Haemoglobin

Why Get Tested?

If you have anaemia (too few red blood cells) or polycythaemia (too many red blood
cells), to assess its severity, and to monitor response to treatment

When to Get Tested?

As part of a full blood count (FBC), which may be requested for a variety of reasons

Sample Required?
A blood sample collected from a vein in your arm or by a finger-prick (children and
adults) or heel-prick (newborns)

What is being tested?

This test measures the amount of haemoglobin (a protein found in red blood cells) in
your blood and is a good indication of your blood's ability to carry oxygen throughout
your body. Haemoglobin carries oxygen to cells from the lungs. If your haemoglobin
levels are low, you have anaemia, a condition in which your body is not getting
enough oxygen, causing fatigue and weakness.

How is it used?
The test is used to:

• detect and measure the severity of anaemia (too few red blood cells) or
polycythaemia (too many red blood cells),
• monitor the response to treatment, and
• help make decisions about blood transfusions.

When is it requested?
Haemoglobin measurement is part of the full blood count (FBC) (which is requested
for many different reasons) and before operations when a blood transfusion is
anticipated. The test is also repeated in patients who have ongoing bleeding problems.

What does the test result mean?

Normal values in an adult are approximately 120 to 180 grams per litre (12 to 18
g/dL) of blood but are influenced by the age, sex and ethnic origin in the person.
Above-normal haemoglobin levels may be the result of:

• dehydration,
• excess production of red blood cells in the bone marrow,
• severe lung disease, or
• several other conditions.

Below-normal haemoglobin levels may be the result of:

• iron deficiency
• inherited haemoglobin defects
• bone marrow failure
• cirrhosis of the liver (during which the liver becomes scarred),
 • bleeding,
• vitamin and mineral deficiencies,
• kidney disease,
• other chronic illnesses or
• cancers that affect the bone marrow.

Is there anything else I should know?

Haemoglobin decreases slightly during normal pregnancy.

Haemoglobin levels peak around 8 a.m. and are lowest around 8 p.m. each day.

Heavy smokers have higher haemoglobin levels than non-smokers.

Living in high altitudes increases haemoglobin values. This is your body's response to
the decreased oxygen available at these heights.

Haemoglobin levels are slightly lower in older men and women and in children.

1. Does exercise affect haemoglobin levels?

No, except that dehydration can temporarily increase haemoglobin levels.

2. How do you treat abnormally low haemoglobin levels?

Treatment depends upon the cause. Some types of anaemia are treated with iron, folic
acid, or vitamin B12 or B6 supplements.

3. Is anyone at greater risk of abnormal haemoglobin levels?

Women of childbearing age may have temporary decreases during menstrual periods
and pregnancy.

4. Are there warning signs for abnormally low haemoglobin

levels?
Some warning signs are fatigue, fainting, pallor (loss of normal skin colour), and
shortness of breath.

5. Can a healthy diet and good nutrition help keep optimal

haemoglobin levels?
A healthy diet containing vegetables and foods high in iron can be beneficial.

White Blood Cell Count

Why Get Tested?

If your doctor thinks that you might have an infection or allergy and to monitor
treatment

When to Get Tested?

As part of a full blood count (FBC), which may be used for a variety of reasons
Sample Required?
A blood sample taken from a vein in your arm or by a fingerprick or heelprick

What is being tested?

The white blood cell (WBC) count indicates the number of white blood cells in a
sample of blood. This count provides a clue to the presence of illness. White blood
cells are made in the bone marrow and protect the body against infection and aid in
the immune response. If an infection develops, white blood cells attack and destroy
the bacteria causing the infection.

How is it used?
Conditions or drugs that weaken the immune system, such as HIV infection or
chemotherapy, cause a decrease in white blood cells. The WBC count detects
dangerously low numbers of these cells.

The WBC count is used to suggest the presence of an infection, an allergy, or

leukaemia. It is also used to help monitor the body’s response to various treatments
and to monitor bone marrow function.

When is it requested?
A WBC count is normally ordered as part of the full blood count (FBC), which is
requested for a wide variety of reasons. A WBC count also may be used to monitor
recovery from illness. Counts that continue to rise or fall to abnormal levels indicate
that the condition is getting worse. Counts that return to normal indicate
improvement.

What does the test result mean?

An elevated number of white blood cells is called leukocytosis. This can result from
bacterial infections, inflammation, leukaemia, trauma, or stress. A WBC count of
11.0–17.0x109/L cells would be considered mild to moderate leukocytosis.

A decreased WBC count is called leukopenia. It can result from many different
situations, such as chemotherapy, radiation therapy, or diseases of the immune
system. A count of 3.0–5.0x109/L cells would be considered mild leukopenia.

Is there anything else I should know?

Eating, physical activity and stress can cause an increased WBC count.

Pregnancy in the final month and labour may be associated with increased WBC
levels.

If you have had your spleen removed, you may have a persistent mild to moderate
increased WBC count.

The WBC count tends to be lower in the morning and higher in the late afternoon.
WBC counts are age-related.

On average, normal newborns and infants have higher WBC counts than adults. It is
not uncommon for the elderly to fail to develop leukocytosis as a response to
infection.

There are many drugs that cause both increased and decreased WBC counts.

1. Are there different types of WBCs?

Yes. There are five main types: neutrophils, lymphocytes, monocytes, eosinophils,
and basophils.

2. How do you treat abnormal WBC levels?

Treatment depends upon the cause. Infections usually cause increased WBC counts
and may be treated with antibiotics. Some diseases cause decreased counts and may
be treated simply with bed rest. Leukaemias require chemotherapy and other
treatments.