HEMOGLOBIN: Normal level, Indications, Interpretation, Symptoms, Interfering Factors and Treatment


Hemoglobin is the protein component of red blood cells that acts as a carrier for oxygen and carbon dioxide transport.           

It is composed of heme (a pigment) that carries iron, and globin (a protein).

A hemoglobin test measures the amount of hemoglobin in your blood.

If hemoglobin level is lower than normal, it means you have a low red blood cell count (anemia).

If a hemoglobin level is higher than normal, there are several potential causes the blood disorder polycythemia vera, living at a high altitude, smoking and dehydration.

When your hemoglobin level is low, it means your body isn’t getting enough oxygen, making you feel very tired and weak.

A severe low hemoglobin level for men is 13.5 gm/dL or lower.

For women, a severe low hemoglobin level is 12 gm/dL.

Hemoglobin tests are measured as part of a complete blood count (CBC).

Normal level of Hemoglobin

● Newborn: 14 to 24 g/dL or 140 to 240 g/L

● Infant One (1) week of age: 15 to 20 gm/dL

● Infant One (1) month of age: 11 to 15 gm/dL

● Children: 11 to 13 gm/dL

● Adult males: 14 to 18 gm/dL

● Adult women: 12 to 16 gm/dL

● Men after middle age: 12.4 to 14.9 gm/dL

● Women after middle age: 11.7 to 13.8 gm/dL

● Critical values: <5 g/dl or >20g/dl

Indications of Hemoglobin

To measure severity of anemia or polycythemia and to monitor response to therapy.

Interpretation of Hemoglobin

● Low hemoglobin indicates anemia, characterized by an insufficient RBC count to deliver oxygen to peripheral tissues.

● High hemoglobin indicates polycythemia when the hemoglobin is more than 18.5g/dl in men and 16.5g/dl in women.

Increased Levels of Hemoglobin

Polycythemia vera


Chronic obstructive pulmonary disease

Congenital heart disease

Congestive heart disease


Decreased Levels of Hemoglobin


Nutritional deficiency

Bleeding from digestive tract or bladder,

Heavy menstrual periods




Kidney disease



Liver disease



Low level of iron, folate, vitamin B12, or vitamin B6

Interfering Factors of Hemoglobin

Conditions that cause changes in plasma volume without changes in overall RBC cell count can also affect the Hb and may lead to relative anemia or relative polycythemia.

Nursing Implications of Hemoglobin

Manage fatigue

Maintain adequate nutrition

Maintain adequate perfusion and encourage patient compliance with prescribed therapy.

How to increase hemoglobin levels

Transfusing red blood cells

Receiving erythropoietin (a hormone used to stimulate red blood cell production in individuals with decreased red blood cell production or increased red cell destruction)

Taking iron supplements

Increasing the intake of iron-rich foods, such as: eggs, spinach, artichokes, beans, lean meats, and seafood.

Increasing the intake of foods rich in cofactors, such as: vitamin B6, folic acid, vitamin B12, and vitamin C.

Such foods include fish, vegetables, nuts, cereals, peas, and citrus fruits.

Hemoglobin A1c test

Hemoglobin A1c or glycosylated hemoglobin is a rough indication of blood sugar control in people with diabetes mellitus over the preceding 3 months.

As more glucose (blood sugar) circulates in the blood on a daily basis, is bound to the circulating hemoglobin.

Normal hemoglobin A1c levels range between 4% to 5.9%.

As this number reaches 6% or greater, it signifies poorer diabetes control.

Hemoglobin A1c of 6% roughly correlates with an average blood sugar level of 135 mg/dL (milligrams per deciliters) over the previous 3 months.

Each 1% increase in hemoglobin A1c above 6% represents an average blood sugar of approximately 35 mg/dL over 135 mg/dL

A hemoglobin A1c measurement of 7% corresponds to an average blood sugar level of 170 mg/dL in the previous 3 months.

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