Hemoglobin too low
Since every red blood cell has the hemoglobin molecule, the hemoglobin value is a meaningful marker for the amount of red blood cells in the bloodstream. During a blood test, the Hb value can be determined in medical laboratories and the quantity of red blood cells can be estimated on the basis of this value. If the value is below the normal range of the respective group of people, an anemia is present.
A whole range of diseases and causes can be behind anemia. In most cases, however, anemia can be treated well. The Hb value is used in the blood count to determine other values, which often indicate a cause of the anemia.
These include MCH, MCHC, MCV and RDW. If the volume and hemoglobin content of a single erythrocyte is reduced, MCH, MCHC and MCV are below normal. In this case, an iron deficiency or a problem in the iron metabolism is the most likely cause. Iron deficiency anemia is a particularly common clinical picture, especially in women. The causes are mostly bleeding.
Haemoglobin too high
Since the hemoglobin value in the blood is a measure of the number of red blood cells, an increased value is often accompanied by an excessive number of erythrocytes. The blood is composed of solid and liquid components, approximately in a ratio of 40:60. Among the solid components, erythrocytes make up the majority.
If there are too many of them, one speaks of “polyglobulia” or “erythrocytosis”. Normally, too high Hb values occur in people who have spent long periods at particularly high altitudes. Due to the reduced oxygen content at altitudes, the body begins to produce additional oxygen carriers to compensate for the deficiency.
Athletes take advantage of this effect by doing altitude training. Due to the increased number of erythrocytes, they are then more efficient when exercising in normal oxygen conditions. This blood production can also be induced by medication, but it is prohibited as “EPO doping” in sports.
Even long-time smokers and patients with lung diseases often have reactively increased Hb values (hemoglobin values). In some cases, the increased number of red blood cells can increase the so-called “hematocrit value”. It describes the proportion of solid blood components (e.g. cells) in relation to the total blood.
A greatly increased hematocrit can lead to thrombosis, heart attacks and strokes. Due to the many solid components, the blood is more viscous and flows more slowly through the vessels. Individual cases of this have been seen in athletes who have taken enormous amounts of EPO doping.
Highly elevated levels bring this risk with them. One pathological change that leads to elevated hemoglobin levels in the blood is polycythaemia vera. The disease is one of the myeloproliferative diseases in which all solid blood components are produced in increased quantities, including leukocytes and thrombocytes.
The disease is very rare and can be congenital or acquired. Patients with slightly elevated Hb values usually do not notice any symptoms in their daily life. Anaemia is a more common problem in everyday hospital life than elevated hemoglobin values.
