We must maintain normal hemoglobin levels. Here’s why.
We are usually concerned about low levels of this proteinin the blood, as this causes anemia, a blood disorder that makes physical activity difficult, among other things. Anemias mostly affect women, due to their greater need for iron and low natural levels of hemoglobin.
In this article, we explain how high hemoglobin levelscan also pose a health risk.
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Why does high hemoglobin appear?
Normal hemoglobin levels in the blood of a healthy, adult person are between 13 and 16.5 g/dL in men, while adult women have levels between 12 and 16 g/dL, which decrease further during pregnancy. Having a lower level can cause anemia, but having a higher than normal level does not benefit us either.
Hemoglobin levelsare used to indirectly measure the levels of red blood cells (also known as hematocrit) in patients. Too low levels of red blood cells cause anemia, while too high counts of these cells cause a disorder known as polycythemia, or erythrocytosis.
Polycythemia is a disorder that can occur due to diseases of the bone marrow, which is known as primary polycythemia, as well as due to the body’s adaptation to a chronic lack of oxygen, such as that experienced by smokers or people suffering from the so-called “mountain sickness”, typical of people who travel to a very high geographical area.
Other examples of causes of high hemoglobin levels could be:
- Congenital heart disease
- Chronic respiratory diseases
- Dehydration
- Some types of cancer
- Stress
- Use of drugs such as testosterone or EPO
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Symptoms and diseases associated with high hemoglobin levels
High erythrocyte counts, as well as high levels of hemoglobin in the blood, can cause a variety of symptoms, ranging from skin disorders and discoloration, such as jaundice or itching , to fatigue, increased bleeding or leakage. unusual weight.
Among the dangers that high levels of hemoglobin hide, we would find that it can cause serious problems at the cardiovascular level, such as a greater ease of suffering cerebral and renal microinfarcts. This is due to the higher density of the blood, which facilitates the formation of clots capable of clogging the veins and arteries.
Primary polycythemia is a bone marrow disorder in which the production of erythrocytes is increased to much higher levels than usual, which raises hemoglobin levels in the blood. This disease is useful in illustrating some of the risks associated with high hematocrit. In addition to the increased chance of blood clots, people with primary polycythemia tend to be hypertensive and have deformed spleens.
There is a possibility of having certain types of polycythemia that are not caused by abnormal bone marrow function. We could distinguish between different types of secondary polycythemias, depending on the underlying cause of the increased hematocrit:
1. Altitude
As we move away from sea level, the atmospheric pressure decreases and with it, the levels of oxygen availability. This lack of oxygen causes certain changes in our metabolism, which tries to compensate for the low concentration of oxygen in the air by increasing the production of red blood cells.
This would be the so-called “altitude sickness”, a disorder that occurs in atmospheric conditions above 2,000 meters. It is even possible to die of hypoxia caused by altitude if we exceed 8,000 meters.
2. Hypoxia associated with another disease
As we have previously mentioned, the lack of oxygen (hypoxia) generated by respiratory diseases such as COPD, or also cardiovascular diseases, causes an increase in hematocrit. In these cases, high hemoglobin is not usually the main symptom , but it must be taken into account during treatment.
3. Genetic causes
There are certain heritable genetic mutations that cause a high hematocrit . These mutations cause, through different mechanisms, an increase in erythropoietin, also known as EPO, which causes an increase in the production of red blood cells and with it the rise in hemoglobin.
4. Hormonal causes, higher testosterone levels
People with higher levels of testosterone, either naturally or through doping, tend to maintain higher than normal blood hemoglobin levels. This also favors the bodybuilding and respiratory capacity of our body.
5. Neoplasms
There are certain tumors, especially those that affect the bone marrow, that can deregulate the normal production of erythrocytes. High hemoglobin could be, in some cases, a tumor indicator.
6. Smoking
Tobacco smoking causes slow degeneration of the respiratory and circulatory system, especially the peripheral one. But in addition, the constant exposure to carbon monoxide, which is produced in the combustion of tobacco, also affects our red blood cells .
Red blood cells bind carbon monoxide with a higher affinity than oxygen, so when they meet one of these molecules, they will hardly let it go. This means that they do not have “so much space” to transport oxygen, since carbon monoxide occupies the transport site in hemoglobin. This situation causes hypoxia, which in turn increases hematocrit levels to compensate.
Treatment
If we have high hemoglobin because of a specific disorder, such as a neoplasm, smoking, or exposure to drugs, treating the underlying cause will bring hemoglobin levels back to normal. This is unfortunately not the case for those with primary erythrocytosis.
In cases where the underlying cause cannot be treated, an effective way to relieve symptoms isbleeding, also known as phlebotomy. This surgical process has a bad reputation due to its indiscriminate use during the middle ages, but it is effective in reducing the hematocrit of these patients.
References
- McMULLIN, M. F. (2008), The classification and diagnosis of erythrocytosis. International Journal of Laboratory Hematology, 30: 447-459. doi:10.1111/j.1751-553X.2008.01102.x
- Pillai AA, Babiker HM. Polycythemia. (2019). In: StatPearls [Internet] Treasure Island (FL): StatPearls Publishing; Available in: https://www.ncbi.nlm.nih.gov/books/NBK526081/.
To the classic question “what do you do?” I always answer “basically I am a psychologist”. In fact, my academic training has revolved around the psychology of development, education and community, a field of study influenced my volunteer activities, as well as my first work experiences in personal services.
