The Biomarker Handbook is a curated series that seeks to provide readers with insights on each biomarker we cover in our blood test packages and its relation to our body.
Nobody needs to tell you how important your blood is. There is, after all, a reason for the term “life’s blood.” It is important for us to understand the various components of our blood, their effects on our health, and how best to measure and track them. Here is what you need to know about your blood’s haemoglobin, as well as the concentration of haemoglobin in your blood, aka, your haematocrit.
Our blood’s haemoglobin is a protein contained in our red blood cells which is responsible for distributing oxygen to our tissues.
And haematocrit is the volume of red blood cells in relation to the total volume the blood.
However, levels of haemoglobin can vary with the volume of blood plasma, which can be affected by hydration levels. This is because plasma mainly comprises of water. Thus, under or over hydration can cause the concentration, or haemoglobin, of haemoglobin per deciliter (haemoglobin is measured using grams per deciliter) to vary.
Additionally, there are also diseases, illnesses and conditions that can affect haemoglobin levels, which is why measuring haematocrit regularly is important.
Importance of Tracking Haemoglobin
Without haemoglobin, oxygen can’t be delivered to your body’s tissues, making it impossible to survive.
An abnormal haemoglobin level, either too low or too high, can indicate the presence of certain diseases, blood loss, nutritional deficiencies or the use of performance enhancing drugs, such as EPO, in athletes.
For instance, low levels of haemoglobin can indicate:
- Kidney failure—Your kidneys are responsible for helping to produce red blood cells, and failing or failed kidneys can mean low levels of it.
- Dietary deficiency— There are certain vitamins and minerals which are essential in the production of haemoglobin, the most mentioned are Vitamin B12, Folic Acid and Iron. Dietary deficiency or malabsorption of these can cause anaemia.
- Leukemia—Your bone marrow is responsible for the production of red blood cells, and when cancer invades our bone marrow, such as with leukemia, end result may be a reduced or loss of capacity to make red blood cells.
- Blood loss—While bleeding due to external trauma is usually obvious, internal injuries or conditions, such as a bleeding colon cancer, can cause your haemoglobin levels to drop and thus giving the clinician valuable clues as to what to look out for.
- Thalassemia— there is a common genetic disease where production of haemoglobin proteins (alpha or beta protein) is defective. You may well be a thalassemia carrier and not know about it.
On the other hand, abnormally high levels of haemoglobin can indicate:
- Lung disease, such as emphysema—Your body produces additional red blood cells in response to low oxygen levels in the body, where poor lung function prevents the body from getting enough oxygen.
- A bone marrow disorder known as polycythemia—Polycythemia Vera is a slow-growing cancer which causes the bone marrow to produce extra red blood cells. This thickens the blood, putting the sufferer at risk of heart attack and stroke.
- Blood doping in athletes—Athletes looking for a performance edge might look to erythropoietin (EPO), as a means of increasing their body’s red blood cell production (thus boosting their oxygen carrying capacity and exercise tolerance). This is because EPO is a hormone responsible for producing red blood cells, which is why it is commonly used to treat anaemia. However, some endurance athletes look to EPO as a performance booster—something which can be detected in a high haematocrit.
Those living at high altitude and those who smoke also have elevated red blood cell counts; and over or under hydration can decrease or increase the concentration of haemoglobin in the blood respectively.
Signs and Symptoms to Watch out For
A haemoglobin count of less than 13.5 grams per 100ml in men, or 12.0 grams per 100ml in women is usually considered abnormal, and symptoms of low haematocrit should be noted as well:
- Pale skin tone
- Feelings of always being tired
- Racing heart
- Shortness of breath
- Always feeling cold
- Worsening heart conditions
However, it should be noted that symptoms of anaemia (low haematocrit) are not always apparent, with some patients showing no symptoms at all.
On the flip side, a haematocrit of more than 17.5 grams per 100ml in men, or more than 15.5 grams per 100ml in women are normally considered too high, and some of the symptoms to be aware of are as follows:
- Nose bleeds, bleeding gums, or excessive bleeding from small cuts
- Uncomfortable feelings of fullness in the left side of the abdomen
- Trouble concentrating, remembering, or a sense of confusion
- Blurry vision, double vision, or blind spots
- A flushed or “ruddy” appearance
- Feeling tired, weak and/or dizzy
Consequences of Having Abnormal Haemoglobin Levels
Ignoring abnormal haemoglobin levels—either too low or too high—can be extremely dangerous or deadly.
Diseases such as COPD, anaemia, heart disease, kidney cancer and liver cancer can all influence haemoglobin levels and should be dealt with immediately upon detection.
Ways to Balance these Levels
Fortunately, there are ways to balance abnormal levels of haemoglobin, depending on the cause. While abnormal levels due to serious medical disorders should be dealt with immediately by a doctor, abnormalities due to such things as diet or habits can be dealt with accordingly:
- Get more vitamin B12. If you are a vegetarian, this may mean supplementing. If you are not, consumption of meat, eggs and dairy is advised. There is a biomarker that monitors your Vitamin B12 needs from a simple blood test (called serum Vitamin B12).
- Consume foods rich in iron, such as leafy greens, beets or chicken livers, or use an iron supplement. There is a biomarker that can monitor your iron needs (called serum iron levels).
- Consume foods rich in folic acid, such as leafy greens, citrus fruit, beans, bread, cereal, rice and pasta. If necessary consider taking supplements. There is a biomarker measuring your folic acid needs in your diet (serum folic acid).
- Avoid “iron blockers,” such as caffeinated drinks and sodas.
- Get moderate to intense exercise on a regular basis.
- If you are a smoker, we advise you to stop smoking.
- Get a clinical workup and further investigation for a cause.
- Drink more water.
- Spend time at lower elevation if you live at high altitude.
- Get a phlebotomy, which is the removal of red blood cells, for instance, during blood donation.
In cases where food, supplements, altitude or habit changes don’t work (such as with bleeding or bone marrow disease), your doctor may use blood transfusion or EPO treatment to maintain your level of haemoglobin.
When to see a Doctor
Obviously, an abnormal haematocrit should not be ignored, and any symptoms indicating levels that are too high or too low should be dealt with at once.
Naturally, if the cause is easily determined, such as high haemoglobin due to smoking tobacco or time spent at high altitude, solutions are readily available, and merely need enactment. Nevertheless this easily determined cause my well be masking a more serious medical condition concurrently present. Therefore any person with low haemoglobin should seek medical help while already improving their lifestyle and diet.
What Further Testing to do to Check for Ailments Related to Abnormal Haemoglobin Levels
A Complete Blood Count (CBC) is most often used to test the entire makeup of the blood. It can be used to detect not just abnormal haematocrit, but also white blood cell count, mean corpuscular volume, platelet count and all the red cell indices.
Other haemoglobin variants blood tests may also be used to determine the presence of non-standard forms of haemoglobin, which includes a variety of tests such as DNA testing and blood smear.
Findings from these tests may lead to further testing to determine the presence of any diseases which may be causing abnormal haematocrit or other abnormalities in the blood. These can include kidney disease, certain cancers, or thalassemia, which are inherited blood disorders which prevent normal production of haemoglobin.
All in all, our blood is connected to every single function in our bodies, and abnormalities in it should never be ignored.
With haemoglobin and haematocrit having such a profound effect on your health, as well as being key biomarkers for a variety of diseases and conditions, consider tracking these biomarkers on an annual basis, or even sooner if you show symptoms of too low or too high levels.
So, for good health and wellbeing, have yours checked regularly, and in the meantime, eat right, stay hydrated, exercise, and get plenty of rest. It is, after all, your health!
If you want to find out more about anaemia and how you can manage your red blood cell count, take a look at our lifestyle article here!
Interested in other biomarkers? Check out the rest of The Biomarker Handbook.
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