How to increase your Hemoglobin Count

Haemoglobin, often known as Hb or Hgb, is an essential protein present in erythrocytes, the red blood cells that carry oxygen from the lungs to all parts of the body and carbon dioxide from those tissues back to the lungs for expiration. It is among the most prevalent proteins in the human body and is necessary for life to exist.

The structure of haemoglobin is made up of four subunits, each of which has a globin chain and a heme group. Haemoglobin is a complicated protein. Haemoglobin A (HbA), which is made up of two alpha and two beta globin chains, is the most common kind of haemoglobin in adults. A heme group, which has an iron ion (Fe2+) that may attach to oxygen molecules, is connected to each globin chain. The heme group contains a porphyrin ring structure that holds the iron ion, enabling reversible binding and oxygen release.

Hemoglobin's principal role is to bind oxygen in the lungs, where oxygen concentrations are high, and release it in tissues with low oxygen concentrations. Haemoglobin and oxygen bind to each other cooperatively, which means that the binding of one oxygen molecule encourages the binding of other oxygen molecules. The haemoglobin molecule undergoes conformational changes during oxygen binding, which makes subsequent oxygen binding events more favourable.

These modifications are the cause of this cooperative binding:

• Oxygen Dissociation Curve: The oxygen dissociation curve illustrates the link between blood partial pressure (pO₂) and haemoglobin saturation, or the proportion of haemoglobin molecules coupled to oxygen. Haemoglobin facilitates the release of oxygen where it is most needed, as seen by this sigmoidal curve, which shows greater affinity for oxygen at high pO₂ (in the lungs) and decreased affinity for oxygen at low pO₂ (in tissues).
• Carbon Dioxide Transport: Haemoglobin is involved in the movement of carbon dioxide, a waste product of cellular metabolism, from tissues back to the lungs for expiration in addition to the movement of oxygen. Three kinds of carbon dioxide are found in blood: it is dissolved in plasma, it is generated as bicarbonate ions (HCO^3-) by hydrating carbon dioxide, and it is attached to haemoglobin as carbaminohemoglobin. Carbon dioxide binds to haemoglobin mostly in tissues with high carbon dioxide content, and is discharged in the lungs with low carbon dioxide content.
• Regulation of Haemoglobin Synthesis: To ensure that the blood has an adequate capacity to carry oxygen, haemoglobin synthesis is strictly regulated. The process of making haemoglobin starts in the bone marrow, where erythroblasts, or precursor cells, go through several stages of maturation to become mature red blood cells with haemoglobin. Erythropoietin (EPO), a hormone secreted by the kidneys in response to low blood oxygen levels, is one of the factors that control the formation of haemoglobin. To improve the amount of oxygen delivered to tissues, EPO promotes the synthesis of red blood cells, which includes haemoglobin.
• Haemoglobin Variants and Disorders: Hemoglobinopathies and related disorders can arise from mutations in the genes encoding haemoglobin, which can cause structural or functional abnormalities in haemoglobin molecules. Hemoglobinopathies, which include sickle cell disease and thalassemia, are a class of hereditary blood illnesses characterised by defective haemoglobin production. A mutation in the beta globin gene causes sickle cell disease by producing haemoglobin S, an abnormal form of haemoglobin that polymerizes in low oxygen environments. This condition results in the formation of sickle-shaped red blood cells as well as a number of complications, such as organ damage and vaso-occlusive crises. Reduced or missing synthesis of one or more globin chains is the hallmark of thalassemia, which causes anaemia and other symptoms.
• Clinical Haemoglobin Measurement: A number of techniques, such as point-of-care hemoglobinometers, haemoglobin electrophoresis, and complete blood counts (CBC) assays, can be used to determine the amount of haemoglobin in the blood. Age, gender, and altitude are among the variables that affect normal haemoglobin levels. For adults, the usual range is 12 to 16 grammes per deciliter (g/dL) for women and 13 to 17.5 g/dL for males. A number of underlying medical disorders may be indicated by anaemia (low haemoglobin) or polycythemia (high haemoglobin), which might be indicated by abnormal haemoglobin levels.

Normal Haemoglobin Levels

Variations in normal haemoglobin levels can be caused by age, sex, altitude, and personal health state. Red blood cells include haemoglobin, a crucial protein that transports carbon dioxide back to the lungs for expiration and oxygen from the lungs to all of the body's organs. It is critical to comprehend normal haemoglobin levels in order to diagnose and track a number of blood illnesses, such as polycythemia and anaemia.

Adult Haemoglobin Levels: For women and men, respectively, normal ranges for haemoglobin levels in adults are 12 to 16 grammes per deciliter (g/dL) and 13 to 17.5 g/dL. Depending on the particular population being tested and the laboratory reference range, these numbers could differ slightly. Normal haemoglobin levels are crucial for preserving tissue oxygenation and general physiological function because they indicate that the blood has the ability to deliver oxygen.

Age-Related Variations: The amount of haemoglobin in the blood can change with age; newborns and infants usually have higher levels than adults. This is because neonates primarily carry foetal haemoglobin (HbF), which has a stronger affinity for oxygen than adult haemoglobin (HbA). Haemoglobin levels progressively fall when infants switch to producing adult haemoglobin, reaching adult reference ranges by early childhood.

Neonatals (0-28 days): The normal range for a neonate's haemoglobin levels is 14-24 g/dL. The physiological modifications required to promote oxygen transport in the intrauterine and newborn settings are reflected in these increased levels.

Infants (one month to one year): During the first year of life, an infant's haemoglobin levels rapidly drop; typical ranges are 9 to 14 g/dL.

Children (1 to 18 years old): With minor variations depending on age and gender, normal haemoglobin levels in children often lie within the adult reference ranges.

Sex Differences: Because men and women have different hormone and physiological makeups, their haemoglobin levels may vary. Male adults often have slightly greater haemoglobin levels than female adults do. The primary reason for this discrepancy is the impact of androgens, or male hormones, on the generation and ageing of red blood cells.

Adult Males: A normal adult male's haemoglobin level should be between 13 and 17.5 g/dL.

Adult Females: Adult females normally have haemoglobin levels between 12 and 16 g/dL.

Reasons for Low Haemoglobin Levels

Anaemia, or low haemoglobin levels, can have a number of underlying reasons, including hereditary disorders, chronic illnesses, and nutritional inadequacies. Comprehending the elements that lead to low haemoglobin levels is crucial for precise diagnosis and suitable treatment. Among the frequent reasons for low haemoglobin levels are:

Iron Deficiency Anaemia:

The most frequent cause of low haemoglobin levels in the globe is iron deficiency anaemia. It happens when the body does not have enough iron to make haemoglobin, which lowers the blood's ability to carry oxygen. A lack of iron in the diet, prolonged blood loss (such as gastrointestinal bleeding, heavy menstrual bleeding), malabsorption disorders (such as inflammatory bowel disease, celiac disease), or increased iron requirements (such as pregnancy, rapid growth during infancy and adolescence) can all lead to iron deficiency.

Acute Vitamin Deficiency:

Megaloblastic anaemia, which is characterised by big, immature red blood cells with a low haemoglobin content, can result from a vitamin B12 shortage. Vitamin B12 deficiency can be caused by some drugs (metformin, proton pump inhibitors), malabsorption diseases (pernicious anaemia, gastrointestinal surgery), and inadequate dietary consumption (vegan or vegetarian diets low in animal products).

Megaloblastic anaemia can also result from a folate deficit because it impairs DNA synthesis and the maturation of red blood cells. Alcoholism, some drugs (e.g., methotrexate, anticonvulsants), malabsorption disorders, and insufficient consumption of foods high in folate are among the causes of folate insufficiency.

Chronic Illnesses:

• Chronic Kidney Disease (CKD): Reduced erythropoietin production, a hormone that promotes the synthesis of red blood cells in the bone marrow, can be brought on by chronic kidney disease and cause anaemia.
• Chronic Inflammatory Disorders: Increased synthesis of inflammatory cytokines, which inhibit erythropoiesis and reduce red blood cell survival, is a cause of anaemia in chronic inflammatory disorders such rheumatoid arthritis, inflammatory bowel disease, and persistent infections.
• Chronic Liver Disease: Anaemia can be brought on by a reduction in the production of proteins necessary for iron metabolism and the synthesis of red blood cells.

Anaemias Hemolytic:

• Autoimmune Hemolytic Anaemia: Hemolysis and low haemoglobin levels result from the immune system unintentionally attacking and destroying red blood cells.
• Hereditary Haemolytic Anaemias: Deviations in the structure, function, or metabolism of red blood cells can result in hemolytic anaemia. These disorders include sickle cell disease, thalassemia, hereditary spherocytosis, and glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Bone Marrow Conditions:

Reduced synthesis of red blood cells, white blood cells, and platelets in the bone marrow causes aplastic anaemia, an uncommon condition that results in pancytopenia and anaemia.

• Myelodysplastic Syndromes (MDS): These disorders are a set of conditions that result in low haemoglobin levels and cytopenias. They are characterised by aberrant bone marrow activity and poor erythropoiesis.
• Haemorrhage: Acute blood loss brought on by trauma, surgery, gastrointestinal bleeding, or other conditions can rapidly reduce haemoglobin levels and red blood cell counts, which can induce acute anaemia.
• Malnutrition: Iron, vitamin B₁₂, folate, and other vital elements should be consumed in sufficient amounts to prevent nutritional deficits and anaemia.
• Medication: Anaemia is a side effect of several medications, including proton pump inhibitors, anticoagulants, chemotherapeutic treatments, and nonsteroidal anti-inflammatory drugs (NSAIDs).
• Genetic Factors: People can be predisposed to anaemia by inherited genetic diseases such as glucose-6-phosphate dehydrogenase deficiency and hereditary hemoglobinopathies (such as sickle cell disease and thalassemia).

Factors Affecting Haemoglobin Levels

A number of factors, such as genetics, iron intake, chronic illnesses, and nutritional condition, can affect haemoglobin levels.

• Nutritional Status: For the best possible generation of red blood cells and haemoglobin synthesis, an adequate diet of iron, vitamin B12, folate, and other nutrients is required. Anaemia and lower haemoglobin levels can result from deficiencies in certain nutrients.
• Chronic Illnesses: Haemoglobin levels and red blood cell synthesis can be impacted by a number of chronic illnesses, including cancer, chronic kidney disease, and inflammatory disorders. Anaemia and reduced erythropoiesis, or the generation of red blood cells, can result from chronic inflammation's stimulation of inflammatory cytokine production.
• Altitude Adjustments: The body adjusts to less oxygen available at high altitudes, which can cause variations in haemoglobin levels. Because the air is less oxygenated at higher elevations, the body produces more red blood cells and haemoglobin to make up for the decreased oxygen carrying capacity of the air.
• Effects of Altitude: People who live in high altitudes, including hilly areas, could have higher haemoglobin levels than people who live at sea level. This physiological adjustment mitigates the consequences of hypoxia (low oxygen levels) and enhances oxygen delivery to tissues.
• Altitude Reference Ranges: To account for altitude-related differences in red blood cell formation and oxygen delivery, reference ranges for haemoglobin levels may be modified for people who live at high altitudes.

How to increase Haemoglobin count?

For the treatment of diseases like anaemia, which is defined by a reduction in the quantity of haemoglobin in the blood or the number of red blood cells in the body, raising haemoglobin levels is crucial. To increase haemoglobin levels and the blood's ability to carry oxygen, a number of techniques can be used. Depending on the underlying reason of low haemoglobin levels and the person's general health status, these approaches might range from food and lifestyle changes to medical procedures.

• Iron-Rich Diet: Since iron is a necessary mineral for the synthesis of haemoglobin, eating foods high in iron can help people with iron deficiency anaemia build up more iron in their bodies and raise their haemoglobin levels. Red meat, chicken, fish, beans, lentils, tofu, spinach, kale, and iron-fortified cereals are among the foods high in iron. Regular consumption of these foods can promote the synthesis of red blood cells and help the body maintain appropriate iron levels.
• Supplementation: To raise haemoglobin levels, iron supplementation may be advised in cases of iron deficiency anaemia or insufficient dietary consumption of iron. Iron supplements can be taken orally as tablets or liquid solutions. They come in many forms such as ferrous fumarate, ferrous gluconate, and ferrous sulphate. Adhering to the quantity and period of iron supplementation as prescribed by a healthcare provider is crucial for preventing iron excess and minimising adverse effects, including upset stomach and constipation.
• Vitamin Supplementation: The synthesis of haemoglobin and the generation of red blood cells are aided by certain vitamins and minerals. Red blood cell maturation and DNA synthesis depend on vitamin B12 and folate (vitamin B9). Megaloblastic anaemia, which is characterised by big, immature red blood cells with a low haemoglobin content, can result from deficiencies in certain vitamins. For people with malabsorption issues or pernicious anaemia, vitamin B12 injections or supplements may be required to raise haemoglobin levels and address deficiency. In a similar vein, folate supplementation can improve haemoglobin synthesis and treat folate deficiency anaemia.
• Agents that Stimulate Erythropoiesis (ESAs): Synthetic forms of erythropoietin, a hormone generated by the kidneys that promotes the synthesis of red blood cells in the bone marrow, are known as erythropoiesis-stimulating drugs. ESAs are sometimes recommended to treat anaemia brought on by cancer, chronic renal disease, or other illnesses in order to raise haemoglobin levels. These drugs, which are usually injected, function by promoting the synthesis of red blood cells, raising haemoglobin levels and alleviating anaemia symptoms.
• Blood transfusion: To quickly raise haemoglobin levels and restore the blood's ability to carry oxygen, blood transfusion may be required in cases of severe anaemia or acute blood loss. In order to restore haemoglobin levels and replace lost blood volume, intravenous infusions of donated blood or blood products, such as packed red blood cells, are performed. Transfusions are usually only given to patients who have hemodynamic instability, symptomatic anaemia, or considerable blood loss from trauma, surgery, or illnesses such gastrointestinal bleeding.

In order to effectively treat anaemia, it is imperative to address any underlying medical disorders that may be causing low haemoglobin levels. Treating ailments including chronic kidney illness, gastrointestinal bleeding, inflammatory diseases, or problems of the bone marrow that reduce the generation of red blood cells or promote their destruction may be necessary for this. Finding and treating the underlying causes of anaemia can help patients with the condition live longer and experience fewer relapses.