Hemoglobin (HGB): What Does Its Low or High Level Mean?

Hemoglobin (HGB) is a type of protein found in red blood cells, and it is one of the parameters commonly measured in almost every blood test. It is typically included in a group of blood tests known as a complete blood count (CBC) or hemogram, and is used to investigate various health issues, including anemia (low blood count). It is important for health that the hemoglobin level falls within the required range. When either low or high hemoglobin levels are detected, the cause should be thoroughly investigated, and necessary treatments should be initiated.

What is HGB?

Hemoglobin is the substance found in red blood cells that gives blood its red color. Hemoglobin contains iron and is responsible for transporting oxygen through the blood to the body's tissues and organs. It also plays a role in carrying carbon dioxide, which accumulates in the tissues and organs, back to the lungs for exhalation. Due to its high iron content, hemoglobin levels can quickly decrease due to iron deficiency. While low hemoglobin levels typically indicate anemia, elevated levels can be a sign of several serious conditions. Due to its crucial role in the body, hemoglobin is always checked during health screenings. A simple blood test can measure hemoglobin levels along with other complete blood count parameters.

What is Low HGB?

A decrease in hemoglobin levels is typically a sign of anemia. Under normal conditions, considering healthy individuals, the following values are used as reference for hemoglobin levels:

• For men: 13.5 g/dL,
• For women: 12 g/dL,
• For children: 11 g/dL,
• For pregnant women: below 10 g/dL.

These are average values, and since reference ranges can vary depending on laboratory conditions, it is more accurate to consider the reference intervals of the testing center. Hemoglobin levels can drop for various reasons, leading to the development of anemia. Therefore, in cases of low hemoglobin, further diagnostic tests should be performed to determine the specific type of anemia.

Symptoms of Low HGB

When hemoglobin levels decrease, the amount of oxygen transported to tissues and organs reduces, leading to several adverse symptoms. Some of these include:

• Quick fatigue
• Shortness of breath
• Unintentional weight loss
• Dizziness
• Rapid and irregular heartbeats, with the pulse being strongly felt in the ears
• Coldness, numbness in hands and feet
• Yellow or pale skin
• Headaches and chest pain

If you experience symptoms similar to the ones above, it is recommended to visit a healthcare facility as soon as possible.

Causes of Low HGB

A decrease in hemoglobin levels is most likely due to anemia. Conditions that can lead to a drop in HGB levels include:

• Iron deficiency anemia
• Vitamin deficiency anemias (B12 or folic acid deficiency)
• Anemia related to pregnancy
• Familial Mediterranean anemia (thalassemia)
• Aplastic anemia caused by autoimmune effects of the immune system
• Hemolytic anemias resulting from the breakdown of red blood cells in circulation or the spleen
• Sickle cell anemia, where the hemoglobin protein is genetically abnormal
• Chemotherapy treatments for cancer
• Acute blood loss
• Sepsis
• Kidney diseases
• Blood cell production affecting diseases like leukemia, lymphoma, or multiple myeloma
• Other chronic diseases
• Certain medications
• Unhealthy and unbalanced nutrition
• Excessive use of tobacco products

Additionally, newborns may experience anemia between 6 to 8 weeks after birth, usually due to the depletion of red blood cells present at birth. This condition is generally considered normal and temporary unless another illness is present.

How is Low HGB Treated?

The treatment for low hemoglobin depends on the underlying cause or the type of anemia that has developed. In cases of anemia caused by iron, B12, or folic acid deficiencies, a dietary plan should be implemented, and additional vitamin or mineral supplements should be considered. In cases of hemoglobin drop due to other diseases, treatments specific to those conditions will help manage hemoglobin levels as well. For anemia caused by medications, alternative medications may be necessary. In severe cases of hemoglobin deficiency, such as in acute blood loss or thalassemia, a blood transfusion may be required. In conditions like sickle cell anemia, stem cell transplantation may be considered as an alternative treatment. If left untreated, anemia can lead to serious complications, such as heart diseases, restless leg syndrome, and even organ failure. Therefore, low hemoglobin requires close monitoring and treatment.

What is High HGB?

While low HGB is a much more common issue, there are cases where HGB levels are higher than normal. Among healthy individuals:

• For men: 18 g/dL,
• For women: 15 g/dL,
• For children, depending on age, HGB levels above an average of 16 g/dL can be considered high hemoglobin.

In some cases, HGB levels that are close to the upper limit may not have medical significance. However, significant increases or consistently elevated HGB levels require further investigation.

What are the Symptoms of High HGB?

When hemoglobin levels are significantly high, several symptoms may occur. These can include:

• Unintentional weight loss
• Itchy skin
• Joint pain and swelling
• Fatigue
• Yellowing of the eyes
• Excessive sweating and hot flashes
• Headaches and dizziness

High hemoglobin levels are less common than low ones, so they definitely require investigation.

What Causes High HGB?

High hemoglobin levels can indicate a rare genetic disease called polycythemia. This condition is a congenital disorder that causes the bone marrow to produce too many red blood cells. In patients with polycythemia, the blood is much thicker than normal, increasing the risk of blood clots, heart attacks, and strokes. Therefore, lifelong monitoring and treatment are necessary. Other potential causes of high hemoglobin levels include:

• Dehydration (fluid loss)
• Heart and lung diseases
• Living at high altitudes
• Severe burns
• Excessive vomiting or diarrhea
• Intense physical activity
• Excessive smoking or use of tobacco products
• Steroids or performance-enhancing drugs
• Kidney tumors
• Bone marrow disorders
• Oxygen deficiency

Since high hemoglobin levels require treatment, it is extremely important to consult with the nearest healthcare facility.

How is High HGB Treated?

In patients with high hemoglobin, if polycythemia has been diagnosed, lifelong repeated blood counts and additional screenings are required. The use of blood-thinning medications is usually a constant part of the treatment process. In cases where hemoglobin levels are significantly elevated, the treatment plan may need to be adjusted. Hemoglobin increases caused by fluid loss due to burns, severe diarrhea, or vomiting are usually acute and temporary. In these cases, replenishing the lost fluids as soon as possible is the most effective way to prevent both high hemoglobin and other serious health problems caused by dehydration. If high hemoglobin levels are caused by kidney tumors, bone marrow disorders, or similar conditions, treatment will follow the protocols for those specific diseases. In cases where slight increases in hemoglobin are considered borderline, simple and temporary causes may be involved, and a follow-up blood test appointment can be scheduled without immediate intervention. In summary, identifying the underlying issue is the key step in determining how treatment will be shaped.

If you notice that your hemoglobin levels are either too low or too high in your blood test results, consult your doctor for more information about the causes and undergo detailed examinations and tests to maintain a healthier lifestyle.