What does a low hemoglobin level mean?

A low hemoglobin is referred to as anemia. There are many reasons for anemia.

Some of the more common causes are:

• loss of blood (traumatic injury, surgery, bleeding colon cancer or stomach ulcer),

• nutritional deficiency (iron, vitamin B12, folate),

• bone marrow problems (replacement of bone marrow by cancer,

• suppression by chemotherapy drugs,

• kidney failure), and

• abnormal hemoglobin (sickle cell anemia).

What does a high hemoglobin level mean?

Higher than normal hemoglobin levels can be seen in people living at high altitudes and in people who
smoker. Dehydration produces falsely high hemoglobin, which disappears when proper fluid balance is
restored.

Some other infrequent causes are:

• advanced lung disease (for example, emphysema),

• certain tumors,

• a disorder of the bone marrow known as polycythemia rubra vera, and

• abuse of the drug erythropoietin (Epogen) by athletes for blood doping purposes.

What is sickle cell disease?

Sickle cell disease is a genetic condition in which the quality of hemoglobin is defective. This condition
can cause abnormal hemoglobin which, in turn, can result in abnormally shaped (sickled) red blood cells.
These abnormal red blood cells cannot easily pass through small blood vessels and, therefore, could
deprive the body organs of adequate oxygen.

Sickle cells also have a shorter life span than normal red blood cells (10-20 days compared to 120 days).
This rapid turn over may result in inadequate time to replace the red blood cells and may result in anemia.

In order for a person to have sickle cell anemia, one defective hemoglobin gene must be inherited from
each parent. If only one gene is inherited from one parent, then the conditions is much milder and it is
referred to as sickle cell trait.

What is thalassemia?
 Thalassemia refers to a group of hereditary conditions with quantitative hemoglobin deficiency. The body's
failure to make globulin molecules will lead to compensatory mechanism to make other less compatible
globulin molecules. The severity of these conditions depend on the type of deficient globulin chain and the
severity of the underproduction. Mild disease may be only present as mild anemia, whereas, severe
deficiency may not be compatible with life.

Hematocrit in the blood is the proportion of the blood that consists of red blood cells, by volume. A low
hematocrit level may signal anemia, or other conditions such as loss of blood, nutritional deficiency, bone
marrow problems, and abnormal hematocrit. High hematocrit levels may be due to chronic smoking, living
at high altitudes, dehydration, or other conditions and diseases

What does a low hematocrit mean?

A low hematocrit is referred to as being anemic. There are many reasons for anemia. Some of the more
common reasons are loss of blood (traumatic injury, surgery, bleeding colon cancer), nutritional deficiency
(iron, vitamin B12, folate), bone marrow problems (replacement of bone marrow by cancer, suppression by
chemotherapy drugs, kidney failure), and abnormal hematocrit (sickle cell anemia).

What does a high hematocrit mean?

Higher than normal hematocrit levels can be seen in people living at high altitudes and in chronic smokers.
Dehydration produces a falsely high hematocrit that disappears when proper fluid balance is restored. Some
other infrequent causes of elevated hematocrit are lung disease, certain tumors, a disorder of the bone
marrow known as polycythemia rubra vera, and abuse of the drug erythropoietin (Epogen) by athletes for
blood doping purposes.

What is polycythemia?

Polycythemia is a condition that results in an increased level of circulating red blood cells in the
bloodstream. People with polycythemia have an increase in hematocrit, hemoglobin, or red blood cell count
above the normal limits.

Polycythemia is normally reported in terms of increased hematocrit or hemoglobin.

• Hematocrit (HCT): Polycythemia is considered when the hematocrit is greater than 48% in women and
52% in men.
• Hemoglobin (HGB): Polycythemia is considered when a hemoglobin level of greater than 16.5g/dL in
women or hemoglobin level greater than18.5 g/dL in men.
Polycythemia can be divided into two categories; primary and secondary.

• Primary polycythemia: In primary polycythemia the increase in red blood cells is due to inherent
problems in the process of red blood cell production.
• Secondary polycythemia: Secondary polycythemia generally occurs as a response to other factors or
underlying conditions that promote red blood cell production.
Red cell production (erythropoiesis) takes place in the bone marrow through a complex sequence of tightly
regulated steps. The main regulator of the red cell production is the hormone erythropoietin (EPO). This
hormone is largely secreted by the kidneys, although, about 10% may be produced and secreted by the
liver.

Erythropoietin secretion is up-regulated in response to low oxygen levels (hypoxia) in the blood. More
oxygen can be carried to tissues when erythropoietin stimulates red blood cell production in the bone
marrow to compensate for the hypoxia.