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Haemoglobin and fluctuations in its levels & Treatment

Haemoglobin and fluctuations in its levels

The red pigment of blood due to which blood appears to be red is the haemoglobin. Haemoglobin is an oxygen carrying Component of RBCs. It is protein component of RBCs in blood. It is an iron containing component of blood. This iron enables Hb to carry oxygen.


Haemoglobin is composed of four polypeptide chains, namely 2 Alpha (141 amino acids) and 2 beta (146 amino acids) globin chains and a heme group (also known as iron porphyrin IX). Heme group is a prosthetic group attach to polypeptide chains. The structure of heme group resembles with chlorophyl in plants, except for the difference in central item enclosed in porphyrin ring is Iron.


Following are the functions of hb;

  • Oxygen carrying

The main function of Hb in blood is carrying oxygen in blood from lungs and supplying the organs for nourishment.

  • Heat transducer

Due to oxygenation and deoxygenation cycle, Hb play significant role in transferring heat to body through its function of carrying oxygen.

  • Modulate erythropoiesis (RBCs production)

Hb also function as mediator for production of RBCs as a result of stimulus (ischemia).

  • Colour to blood

Heme in HB of RBCs give red colour to blood. When the Hb level of blood decrease the blood seems to be less red and vice versa. This red colour of Hb is visible when oxygen is attached to HB. This is the reason the deoxygenated blood appear to be blue in colour.

Haemoglobin and fluctuations

Normal levels

Maintaining normal levels of Hb in blood is very crucial for normal function of blood which otherwise may cause ischemia or infarcts in body. The normal range of Hb in human body ranges from 13.8 g/dl to 17.2 g/dl in males and from 12.1g/dl to 15.1 g/dl in females. Normal ranges also vary with age for example, children normal Hb level ranges from 9.5 to 14g/dl , 10.5 to 15.5 g/dl in young adult (6 to 18yr). Hb level less the 11.6 g/dl in females and 13.2 g/dl in males is considered low. Hb level less the 6.5 g/dl is considered life threatening and need urgent medical attention.


All the blood disorder that alters (decrease) the oxygen carrying capacity of blood are termed as abnormalities. The abnormalities in Hb can be due to genetic factors, environmental factors or secondary to pre-existing illness. Following are the causes of Hb defects along with defects,

  • Genetic defects

There are group of genetic disorder that alter the str and function of Hb, namely sickle cell anaemia (most common), thalassemia (and its types), oxygen transport disorder, Barts etc. The mutations in different genes result in changes in shapes and sizes of Hb and RBCs or deficiencies in protein globin chains that in turn impair haemoglobin function.

  • Environmental factors

Poor nutrition (low iron content in diet), unhygienic diet, excessive prolonged bleeding and liver infections (bacterial, viral) all result in impaired Hb concentration and function.

  • Secondary Hb abnormalities

Anaemia, polycythaemia, secondary erythrocytosis and different liver diseases are the major causes of compromised Hb function that result from excessive blood loss or intense iron deficiency led to haemoglobin deficiency hence the oxygen carrying capacity. Chronic Kidney disease also lead to Hb abnormalities


The symptoms associated with Hb abnormalities are breathlessness, chest pain, dizziness, exhaustion, headache, cold feet and hands (Reynard’s phenomenon), pale yellowish skin, abdominal and body pain, weakness, lethargy and ischemia in severe cases.


Different tests are carried to check changes in Hb concentration, shape, size and function, out of which the most used is CBC (complete blood count). This test shows the concentration of RBCs and haemoglobin along with other components of blood. Other haemoglobin tests are the component of CBC. Hb electrophoresis check for abnormal Hb globin types in blood.

Haemoglobin and fluctuations


Treatment of Hb disorder includes,

  • Lifestyle changes

Eating healthy, avoid alcohol or smoking, take proper rest, avoid excessive bleeding, avoid living at high attitude due to atmospheric pressure changes, avoid iron overloading diet, In case of thalassemia take proper hygienic measure during blood transfusions, avoid vigorous exercise in case of sickle cell anaemia as it can cause ischemic attack and use massage to keep body relaxed

  • Medication

Taking proper vaccination against bacterial or viral infections to avoid liver infection, take proper blood transfusion, drugs (chelators) should be carefully administered as they tend to remove excess iron from body, food supplements (multi vitamins, minerals, etc.) are prescribes to help Hb and RBCs production and anti-inflammatory drugs and pain killers are prescribed to relieve symptoms.

  • Surgical treatment

Last but not least, bone marrow transplant is the best method for treatment of Hb abnormalities, but the biggest problem of this treatment method is difficulty in finding the perfect matched donor for transplant moreover this method is not common and too much expensive.


The epidemiological studies regarding Hb disorder suggest that around 1.1% couples are at risk of transferring Hb abnormalities in their children whereas 2.7% conceptions are affected with Hb abnormalities worldwide. Epidemiologist claims that 3.4% of deaths in children occur due to genetic Hb abnormalities globally. Research works are directed to find the appropriate medical treatment and remedies for Hb abnormalities. The studies are trying find the risk factors and how changes in lifestyles causes Hb abnormalities.


After reading and writing about Hb abnormalities we have come to conclusion the abnormalities of blood may lead to abnormalities in Hb concentration and function. The preventive measure to avoid the genetic predisposition of Hb abnormalities in children is to avoid cousin marriages and take genetic test before marriage to avoid genetic disorder in children. Moreover, the diseases that can lead to Hb abnormalities in people should be treated in early stages to avoid other complications. Special cares should be taken before blood transfusions. Cheap surgical procedures should be carried out for Bone marrow transplant to be easily accessible to not so affording patients. Donors from all around the world should be registered on global websites.

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