ALBUMIN LEVELS

My four year old is below the 3rd percentile for height and has now fallen below the 10th percentile for weight (he was born on the 50th percentile for both). He is a fussy eater for textures only (ie will not eat anything with "bits"? , but eats pasta, lots of cheese, sandwiches with vegimite (at least 4 a day) chicken and fish fingers, lots of tomatoes peaches and strawberries.  We think he gets enough protein - so we don;t think this is the problem.His current height is 94cm and weight 14.25kg.  He albumin level is now at 3.0. In the last three years he has dropped from 3.3 to 3.2 to 3.1 and now to 3.0.  At what point do albumin levels effect growth???And when should you start being concerned??

[Kevin Pho, MD]

Hello - thanks for asking your question.

There are many reasons that can cause a low albumin.  This test helps in determining if a patient has liver disease or kidney disease, or if not enough protein is being absorbed by the body.
Because albumin is synthesized by the liver, decreased serum albumin may result from liver disease. It can also result from kidney disease, which allows albumin to escape into the urine. Decreased albumin may also be explained by malnutrition or a low protein diet.

Lower-than-normal levels of albumin may indicate:
- ascites
- burns (extensive)
- glomerulonephritis
- liver disease (for example, hepatitis, cirrhosis, or hepatocellular necrosis "tissue death")
- malabsorption syndromes (for example, Crohn's disease, sprue, or Whipple's disease)
- malnutrition
- nephrotic syndrome

An albumin level of less than 2.2 is suggestive of severe malnutrition.  You may want to inquire about a pre-albumin level, which is a more accurate indicator of present nutritional status.  However, if there is presence of kidney or liver disease, these must be evaluated first (i.e. via blood tests for liver and kidney function) - if present, the albumin and pre-albumin cannot be relied upon for nutritional status.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.