What is the clinical significance of having an albumin level of 45 g/L and an alpha 2 globulin level of 5 g/L?

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Clinical Significance of Albumin 45 g/L and Alpha-2 Globulin 5 g/L

These values are within normal limits and do not indicate pathology. The albumin of 45 g/L falls in the normal range of 35-50 g/L, and the alpha-2 globulin of 5 g/L is also normal 1.

Interpretation of These Specific Values

Your albumin level of 45 g/L is normal and reassuring. This value sits comfortably within the reference range of 35-50 g/L (or 3.5-5.0 g/dL) when measured by electrophoretic methods 1. This indicates:

  • Normal hepatic synthetic function, as albumin is produced exclusively by the liver 2
  • Absence of significant protein loss through kidneys, gastrointestinal tract, or other routes 3
  • No evidence of malnutrition or significant inflammation that would suppress albumin production 3
  • Adequate hydration status, as dehydration would elevate albumin above this level 1

Alpha-2 Globulin Assessment

The alpha-2 globulin level of 5 g/L is normal. This fraction includes haptoglobin, ceruloplasmin, and alpha-2 macroglobulin 4, 5. Normal alpha-2 globulin levels indicate:

  • No active inflammatory process, as alpha-2 globulins are acute phase reactants that rise during inflammation 5
  • No evidence of reticuloses or lymphoproliferative disorders, which characteristically elevate alpha-2 globulins 5
  • No diabetic microangiopathy concerns, as the alpha-2 globulin to albumin ratio is normal 4

Clinical Context

No further workup is needed based solely on these values. The albumin/alpha-2 globulin ratio is approximately 9:1, which is normal and indicates absence of active disease 6. This ratio is more clinically useful than either value alone for detecting occult pathology 6.

Common Pitfalls to Avoid

  • Do not assume these normal values rule out all disease, as albumin can remain normal in early liver disease until >70% of synthetic function is lost 2
  • Confirm the laboratory method used, as bromcresol green versus bromcresol purple methods have different reference ranges and the BCG method may overestimate albumin by 0.61 g/dL in the low range 1
  • Recognize that albumin has a long half-life (approximately 20 days), so acute nutritional changes or recent illness may not yet be reflected 2

References

Guideline

Elevated Serum Albumin and Total Protein Levels: Assessment and Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Etiologies of Hypoalbuminemia

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

CHANGES IN SERUM ALPHA-2 GLOBULINS IN RETICULOSES.

Journal of clinical pathology, 1964

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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