Hemoglobin

What is Hemoglobin?

Hemoglobin is the iron-containing protein in red blood cells that carries oxygen from the lungs to the rest of the body.

Hemoglobin binds oxygen in the lungs and releases it to tissues throughout the body, making it central to energy production and overall oxygen delivery. It's one of the primary values used to diagnose anemia (too little hemoglobin) or polycythemia (too much). Levels are affected by iron and vitamin status, hydration, altitude, and underlying disease, so a single reading is best interpreted alongside other CBC values like hematocrit and RBC count.

Tests often checked alongside this

• Ferritin — reflects iron stores and helps confirm iron deficiency as a cause of low hemoglobin
• Iron and TIBC (Total Iron Binding Capacity) — assess iron availability and transport
• Vitamin B12 and Folate — deficiencies cause macrocytic anemia with low hemoglobin
• Reticulocyte Count — shows whether bone marrow is responding appropriately to anemia

How this can show up in how you look and feel

• Low levels are sometimes associated with fatigue, weakness, or pale skin
• Low levels are sometimes associated with shortness of breath or dizziness
• High levels are sometimes associated with headaches or a flushed complexion
• Very high levels are occasionally associated with itching, especially after a warm shower

What can affect this marker

• Iron, vitamin B12, and folate status — deficiencies lower hemoglobin production
• Altitude — living at higher elevations raises hemoglobin as the body adapts to lower oxygen
• Hydration status — dehydration concentrates the blood and can raise readings; overhydration can dilute and lower them
• Smoking — chronic carbon monoxide exposure can raise hemoglobin ("smoker's polycythemia")

What to track over time

• Whether hemoglobin trends downward over successive tests (may signal developing anemia)
• Sudden drops, which can indicate bleeding
• Whether hemoglobin rises alongside hematocrit and RBC together (concentration effect vs. true increase)
• Changes around major life events — pregnancy, altitude changes, starting or stopping smoking

What to ask your doctor

• Is my hemoglobin trending in a direction that concerns you?
• Could this level reflect dehydration rather than a true blood change?
• Should we check iron, ferritin, B12, or folate to find a cause?
• Does my hemoglobin level fit with how I've been feeling lately?

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