What effect does low albumin have on calcium levels?

Low albumin can lead to transient hypocalcemia due to its role in calcium binding in the blood. Albumin is a major plasma protein that binds to calcium, and when albumin levels are low, there is less protein available to hold onto calcium. This can result in an increase in the amount of free (ionized) calcium in the bloodstream. However, it may also cause a paradoxical decrease in total serum calcium levels because total calcium measurements include both bound and free calcium.

In patients with low albumin, the total calcium measurement may appear lower than what is actual for the ionized calcium. This situation creates a condition where total calcium levels decrease even if the free (active) calcium remains normal, leading to a transient state of hypocalcemia. Therefore, due to the effects of low albumin on calcium binding, the condition can result in transient hypocalcemia, reflecting the dynamics of calcium distribution and protein binding in the bloodstream.