Low Haemoglobin: Causes, Symptoms, Treatment

What is haemoglobin?

Haemoglobin is a protein found in red blood cells that helps transport oxygen from the lungs to the rest of the body. Its distinctive red colour is due to its iron content, which binds with oxygen and facilitates its distribution through the bloodstream.

Haemoglobin levels

• Men: Between 13.5 to 18.0 g/dL
• Women: Between 12.0 to 15.0 g/dL

Anything lower than the range above is regarded as inadequate.

What is low haemoglobin?

Low haemoglobin, often referred to as anaemia, is a decrease in the body’s red blood cells or haemoglobin count in the blood. It can affect anybody, including those who may consider themselves generally healthy. Various factors, such as an inadequate diet, chronic diseases, or specific medical conditions, can contribute to low haemoglobin levels.

Low haemoglobin can cause various health issues, from daily fatigue, shortness of breath, and headaches to severe conditions. If left untreated, the severity and potential complications will depend on the cause, degree of haemoglobin deficiency, and the overall health of the individual.

What are the symptoms?

Low haemoglobin levels often show some early warning signs. However, it is easy to overlook or see the symptoms as indicators of other health issues. This is why you should visit your doctor immediately if you notice any signs of anaemia. 

Here are common indicators that your haemoglobin levels may be below the optimal range:

• Fatigue: Persistent tiredness and a lack of energy, even after adequate rest.
• Weakness: Generalised weakness and a sense of physical lethargy.
• Shortness of breath: Difficulty breathing or breathlessness, especially during physical activities.
• Pale skin: A noticeable paleness in the skin, particularly in the face and palms.
• Dizziness or light-headedness: Feeling dizzy or lightheaded, especially when standing up.
• Headaches: Frequent headaches that may result from reduced oxygen supply to the brain.
• Cold hands and feet: Poor circulation, leading to colder extremities.
• Irregular heartbeat: Anaemia can affect the heart's ability to pump blood efficiently, leading to an irregular heartbeat.

What causes low haemoglobin?

Several factors contribute to a decline in haemoglobin concentration within the blood:

• Iron deficiency: Iron is essential for haemoglobin production. A lack of iron in the diet, poor absorption of iron from the digestive tract, or chronic blood loss (e.g., from heavy menstrual periods or gastrointestinal bleeding) can lead to iron-deficiency anaemia.

• Vitamin deficiencies: Deficiencies in vitamins such as B12 and folate are crucial for red blood cell production. Pernicious anaemia, for instance, results from a deficiency in vitamin B12.

• Chronic diseases: Chronic kidney diseases, inflammatory disorders, and certain types of cancers can impact red blood cell production, leading to low haemoglobin.

• Genetic factors: Some anaemic patients may have inherited conditions like sickle cell anaemia or thalassemia, which can result in lower haemoglobin levels.

• Blood loss: Excessive menstrual bleeding, gastrointestinal bleeding, or trauma can lead to a loss of red blood cells, contributing to low haemoglobin.

• Bone marrow disorders: Diseases affecting the bone marrow, where red blood cells are produced, can affect the bone marrow's ability to produce sufficient red blood cells.

• Pregnancy: Increased blood volume during pregnancy dilutes haemoglobin, and higher iron demand can result in anaemia during pregnancy if not met by dietary intake or supplements.

How is low haemoglobin diagnosed?

Low haemoglobin is diagnosed through a combination of medical history, physical examination, and laboratory tests.

1. Blood tests, including a complete blood count (CBC), is commonly used to diagnose low haemoglobin. CBC provides detailed information about red blood cells, haemoglobin levels, and related parameters, helping healthcare professionals identify any abnormalities.
2. Iron studies is conducted to assess the body’s iron levels. These studies include tests for serum iron, ferritin, and total iron-binding capacity (TIBC), to evaluate iron levels and iron storage in the body.
3. Sometimes, your doctor may recommend additional tests like a peripheral blood smear or bone marrow biopsy. These tests are to investigate the cause of low haemoglobin further, especially if it's attributed to more complex factors.

How is low haemoglobin treated?

There are various treatment options for low haemoglobin depending on the underlying cause. 

1. Iron-deficiency anaemia:
   • Oral iron supplements like ferrous sulfate.
   • Intravenous iron may be given if oral supplements are ineffective or not tolerated.
   • Increase the intake of iron-rich foods such as red meat, poultry, fish, legumes, dark green leafy vegetables, and fortified cereals.
   • Treat sources of chronic blood loss, such as gastrointestinal bleeding or heavy menstrual periods.
2. Vitamin B12-deficiency anaemia:
   • Vitamin B12 supplements can be given orally or by injection, depending on the severity of the deficiency and the body’s ability to absorb the vitamin.
   • Include more B12-rich foods such as meat, eggs, dairy products, and fortified cereals.
3. Folate-deficiency anaemia:
   • Oral folic acid (folate) supplements.
   • Consume more folate-rich foods such as green leafy vegetables, fruits, nuts, beans, and fortified grains.
4. Anaemia of chronic disease:
   • Treat chronic diseases like kidney disease, cancer, or rheumatoid arthritis.
5. Aplastic anaemia:
   • Bone marrow stimulants
   • Blood transfusions to temporarily increase red blood cell counts.
   • In severe cases, a bone marrow or stem cell transplant may be necessary.
6. Haemolytic anaemia:
   • Steroids or other immunosuppressive drugs to reduce the immune response if the anaemia is autoimmune in nature.
   • Blood transfusions
   • Treat underlying infections or discontinue causative medications.
   • Splenectomy (removal of the spleen) may be necessary in certain cases.

When to call a doctor? 

When dealing with anaemia, you should always ensure your doctor is actively involved. 

If you experience persistent symptoms such as fatigue, weakness, shortness of breath, or pale skin, it is advisable to consult a healthcare professional promptly. Early diagnosis and medical intervention can prevent complications and improve overall outcomes.

Make an appointment at Pantai Hospitals 

Early and accurate diagnosis is crucial for effective treatment. If you suspect low haemoglobin, you should consult your doctor for a proper check-up. A dedicated and expert team of haematologists at Pantai Hospitals is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding iron deficiency anaemia. We assure you the best possible care tailored to your specific needs.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.