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Blood test for hemoglobin - necessary stage diagnostics of various diseases. Based on the results of only one blood test for hemoglobin, it is impossible to make an accurate diagnosis, but the determination of hemoglobin will reveal possible disturbances in the activity of the body and indicate the need for additional examination.

Hemoglobin (HGB, hemoglobin). Hemoglobin- a complex protein in the composition of erythrocytes, consisting of 2 parts: protein (globin) and iron compounds (heme). It is the atoms of iron (heme) that make the blood red. Hemoglobin is involved in the transport of oxygen and carbon dioxide between the lungs and cells of other organs, and maintains the pH of the blood. With a lack of hemoglobin in the blood, it becomes difficult to transfer oxygen by hemoglobin. As a result, cells do not receive enough oxygen and their metabolism and functions are disturbed.

Blood test for hemoglobin

Physiological forms of hemoglobin:

1) oxyhemoglobin (HbO2) - the combination of hemoglobin with oxygen is formed mainly in arterial blood and gives it a scarlet color (oxygen binds to the iron atom through a coordination bond);

2) reduced hemoglobin or deoxyhemoglobin (HbH) - hemoglobin that has given oxygen to tissues;

3) carboxyhemoglobin (HbCO2) - a compound of hemoglobin with carbon dioxide; is formed mainly in venous blood, which as a result acquires a dark cherry color.

Pathological forms of hemoglobin:

1) carbhemoglobin (HbCO) - formed by carbon monoxide (CO) poisoning, while hemoglobin loses its ability to attach oxygen;

2) methemoglobin - is formed under the action of nitrites, nitrates and some drugs (ferrous iron is converted to trivalent with the formation of methemoglobin - HbMet).

A blood test for hemoglobin is a necessary stage in the diagnosis of various diseases. Based on the results of only one blood test for hemoglobin, it is impossible to make an accurate diagnosis, but the determination of hemoglobin will reveal possible disturbances in the activity of the body and indicate the need for additional examination.

Possible measurement errors

Level up:

An increase in the concentration of hemoglobin is observed with thickening of the blood or is the result of increased production of red blood cells.

An increase in hemoglobin in the blood occurs after exercise, among climbers, among pilots (after high-altitude flights), among residents of highlands. An elevated level of hemoglobin in the blood can occur even after being outdoors.

1. Primary and secondary erythrocytosis;

2. Congenital heart defects;

3. Cardiopulmonary insufficiency;

4. Thickening of blood (with dehydration, burns, persistent vomiting, intestinal obstruction);

5. Primary and secondary erythremia.

Decrease in level:

The condition of the body in which there is a decrease in hemoglobin in the blood is called anemia.
A pathological decrease in the hemoglobin content in the blood (anemia) may be the result of increased hemoglobin losses during various bleeding, the result of accelerated destruction (hemolysis) of erythrocytes, a violation of the formation of erythrocytes, or other reasons. Low hemoglobin occurs as a result of blood transfusion.

Anemia can be either an independent disease or a symptom of a common chronic disease (anemia of chronic diseases). As an independent disease, anemias develop with a lack of iron, which is necessary for the synthesis of hemoglobin, with a deficiency of vitamins involved in the formation of red blood cells (mainly vitamin B12, folic acid), due to increased destruction of red blood cells in the peripheral bed (hemolytic anemias) or a violation of the formation of blood cells in the bone marrow with specific hematological diseases.

Often there is a decrease in hemoglobin in pregnant women... During pregnancy, hemoglobin usually decreases with a lack of iron, as the daily iron requirement of pregnant women increases. If usually a person needs 5-15 mg of iron per day, then a pregnant woman will need 15-18 mg. Low hemoglobin in pregnant women can adversely affect the health of the expectant mother, cause premature birth or fetal growth retardation.

1. Anemia of various etiologies (the main symptom).

2. Hyperhydration (increase in the volume of circulating plasma due to detoxification therapy, elimination of edema, etc.).

Reference values:

Men: 13.7 - 17.5 g / dL
Women: 11.2 - 15.7 g / dl

Hematocrit- (HCT, hematocrit).

Blood 40-45% consists of corpuscles (erythrocytes, platelets, leukocytes) and 55-60% of plasma.

Hematocrit (in hematology analyzers) shows how much of the blood sample volume is the volume of precipitated erythrocytes in percent. Those. the sum of the volumes of red blood cells in a unit of blood volume (not to be confused with the total number of red blood cells). For example, a hematocrit of 40% means that 100 ml of blood contains 40 ml of precipitated erythrocytes.

The study of hematocrit is carried out in isolation or as part of a complete blood count. The hematocrit value depends on the number and volume of erythrocytes. Changes in hematocrit do not always correlate with changes in total red blood cell count.

It is used to assess the state of the erythrocyte system as a whole for various diseases: conditions associated with changes in the volume of circulating blood, anemias, erythrocytosis, diseases of the gastrointestinal tract, cardiovascular pathology, oncological processes, and also serves as a guide for judging hemoconcentration and hemodilution.

The hematocrit value is not indicative in assessing the degree of anemia immediately after blood loss or blood transfusion. Since, due to blood thickening, the hematocrit can be normal or even high, although, due to blood loss, the total number of red blood cells can be significantly reduced. It should be borne in mind that hematocrit decreases with hemodilution.

Possible measurement errors

Severe agglutination of red blood cells can lead to incorrect hematocrit values. a, since Erythrocyte agglutinates can be perceived by the device as leukocytes and are not taken into account when calculating HCT. In such cases, it is recommended to determine the hematocrit on a hematocrit centrifuge.

Increased hematocrit observed with reactive and tumor erythrocytosis, a decrease in the volume of circulating plasma (burn disease, dehydration). Decreased hematocrit occurs with anemia, pregnancy (second trimester), overhydration.

With hyperglycemia and diabetic ketoacidosis, hyperosmolarity of blood plasma is noted. When blood is diluted in vitro with an isotonic solution, a rapid swelling of erythrocytes occurs, which causes an overestimation of HCT. In these cases, the determination of the hematocrit on the hematocrit centrifuge is more accurate.

Hematocrit and hemoglobin are important parameters for overall health., an increase in which, for example, in athletes, may indicate the intake of drugs that cause exogenous stimulation of the bone marrow (administration of erythropoietin).

Factors leading to an increase in the result:

1. Hemoconcentration due to the application of a tourniquet for more than 1 min (usually causes an increase in hematocrit by 2.5-5%).

2. Drugs that provoke the development of aplastic anemia or cause hemolysis in case of glucose-6 phosphate dehydrogenase deficiency.

Factors leading to a decrease in the result:

1. When taking blood in the supine position

2. Hemodilution when taking blood from the arm into which an intravenous infusion is made.

3. Medicines: α-interferon, thrombolytics (for example, alteplase, antistreplase, streptokinase)

In newborns, the hematocrit is about 10% higher, and in young children it is about the same amount lower than that of an adult.

Level up:

1. Primary erythrocytosis (erythremia) - up to 65%;

2. Symptomatic erythrocytosis (congenital heart defects, pulmonary insufficiency, some hemoglobinopathies, renal neoplasms, accompanied by increased formation of erythropoietin, hydronephrosis and polycystic kidney disease) - up to 50-55%;

3. Hemoconcentration (decrease in the volume of circulating plasma) in case of burn disease, peritonitis, dehydration of the body (with severe diarrhea, indomitable vomiting, excessive sweating, diabetes);

4. Polycythemia;

6. Stay at high altitudes.

Decrease in level:

1. Anemia - up to 20-25%;

2. Increase in the volume of circulating blood:

Pregnancy (especially the second half)

Hyperproteinemia;

3. Hyperhydration;

4. In the supine position.

Reference values:

Men: 40.1 - 51.0%
Women: 34.1 - 44.9%

Erythrocytes (Еrythrocytes).

Erythrocytes are highly specialized disc-shaped non-nuclear blood cells containing hemoglobin, the main function of which is to transport oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs.

Red blood cells are formed in the red bone marrow from stem cells. For the normal development of red blood cells, vitamin B12, folic acid and an adequate supply of iron are needed. Erythrocyte production is stimulated by erythropoietin, which is produced in the kidneys. The level of erythropoietin increases with tissue hypoxia. The average life of erythrocytes in the vascular bed is 120 days. In newborns, the size of red blood cells is slightly larger than in adults. Old cells are destroyed in the reticuloendothelial system and the spleen, and the iron in hemoglobin is used to form new red blood cells. About 1% of red blood cells are renewed in one day.

Erythrocyte parameters:

RBC (red blood cells) - the number of red blood cells.

The determination of the number of erythrocytes is carried out by subtracting platelets and leukocytes from the total number of cells in whole blood. To exclude platelets from the count, which are significantly smaller than erythrocytes and leukocytes, threshold values are used. All particles larger than 36 fl. The coefficient of variation for this parameter is 1-2%, and in some devices it is less than 1%.

It should be noted that sometimes leukocytes are included in the count together with erythrocytes, but their influence is normally insignificant, because the number of leukocytes is significantly less (by 3 orders of magnitude - several thousand) the number of erythrocytes (several million). In cases of hyperleukocytosis, the error in measuring erythrocytes increases.

An increase in the number of red blood cells above normal levels is called erythrocytosis., a decrease in the number of red blood cells (and hemoglobin) - anemia.

Possible measurement errors

The presence of cryoglobulins can cause an increase in WBC, RBC or PLT and HGB concentration. In such cases, warm the blood sample to 37 ° C for 30 minutes and measure the sample immediately. Cryoglobulinemia can be observed in patients with myeloma, Waldenstrom's macroglobulinemia, malignant neoplasms, leukemia, lymphoproliferative and autoimmune diseases, viral hepatitis, diabetes mellitus.

Agglutination of erythrocytes can lead to an underestimation of RBC values, an increase in MCV. This can be verified by the increased MCH and MCHC values.

An increase in the number of red blood cells is called erythrocytosis (polyglobulia)... A decrease in the number of red blood cells (and hemoglobin) - anemia.

Physiological erythrocytosis is observed in newborns in the first days of life, under stress, increased physical exertion, increased sweating, starvation. The number of erythrocytes may physiologically decrease slightly after eating, between 17.00 and 7.00, as well as when taking blood in the supine position.

Level up:

1. Neoplasms;

2. Polycystic kidney disease;

3. Dropsy of the renal pelvis;

4. The effect of corticosteroids;

5. Disease and Cushing's syndrome;

6. Steroid treatment;

7. Erythremia, or Vakez's disease - one of the variants of chronic leukemia
(primary erythrocytosis);

8. Secondary erythrocytosis:

absolute - in hypoxic conditions (chronic lung diseases, congenital heart defects, altitude sickness), stimulation of erythropoiesis (hypernephroma, Itsenko-Cushing's disease, cerebellar hemangioblastoma), when erythropoiesis is stimulated and the number of erythrocytes increases;
relative - with thickening of the blood (excessive sweating, vomiting, diarrhea, burns, increasing edema, ascites and taking diuretics), when the plasma volume decreases while maintaining the number of erythrocytes.

Decrease in level:

1. Blood loss;

2. Pregnancy;

3. Decrease in the intensity of formation of erythrocytes in the bone marrow;

4. Accelerated destruction of red blood cells;

5. Hyperhydration;

6. Deficiency anemias of various etiologies - as a result of a deficiency of iron, protein,
vitamins;

7. Aplastic processes;

8. Leukemia, myeloma;

9. Metastases of malignant tumors.

Reference values:

Men - (4.63-6.08) x 106 / μl
Women - (3.93-5.22) x 106 / μl

MCV (mean cell volume) - the average volume of erythrocytes.

In old analyzes indicated: microcytosis, normocytosis, macrocytosis.

In the models of modern hematology counters, the volume of each erythrocyte is automatically measured; thus, the MCV value in these instruments is average the volume of all measured erythrocytes.

The MCV indicator has a diagnostic value in assessing micro-, normo- and macrocytosis and also use it in calculating the average content and concentration of hemoglobin in erythrocytes... Based on the MCV value, microcytic, normocytic and macrocytic anemias are distinguished.

Normally, the average volume of an erythrocyte is from 80 to 100 fl. These MCV values are characteristic of normocytes. If the MCV value is less than 80 fl, they speak of microcytosis, if more than 100 fl, it is macrocytosis. Based on the MCV value, microcytic, normocytic and macrocytic anemias are distinguished.

Microcytosis is characteristic of iron deficiency anemias, heterozygous thalassemias; macrocytosis - for B12 and folate deficiency anemias. Aplastic anemia can be normocytic and macrocytic. A quantitative indicator of the volume of red blood cells, a more accurate parameter than a visual assessment of the size of red blood cells when viewing a smear under a microscope.

However, it should be borne in mind that this parameter is an average value, and with pronounced anisocytosis, as well as in the presence of a large number of erythrocytes with a changed shape, it does not sufficiently reflect the true cell size.

MCV can be normal if the patient has both macro- and microcytosis, with a large number of abnormal red blood cells (for example, sickle cell anemia; severe poikilocytosis). In this case, the analysis of the erythrocyte histogram and the morphology of cells in blood smears are of particular diagnostic importance.

Possible MCV measurement errors

In the presence of agglutination of erythrocytes, the device perceives them as one large cell, if their size is less than the upper threshold of the erythrocyte channel, which leads to an increase in MCV. Preservation of blood in vitro and measurement of such samples at 37 ° C will help to obtain correct results.

A false overestimation of MCV can occur in the presence of cold agglutiates (they are perceived by the device as one large cell), in hyperglycemia and diabetic ketoacidosis due to plasma hyperosmolarity (which causes rapid swelling of erythrocytes during in vitro dilution).

A relative decrease in MCV can be observed with an increased content of erythrocyte fragments due to mechanical hemolysis, consumption coagulopathy, and the presence of giant platelets. It should be borne in mind that MCV can have a normal value if the patient has both pronounced macro- and microcytosis, therefore MCV should always be considered in conjunction with the erythrocyte histogram and the RDW indicator.

Level up:

1. Megaloblastic anemia (B12-deficiency, folate deficiency);

2. Macrocytosis in aplastic anemia, hypothyroidism, liver disease, metastases
malignant tumors; \

3. Spherocytic autoimmune hemolytic anemias;

4. Smoking and drinking alcohol.

Decrease in level:

1. Hypochromic and microcytic anemias (anemia with iron deficiency, chronic
pathological conditions, thalassemias);

3. Hyperthyroidism (rare).

MCV value< 80 фл

Microcytic anemias:

1. Iron deficiency anemias

2. Thalassemias

3. Sideroblastic anemias

Anemias that may be accompanied by microcytosis:

1. Hemolytic anemias

2. Hemoglobinopathies

MCV value> 80 fl and< 100 фл

Normocytic anemias:

1. Aplastic anemias

2. Hemolytic anemias

3. Hemoglobinopathies

4. Anemia after bleeding

Anemias that may be accompanied by normocytosis:

1. Regenerative phase of iron deficiency anemia

2. Myelodysplastic syndromes

MCV value> 100 fl

Macrocytic and megaloblastic anemias:

1. Deficiency of vitamin B12, folic acid deficiency

Anemias that may be accompanied by macrocytosis:

1. Myelodysplastic syndromes

2. Hemolytic anemias

3. Liver disease

Reference values:

Men: 79.0-92.2 fl
Women: 79.4-94.8 fl

MCH (mean cell hemoglobin) - the average hemoglobin content in the erythrocyte.

MCH - the average hemoglobin content in an individual erythrocyte is expressed in absolute mass units - picograms (1 pg = 1x10-12g).

It is determined by dividing the concentration of hemoglobin in 1 liter by the number of erythrocytes in the same volume: MCH = HGB / RBC.

The clinical significance of MCH is similar to the color indicator, which is traditionally used by many specialists today. The color index, as you know, is a relative value and, according to modern data, is the ratio of the amount of hemoglobin in one erythrocyte of a patient to its normal content (taken equal to 33.3).

Thus, in order to move from the MCH value to a more familiar color indicator, it is enough to divide the MCH by 33.3. MCH changes underlie the division of anemias into normochromic (MCH - 27-31 pg), hypochromic (MCH less than 27 pg) and hyperchromic (MCH more than 31 pg). A decrease in MCH is observed in anemias caused by impaired hemoglobin synthesis (iron deficiency anemia, porphyria), an increase in macrocytic and especially megaloblastic anemias.

MCH is a more objective indicator than a color indicator, which does not reflect the synthesis of hemoglobin and its content in the erythrocyte, but largely depends on the volume of the cell.

It must be remembered that a decrease or increase in MCH does not always indicate hypo- or hyperchromia of erythrocytes. For example, in microcytic anemia, the average hemoglobin content in erythrocytes will be reduced due to a decrease in the volume of erythrocytes, while their normochromic color will be retained. In this regard, the MCH indicator is relatively rarely used in clinical practice to characterize anemias.

Possible measurement errors.

The MCH parameter is calculated, therefore, all factors influencing an increase in hemoglobin values and a decrease in the number of erythrocytes lead to false-increased results. Falsely lowered MCH results are obtained due to errors associated with incorrect determination of the number of red blood cells (overestimation of their number) and underestimation of the hemoglobin concentration.

Level up:

1. Megaloblastic anemia (B12-deficiency, folate deficiency).

2. Macrocytosis (aplastic anemia, hypothyroidism, liver disease, metastases of malignant tumors).

Decrease in level:

1. Hypochromic anemia (anemia with iron deficiency, chronic pathological conditions).

2. Some types of hemoglobinopathies;

3. Hyperthyroidism (sometimes).

Reference values:

Men: 25.7-32.2 pg
Women: 25.6-32.2 pg

MCHC (mean cell hemoglobin concentration) - the average concentration of hemoglobin in the erythrocyte.

It is calculated by dividing the blood hemoglobin concentration by the hematocrit and multiplying by 100. Calculated by the formula: MCHC = HGB (g / dl) / HCT (%) x 100 (g / dl).

The differences between MCH and ICSU are that MCH indicates the mass of hemoglobin in one erythrocyte and is expressed in fractions of a gram, while MCHC shows the concentration of hemoglobin in one erythrocyte, that is, the ratio of hemoglobin content to cell volume.

It is directly related to the synthesis of hemoglobin and reflects the saturation of the erythrocyte with hemoglobin.
Unlike MCH, MCHS does not depend on the cell volume and is a sensitive indicator of hemoglobin formation disorders, in particular, in iron deficiency anemias, thalassemias, and some hemoglobinopathies (decreased MCHS). With B12 and folate deficiency anemia, MCHS will be normal, and hyperchromia in this case will be due to an increase in the volume of red blood cells.

With the development of diseases accompanied by a violation of hemoglobin synthesis, MHCS decreases in the last turn, when the compensatory reactions of the body are depleted, therefore, a reduced value of this parameter against the background of a normal content of erythrocytes and hemoglobin may indicate an incorrect study.

The limiting concentration of hemoglobin in the erythrocyte (38 g / dl) is also quite rare. This is due to the structure of the hemoglobin molecule, its solubility in water and, accordingly, the way it is packed in the erythrocyte.

Possible measurement errors.

Since the MCHC parameter is calculated, all factors that affect the overestimation of hemoglobin values and underestimation of the hematocrit (the latter is associated with measuring the volume of erythrocytes) lead to falsely overestimated results. Falsely lowered MCHC results are obtained due to incorrect determination of MCV (overestimation of their value) and underestimation of the hemoglobin concentration.

Level up:

1. Hereditary microspherocytic hemolytic anemia;

2. False overestimation, indicating a technical error in the measurement;

An increase in MCSU more than 38 g / dl actually cannot be, because this value is the upper limit of the solubility of hemoglobin in water (an increase in the concentration of hemoglobin above physiological may result in its crystallization and hemolysis of the erythrocyte). Therefore, an increase in ICSU indicates:

a) errors at the analytical stage when measuring this sample (errors in the determination of hemoglobin or the average volume of erythrocytes);

b) errors at the preanalytical stage (partial hemolysis of erythrocytes).

Decrease in level:

1. Absolute hypochromia of erythrocytes (for example, with iron deficiency anemia, thalassemia);

2. Macrocytic and especially megalocytic forms of anemia (disproportionately large increase in the volume of erythrocytes compared with an increase in its saturation with hemoglobin);

3. Some hemoglobinopathies.

Reference values:

Men: 32.3-36.5 g / dl
Women: 32.2-35.5 g / dL

RDW (red cell distribution width) - the width of the distribution of erythrocytes by volume.

Red blood cell size distribution - a numerical value associated with the degree of anisocytosis(differences in the volumes of erythrocytes in the population). The calculation of this indicator becomes possible thanks to the use of modern hematological analyzers, which automatically determine the volume of each measured erythrocyte. According to this parameter, anisocytosis is captured by the device much faster than by visual examination of a blood smear.

At the same time, the RDW index characterizes fluctuations in the volume of cells within a population and is not related to the absolute value of the volume of erythrocytes. Therefore, if there is a population of red blood cells in the blood with an altered, but sufficiently uniform size (for example, microcytes), the RDW values may be within normal limits. It is advisable to analyze the RDW together with the histogram of the distribution of erythrocyte volumes and the MCV value.

RDW-CV - the relative width of the distribution of erythrocytes by volume, the coefficient of variation, i.e. the percentage of deviation of the volume of erythrocytes from the mean in the population (% spread).

It is calculated as the coefficient of variation of the average volume of erythrocytes according to the formula:
RDW-CV = (SDx100%) / MCV

where SD is the standard root-mean-square deviation of the erythrocyte volume from the mean. This indicator is influenced by MCV, therefore, both with microcytosis and with macrocytosis, there is a tendency to an increase in RDW-CV.

RDW-SD In hematology analyzers there is another calculated indicator of RDW - this is RDW-SD - the relative width of the distribution of erythrocytes by volume, standard deviation, shows the difference between the maximum and minimum volume of erythrocytes in the population. Independent of MCV and is a direct measurement of the width of the erythrocyte histogram at 20% of the peak of the curve. In this case, the height of the RBC-histogram peak is taken as 100%. Clinically significant RDW-SD> 60fl.

Both RDW measures measure the volume variability of red blood cells. An increase in RDW suggests the presence of a mixed population of cells (normocytes and microcytes or macrocytes and normocytes). High RDW values are found in almost all types of anemias, as well as in myelodysplastic syndromes, bone marrow metaplasia, and tumor metastases to the bone marrow.

A significant increase in RDW is characteristic of iron deficiency and sideroblastic anemias, while normal or slightly changed RDW values (with MCV less than 80 fl) are more common in thalassemia and secondary anemias in various chronic diseases. At a high RDW value, MCV becomes uninformative due to its averaging.

RDW-SD is more sensitive in the presence of a minor population of macrocytes or microcytes since it measures the lower part of the distribution curve of red blood cells by volume (displayed by flattening and stretching the red blood cell histogram). At the same time, this indicator will change with high reticulocytosis due to their large volume, which expands the base of the erythrocyte distribution curve. RDW-CV is less sensitive to the presence of a small population of microcytes or macrocytes or reticulocytes, but better reflects general changes in red blood cell size in macrocytic or microcytic anemia.

Anisocytosis is captured by the device much faster than by visual examination of a blood smear, since the device directly measures the volume of cells, and a morphologist under a microscope sees a cell in a plane and can miss the initial changes in volume. In addition, the assessment of the degree of anisocytosis under a microscope is accompanied by a number of errors.

When dried in smears, the diameter of erythrocytes decreases by 10-20%. In thick preparations, it is less than in thin ones. The RDW index characterizes fluctuations in the volume of cells within a population and is not related to the absolute value of the volume of erythrocytes. Therefore, if there is a population of red blood cells in the blood with an altered, but sufficiently uniform size (for example, microcytes), the RDW values may be within normal limits. At the same time, with pronounced anisocytosis of erythrocytes, the MCV index, which characterizes the average volume of the entire cell population, is normal, and the RDW will be increased.

Thus, the combined use of two parameters - RDW and MCV - makes it possible to more accurately characterize changes in the peripheral link of the erythron. RDW can also be helpful in recording hemotherapy results for iron deficiency or megaloblastic anemia. As patients reproduce new, normal-sized erythrocytes, RDW first rises, but then decreases when normal-sized cells make up the majority

RDW together with MCV serves to differentiate microcytic anemias. The RDW should be analyzed in conjunction with the RBC histogram, which is provided by most modern hematology analyzers.

Level up:

1. Macrocytic anemias

2. Myelodysplastic syndromes

3. Metastases of neoplasms in the bone marrow

4. Iron deficiency anemias

Clinical and diagnostic value for anemia:

MCV value> 80 fl, RDW is normal:

1. Anemia in chronic diseases

2. Thalassemia

MCV value> 80 fl, RDW high:

1. Iron deficiency anemias
2. Sideroblastic anemias. Published.

Changes in indicators for the most common hematological syndromes of red blood:

Defining feature

If you have any questions, ask them

What is hemoglobin? Is a complex blood protein. It is found in red blood cells and is formed from iron and protein. Hence its name. Translated iron - "heme", and protein - "globin". It is thanks to the iron ion that the blood takes on its color. It is believed that the brighter and richer the color of the blood, the better the hemoglobin level in the blood. It transports oxygen from the lungs to the rest of the cells in the body, and also performs the function of removing carbon dioxide from the tissues to the lungs. The higher the amount of hemoglobin, the better the body's cells receive oxygen and work faster.

When there is not enough hemoglobin, oxygen transport throughout the body is impaired. Then metabolism is disturbed in the cells and their functions deteriorate.

Hemoglobin rate

Checking indicators is an important stage in diagnosing the state of the body. As a result of a blood test alone, no diagnosis can be made, but a timely determination of the amount of hemoglobin in the blood can indicate obvious violations in the functions of the body and the need for treatment.

The norm for men and women of different ages is different. Another in pregnant women. For girls and boys under the age of 12, the norm is one. We present below the scale of the hemoglobin norm for infants, children, women and men of different ages.

In infants:

newborns - from 135-140.

Normal level in children:

from one month: from 100-200;
from one to two months: from 100-180;
from two to six months: from 105-140;
from six months to two years: from 105-135;
from two to six years: from 115-135;
from six to twelve years old: from 115-155.

Among women:

from twelve to eighteen years old: from 120-160;
from eighteen to sixty years: from 120-150;
after sixty years: from 117-138.

In pregnant women:

in pregnant women, the rate can drop to 110.

In men:

from twelve to eighteen years old: from 130-160;
from eighteen to sixty years old: from 136-177;
after sixty years: from 124-149.

Low hemoglobin

This condition is called anemia (anemia). It is characterized by a sharp decrease in full-value erythrocytes. If hemoglobin is low, cells and tissues begin to suffer from a lack of oxygen.

Causes

Significant blood loss. Among them there are explicit and hidden ones. Explicit blood loss includes menstruation, bleeding during hemorrhoids, and blood loss during trauma or surgery. Latent blood loss can occur during gastrointestinal diseases.
Lack of vitamins C and B12.
Past infectious diseases or autoimmune diseases. Such diseases damage red blood cells, shortening their life span. Dysentery, salmonellosis, hepatitis, pneumonia, pyelonephritis, tuberculosis - all these diseases damage erythrocytes.
Helminths. They suck out huge amounts of B12, which is responsible for the absorption of iron.
Unbalanced diet. The diet does not contain foods containing folic acid, protein, B vitamins.
Carrying a baby and feeding. During these periods, a woman's body consumes too much iron.
Iron is not absorbed. This happens with gastritis, when the gastric mucosa becomes thinner, during dysbiosis, after undergoing surgical interventions in the gastrointestinal tract.
Malignant blood diseases.
Gastrointestinal cancer.
Blood pathologies.
Diseases of the bone marrow.
Chemotherapy sessions.
Kidney failure.
Stress.
Diets.
Disorders of the liver.

Symptoms

About low hemoglobin can be found out not only by a blood test. This is almost always due to a lack of iron.

Some symptoms can indicate low hemoglobin:

low pressure;
lack of energy, lethargy;
accelerated heartbeat;
headache;
brittle nails, spotting, flaking;
hair loss;
dry skin becomes;
strange taste preferences (for example, most often such people like the smells of gasoline, paint, varnish, solvent);
the skin becomes pale;
changes in the color of the tongue - it becomes reddish and painful in appearance;
a slight increase in body temperature.

Treatment

Treatment always comes from the causes of the deviations. If the violation caused gastritis - you need to treat it, if the cause was bleeding - solve this problem.

In addition to local treatment, it is prescribed to drink an iron preparation, which can only be prescribed by a doctor. The iron preparation is inscribed in a moderate dosage, since its increased rate can cause the opposite effect - intolerance of the body. The average daily intake of iron for an adult is 300 mg. At the beginning of treatment, doctors give the maximum dosage, then after normalizing the hemoglobin level, the dose of the drug is reduced by two or three times.

When the level returns to normal, treatment should be continued for another two or four months.

After completing the course of treatment, prophylaxis should certainly be done two or three times a year. At this stage, they are prescribed to take about 40-60 mg of iron preparation per day. An increase in hemoglobin will be observed only a month after taking the medication.

When low hemoglobin is associated with a lack of vitamin B12, vitamin injections are prescribed at a dosage of 300-500 mcg per day. When hemoglobin returns to normal, which often occurs in the fourth or sixth week, the dosage is reduced and treatment with the drug also continues for about two or three months.

A special diet will help to increase the level. List of foods that increase hemoglobin:

meat products
liver
languages
beef meat
egg yolks
buckwheat
peas
lentils
tomatoes
all types of onions
pumpkin
potatoes
Apple
grenades
pears
apricots
black currant berries
cranberries
nuts
all kinds of dried fruits
dry mushrooms
salmon caviar
dark chocolate
green tea (promotes the absorption of iron)

Video: Low hemoglobin - School of Dr. Komarovsky

Increased hemoglobin

Too much high level speaks of an excess of red blood cells. There is such a diagnosis - erythrocytosis. This disrupts blood circulation, blood clotting and leads to poor health.

Natural causes

The normal increase in hemoglobin will be for people living in the mountains, where the air contains less oxygen. Then the excess cannot be called a deviation. So the body gets accustomed to the external environment.

Hemoglobin can naturally rise in athletes. Their body needs more oxygen and therefore the body thus reacts to constant physical activity.

Pathological causes

An increase in the norm of red blood cells in a person or an increase in their size is the main reason for an excess of hemoglobin in the body. In addition, it can increase in the following cases:

congenital heart disease;
fibrosis of the lungs;
heart and vascular failure;
intestinal obstruction;
cancer.

Symptoms

thick blood;
high pressure;
redness of the skin;
sleep disturbance;
weakness, tiredness.

Treatment

You can treat elevated hemoglobin with diet, limiting the intake of animal protein. They contain iron, which is easily absorbed. By changing your diet, choosing foods with less iron, hemoglobin can be normalized.

For treatment, drugs are prescribed that help thin the blood.

Erythrophoresis helps in the treatment of high hemoglobin. This procedure reduces the number of red blood cells, lowers hemoglobin.

In treatment, it is important to take into account the cause of the disease and treat it first. Diet can lower the level, but it won't fix the problem permanently.

A normal hemoglobin level is very important for the normal functioning of the body. Try to eat a healthy and balanced diet to keep your nutritional level. We hope that our article will help you maintain your health and well-being for years to come. We wish you and your loved ones good health!

Decreased hemoglobin in women and men, what does this mean and what should be done?

Decreased hemoglobin in blood ( hematological syndrome, characterized by a violation of hemoglobin synthesis due to iron deficiency) - a situation typical for people of any age. Many do not realize the dangers behind this.

In this article, we will look at why women and men have hematological syndrome, what it means, what to do if there is low hemoglobin in the blood, how to increase it at home.

What is this substance (definition)

Hemoglobin is a complex iron-containing protein provides transfer oxygen in the body. The composition includes iron, with attaching oxygen molecules, transported through the vessels. It is the main protein without which blood circulation is impossible.

Side function of the main blood protein- transport of carbon dioxide in order to remove it from the body. The iron contained in this protein can also bind with (it is even given priority over oxygen), provoking powerful hypoxia. As a result, even death. Well, this is in extreme cases. With a low concentration of carbon monoxide, a person may experience milder forms of oxygen deficiency.

Protein is made if there is a lot iron-containing food... It is also important that the digestive system works well and absorbs iron from food. Otherwise, hemoglobin will simply have nothing to synthesize.