Serum Albumin

Also known as: Serum albumin, Plasma albumin

Albumin is the most abundant plasma protein, made exclusively by the liver. It maintains oncotic pressure (keeping fluid in blood vessels) and transports hormones, drugs, and fatty acids. Low albumin is one of medicine's most informative and under-appreciated findings.

Specimen

Venous blood (serum separator tube)

Turnaround

2–4 hours

Fasting

Not required

Category

Liver Function

Reference Ranges

MeasurementReference RangeUnit
Adults3.4 – 5.4g/dL

Reference ranges are typical adult values. Your laboratory may use slightly different intervals — always use your lab's reported reference.

What This Test Measures

The liver produces 12–25 grams of albumin daily. With a half-life of 17–26 days, serum albumin reflects synthetic function over the past 2–4 weeks — it is an excellent marker of chronic liver disease and nutritional status, but too slow-changing to detect acute liver failure (where prothrombin time is better). Albumin's negative charge attracts positively charged molecules, making it the principal carrier for calcium, thyroid hormones, bilirubin, and many drugs.

When Is This Test Ordered?

  • Liver disease evaluation and staging (Child-Pugh score uses albumin)
  • Nutritional assessment in hospitalised patients
  • Nephrotic syndrome investigation (massive protein loss lowers albumin)
  • Interpreting calcium levels (albumin-corrected calcium adjusts for low albumin)
  • Monitoring chronic illness and critical illness severity

When Results Are High

Slightly elevated albumin is almost always dehydration — a concentrated plasma with less water. Values above 5.5 g/dL are uncommon and usually artefactual.

When Results Are Low

Hypoalbuminaemia below 3.4 g/dL is a marker of severity across many conditions: advanced cirrhosis, nephrotic syndrome, protein-losing enteropathy, severe malnutrition, or critical illness. It causes oedema, ascites, and affects drug dosing (more free drug circulates when albumin is low). Below 2.5 g/dL is associated with significantly higher morbidity and mortality.

Factors That Can Affect Your Result

  • Albumin is an acute-phase reactant in reverse — inflammation lowers it (negative acute phase protein)
  • Pregnancy lowers albumin by ~0.5 g/dL through dilution
  • Overhydration lowers albumin by dilution — IV fluids in hospitalised patients routinely drop albumin
  • Posture matters — upright position concentrates albumin by ~10% vs supine
  • Many drugs compete with albumin binding, changing drug distribution

Tracking This Test Over Time

Always correct serum calcium for albumin: corrected calcium (mg/dL) = measured calcium + 0.8 × (4 – albumin in g/dL). A calcium of 8.2 mg/dL with albumin of 2.0 g/dL gives a corrected calcium of 9.8 mg/dL — actually normal. Missing this correction leads to misdiagnosis of hypocalcaemia in hypoalbuminaemic patients.

Track your Albumin in Looms

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Medical disclaimer

This page is for educational purposes only and does not constitute medical advice. Reference ranges vary between laboratories, and results must be interpreted in the context of your symptoms, history, and other tests. Always discuss your results with your healthcare provider. Content reviewed by the Looms medical team, 2026-06-01.