Hgb (Hemoglobin) Test Results: What Could Cause Low Or High ...

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Key takeaways

A hemoglobin test measures the amount of hemoglobin in red blood cells, which is essential for transporting oxygen throughout the body and carbon dioxide back to the lungs.
Normal hemoglobin levels vary based on age, sex, and pregnancy status. Abnormal levels can indicate underlying health conditions like anemia or heart, lung, or kidney diseases.
Symptoms of low hemoglobin (anemia) include exhaustion and shortness of breath, while high hemoglobin can cause itchiness and dizziness. Both may require medical evaluation to diagnose the underlying cause.

Tubes in laboratory. — Sebastian Condrea /Getty Images

The hemoglobin (Hgb) test measures how much hemoglobin your red blood cells contain.

Hgb is a protein produced by your bone marrow that’s stored in red blood cells. It helps red blood cells transport oxygen from your lungs to your body through your arteries.

It also transports carbon dioxide (CO2) from around your body back to your lungs through your veins. Hgb is what makes red blood cells look red.

Abnormally high or low Hgb can cause symptoms like exhaustion, dizziness, or shortness of breath. Your doctor may suggest an Hgb test if you’re experiencing these symptoms. You may have an underlying condition that needs to be diagnosed.

Learn why you may need an Hgb test, what the typical ranges are for Hgb, and what can cause abnormal Hgb levels.

What is a healthy hemoglobin level by age?

Your age and gender both affect your Hgb levels. Typical healthy Hgb levels are as follows:

Category	Hgb level, in grams per deciliter (g/dL)
children	9.5-15.5
adult males assigned at birth (MAABs)	14–18
adult females assigned at birth (FAABs) who aren’t pregnant	12–16
adult FAABs who are pregnant	first trimester: 11.5–14second trimester: 10–15third trimester: 9.5–15

What level of Hgb is concerning?

For MAABs, Hgb levels below 14 g/dL are considered low. For FAABs, Hgb levels below 12 g/dL are considered low if they are not pregnant.

This threshold may change with certain conditions. It can also vary depending on the lab, so be sure to check your lab’s reference range. For children these levels may also vary due to age, especially in infants under 6 months old.

Why do I need the Hgb test?

The Hgb test uses a sample of your blood to determine hemoglobin levels.

To take a sample, your healthcare professional extracts blood from a vein by pricking your finger or inserting a needle with an attached tube into the crease of your arm. The sample is then stored in the tube to be analyzed later at a lab.

The needle may cause brief discomfort, but the insertion usually lasts less than a minute. If you’re sensitive to getting blood drawn or the sight of blood, have someone come with you and let your provider know.

The Hgb test may be ordered as part of a complete blood count (CBC) test. A CBC test also measures other important components of your blood, such as white blood cells and platelets. Abnormal levels of any of these cells can indicate underlying conditions or blood disorders.

Here are a few other reasons your doctor may order an Hgb test:

You have parents or other family members who have blood disorders, such as sickle cell anemia.
You have an infection.
You don’t have enough iron, vitamin B12, or folate in your diet.
You’ve lost a lot of blood after surgery or a traumatic injury.
You’re pregnant.
You have a medical condition that can affect your Hgb levels.

You don’t need to fast for the Hgb test specifically. You may need to fast — avoiding food or liquids with calories for about 12 hours — if your doctor plans to test the chemistry of your blood at the same time. You should drink plenty of water, however.

What are the symptoms of low hemoglobin?

Low Hgb is also known as anemia, which means you don’t have enough red blood cells in your body.

With anemia, a blood test will also show that you have a low red blood cell count and may have low hematocrit, the volume of red blood cells to other components in your blood.

Anemia can have many causes, so symptoms vary widely. Common anemia symptoms can include:

exhaustion
skin paleness
shortness of breath
abnormal or rapid heartbeat
pain in your chest
cold, swollen hands or feet
headache
trouble with physical activity

While exhaustion or fatigue isn’t a cause of low hemoglobin, it can be a symptom. A lower-than-normal amount of hemoglobin can result in decreased oxygen delivery to vital organs and muscles, resulting in fatigue or a lack of energy.

What does it mean when Hgb is low?

Low Hgb levels can be caused by any condition that affects your body’s ability to create red blood cells or conditions that lower red blood cells in your bloodstream.

Possible causes of low Hgb include:

Lack of iron in your diet: This makes it harder for your bone marrow to produce Hgb.
Lack of folate or vitamin B-12: This can lead to your body producing fewer red blood cells than are needed
Severe blood loss: This can happenafter surgery or a major injury.
Internal bleeding: This can be caused by stomach ulcers, stomach or colon cancer, or internal injuries.
Sickle cell anemia: This is a genetic condition that causes red blood cells to be abnormally sickle-shaped and able to carry less Hgb.
Hypothyroidism: This means that the thyroid gland doesn’t produce enough thyroid hormones.
Splenomegaly: This is an enlarged spleen caused by infection, liver conditions, or cancer.
Bone marrow conditions: This includes cancer leukemia, which prevents your bone marrow from producing enough red blood cells.
Chronic kidney disease: With this, your kidneys don’t function properly (resulting in a deficiency of erythropoietin, a hormone that stimulates red blood cell production in your bone marrow).

Other causes can include:

donating blood too often
conditions that cause chronic bleeding, such as gastric ulcers, colon polyps, colon cancer, uterine fibroids, or heavy menstrual bleeding
alcohol misuse
chronic health problems such as autoimmune diseases or cancer

What are the symptoms of high hemoglobin?

High Hgb is known as polycythemia. This means you have too many red blood cells.

Polycythemia vera is a cancer of the blood in which your bone marrow overproduces red blood cells.

With polycythemia, a blood test also shows that you have a high red blood cell count and high hematocrit.

Common symptoms of high Hgb levels include:

itchiness
headache
dizziness
getting easily bruised or bleeding
sweating more than usual
painful joint swelling
abnormal weight loss
a yellow tint to the eyes and skin (jaundice)
feeling exhausted
a purple or reddish tint to the skin

What does it mean if your Hgb is high?

High Hgb may result from your body needing to store more Hgb in red blood cells in response to low oxygen. This can happen due to factors in your environment, a condition that affects your heart or lung function, or certain lifestyle choices.

Possible causes of high Hgb levels include:

Living at high altitudes: At high locations like mountains, there isn’t as much oxygen in the air.
Smoking tobacco products: This includes cigarettes or cigars.
Chronic obstructive pulmonary disease (COPD): This is a condition that inflames the lungs and blocks air from getting into your lungs.
Heart or lung diseases: These affect your ability to breathe, your lungs’ ability to pass oxygen into your bloodstream, or your heart’s ability to pump normally.
Taking erythropoietin unnecessarily: This may happen to enhance high-level physical performance, for example.

Other causes include:

being severely dehydrated
heart failure
cancer of the liver or kidneys

Takeaway

Your doctor may recommend a Hgb test if you have symptoms of abnormal Hgb levels or if you’re pregnant.

The earlier you notice the symptoms of abnormal Hgb levels and have the cause diagnosed, the more likely you are to have successful treatment.

See your doctor if you’re experiencing any symptoms of high or low Hgb. If you have a family history of blood disorders or conditions that can affect the bone marrow or red blood cell production, you’ll likely need regular Hgb tests along with a CBC to monitor how these health problems may be affecting your blood cells.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Chen KK. (2021). Hematological normal ranges in pregnancy. Maternal medical health and disorders in pregnancy. The continuous textbook of women’s medicine series – obstetrics module. Volume 8.https://www.glowm.com/article/id/413403
Hemoglobin test. (n.d.).https://medlineplus.gov/lab-tests/hemoglobin-test/
Pillai AA, et al. (2023). Polycythemia.https://www.ncbi.nlm.nih.gov/books/NBK526081/
Turner J, et al. (2023). Anemia.https://www.ncbi.nlm.nih.gov/books/NBK499994/
Understanding blood counts. (n.d.).https://www.lls.org/treatment/lab-and-imaging-tests/understanding-blood-counts

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Medically reviewed by Kelsey Nank, PA-C — Written by Tim Jewell — Updated on March 29, 2024

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Key takeaways

What is a healthy hemoglobin level by age?

What level of Hgb is concerning?

Why do I need the Hgb test?

What are the symptoms of low hemoglobin?

What does it mean when Hgb is low?

What are the symptoms of high hemoglobin?

What does it mean if your Hgb is high?

Takeaway

How we reviewed this article:

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