Albumin - Again

Hi - I asked a question before about albumin but was not really clear on the answer.  So I have two questions:

1) Regardless of the cause ( ie the cause had not yet been determined) could an albumin level of 3.0 in a child effect it's growth both in height and weight ??

2) Does a low albumin level (of around 3) mean there is something wrong - ie can a healthy , fit child have such a level???

3)(And most important) Are there any malabsorption conditions that would not show up in levels of fecal fat and an endoscopy.  If there are any conditions like this - what tests should be done to confirm such a diagnosis


Thankyou so much for your assistance.


Kay (frustrated mother!!!!)

[Kevin Pho, MD]

Hello - thanks for asking your question.

1) The normal albumin level is between 3.9 and 5.  With the child falling in terms of height and weight percentile, it is certainly possible that nutrition can play a role.  An albumin of 2.3 is considered to be severe malnutrition.  If the cause of the low albumin is due to malnutrition, then it can affect height and weight.

2) As I mentioned in my previous answer, there are many causes of a low albumin.  Primarily these would be liver, kidney or malabsorption diseases.  To evaluate this further, I would obtain liver and kidney panels.  If they are negative, then further tests into malabsorption may be considered.

3) Levels of fecal fat tests for fat malabsorption.  There are other types, including carbohydrate and protein malabsorption.  Tests for carbohydrate malabsorption includes the D-Xylose test, lactose tolerance test, and breath tests which can diagnose specific forms of carbohydrate malabsorption.

Protein malabsorption is not routinely tested for - indirect tests for bacterial overgrowth causing protein malabsorption may be discussed with a pediatric gastroenterologist.  

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.