What conditions can result in low total protein and low albumin levels?

Low total protein and low albumin levels can occur in several pathological states, particularly those that affect protein synthesis or increase protein loss. Hepatic cirrhosis is a prime example as it leads to decreased production of albumin by the liver due to the loss of functional hepatocytes. When the liver is damaged, its ability to synthesize proteins diminishes, resulting in lower levels of albumin and overall protein in the blood.

Nephrotic syndrome is another condition characterized by significant protein loss through the kidneys. In this syndrome, glomerular damage leads to excessive excretion of proteins in urine, including albumin, which directly contributes to lower serum protein levels. The kidney's inability to retain protein properly can lead to a decreased total protein level in addition to a drop in albumin.

Together, these two conditions exemplify how systemic diseases can impair protein metabolism and regulation, leading to both low total protein and low albumin levels in the patient.