Albumin

Low Albumin Causes:

• Liver dysfunction (reduced production) — check ALT, AST, GGT, bilirubin
• Chronic inflammation (albumin is a negative acute-phase reactant — drops when CRP is high)
• Malnutrition or insufficient protein intake
• Overhydration (dilutional effect)
• Kidney disease (protein loss in urine — check urine ACR)

Supplements:

• Protein intake -- ensure 1.6-2.2g/kg/day from quality sources
• Digestive enzymes -- if protein absorption is an issue (bloating, GI symptoms)
• NAC -- 600mg/day (supports liver function if hepatic cause)

Lifestyle:

• Optimise nutrition — albumin reflects protein status over weeks
• If persistently low despite adequate protein: investigate liver function and inflammation markers
• Avoid drawing blood in over-hydrated state (hemodilution lowers albumin)
• Low albumin alters drug binding — may affect PED pharmacokinetics

References:

• Cabrera, D., Arab, J. P., & Arrese, M. (2019). UDCA, NorUDCA, and TUDCA in liver diseases: A review of their mechanisms of action and clinical applications. Handbook of Experimental Pharmacology, 256, 237-264. DOI: 10.1007/164_2019_241
• Mokhtari, V., Afsharian, P., Shahhoseini, M., Kalantar, S. M., & Moini, A. (2017). A review on various uses of N-acetyl cysteine. Cell Journal, 19(1), 11-17. DOI: 10.22074/cellj.2016.4872