Low albumin: What it means and what you should do

Low albumin (hypoalbuminemia) means your blood has less albumin than normal. Albumin is a protein made by your liver. It helps keep fluid in your blood vessels and carries hormones, vitamins, and enzymes throughout your body. When it’s low, it can be a sign of liver problems, kidney disease, poor nutrition, or inflammation.

In this guide, you'll learn what low albumin means, what causes it, how it's diagnosed, and what you can do to improve it.

What is albumin and why does it matter?

Albumin is the most common protein in your blood. It helps:

• Keep fluid inside your blood vessels (so it doesn’t leak into tissues)

• Move hormones, medications, and nutrients around the body

• Balance the pH level in your blood

• Support your immune system and healing

Normal albumin levels are usually between 3.4 to 5.4 g/dL.

What causes low albumin?

Several conditions can lead to low albumin. The most common include:

1. Liver Disease

The liver is the sole producer of albumin. Conditions that damage the liver or impair its ability to synthesize proteins can lead to hypoalbuminemia.

• Cirrhosis: Long-term liver scarring reduces albumin production.

• Hepatitis: Inflammation of the liver (viral, autoimmune, or toxic) affects protein synthesis.

• Liver cancer: Cancerous tissue replaces healthy albumin-producing liver cells.
  
  

2. Kidney Disease

Healthy kidneys normally prevent albumin and other proteins from leaking into urine. When the kidneys are damaged, albumin may escape, lowering blood levels.

• Nephrotic syndrome: A condition marked by heavy protein loss in urine.

• Chronic kidney disease (CKD): Progressive kidney damage reduces albumin retention.

To learn more, check out our guide on The Complete Guide to At-Home Kidney Function Tests.

3. Malnutrition and Poor Diet

If the body doesn’t get enough protein through diet, it cannot maintain healthy albumin levels. This is seen in:

• Severe calorie or protein malnutrition (e.g., kwashiorkor).

• Eating disorders.

• Elderly individuals with reduced food intake.

4. Digestive Disorders

Some gastrointestinal problems interfere with protein absorption or cause excessive protein loss.

• Inflammatory bowel disease (IBD) such as Crohn’s disease or ulcerative colitis.

• Celiac disease: Gluten sensitivity damaging the small intestine.

• Protein-losing enteropathy: A condition where the gut leaks proteins.

5. Infections and Inflammation

Albumin is a negative acute-phase reactant, meaning its levels drop during systemic inflammation or infection. Chronic conditions such as sepsis, tuberculosis, or autoimmune diseases can suppress albumin production.

6. Heart Failure

In congestive heart failure, poor circulation and fluid overload can dilute albumin in the bloodstream.

7. Burns and Trauma

Severe burns or major injuries cause protein loss through damaged skin and increased metabolic demand.

8. Pregnancy

Albumin naturally decreases in pregnancy due to increased plasma volume, although extremely low levels should still be investigated.

9. Certain Medications

Some drugs can reduce albumin levels directly or indirectly, including:

• Chemotherapy agents.

• Corticosteroids.

• Certain antibiotics.

What are the symptoms of low albumin?

You might not notice symptoms if your levels are just a little low. But when they drop more, you could have:

• Swelling in your legs, ankles, or belly

• Weakness or fatigue

• Poor appetite

• Muscle loss

• Trouble healing wounds

• Frequent infections

Some people also notice weight gain from fluid buildup or feel bloated.

How is low albumin diagnosed?

A blood test called a comprehensive metabolic panel (CMP) includes albumin. If your level is low, your doctor may order more tests to find the cause:

• Liver tests (AST, ALT, bilirubin)

• Kidney tests (creatinine, urine protein)

• Inflammation markers (CRP, ESR)

• Nutritional markers (prealbumin, total protein, vitamins)

If needed, imaging tests or stool tests may be done to check for liver or gut conditions.

Can low albumin be treated?

Yes—but treatment depends on the cause. You can't just “replace” albumin long-term without fixing the reason it's low.

Here’s what may help:

• Treat the cause: Whether it’s liver, kidney, or gut-related, managing the underlying issue is key.

• Improve your nutrition: Eat more high-protein foods like eggs, dairy, lean meats, fish, beans, and tofu. 

• Work with a dietitian: They can guide you if you have special needs (like liver or kidney disease).

• Stay hydrated: Proper fluid balance helps avoid swelling and strain on organs.

• Avoid alcohol: It can worsen liver damage and lower albumin further.

In some hospital settings, you may receive IV albumin, especially if you have fluid buildup (ascites) or are getting dialysis. But this is a short-term solution.

Why does low albumin matter?

Low albumin isn’t just a lab number—it can affect how your body heals and handles illness. It may lead to:

• Edema: Fluid leaks into tissues, causing swelling

• Poor healing: Wounds or surgeries take longer to recover

• More infections: Your immune system doesn’t work as well

• Longer hospital stays

In serious illness, low albumin can signal a higher risk of complications.

What if I have low albumin in the hospital?

It’s common for hospitalized people to have low albumin, especially with:

• Infections or sepsis

• Surgery

• Liver or kidney problems

• Poor nutrition

Doctors may use albumin infusions for certain cases (like removing large amounts of fluid from your belly), but it’s not always needed.

The goal is always to support healing and treat what’s causing the drop.

Can albumin levels improve?

Yes—if the underlying issue is managed. For example:

• People with liver disease may see levels rise with better nutrition and alcohol avoidance

• People with kidney disease can reduce protein loss with medications and diet changes

• Treating inflammation or infections can restore balance

Just eating more protein won't help if your body can't use it properly, so always check with your provider.

What should you ask your doctor?

• What’s causing my low albumin?

• Do I need more tests for liver, kidney, or digestive issues?

• Should I change my diet?

• Could this be related to inflammation or infection?

• How often should I check my levels?

Takeaway

Low albumin means your liver isn’t making enough protein or you’re losing it through your kidneys or gut. It often signals a bigger problem like liver disease, kidney damage, or poor nutrition.

You may not feel symptoms at first, but swelling, fatigue, and infections can follow. Talk to your doctor if your level is below 3.4—and especially if it’s under 3.0.

Treatment focuses on fixing the root cause. With the right care, albumin can go back to normal.

Want to track your albumin levels over time? Try  Ribbon Checkup to stay on top of your liver health and get custom tips.

Related resources 

• The Ribbon Liver Test: A Simple, Science-Backed Way to Track Liver Health    from Home

• How to Protect Your Kidneys: Kidney Health Guide

• At-home Liver Test: A Comprehensive Guide

Frequently Asked Questions (FAQ) About Low Albumin

1. What is albumin and why is it important?
Albumin is the most common protein in your blood, made by your liver. It helps keep fluid inside your blood vessels, transports hormones and nutrients, balances blood pH, and supports your immune system and healing.

2. What are normal albumin levels?
Normal albumin levels are usually between 3.4 to 5.4 g/dL. Levels below this range may indicate health problems.

3. What causes low albumin (hypoalbuminemia)?
Low albumin can be caused by:

• Liver disease (cirrhosis, hepatitis, liver cancer)

• Kidney disease (nephrotic syndrome, chronic kidney disease)

• Poor nutrition or malnutrition

• Digestive disorders (IBD, celiac disease, protein-losing enteropathy)

• Infections and inflammation (sepsis, tuberculosis, autoimmune conditions)

• Heart failure

• Burns and trauma

• Pregnancy (due to increased blood volume)

• Certain medications (chemotherapy, corticosteroids, antibiotics)

4. What are the symptoms of low albumin?
Mildly low levels may not cause symptoms. With more significant drops, you may notice:

• Swelling (edema) in legs, ankles, or abdomen

• Weakness or fatigue

• Poor appetite and muscle loss

• Trouble healing wounds

• Frequent infections

• Bloating or unexplained weight gain from fluid buildup

5. How is low albumin diagnosed?
Low albumin is detected through a blood test (comprehensive metabolic panel). If results are abnormal, additional tests may include:

• Liver function tests (AST, ALT, bilirubin)

• Kidney tests (creatinine, urine protein)

• Inflammation markers (CRP, ESR)

• Nutritional markers (prealbumin, total protein, vitamins)

• Imaging or stool tests (for liver or gut issues)

References

References

0. (2018, March 8). What to know about low albumin levels. Medicalnewstoday.com; Medical News Today. https://www.medicalnewstoday.com/articles/321149 

Clinic, C. (2022, February 16). An albumin blood test checks your liver and kidney function. High or low levels can indicate health conditions. Cleveland Clinic. https://my.clevelandclinic.org/health/diagnostics/22390-albumin-blood-test 

Gounden, V., Rishik Vashisht, & Ishwarlal Jialal. (2023, August 28). Hypoalbuminemia. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526080/ 

Hypoalbuminemia: Causes, Symptoms, Treatment & Outlook. (2022, March 21). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22529-hypoalbuminemia 

Jewell, T. (2017, August 10). What Is Hypoalbuminemia and How Is It Treated? Healthline; Healthline Media. https://www.healthline.com/health/hypoalbuminemia