The red blood cells and hemoglobin inside them synthesize the bone marrow. The speed of their production may vary depending on the circumstances. For example, blood loss forces the bone marrow to work faster, but not indefinitely. The destruction of obsolete, defective, infected red blood cells is carried out by the liver and spleen.
The joint coordinated work of these three organs creates a relative constancy of the content of red bodies in the bloodstream. The results of measurements of the amount of hemoglobin and erythrocytes may not coincide, since in each individual red blood cell it may be less or more than normal. There are even completely devoid of his body (they look just like a colorless ring in the sample).
The basic hemoglobin molecule, if it is normally formed, always looks the same, and the life cycle of red blood cells is about 120 days. Their functions are reduced to a constant transfer:
- oxygen – from capillaries in the alveoli of the lungs to the cells;
- carbon dioxide – from cells back to the lungs.
Attach other gases or substances for the glandular protein in the erythrocyte nucleus is uncharacteristic. But this sometimes happens due to the intrinsic properties of certain substances and gases. This phenomenon does not lead to anything good, since hemoglobin that is “occupied” by something else does not participate in breathing. And if there are too many red blood cells carrying such hemoglobin in the blood, oxygen starvation sets in.
You need to be afraid of carbon monoxide, nitric acid, ammonia. Inhalation of large concentrations of these substances is life threatening, as it may result in death by suffocation. But violations of the binding of hemoglobin to oxygen also occur when red blood cells carry standard oxygen and carbon dioxide. For example, at high concentrations of carbon dioxide in the air.
Deficiency of functional hemoglobin in the blood is called anemia. In all these cases, there are constantly or temporarily non-functional forms of hemoglobin.
- Carboxyhemoglobin. Formed by inhalation of carbon monoxide. Instead of carbon dioxide, in this case, hemoglobin binds to its monoxide, the valence activity of which is much higher, and turns into carboxyhemoglobin. This phenomenon is reversible if blood circulation in the lungs is activated. It is associated with saving many lives after carbon monoxide poisoning, if help arrived in time. The critical norm for the presence of carboxyhemoglobin in the blood of non-smokers of adults is 2,3%, and smokers – no more than 8%.
- Methemoglobin This is what is called “peroxidized” hemoglobin, a trivalent iron molecule instead of the standard divalent one, which joins three oxygen atoms rather than two. The bond that forms in this case is strong (the hemoglobin molecule cannot give such oxygen). Therefore, the red blood cell loses the function of oxygen transfer. In the blood of healthy people, the percentage of methemoglobin does not exceed 1%.
- Sulfhemoglobin. A compound of hemoglobin with sulfur or its derivatives that rarely occurs without special external conditions and in the body of a living person. Sulfhemoglobin is more typical for certain stages of post-mortem decomposition – it gives the corpse tissues a characteristic greenish tint. Its formation in the blood of living people is usually associated with poisoning by sulfur vapor or certain drugs. This process is irreversible, and sulfhemoglobin is toxic for both the blood itself and the tissues in which it circulates, and for the liver. When its blood content exceeds 10% of the total hemoglobin mass, it already threatens a person’s life.
- Glycated hemoglobin. Hemoglobin creates this relationship no longer with gases or toxic sulfur, but with glucose, a product of the breakdown of carbohydrates. This reaction can occur both in a healthy body and in prediabetes or diabetes. Glycated hemoglobin continues to successfully fulfill its “responsibilities” in transporting gases, and analysis for it is important only for the early diagnosis of diabetes. The rate of glycated hemoglobin for a healthy person is 5,7% of the total volume of hemoglobin in the blood. The higher its indicator, the higher the risk of diabetes mellitus (such a diagnosis is made even with 6,5% glycated hemoglobin and more).
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A significant part of anemia is associated with an excess of red blood cells, which have not lost the ability to transport oxygen and carbon dioxide due to communication with other gases, but are formed with a defect. It is he who does not allow them to fulfill their main function. Such abnormalities are hereditary and common in countries where malaria infection is common.
Immunity to malaria is not produced, since its causative agent is not a bacterium or a virus, but a microorganism – a malarial plasmodium. But the carriers of erythrocyte mutations have immunity to it – precisely due to the inability of the pathogen to infect abnormal blood cells. This phenomenon is one of the striking examples of fixing a random, but useful mutation at the gene level.
The deviations that became hereditary “discharge”, which were originally caused by a protective reaction to frequent infections with malarial plasmodium, are called thalassemia, because they are most often found in the inhabitants of the Mediterranean. They are currently divided into alpha, beta, delta and S-thalassemia (sickle cell anemia).
The rate of hemoglobin in men and women
The following indicators are considered the norm of hemoglobin at different ages:
The cause of a higher hemoglobin level is:
- Dehydration, as a result of which blood coagulates. This condition is observed with intestinal infections with diarrhea and vomiting, diabetes mellitus, SARS with fever, extensive burns and other pathologies.
- Chronic disease of the respiratory system, in which respiratory failure develops, and the number of red blood cells increases compensatory to provide the body with oxygen.
- Chronic heart failure, which in childhood is often caused by congenital heart disease.
- Erythrocytosis. Such a disease, also called polycythemia, is characterized by activation of the formation of blood cells (mainly red) in the bone marrow.
- A kidney disease in which an excess of erythropoietin is produced.
Non-dangerous causes of increased hemoglobin levels are physical activity and mountain living. Also, a slight increase in this indicator is noted with a long stay in a warm and dry room. In adolescents, high hemoglobin can be caused by anabolics (if the teenager is involved in sports) or smoking.
The opinion of Dr. Komarovsky regarding increased hemoglobin is here:
, but with such changes in the blood, the child may experience lethargy, poor appetite, fatigue, drowsiness, increased blood pressure, and
headaches and other ailments.
Why is it dangerous
Due to the strong thickening of the blood, blood clots may form, which threatens to impair the functioning of internal organs, as well as the brain. Also, with high hemoglobin in children, the pathology of the spleen can develop, and excess iron can be deposited in the internal organs, which also disrupts their work. Especially dangerous is such deposition for the kidneys of a child.
How to reduce
First of all, it should be understood that high hemoglobin is only one of the symptoms of the disease, and the task of parents and doctors should be to find out which disease. In most babies, an increase in hemoglobin is caused by non-dangerous reasons, so a change in diet or humidification of the air helps them to reduce the rate.
The child should be given less iron-containing products, replacing them with fish, seafood, white chicken and legumes. If hemoglobin increased with an infectious disease or other pathology, the doctor will prescribe the appropriate treatment.
Why is falling
In newborns, a lack of iron is often triggered by anemia in a woman during pregnancy, because of which the child received less iron and was unable to accumulate its reserves in his blood.
In children older than 6 months, iron deficiency causes untimely administration of complementary foods. It is by this age that all the iron reserves that the baby accumulated during fetal development are running out. And if the mother continues to feed her baby only with breast or with a mixture, the baby gradually develops a lack of iron, which leads to anemia.
In school-age children and adolescents, iron deficiency is often caused by an unbalanced diet, for example, if the child adheres to a vegetarian diet. Passion for adolescent girls to diets for weight loss also threatens the development of iron deficiency anemia.
Among other causes of low hemoglobin note:
- Blood loss – acute (due to surgery or injury) or chronic (for example, frequent nosebleeds).
- Anemia caused by a lack of folic acid and vitamin B12.
- Hemolytic anemia in which red blood cells are destroyed.
- Other blood diseases.
- Diseases of the gastrointestinal tract.
- Infectious diseases.
- Taking some medications.
- Autoimmune pathologies.
- Malignant tumors.
We recommend that you watch the recording of the webinar for parents as part of the MD Class social project seminar. It discusses in detail the problems of the occurrence of anemia in children, its causes and consequences.
Assume anemia in a child by the appearance of:
- Decreased appetite.
- Weaknesses and breakdowns.
- Pale skin tone.
- Sleep disturbance.
- Dry skin and peeling.
- White spots and dashes on the nails.
- Eye circles.
- Irritability and moodiness.
- Increased heart rate.
- Elevated body temperature.
Why is it dangerous
In a child with anemia, the general condition worsens, his body becomes weakened, and his organs lack oxygen, which is especially bad for brain tissue. In addition, a lack of hemoglobin threatens the child with a decrease in immunity and frequent diseases. If such a problem is not resolved in time, there is a risk of delayed physical and intellectual development.
According to WHO recommendations, the hemoglobin boundary indicators, in which anemia is not diagnosed in a child, are:
Mild anemia is diagnosed with such indicators:
If a child under 5 years of age has hemoglobin ranging from 70 to 99 g / l, and a child older than 5 years of age ranges from 80 to 109 g / l, this indicates moderate anemia. Acute anemia is characterized by a drop in hemoglobin levels below 70 g / l in children under five years old and below 80 g / l in children older than 5 years.
Mandatory annual examination, which are children in medical facilities, begins with blood sampling for a general analysis. This applies to newborns, adolescents and youth. Such an analysis, by the way, must be carried out after a child’s illness, in order to find out if there are any complications.
Having received an answer on their hands, many mothers pay attention primarily to hemoglobin, since it is one of the most important indicators of a child’s health. He is involved in the formation of red blood cells. We will understand what it is and whether this indicator changes in children with age.
Hemoglobin is an iron-containing protein. Its function is very important: it binds oxygen molecules and transfers them to cells. Thanks to him, they live, are saturated and updated. It is because of it that the blood has a bright red color. The norm of hemoglobin differs in newborns, adolescents, young and age-old women and men.
Information on the level of this protein in the blood of a child allows you to make a picture of its development, explains the disturbances in behavior and health.
Which hemoglobin in children can be considered normal, and which alarm parents?
Children who have just been born have an overestimated rate. It ranges from 145 to 225 g / l. This is considered normal. In the process of development, the hemoglobin in the newborn decreases. Until the first month it will fall to 100–205 g / l.
Low hemoglobin in a child leads to hypoxia of all organs. This will be reported by such changes in the behavior and well-being of children:
- drowsiness, weakness, and lethargy;
- memory impairment;
- lack of appetite;
- intense hair loss and stratification of nails;
- weight loss;
- soreness (the child is often sick for a long time);
Hemoglobin level is important for determining the health status of adults. Let’s see what is considered the norm for each gender category:
- Hemoglobin in women is normal if it ranges from 120–160 g / l. Its changes within these indicators are associated with critical days, age-related changes, hormonal stress. If the indicator dropped below 110 g / l, then anemia develops.
- In pregnant women, normal hemoglobin is 110–150 g / l. This is due to an increase in the volume of blood that circulates, so this indicator may decrease. Women in position regularly pass hemoglobin analysis, because the development of the fetus depends on its level. If this indicator drops sharply, then hypoxia develops, which can lead to irreversible violations of the baby’s health.
- For men, hemoglobin in the range of 130–170 g / l is considered normal.
Be careful about the level of hemoglobin in the blood of children and adults. This is one of those indicators that indicate violations in the body.
This is especially true for children. If the child looks tired, pale, eats poorly, then pay attention to hemoglobin. It is easy to raise at home, changing the diet and rest.
The hemoglobin concentration standards in the patient’s blood take into account all its forms, including pathological and reticulocytes (red blood cell precursor cells with the same functions, but temporarily reduced effectiveness). This should be remembered when self-decoding blood tests, since the maximum permissible values for some of them, including carboxyhemoglobin, are considered separately. Individual forms of hemoglobin in a detailed blood test are indicated as follows:
- HBO2 – hemoglobin, which circulates in arterial blood and carries oxygen to tissues;
- HbH – hemoglobin, after it gives the oxygen brought with it to the cells;
- HbCO2 – iron-containing protein after carbonation, present in venous blood;
- HbCO — carboxyhemoglobin;
- Hba1c – glycated hemoglobin;
- HbMet – Methemoglobin.
The amount of iron-containing protein in the blood repeatedly changes throughout life. The most labile hemoglobin rates in children. For example, in newborns, there is a complete replacement of fetal hemoglobin (intended for supplying oxygen through the blood of the mother) to adults, suitable for spontaneous breathing.
If for some reason the child’s liver does not manage to utilize uterine erythrocytes, which die massively due to a more intensive supply of oxygen, he may develop newborn jaundice. It is useless to measure his hemoglobin content before the end of this process – fluctuations in this period are not a diagnostic sign of the disease and will pass by themselves over time.
- Hemoglobin is an important component of the blood and an indicator of the functioning of the body.
- Various factors can affect the change in the norm: the age of the child, his physiological and psychological state, the level of iron in the body, the presence of an infectious disease at the time of analysis.
- How much hemoglobin should a child have, which means an increased indicator and why does it decrease, why is its high or low level so dangerous?
|Age||Level, g / l||The average value, g / l|
|Newborns||135 – 140||165|
|Up to 1 month||100 – 200||139|
|1-2 months||100 – 180||112|
|2-6 months||105 – 140||126|
|6 months – 2 of the year||105 – 135||120|
|2 – 6 years||115 – 135||125|
|6 – 12 years||115 – 155||135|
|12-18 years old||120 – 160||145|
|12-18 years (m)||130 – 160||140|
The use of iron preparations
Why rises and falls
The concentration of hemoglobin (as well as the number of red blood cells in the blood) of individuals can be not only reduced, but also increased. And not all factors affecting its level are endogenous (internal), there are exogenous (external).
Residents of highlands around the world both have an order of magnitude higher than that of the inhabitants of the plains, as they breathe rarefied air and are constantly experiencing a lack of oxygen. Smokers, pilots, climbers and professional athletes engaged in aerobic sports, the concentration of red blood cells and hemoglobin in the blood will also be higher than their compatriots, only non-smokers and leading a sedentary lifestyle.
High hemoglobin can also be attributed to dehydration – a low water content in the bloodstream, which is why the concentration of blood cells “thickens”.
Among the most common internal factors that reduce the content of hemoglobin and red blood cells in the blood, science distinguishes:
- iron deficiency – the main component of heme, without which the synthesis of the entire red blood cell is impossible;
- blood cancer – the dominance of other bodies in the bloodstream, the production of which consumes the entire bone marrow resource;
- deficiency of vitamins – folic acid or cyanocobalamin, two B vitamins actively involved in hematopoiesis;
- bone marrow failure – or its death as a result of a malignant or radioactive lesion, the action of toxic substances;
- cirrhosis of the liver – which leads to bleeding from the veins of the esophagus and a deficiency of folic acid;
- hemolytic anemia – as a result of sepsis, the action of certain hemolytic poisons;
- hemorrhage – single and significant or small, but constant / regular bleeding.
With oncology, not associated with the degeneration of some blood cells or bone marrow, the stage of decay of the tumor center is inevitable, as a result of which bleeding opens. Secondary (or primary, when it comes to liver cancer) neoplasms in organs with intensive blood supply – the liver, kidneys, lungs, brain, spinal cord and bone marrow – also contribute.
The normal level of hemoglobin in the blood also depends on age. Indicators of iron-containing protein can form by adulthood and do not change in the future, but most often there is a tendency to increase its concentration, more pronounced in men. It is necessary to take into account fluctuations in its content in special periods:
- during pregnancy (including fluctuations in the trimesters);
- after childbirth;
- after heavy physical exertion;
- as a result of a strict diet or fasting;
- due to treatment with certain drugs.
A temporary decrease in hemoglobin in women can be observed after menstruation.
It is difficult to say which hemoglobin (high or low) is more common. But if it is elevated, the doctor will look for the cause of chronic oxygen starvation. With reduced hemoglobin, it will begin by detecting internal bleeding. Given the high prevalence of oncological diseases and the difficulties with their diagnosis, the primary suspicion (unless the patient has already been diagnosed with an anemia diagnosis – ulcer, hemorrhoids) will be in favor of tumors.
Healthy values based on gender and age
Moreover, the upper threshold of normal hemoglobin in men in all age groups is higher than the upper limits of the hemoglobin norm in women; more significant fluctuations are also allowed. For the weaker sex, the widest range of hemoglobin norm is during pregnancy. So, the lower threshold of normal values in pregnant women is at the level of teenage 112-115 g / l, and the upper reaches even 160 g / l in the first trimester. A detailed table of hemoglobin rates by age is as follows.
Table – Normal hemoglobin concentrations in men and women of different ages
|Age||Male g / l||Woman g / l|
|Up to 2 weeks||135 – 198|
|2 weeks – 1 month||107 – 170|
|1 month – 2 months||95 – 130|
|2 months – 4 months||103 – 141|
|4 months – six months||110 – 141|
|6 months – 9 months||115 – 140|
|9 months – 1 year||113 – 141|
|1 year – 6 years||110 – 140|
|6 – 9 years||115 – 145|
|9 – 12 years||120 – 150|
|12 – 15 years||120 – 160||115 – 150|
|15 – 18 years||117 – 165||117 – 153|
|18 – 45 years||135 – 173||117 – 155|
|45 – 60 years||130 – 172||117 – 160|
|60 years and older||125 – 175||117 – 160|
Deviation from the given age norm of hemoglobin in the blood by a plus or minus a couple of units is not a cause for concern. But it may indicate an increased risk of anemia, dehydration, oxygen starvation, diabetes mellitus (depending on which indicator is changed, and in which direction). Such cases require monitoring of further changes in blood counts.
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