecules such as proteins and ensure that they remain in the blood. Any protein that does escape into the urine is quickly re-absorbed by the body and used as a source of energy. The amount of albumin can be measured using either a urine test or a serum albumin test. In a serum albumin test the amount of albumin present in the clear liquid portion (i.e. serum) of the blood is measured. The normal range of albumin is 3.4 - 5.4 grams per deciliter (g/dL).


 

Albumin is a blood plasma protein synthesized in the liver. It is the single most abundant protein in plasma and constitutes about two-thirds of total protein content. Because it is the main protein in human blood, decreases in albumin due to decreased synthesis or losses result in impaired regulation of intravascular oncotic pressure and manifests as edema. As such, it transports certain hormones (eg, thyroid, estrogen, cortisol) when their specific binding globulins are saturated, unconjugated bilirubin and other organic anions, and many drugs (eg, penicillin, warfarin). Albumin is soluble in water, precipitated by acid, and coagulated by heat. The chief functions of albumin are to transport a wide variety of ligands, to maintain plasma oncotic pressure, and to serve as a source for endogenous amino acids.
Several methods exist for determining albumin levels, including dye-binding methods, electrophoresis, and immunochemical methods, as well as dipstick methods for urinary albumin.
For the determination of albumin in serum/plasma, the patient should stop taking drugs that affect albumin measurements, such as anabolic steroids, androgens, growth hormones, and insulin.
A blood sample is put in a centrifuge, which spins and separates the cells from the serum.
The albumin test measures the amount of albumin in the clear liquid portion of blood.
Conditions associated with "high" levels of albumin: dehydration.
Conditions associated with "low" levels of albumin are as follows:

  • Ascites
  • Burns
  • Glomerulonephritis
  • Liver disease (hepatitis or cirrhosis)
  • Malabsorption syndromes (eg, Crohn disease, celiac disease, or Whipple disease)
  • Malnutrition

Other states are as follows:

  • Nephropathy
  • Hepatic encephalopathy
  • Hepatorenal syndrome
  • Sprue
  • Wilson disease

Albumin is a carbohydrate-free protein, which constitutes 55-65% of total plasma protein. It maintains oncotic plasma pressure, is involved in the transport and storage of a wide variety of ligands, and is a source of endogenous amino acids. Albumin binds and solubilizes various compounds, including bilirubin, calcium, long-chain fatty acids, toxic heavy metal ions, and numerous pharmaceuticals.
Hypoalbuminemia is caused by several factors: impaired synthesis due either to liver disease (primary) or due to diminished protein intake (secondary); increased catabolism as a result of tissue damage and inflammation; malabsorption of amino acids; and increased renal excretion (e.g. nephrotic syndrome).
Research from Fred Hutchinson Cancer Research Center indicates that serum albumin measurements may be able to be used to help predict the severity of acute graft-versus-host-disease (GVHD) in stem-cell transplant patients who develop the complication. Until now such predictions have been possible only via expensive biomarker tests.
In the study in the journal Biology of Blood and Marrow Transplantation (2011;17:1594-1601), led by Andrew Rezvani, MD, Research Associate in Fred Hutchinson's Clinical Research Division, in 401 transplant patients who had developed acute GVHD, serum albumin concentrations were lower both before and after being given treatment.Although only about 5% to 10% of the 50% to 60% of transplant patients with acute GVHD requiring treatment develop the most severe form of the disease, mortality rates from the complication are approximately 50% to 80% for those patients, Rezvani noted in an email interview.
The study found that for patients who showed at least a 0.5 mg/dL decrease in serum albumin, 73% developed severe acute GVHD. Rezvani said that although additional testing is still needed before such tests can be put to clinical use, this early research is important because it suggests that serum albumin performs comparably to more sophisticated, expensive biomarkers in terms of accuracy and predictive power.
Serum albumin is a large protein produced in the liver that is present in the blood in large quantities. It is used as a marker of nutrition and liver function. The concentration of albumin in your blood can provide information about your liver. It can be low in many chronic liver disease states, such as cirrhosis. However, it can also be low for other reasons -- in malnourished patients and conditions like nephrotic syndrome and systemic inflammation. Serum albumin concentration can be high in dehydrated patients.
Serum albumin is not as helpful in the diagnosis of acute liver dysfunction such as acute viral hepatitis, drug-related hepatotoxicity and obstructive jaundice.
Albumin is one of the most important and sensitive factors on a blood test. It is made almost entirely in the liver. If low, it can correlate with blood pressure irregularities, as well as nutrient deficiencies. Albumin is a nutrient transport. It "delivers the goods" to the cells. Albumin transports hormones, antioxidants such as glutathione and essential lipids, minerals and nutrients. If serum albumin is low (<4.1) there will necessarily be deficiencies in these critical factors.
Albumin is the primary protein in plasma. A low albumin level will have a grave effect on how the body is able to function.
Albumin transports numerous hormones to cell receptor sites. T4 uses albumin as its carrier, as well as other blood proteins such as globulin fractions. Steroidal hormones can use albumin as its carrier to receptor sites.
Albumin is also a carrier of the body's most ubiquitous, endogenously produced antioxidant: Glutathione. Low blood levels of albumin will necessarily minimize circulating glutathione. Glutathione of course is critical for cellular and liver detoxification.
Albumin is also critical for colloid osmotic pressure balance. When there is a low albumin level, it is common for there to be edema, as well as aberrant blood pressure.
A low albumin level correlates with catabolic activity.
The overwhelming majority of albumin is produced by the liver. So low levels of this critical blood protein could be reflective of liver toxicity and dysfunction, as well as free radical activity and oxidative stress.
Serum Albumin Levels Indicate Severity Of Multiple Myeloma:
A study published in Annals of Hematology examined the relationship between serum albumin levels and disease severity in multiple myeloma patients. Results showed that lower levels of serum albumin are associated with greater disease severity.
Serum albumin is the most abundant protein in blood plasma in humans. A patient’s serum albumin level indicates the amount of albumin in grams per deciliter (g/dL) of serum. It is measured by a serum albumin test.
This study retrospectively examined 373 multiple myeloma patients in Seoul, Korea. Patients were split into two groups: those with serum albumin greater than 3.5 g/dL and those with serum albumin less than 3.5 g/dL. Serum albumin levels were compared to other clinical factors used to predict severity of myeloma.
Patients in the lower serum albumin group were, on average, older with a median age of 62 years compared to 58 years for the higher serum albumin group.
The lower serum albumin group had lower levels of hemoglobin, the protein found in red blood cells that helps transport oxygen throughout the body. Low hemoglobin levels means that the bone marrow is overcrowded with myeloma cells and cannot produce the number of red blood cells that the body needs. Symptoms such as fatigue and shortness of breath result from low hemoglobin levels.
The patients with low serum albumin levels had higher levels of serum beta2-microglobulin, M proteins, and bone marrow plasma cells at the time they were diagnosed. These are all indicative of increased disease severity and cancer progression.
Myeloma cells produce monoclonal antibodies or “M” proteins. Higher levels of M proteins are directly related to increased disease progression and severity.
High levels of serum beta2-microglobulins, a protein found on the surface of cells, indicate greater disease progression. Beta2-microglobulin serum levels increase when white blood cells are either created or destroyed. Doctors test the amount of beta2-microglobulin in the blood at the time of a myeloma patient’s diagnosis to determine how much the cancer has multiplied.
This study showed that low serum albumin levels correlated with increased disease severity, but it is unclear as to why this relationship exists. One idea is that serum albumin levels are associated with increased serum concentrations of interleukin-6, a signaling molecule that encourages the growth of myeloma cells. High interleukin-6 levels are already known to exist in multiple myeloma patients.

 

Why do I need this test and how should I get ready for the test?

This test is done to screen for a liver disorder or kidney disease or to evaluate nutritional status, especially in hospitalized patients, along with or instead of a prealbumin test.
When your doctor thinks that you have symptoms of a liver disorder or kidney disease; sometimes when you have an unintended weight loss, have symptoms associated with malnutrition, or prior to a planned surgery.
This test helps detecting a liver disease such as kidney disease. It is also applied in order to evaluate nutritional status. It is prescribed when you have a rapid weight change, or prior to a planned surgery.
Albumin concentration drops with damaged liver or kidney disease also when a person is malnourished or experiences inflammation in the body, or shock. Albumin increases when a person is dehydrated.
Albumin testing is used in a variety of situations to diagnose disease and to monitor changes in health status with treatment.
Doctor orders a blood albumin test after symptoms of liver disorder or nephrotic syndrome. Also in order to check a person's nutritional status, for example, after an important lose of weight.
The serum albumin test is done to check for levels of albumin because a low level of albumin may point to liver diseases such as hepatitis, cirrhosis, malabsorption such as in the case of Crohn's disease, malnutrition, and other problems. An elevated level could point to diabetic sclerosis, tropical spruce, Wilson's disease, and other ailments.
This test measures the level of albumin in the blood. Albumin is the most abundant protein in the fluid portion of the blood, the plasma. It keeps fluid from leaking out of blood vessels; nourishes tissues; and transports hormones, vitamins, drugs, and ions like calcium throughout the body. Albumin is made in the liver and is extremely sensitive to liver damage. The concentration of albumin drops when the liver is damaged, when a person has a kidney disease that causes nephrotic syndrome, when a person is malnourished, has inflammation, or is in shock. Albumin levels can rise when a person is dehydrated. This is a relative increase that occurs as the volume of plasma decreases.
The albumin test helps to determine if the patient has liver or kidney disease or if the body is not absorbing enough protein.
When and how often laboratory tests are done may depend on many factors. The timing of laboratory tests may rely on the results or completion of other tests, procedures, or treatments. Lab tests may be performed immediately in an emergency, or tests may be delayed as a condition is treated or monitored. A test may be suggested or become necessary when certain signs or symptoms appear.
Due to changes in the way your body naturally functions through the course of a day, lab tests may need to be performed at a certain time of day. If you have prepared for a test by changing your food or fluid intake, lab tests may be timed in accordance with those changes. Timing of tests may be based on increased and decreased levels of medications, drugs or other substances in the body.
The age or gender of the person being tested may affect when and how often a lab test is required. Chronic or progressive conditions may need ongoing monitoring through the use of lab tests. Conditions that worsen and improve may also need frequent monitoring. Certain tests may be repeated to obtain a series of results, or tests may need to be repeated to confirm or disprove results. Timing and frequency of lab tests may vary if they are performed for professional or legal reasons.
Before having blood collected, tell the person drawing your blood if you are allergic to latex. Tell the healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. Also tell the healthcare worker if you have felt nauseated, lightheaded, or have fainted while having blood drawn in the past.
Tell the person doing the test if you are pregnant.
When a blood sample from a vein is needed, a vein in your arm is usually selected. A tourniquet (large rubber strap) may be secured above the vein. The skin over the vein will be cleaned, and a needle will be inserted. You will be asked to hold very still while your blood is collected. Blood will be collected into one or more tubes, and the tourniquet will be removed. When enough blood has been collected, the healthcare worker will take the needle out.
The health professional taking a sample of your blood will:

  • Wrap an elastic band around your upper arm to stop the flow of blood. This makes the veins below the band larger so it is easier to put a needle into the vein.
  • Clean the needle site with alcohol.
  • Put the needle into the vein. More than one needle stick may be needed.
  • Attach a tube to the needle to fill it with blood.
  • Remove the band from your arm when enough blood is collected.
  • Put a gauze pad or cotton ball over the needle site as the needle is removed.
  • Put pressure on the site and then put on a bandage.

The amount of discomfort you feel will depend on many factors, including your sensitivity to pain. Communicate how you are feeling with the person doing the test. Inform the person doing the test if you feel that you cannot continue with the test.
During a blood draw, you may feel mild discomfort at the location where the blood sample is being collected.
After a blood sample is collected from your vein, a bandage, cotton ball, or gauze may be placed on the area where the needle was inserted. You may be asked to apply pressure to the area. Avoid strenuous exercise immediately after your blood draw. Contact your healthcare worker if you feel pain or see redness, swelling, or discharge from the puncture site.
Laboratory tests may be done for many reasons. Tests are performed for routine health screenings or if a disease or toxicity is suspected. Lab tests may be used to determine if a medical condition is improving or worsening. Lab tests may also be used to measure the success or failure of a medication or treatment plan. Lab tests may be ordered for professional or legal reasons. The following are possible reasons why this test may be done:

  • Community acquired pneumonia
  • Decreased blood albumin
  • Decreased blood calcium
  • Elevated blood calcium
  • Kawasaki disease
  • Nutritional disorder
  • Pancreatitis

Since albumin is low in many different diseases and disorders, albumin testing is used in a variety of settings to help diagnose disease, to monitor changes in health status with treatment or with disease progression, and as a screen that may indicate the need for other kinds of testing.
An albumin test may be ordered as part of a liver panel to evaluate liver function, along with a creatinine and BUN (Blood Urea Nitrogen) to evaluate kidney function, or along with a prealbumin to evaluate a person's nutritional status.
A physician may order an albumin test, along with other tests, when a person has symptoms of a liver disorder such as jaundice, fatigue, or weight loss, or symptoms of nephrotic syndrome such as swelling around the eyes, belly, or legs.
Doctors may also order blood albumin tests along with or instead of a prealbumin test when they want to check or monitor a person's nutritional status. Albumin concentrations do not change as rapidly as prealbumin, but decreases can reflect protein deficiencies and malnutrition.
Indications for the albumin test are as follows:

  • Jaundice
  • Fatigue
  • Weight loss
  • Symptoms of nephrotic syndrome (swelling around eyes, belly, or legs)

Causes of changes in albumin levels are as follows:

  • Decreased production (low protein diet or malnutrition, malabsorption)
  • Cirrhosis of the liver
  • Excess excretion by the kidneys (ascites or protein-losing nephropathy or enteropathy)
  • Prolonged diarrhea
  • Loss from skin through burns

 

 

What should I do before the Albumin test?


Specimen type

Specimen collection procedure

Preparatory instructions before the test*

Serum (Blood Sample)

Venipuncture
Collection of blood from a vein, usually from the arm

No Fasting Required.
No other special preparations required.

*Subjects suffering from any illness or on oral or injectable medications are advised to consult their physician prior to requesting any tests or procedures.

 

The doctor will advise you, if required, to discontinue certain drugs that could affect albumin levels. Some drugs such as anabolic steroids, androgens, growth hormone, and insulin can elevate albumin levels and give false test results. Be sure to inform your doctor about all your medications and medical conditions before going for the test.

 

Test Procedure

The health care worker will tie an elastic band around the patient's forearm, near the elbow. This will cause the vein below the band to swell. The area is cleaned with antiseptic and a sterilized needle attached to a tube is then inserted into the vein and blood is collected. The blood sample is usually drawn from a vein or capillary. The band is removed and the needle is then gently removed from the vein. A small bandage is placed on the puncture site. The collected sample is then placed in a centrifuge so as to separate the blood cells from the serum. In an albumin serum test, the health care worker will measure the amount of albumin present in this serum, separated from the blood.

During a blood draw, a hematoma (blood-filled bump under the skin) or slight bleeding from the puncture site may occur. After a blood draw, a bruise or infection may occur at the puncture site. The person doing this test may need to perform it more than once. Talk to your healthcare worker if you have any concerns about the risks of this test.

Ask your healthcare worker how you will be informed of the test results. You may be asked to call for results, schedule an appointment to discuss results, or notified of results by mail. Follow up care varies depending on many factors related to your test. Sometimes there is no follow up after you have been notified of test results. At other times follow up may be suggested or necessary. Some examples of follow up care include changes to medication or treatment plans, referral to a specialist, more or less frequent monitoring, and additional tests or procedures. Talk with your healthcare worker about any concerns or questions you have regarding follow up care or instructions.

Plasma albumin is a component of liver function tests (LFTs), but may be ordered separately. Albumin can be measured in serum (yellow-top tube), plain tube with no additives (red-top tube), or heparin plasma (green-top tube). The reference interval is 36 - 52 g/L. (upper limit increased from 47 g/L on the 15th June 2007). One of the methods used is bromocresol green on a Roche Modular or Olympus AU2700 analyser.
Bromocresol Green (BCG) is a dye of the triphenylmethane family (triarylmethane dyes), which is used as a pH indicator and as a tracking dye for DNA agarose gel electrophoresis. It can be used in its free acid form (light brown solid), or as a sodium salt (dark green solid). It is also an inhibitor of the prostaglandin E2 transport protein.
In aqueous solution, both solids ionize to give the monoanionic form (yellow), that further deprotonates at higher pH to give the dianionic form (blue), which is stabilized by resonance:
 
The acid and basic form of this dye have an isosbestic point in their spectra, around 515 nm.
Ethanol solution (0.04 wt.%) of Bromocresol Green has been proposed for TLC staining and is suitable for visualisation of the compounds with functional groups whose pKa is below 5.0 (carboxylic acids, sulfonic acids etc.). These appear as yellow spots on light or dark blue background; no heating is necessary. Bromophenol Blue solution can be used for the same purpose.


The compound is synthesized by bromination of Cresol Purple (m-cresolsulfonphthalein).
Determination of serum albumin is usually made using an ultra-centrifugation, salt fractionation, electrophoretic or dye binding method. Dye binding procedures are the simplest to perform, and lend themselves to high volume testing and automation. They are also the procedures most widely used in combination with total protein determinations to yield an A/G ratio. In 1953, the use of methyl orange for direct determination was described.
This method suffered from non-specific binding characteristics.
The use of a HABA dye was introduced in 1954. This method was specific for albumin but displayed poor sensitivity, poor correlation with electrophoresis methods and significant interference from bilirubin, lipids, salicylates, penicillin and sulfonamides.
A bromocresol green (BCG) dye-binding procedure was first proposed in 1964.
This procedure exhibited greater sensitivity and much lower susceptibility to interfering substances. The original method has been optimized to improve correlation with electrophoretic methods.
The present procedure follows a modification of the original BCG dye-binding procedure. Several publications of the late 1970’s reported that abnormal proteins will bind with BCG after the first minute. The present procedures include a reduced measuring time to eliminate abnormal globulin interference and offers linearity to 8.0 g/dl.

 

What are normal results for this test?

The normal range is 3.4 - 5.4 grams per deciliter (g/dL).
Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.
The examples above show the common measurements for results for these tests. Some laboratories use different measurements or may test different specimens.
Low albumin levels can suggest liver disease. Other liver enzyme tests are ordered to determine exactly which type of liver disease.
Low albumin levels can reflect diseases in which the kidneys cannot prevent albumin from leaking from the blood into the urine and being lost. In this case, the amount of albumin or protein in the urine also may be measured (see microalbumin).
Low albumin levels can also be seen in inflammation, shock, and malnutrition.
Low albumin levels may be seen with conditions in which the body does not properly absorb and digest protein, such as Crohn's disease or celiac disease, or in which large volumes of protein are lost from the intestines.
High albumin levels can be seen with dehydration, although the test is not typically used to monitor or detect this condition.
The reference range for albumin testing is as follows:

  • The normal range is 3.5 to 5.5 g/dL or 35-55 g/liter. This range may vary slightly in different laboratories.
  • Albumin composes 50%-60% of blood plasma proteins.

Reference Values
> or = 12 months: 3.5-5.0 g/dL
Reference values have not been established for patients that are less than 12 months of age.


Laboratory test results may vary depending on your age, gender, health history, the method used for the test, and many other factors. If your results are different from the results suggested below, this may not mean that you have a disease. Contact your healthcare worker if you have any questions. The following is considered to be a normal result for this test:
Adults: 3.5-5.5 g/dL (35-55 g/L)
A total serum protein test is a blood test that measures the amounts of total protein, albumin, and globulin in the blood. Results are usually available within 12 hours.


Normal
The normal values listed here—called a reference range—are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what’s normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.


Total protein:

6.4–8.3 grams per decilitre (g/dL) or 64–83 grams per litre (g/L)

Albumin:

3.5–5.0 g/dL or 35–50 g/L

Alpha-1 globulin:

0.1–0.3 g/dL or 1–3 g/L

Alpha-2 globulin:

0.6–1.0 g/dL or 6–10 g/L

Beta globulin:

0.7–1.1 g/dL or 7–11 g/L

Total serum protein 

High values
High albumin levels may be caused by: Severe dehydration.
High globulin levels may be caused by:

  • Diseases of the blood, such as multiple myeloma, Hodgkin's lymphoma, leukemia, macroglobulinemia, or hemolytic anemia.
  • An autoimmune disease, such as rheumatoid arthritis, lupus, autoimmune hepatitis, or sarcoidosis.
  • Kidney disease.
  • Liver disease.
  • Tuberculosis.
  • Low values

Low albumin levels may be caused by:

  • A poor diet (malnutrition).
  • Kidney disease.
  • Liver disease.
  • An autoimmune disease, such as lupus or rheumatoid arthritis.
  • Gastrointestinal malabsorption syndromes, such as sprue or Crohn's disease.
  • Hodgkin's lymphoma.
  • Uncontrolled diabetes.
  • Hyperthyroidism.
  • Heart failure.

The human blood contains serum proteins that help in the proper functioning of the human body. There are many types of proteins present in the human blood that also help in the proper functioning of the immune system and various other body cells. Of the many different proteins, albumin and globulin are the most important ones. They are produced in the liver and albumin helps in preventing the blood from the blood vessels leaking out. It also helps in growth of tissue as well as healing of tissue injury. Serum albumin is used to check chronic liver disorders and the level of nutrition in the body. We shall understand causes of high albumin levels as well as low albumin levels during a blood test.
Normal Albumin Levels
Albumin test is normally carried out during a liver panel done to evaluate liver diseases. It is also carried out along with creatinine and Blood Urea Nitrogen (BUN) test for evaluation of kidney function. A person's nutritional status is evaluated along with a prealbumin test. Those who suffer from jaundice, fatigue, unexplained weight loss, swelling around the legs, abdomen and eyes are asked to check the albumin levels in blood. The normal albumin levels in blood is between 3.4 to 5.4 g/dL. Normal albumin level in urine is about 0-8 mg/dL. But, do you know what do high albumin levels mean? The following paragraph will cover some information related to the increase in albumin levels.
Increase in Albumin Levels
High albumin levels in blood is called hyperalbuminemia in medical terms. There are various disorders that can cause high blood albumin levels. These conditions include:

  • Tuberculosis
  • Hepatitis
  • HIV

These conditions affect the immune system of the body, causing the protein levels in the body to increase. People suffering from chronic inflammation, severe infection, etc. may also show hyperalbuminemia in serum. It may also mean, a person may be suffering from an abnormal swelling, immune system disorder, cancer, malnutrition, liver disorder and kidney disorder.
It may also be seen in different conditions mainly dehydration. A severe or chronic case of dehydration shows high protein levels in blood. Other conditions include:

  • Congenital disorders
  • Poor utilization of proteins in blood
  • Congestive heart failure
  • Glucocorticoid excess due to overdose of cortisone medications, overproduction of cortisol by adrenal gland or a tumor within the body that produces extra cortisol like substances in the body

Low Albumin Levels
There are many reasons for low albumin levels in the body. It is a sign of liver disease, inflammation, shock and malnutrition. Low albumin levels also indicate kidney diseases that causes albumin from blood to leak into urine and being flushed out of the body. Diseases like Crohn's disease, celiac disease, etc. where the body cannot absorb and digest proteins may cause low blood albumin levels. Other conditions include:

  • Exfoliative dermatitis
  • Severe burn injuries
  • Drinking too much water or polydipsia
  • Chronic debilitating diseases
  • Enteropathy
  • Liver dysfunction

 

What might affect my test results?
Certain drugs increase albumin in the blood, including anabolic steroids, androgens, growth hormones, and insulin. If someone is receiving large amounts of intravenous fluids, the results of this test may be inaccurate.
Albumin production is decreased during pregnancy. Patients taking large amounts of intravenous fluids may have inaccurate results. The test may need to be performed with creatinine and blood urea nitrogen tests to evaluate kidney function.
Lower-than-normal levels of serum albumin may be a sign of:

  • Kidney diseases
  • Liver disease (for example, hepatitis, cirrhosis, orascites)

Decreased albumin may occur when your body does not get or absorb enough nutrients, such as:

  • After weight-loss surgery
  • Crohn's disease
  • Low-protein diets
  • Sprue
  • Whipple's disease

Other conditions under which the test may be performed:

  • Burns (widespread)
  • Wilson's disease

This test may need to be performed with a prealbumin test to evaluate nutritional status. Marked lipemia can interfere with albumin measurement.
Results increased in:

  • Dehydration
  • Hemoconcentration

Results decreased in:

  • Increased loss via body surfaces (eg, burns, trauma)
  • Hypervolemia
  • Pregnancy

Few Common Questions:
1. Is anyone at high risk for abnormal albumin levels?
Individuals who have chronic liver disease and kidney disorders are at highest risk for developing abnormal albumin levels. In addition, individuals whose GI tract doesn't absorb nutrients properly and individuals who have prolonged diarrhea can develop abnormal albumin levels.
2. Is there a home test for albumin levels?
No, not for blood albumin. You can test for high albumin levels in urine with a dipstick purchased in a drug store.
3. What is the difference between albumin, prealbumin, and microalbumin tests?
Albumin and microalbumin are the same molecule while prealbumin, despite the similar-sounding name, is a completely unrelated molecule. The prealbumin test measures a protein that reflects your current nutritional status, particularly before and after surgery, or if you are hospitalized or taking nutritional supplements. Albumin testing is more often used to test for liver or kidney disease or to learn if your body is not absorbing enough amino acids. Albumin can also be used to monitor nutritional status and is a more widely available test than prealbumin. However, prealbumin changes more quickly, making it more useful for detecting changes in short-term nutritional status than albumin. The microalbumin test measures very small levels of albumin in your urine and may indicate whether you are at risk for developing kidney disease.


There is very little risk involved with having your blood taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight but may include:

  • Bleeding from where the needle was inserted
  • Fainting or feeling light-headed
  • Hematoma (blood collecting under the skin)
  • Infection (rare)

Diseases/conditions related to the Albumin test

  • Ascites
  • Burns (extensive)
  • Glomerulonephritis
  • Liver disease (for example, hepatitis, cirrhosis, or hepatocellular necrosis)
  • Malabsorption syndromes (for example, Crohn's disease, sprue, or Whipple's disease)
  • Malnutrition
  • Jaundice
  • Nephrotic syndrome
  • Dehydration

There is very little chance of a problem from having blood sample taken from a vein.
You may get a small bruise at the site. You can lower the chance of bruising by keeping pressure on the site for several minutes. In rare cases, the vein may become swollen after the blood sample is taken. This problem is called phlebitis. A warm compress can be used several times a day to treat this.
Ongoing bleeding can be a problem for people with bleeding disorders. ASA, warfarin (Coumadin), and other blood-thinning medicines can make bleeding more likely. If you have bleeding or clotting problems, or if you take blood-thinning medicine, tell your doctor before your blood sample is taken.
Reasons you may not be able to have the test or why the results may not be helpful include:

  • Taking medicines, such as corticosteroids, estrogens, male sex hormones (called androgens), growth hormone, or insulin.
  • Injuries or infections.
  • Prolonged bed rest, such as during a hospital stay.
  • A long-term (chronic) illness, especially if the disease interferes with what you are able to eat or drink.
  • Being pregnant.

What to think about:

  • If you have abnormal globulin levels, another test called serum protein electrophoresis is often done. This test measures specific groups of proteins in the blood. For more information, see the topic Serum Protein Electrophoresis.
  • Damaged liver cells lose their ability to make protein. But previously produced protein may stay in the blood for 12 to 18 days, so it takes about 2 weeks for damage to the liver to show up as decreased serum protein levels. The liver's ability to make protein may be used to predict the course of certain liver diseases.
  • Unlike carbohydrates and fats, proteins are not stored in the body. They are continuously broken down (metabolized) into amino acidsthat can be used to make new proteins, hormones, enzymes, and other compounds needed by the body.
  • Protein also can be measured in the urine. For more information, see the topic Urine Test.

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