Low hemoglobin is not always a sign of disease. A slightly low hemoglobin count is normal for some people and is common during pregnancy. The low count may simply be due to heavy menstrual bleeding, or frequent blood donation. However, there are several diseases and conditions associated with low hemoglobin, and any concerns should be discussed with a doctor. Causes can be broken down into two categories: problems producing red blood cells, and problems with losing red blood cells.

Normal Low Hemoglobin

Low hemoglobin is not always cause for concern. Sometimes, normal levels of hemoglobin are just a little lower than the average. Having a baseline of one’s unique levels is always a good idea so that a doctor can note any fluctuations. Another common cause of low hemoglobin is pregnancy, which can cause temporary drops in levels. Though normal, an OG/GYN will monitor these changes.

Chronic Inflammation

Many chronic illnesses cause inflammation, which can contribute to low levels of hemoglobin. Kidney disease, hypothyroidism, cirrhosis of the liver, and certain cancers seem to interfere with the making of red blood cells. Treatment is generally available for these causes of inflammation.

Vitamin B12 Deficiency

One of the common causes of low hemoglobin is a deficiency in vitamin B12 and folate. Both vitamins are essential to the formulation of red blood cells. Simple changes in diet can be made to increase vitamin B12 intake. Certain foods and drinks such as coffee, dairy, and foods with high levels of phytic acid make it difficult for the body to absorb iron. Limiting those factors can increase iron absorption and stabilze hemoglobin levels.

Iron Deficiency

Extreme fatigue, shortness of breath, weakness, brittle nails, and unusual cravings (ice, dirt, starch, etc.) are signs of low hemoglobin levels caused by an iron deficiency. The most common is a diet lacking in iron. The addition of iron-rich foods such as beef, eggs, leafy green vegetables, brown rice, and peanut butter can have a profound effect on hemoglobin levels. Adding foods rich in vitamin C will enhance the absorption of iron.

Chronic Bleeding

Chronic bleeding can refer to anything from heavy menstrual bleeding to internal bleeding. Bleeding in the stomach, small intestine, and large bowel are especially prone to causing low hemoglobin levels. A lesser-known cause of chronic bleeding is excessive blood draws. This typically encompasses individuals receiving multiple blood draws for a medical reason but can also be due to blood donation. Chronic internal bleeding alone is dangerous, but the combination of that bleeding and low hemoglobin levels is even more serious.

Sickle Cell Anemia

Sickle cell anemia causes the body to destroy red blood cells faster than it can make them. Red blood cells typically live for 120 days, but the sickle cells die in an exponentially shorter time, causing the shortage. A defective form of hemoglobin is the cause of this disease, and while there are few treatments for a complete cure, there are many options for treating the symptons.

Aplastic Anemia

Aplastic anemia is caused by damage to bone marrow. This damage causes a slowing or shut down of red blood cell production. Stem cells in the bone marrow produce blood cells, and when that production slows, a shortage occurs. Treatment for aplastic anemia include medications, blood transfusions, and stem cell transplants.

Blood and Bone Marrow Disorders

Serious blood disorders, such as some cancers, can lead to low hemoglobin levels. These disorders leave bone marrow unable to produce red blood cells fast enough, leading to a severe shortage. In addition to the conditions and diseases themselves, the treatment of those diseases often causes low levels, as well. Chemotherapy and radiation are two such treatments.

Erythropoietin Levels

Low levels of erythropoietin is another issue that can cause anemia and low levels of hemoglobin. Erythropoietin is produced by the kidneys, and people with kidney disease often have reduced levels of this hormone. Treatment of the disease will often alleviate the low hemoglobin symptoms.

Treatments For Low Levels of Hemoglobin

Treatments range from waiting for a pregnancy to conclude, to bone marrow transplants. While most causes of low hemoglobin are not serious, it is still important to speak with a doctor before making a self-diagnosis or beginning a course of treatment. Simple changes in diet and the addition of exercise can eliminate the most common causes of anemia from low levels of hemoglobin.