Low hemoglobin is most often caused by nutrient deficiencies, such as low iron or vitamin B12, or by inflammation related to chronic disease. However, it can also indicate blood loss, kidney problems, or red blood cell destruction in some cases.
Hemoglobin is a protein found in red blood cells that transports oxygen throughout the body. When hemoglobin levels are low, it usually indicates anemia, which may cause symptoms like fatigue, rapid heartbeat, or pale skin.
If a blood test shows low hemoglobin levels, it’s recommended to see a primary care provider or a hematologist. Identifying the underlying cause is essential to determine the most appropriate treatment.
Possible causes
The main causes of low hemoglobin include:
1. Nutrient deficiencies
Nutrients such as iron, folate, and vitamin B12 are essential for producing hemoglobin and red blood cells. A deficiency in any of these nutrients can lead to low hemoglobin levels.
In this case, low hemoglobin may indicate different types of anemia depending on which nutrient is lacking, such as iron deficiency anemia (caused by low iron) or megaloblastic anemia (associated with low vitamin B12 or folate).
What to do: if you suspect a nutrient deficiency, it’s important to see your primary care doctor or a hematologist. Treatment usually involves supplements to replace the missing nutrient, with hemoglobin levels typically returning to normal over time.
To prevent nutrient deficiencies, it’s also important to follow a healthy and balanced diet.
Also recommended: Foods for Anemia: What to Eat & What to Avoid tuasaude.com/en/foods-for-anemia2. Inflammation
Severe or chronic inflammation, caused by infections or autoimmune diseases, can lead to low hemoglobin by interfering with iron absorption and metabolism and by reducing red blood cell circulation.
In addition to anemia symptoms, inflammation can also cause fever, swelling, or joint pain, depending on the underlying cause.
What to do: if you suspect an inflammatory condition, it’s best to consult a primary care provider first. Treatment should target the cause of the inflammation. Hemoglobin levels generally return to normal as inflammation improves.
3. Blood loss
Low hemoglobin may also result from blood loss caused by intestinal parasites, peptic ulcers, heavy menstrual bleeding, or, in more severe cases, hemorrhage or colon cancer.
Along with anemia symptoms, other signs may include heartburn, blood in the stool, weight loss, or reduced appetite, depending on the cause.
What to do: if you suspect bleeding, it is important to see your primary care provider in order to identify the cause and receive the appropriate treatment.
In cases of significant blood loss, a doctor may recommend IV fluids or blood transfusions. Therefore, in cases of heavy bleeding, it’s important to seek emergency medical care.
4. Hypothyroidism
A lack of thyroid hormones, known as hypothyroidism, can sometimes lead to low hemoglobin because these hormones help stimulate red blood cell production in the bone marrow.
Other common symptoms of hypothyroidism include constipation, weight gain, cold intolerance, and hair loss when thyroid hormone levels are low.
What to do: if hypothyroidism is suspected, consult an endocrinologist or your primary care provider. Treatment usually involves thyroid hormone replacement medication, which can help normalize hemoglobin levels.
5. Chronic kidney disease
Low hemoglobin caused by chronic kidney disease tends to develop gradually as kidney function declines. This is linked to low levels of erythropoietin, a hormone produced by the kidneys that stimulates red blood cell production.
Depending on its severity, chronic kidney disease may cause nausea, vomiting, fatigue, cramps, itching, or swelling, in addition to anemia symptoms. In the early stages of the disease, symptoms may be mild or absent.
What to do: if chronic kidney disease is suspected, it’s important to see a nephrologist (kidney specialist). In this case, treatment for low hemoglobin usually involves erythropoietin and iron supplementation to stimulate red blood cell production.
6. Red blood cell destruction
Low hemoglobin can also occur due to red blood cell destruction, which is common in conditions such as sickle cell anemia, thalassemia, or spherocytosis.
Low hemoglobin caused by these conditions results in a type of anemia called hemolytic anemia, which can also cause yellowing of the skin and eyes or dark urine, along with the usual anemia symptoms.
What to do: if hemolytic anemia is suspected, it’s important to see a hematologist. Treatment depends on the underlying cause and may include corticosteroid medications, blood transfusions, or, in some cases, surgery.