Hemoglobin

Blood

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Evaluates blood components for anemia or infection

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Hemoglobin Test Information Guide

Why is it done?
- Measures the amount of oxygen-carrying protein in red blood cells to assess overall blood health and oxygen transport capacity
- Screen for anemia (low hemoglobin levels) and polycythemia (high hemoglobin levels)
- Evaluate symptoms such as fatigue, weakness, shortness of breath, dizziness, or pale appearance
- Monitor chronic medical conditions including kidney disease, heart disease, cancer, or blood disorders
- Assess response to treatment for anemia, bleeding disorders, or chemotherapy
- Part of routine physical examination and preventive health screening
- Evaluate fitness for surgery or blood donation eligibility
Normal Range
- Adult Males: 13.5 - 17.5 g/dL (grams per deciliter)
- Adult Females: 12.0 - 15.5 g/dL (grams per deciliter)
- Children (ages vary): 11.0 - 16.0 g/dL (age-dependent)
- Newborns: 14.0 - 20.0 g/dL
- Unit of Measurement: g/dL or mmol/L (in some countries: 8.4 - 10.9 mmol/L for adult males; 7.4 - 9.6 mmol/L for adult females)
- How to Interpret Results:
- Normal Range: Indicates adequate oxygen-carrying capacity and healthy red blood cell production. Individual normal ranges may vary by laboratory, altitude, and smoking status.
- Low (below normal): Suggests anemia; may indicate reduced oxygen delivery to tissues causing fatigue and weakness
- High (above normal): Suggests polycythemia or hemoconcentration; may indicate dehydration or chronic hypoxia compensation
Interpretation
- Low Hemoglobin (Anemia):
- May result from iron deficiency, vitamin B12 or folate deficiency, chronic kidney disease, bone marrow disorders, hemolysis, blood loss, or medications affecting red blood cell production
- High Hemoglobin (Polycythemia):
- May result from polycythemia vera, smoking, chronic lung disease, high altitude residence, dehydration, or erythropoietin-producing tumors
- Factors Affecting Results:
- Pregnancy (typically lower), altitude, smoking status, exercise level, medications (including some chemotherapy agents), recent blood transfusion, and time of day (slight variations possible)
- Clinical Significance:
- Hemoglobin level directly correlates with oxygen-carrying capacity; abnormal values increase risk of complications including increased infection, bleeding, clotting, organ dysfunction, and cardiovascular events. Severe anemia (<7 g/dL) or severe polycythemia (>20 g/dL) require urgent evaluation and treatment.
- Trending Values:
- Serial measurements over time may be more clinically significant than a single value. Rapid changes warrant investigation for acute pathology.
Associated Organs
- Primary Organ Systems:
- Hematopoietic (blood-forming) system, bone marrow (primary site of red blood cell production), spleen (storage and filtering of red blood cells)
- Medical Conditions Associated with Abnormal Results:
- Iron deficiency anemia, megaloblastic anemia, hemolytic anemia, aplastic anemia, sickle cell disease, thalassemia, autoimmune hemolytic anemia
- Chronic Diseases Associated:
- Chronic kidney disease (reduced erythropoietin production), heart disease, COPD, cancer, inflammatory bowel disease, rheumatoid arthritis, HIV/AIDS
- Bone Marrow Disorders:
- Leukemia, lymphoma, myelodysplastic syndromes, myelofibrosis, bone marrow aplasia
- Gastrointestinal Conditions:
- Peptic ulcer disease, inflammatory bowel disease, celiac disease (affecting nutrient absorption)
- Potential Complications from Abnormal Results:
- Severe anemia: organ dysfunction, cardiac arrhythmias, hypoxia, shock, increased infection risk
- Severe polycythemia: thrombosis, stroke, myocardial infarction, pulmonary embolism, hypertension
Follow-up Tests
- For Low Hemoglobin (Anemia Workup):
- Complete Blood Count (CBC) with differential, Peripheral blood smear, Iron studies (serum iron, ferritin, TIBC), Vitamin B12 and folate levels, Reticulocyte count, Liver function tests, Kidney function tests (creatinine, BUN), Thyroid function tests, Direct antiglobulin test (Coombs test), Fecal occult blood test
- For High Hemoglobin (Polycythemia Workup):
- Complete Blood Count (CBC) with differential, Hematocrit, Red blood cell count, JAK2 mutation testing (for polycythemia vera), Erythropoietin level, Arterial oxygen saturation, Chest X-ray (if lung disease suspected), Abdominal imaging (if renal disease suspected)
- Monitoring Frequency:
- For chronic conditions: every 3-6 months; for acute conditions or treatment response: every 1-4 weeks; for routine screening: annually in healthy individuals; during chemotherapy or aggressive treatment: weekly to every other week
- Related Complementary Tests:
- Hematocrit (percentage of blood volume occupied by red cells), Mean corpuscular hemoglobin (MCH), Mean corpuscular volume (MCV), Mean corpuscular hemoglobin concentration (MCHC), Red blood cell distribution width (RDW)
- Additional Investigations:
- Bone marrow biopsy may be needed for unexplained anemia or if malignancy is suspected; Endoscopy or colonoscopy for evaluation of chronic GI bleeding
Fasting Required?
- Fasting Required: NO
- Sample Collection:
- No special fasting requirement; blood sample can be drawn at any time of day. Patient may eat, drink, and take medications as usual.
- Patient Preparation Instructions:
- Wear loose-fitting clothing on the arm where blood will be drawn for easy access; Ensure proper hydration before the test; Avoid strenuous exercise 24 hours prior if possible (may temporarily alter hemoglobin levels)
- Medications to Avoid:
- No medications need to be withheld; however, inform healthcare provider of all current medications as some may affect hemoglobin levels (e.g., epoetin alfa, androgens, steroids). Do not stop or start any medication without consulting healthcare provider.
- Other Preparation:
- Blood sample is typically collected by venipuncture (needle insertion into a vein), usually from the arm; The procedure takes 1-2 minutes; Inform phlebotomist of any anxiety, history of fainting, or previous difficult blood draws; No special recovery period required; Slight bruising at the needle site is normal and typically resolves in 1-2 weeks

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