Connection between albumin and vitamin A deficiency?

Question

Dear team,

My current lab values say that both my albumin value and vitamin A level (104 µg/l) are too low. I have been struggling with the vitamin A for a while, despite carrot juice, red pepper, green vegetables, etc.

Now I read that albumin is one of the body’s most efficient antioxidants and that it transports and distributes vitamins.

Above all, I would be interested to learn whether my vitamin A deficiency could actually be caused by the low albumin levels and whether one can get this under control. For instance with chlorella, which is supposed to have a high amount of beta carotene (pro-vitamin A) and to be able to increase the amount of albumin in the blood.

Thank you and kind regards.

Answer

Hello,

Indeed, albumin has antioxidant capacity, but it does not transport vitamin A. This is done by the retinol-binding protein that belongs to the pre-albumin fraction, i.e. to the fraction of serum proteins that are located in the upstream region of albumin after electrophoresis due to smaller size. Interestingly, both albumin and prealbumin belong to the most important biological parameters for (protein) malnutrition in the serum. If the albumin deficiency lasts, it is imperative to inquire about its cause. Apart from liver disease, this could be malnutrition, losses via the kidneys or into the intestines, or inflammations.

The label “vitamin A” is an umbrella term for different forms of this vitamin. The foods you mention (red/orange, yellow and green vegetables and fruits) and chlorella are absorbed as provitamin A (beta carotene). This has to be split into retinol in the liver first. The bioavailability of beta carotenes is inferior to retinol: 6 mg parallel 1 mg retinol, i.e. 6 mg all-trans-beta carotene are as effective as 1 mg retinol. The vitamin A deficiency has various causes. Especially with CF, apart from an inadequate enzyme substitution (lipase) due to pancreatic insufficiency, a liver or gall problem is also a possible reason. A compound in the food, retinyl palmitate, is split into retinol only through pancreatic lipase. Retinol as well as retinal are absorbed together with gall secretion via the intestinal mucosa and are bound to the retinol-binding protein in the mucosa cell. Vitamin A is stored mostly in the liver. Cholestasis (obstruction of the bile flow) and liver fibrosis would be diseases that could affect absorption and storage.

Apart from talking to your doctor about a possible liver-gall disease, I would recommend that you also consult the nutritionist at your local CF centre in order to examine your current nutrition situation for potential protein malnutrition. There are indeed hints that chlorella can increase serum albumin, but first the cause of the insufficiency should be looked for and treated. There are no objections to chlorella as a dietary supplement, though.

In case of vitamin A insufficiency, it is not sufficient to balance the deficiency through vegetables. For this purpose, higher dosed preparations with retinol / retinyl palmitate are necessary. Have your CF doctor check your vitamin A substitution and take liposoluble vitamins (A, D, E, K) together with fatty foods and adequate enzyme substitution.

I hope this answers your questions.

Kind regards,
Suzanne van Dullemen
Nutrition scientist

04.08.2011