Understanding hypoproteinaemia
Hypoproteinaemia is when the protein levels in the blood are too low. In this article, a consultant hepatologist, Dr Patrick Kennedy, explains how hypoproteinaemia can occur, and what can be done to correct it.
What are proteins and why do we need them?
Proteins are an essential component in every cell in the human body. They are long chains of molecules that are composed of amino acids, and make up the ‘building blocks’ of cells, fuelling the processes that make up bones, muscles, and other tissues. They are utilised in cell recovery, enzyme and hormone production, strengthening our hair, skin, and nails, and for maintaining the immune system, muscles, and organs. The human body makes proteins, but we acquire most of them from the food we eat.
There are two main proteins in the blood: albumin, which is found in blood plasma, and globulin, which is used to form blood clots and in kidney and liver function.
What are the signs of hypoproteinaemia?
A patient with hypoproteinaemia may experience a variety of symptoms, such as:
- Brittle hair and nails
- Hair loss and white or greying hair
- Dry, itchy, and dull skin, or rashes and sores
- Fluid buildup in the pelvic area and lower limbs
- Fatigue and wooziness
- Jaundice
What causes hypoproteinaemia?
Hypoproteinaemia can be caused by many different conditions, including:
- Autoimmune diseases like coeliac and Crohn’s disease, which can affect how protein is absorbed into the body
- During periods of infection and inflammation, the body needs more protein to heal
- Overactive metabolism, where the body uses up protein faster than usual
- Malnutrition, due to environmental or socioeconomic factors, or the patient may have an eating disorder
- Pregnancy, where the protein is used in fetal development
- Kidney disease, like nephrotic syndrome
- Liver disease, like cirrhosis and hepatitis
Left untreated, hypoproteinaemia can lead to kwashiorkor, a severe type of protein malnutrition.
How is hypoproteinaemia treated?
Hypoproteinaemia is typically diagnosed by undergoing blood tests, such as a comprehensive metabolic panel or tests that specifically look for the levels of albumin and globulin.
Approaches to treatment for hypoproteinaemia will vary depending on the cause of the low levels of protein. For many patients, particularly those with malnutrition and who are pregnant, their symptoms can improve by incorporating more protein into their diet.
A high-protein diet can consist of:
- Eggs
- Meat like chicken breast and beef
- Fish
- Nuts and nut butters like almonds and peanuts
- Oats, seeds, and grains like lentils and quinoa
- Dairy products like cottage cheese and Greek yoghurt
- Tofu
Patients can also take additional protein supplements.
For patients with kidney or liver disease, their doctors will explore several options for treatment, ranging from conservative methods like medications to improve protein retention and absorption, to more intensive procedures like dialysis and organ transplant. If they haven’t already, it is recommended to cease or reduce alcohol consumption in order to avoid further damaging their kidneys and livers.
Patients with eating disorders will be encouraged to undergo psychotherapy, such as cognitive behavioural therapy, to recontextualise their relationship with food and maintain a balanced diet.
Patients with coeliac disease should abstain from eating gluten and products with gluten in order to improve intestinal function and the absorption of nutrients which includes protein.