Poor health of a person can be due to several reasons. Feelings of weakness, lack of strength, constant insomnia, frequent colds are frequent companions to the development of anemia or a decrease in blood hemoglobin. People have long called this condition anemia.
The level of hemoglobin can be determined using a general blood test, which is prescribed by a doctor as part of a set of diagnostic measures. Hemoglobin 90 (but not lower than this number) means that the patient’s anemia has an initial, first degree of severity. Values below this figure indicate a moderate severity of the disease.
How dangerous is this condition for adults or children? Do deviations depend on a person’s gender? Why is it important to prevent anemia during pregnancy? What should I do to bring the indicator back to normal? Is special treatment required? Questions like these are very popular and are often answered by doctors.
Functions and cycle of hemoglobin conversion
An obligatory stage of modern clinical diagnostics is the study of general blood test parameters. The pathological processes occurring in the body are one way or another reflected in the cellular and biochemical composition of this tissue. One of the CBC parameters is erythrocyte indices, which make it possible to record quantitative and qualitative changes in the composition of red blood cells. Some of the erythrocyte indices reflect the metabolic state of hemoglobin, a protein that performs a unique function in the human body.
Hemoglobin is a complex protein compound that consists of four peptide molecules and associated iron-containing complexes. These complexes, called hemes, are responsible for the main purpose of hemoglobin in the body - transporting oxygen from the lungs to the tissues and carbon dioxide in the opposite direction.
In humans, as in all vertebrates, hemoglobin is the main component of erythrocytes, red blood cells. The divalent iron atoms that make up heme are capable of oxidation (addition of oxygen molecules) and reduction (release of O2).
Oxygen saturation occurs in the smallest pulmonary vesicles - alveoli. Here, due to the high partial pressure, O2 molecules overcome the thin barrier between the lung tissue and the blood capillaries and attach to the heme iron. Intense saturation is facilitated by the disc-shaped shape of red blood cells with a flattened center: due to it, the contact area between hemoglobin and oxygen significantly increases. As a result, the stable form of hemoglobin, deoxyhemoglobin, is oxidized and converted into oxyhemoglobin.
Together with the bloodstream, oxyhemoglobin penetrates almost all tissues of the body, where it releases the oxygen necessary for the normal functioning of cells. Having shared O2 with tissues, hemoglobin binds cell waste products - carbon dioxide and hydrogen ions. A new form of hemoglobin (carboxyhemoglobin) is sent back to the lungs and the metabolic cycle repeats.
In a number of genetic diseases and chemical poisonings, the iron contained in heme is oxidized to degree +3 and loses its ability to transport oxygen. In mild cases of methemoglobinemia, the restoration of the iron atom is achieved by administering ascorbic acid orally; in severe cases, transfusion of red blood cells to the patient has a good effect.
Normal hemoglobin content in blood
The normal hemoglobin content per liter of blood is:
- 130-160 g/l for men
- 120-150 g/l for women
In children, the maximum level of hemoglobin per unit volume of blood is observed during the first three days of life (145-225 g/l), by 4-6 months it decreases to a minimum (95-135 g/l), then slowly increases and by 18 years is within the normal range of an adult.
In clinical practice, the following indicators of erythrocyte indices are considered more informative:
- MCH is the absolute content of hemoglobin in the erythrocyte. The normal value for this parameter in adults is 27-35*10-12 grams (picograms). MCH varies depending on age: the peak occurs at the time of birth, and from the first months of life it fluctuates slightly.
- MCHC is the average concentration of hemoglobin in red blood cells, the amount of hemoglobin per unit volume of red blood cells. This is the most reliable of the erythrocyte indices. The average MCHC value for a healthy adult is 310-360 g/l. With age, the level of MCHC changes in inverse proportion to MCH: the minimum is observed in the first day of life, but by four months it reaches a level at which it will remain throughout life. At the stage of growing up, this MCHC indicator in women and men is slightly different, but this difference is so small that it can be neglected.
In the first trimester of pregnancy, the CBC often demonstrates a false decrease in hemoglobin levels. In reality, the amount of hemoglobin in the mother’s blood remains the same, but its concentration decreases due to an increase in the volume of the liquid fraction of the blood. However, in the second trimester, the fetus absorbs a significant amount of dietary iron. During this period, monitoring the hemoglobin content in the blood of pregnant women is especially important for the health of the mother and fetus.
The MCH and MCHC indicators are considered inextricably linked with each other and other results of the study of red blood cells: hematocrit (the ratio of red blood cell volumes to blood plasma), MCV (average erythrocyte volume), ESR (erythrocyte sedimentation rate) and others.
Reduced values in children
Normal hemoglobin levels in children differ from those of an adult. A newborn child most often suffers from anemia if his mother’s iron level was below normal during pregnancy. Anemia in a baby can be caused by the woman's health condition during pregnancy - previous colds or infectious diseases. Low hemoglobin in the first days of a child’s life can be observed if a woman had a multiple pregnancy.
A one-month-old baby may not experience iron deficiency for the reasons listed; the analysis will show a low indicator - hemoglobin at a level of 89 or lower after he reaches the age of three months. At this age, dangerous values in tests require close attention - hemoglobin 87-88. They mean that the child does not receive adequate nutrition; it needs to be changed so that the baby develops normally.
The hemoglobin of a one-year-old baby is normally in the range of 100 to 140 g/l. A stable hemoglobin value of 98 or lower is critical for health. It can threaten developmental delays and mental retardation of the child due to the constant lack of oxygen that his brain does not receive.
A teenager in normal health has hemoglobin in the range of 120 to 160 units. Anemia in a child at this age has a dangerous consequence - the development of pathologies of the heart and blood vessels, brain, and digestive organs.
Increasing hemoglobin levels in the blood
An increase in MCH usually occurs with increased hemoglobin synthesis in the red bone marrow and is typical for the following diseases and conditions:
- chronic blood loss due to hemorrhoids, diseases of the digestive system and heavy menstruation in women
- hyperchromic anemia, in which a slight change in hemoglobin level is accompanied by a sharp decrease in the number of red blood cells
- megaloblastic anemia (macrocytosis), developing in response to a deficiency of folic acid and vitamin B in the body. In this disease, macrocells megaloblasts, immature precursors of red blood cells, circulate in the bloodstream.
- hypothyroidism
- liver disease
- oncological diseases complicated by metastases
Increases in MCH levels may also occur in response to radiation treatments, anticonvulsant therapy, and oral contraceptives.
Increased MCHC is uncommon and difficult to diagnose. This phenomenon usually accompanies hyperchromic anemia and disturbances in the exchange of tissue electrolytes, leading to dehydration of the body. Even less common is spherocytosis - usually a hereditary defect in the cell membrane of red blood cells, as a result of which the cells acquire a spherical shape and are destroyed prematurely.
If the CBC reveals an MCHC level above 380 g/L, it is safe to say that an error occurred during the study. This is due to the physicochemical properties of protein and red blood cells: 380 g/l is the maximum concentration of hemoglobin in a red blood cell; if it is exceeded, hemoglobin will precipitate.
Indications for analysis
An MSHC analysis is a study of blood at the cellular level in order to identify the qualitative and quantitative presence of red blood cells, as well as their saturation with hemoglobin as a percentage, therefore, if the amount of hemoglobin in a red blood cell is reduced, then this is a signal of the necessary help. What does it mean? Red blood cells perform one of the main functions: they are responsible for supplying the required amount of oxygen to all systems of the human body. Each red blood cell has its own specific content of hemoglobin; due to the iron present in it, the action of binding oxygen is carried out. The amount of oxygen in the blood depends on how saturated the red blood cells are with hemoglobin.
To identify this type of filling, the MSNS procedure is carried out, and the procedure itself is quite simple. Blood is used for the study, and experts believe that such a blood test is one of the most effective and reliable. If the mch results obtained in a blood test do not correspond to the norm, this means that there are pathological processes that negatively affect the process of hemoglobin formation.
The procedure for studying the material taken (MSNS in a blood test) makes it possible to identify two main indicators:
- MCH is the average amount of hemoglobin present in a red blood cell;
- MSV is the average value of erythrocyte volume.
It is these indicators that make it possible to determine the quality and condition of red blood cells. If the value exceeds normal values, this may not always mean the presence of diseases. To confirm, specialists resort to additional methods of studying mchc in a blood test. However, such a process can be characterized by an increase in density, while its crystallization and subsequent destruction of red blood cells cannot be ruled out.
Decreased hemoglobin levels in the blood
A decrease in MCH and MCHC levels are usually combined and indicate the following disorders and diseases:
- A wide range of hypochromic (accompanied by a decrease in hemoglobin levels) anemia:
- iron deficiency, associated with a lack of iron in the body
- sideroachristic, in which the process of iron absorption in the intestine is disrupted
- iron redistribution, which develops with increased breakdown of red blood cells
- hypochromic anemia of mixed origin
- Thalassemia (hereditary disorder of the synthesis of hemoglobin polypeptide chains) and other hemoglobinopathies
- Sideroblastic anemia is a group of diseases accompanied by disorders of erythropoiesis and iron metabolism
- Acute blood loss
- Chronic lead intoxication
- Hyperthyroidism
- Electrolyte imbalance
- Chronic inflammatory diseases (more often kidney diseases) associated with impaired iron metabolism
In some cases, a decrease in hemoglobin levels is also observed in macrocytic anemia, when the increase in cell size does not correspond to their filling with iron-containing protein.
Diagnosis and treatment of abnormalities
The determination of erythrocyte indices is carried out during an extended blood test. The methods of these studies have been known for a long time, but required highly qualified laboratory assistants and the use of additional reagents. Today, automatic hemoanalyzers are widely used in clinical practice, which are capable of counting the number of blood cells and conducting their qualitative analysis. The sample for the study is a regular blood smear taken from a finger or vein.
Since conditions associated with a violation of the amount of hemoglobin in the blood are secondary, doctors direct their efforts to the treatment of primary diseases. Depending on the causes of anemia of various origins, patients are prescribed iron supplements, vitamins, and a diet with a high content of fresh juices, red meat and fish. Severe forms of blood diseases can be treated with infusion therapy, the use of specific drugs and procedures. Symptoms of hemoglobin metabolism disorders are relieved with correctly chosen tactics for treating pathologies of the thyroid gland, liver and kidney diseases, and chronic diseases of the gastrointestinal tract that lead to the development of anemia.
Low hemoglobin consequences
A decrease in hemoglobin concentration leads to the body not receiving the required amount of oxygen.
- The consequence of this may be a decrease in immunity and, as a result, an increase in the incidence of infectious diseases.
- In most cases, a person becomes quickly fatigued and constantly weak.
- Anemia can cause deformation in human epithelial tissues - the mucous membranes of the respiratory tract, oral cavity, gastrointestinal tract and the upper protective layers of the skin.
- Anemia often causes nervous system disorders: irritability, causeless mood swings, and reduced concentration.
