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Evidence-Based & Clinical Guidance
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Blood & Hemoglobin

Evidence-based clinical and organizational questions.

Direct Answer:

Low hemoglobin is caused by iron deficiency, Vitamin B12/folate deficiency, chronic blood loss, or kidney disease. Diagnosed via Complete Blood Count (CBC), Serum Ferritin, and Peripheral Smear.

Hemoglobin is the iron-rich oxygen-carrying protein inside red blood cells. Normal reference ranges vary by sex and pregnancy status (Men: 13.5-17.5 g/dL, Women: 12.0-15.5 g/dL, Pregnant Women: >11.0 g/dL).

Diagnostic Blood Work

  • CBC: Evaluates Hb, Hematocrit, and MCV (size of RBCs).
  • Serum Ferritin: Gold standard measure for stored tissue iron stores (<30 ng/mL indicates iron depletion).
  • TIBC & TSAT %: Measures iron-binding capacity and transferrin saturation.
When to Seek Medical Care:

Seek urgent care if low hemoglobin is accompanied by extreme dizziness, fainting spells, rapid heart rate, or chest pain.

Direct Answer:

Mentzer Index is calculated as MCV divided by total RBC count. A ratio below 13 indicates high probability of Thalassemia Trait, whereas a ratio above 13 indicates Iron Deficiency Anemia.

In microcytic anemias (MCV < 80 fL), differentiating Thalassemia trait from nutritional iron deficiency is crucial to avoid inappropriate iron therapy.

Mentzer Index = MCV (fL) / RBC Count (million/µL)

Thalassemia trait features high RBC count relative to MCV, yielding a low ratio (<13). Confirmation requires Hemoglobin Electrophoresis / HPLC.

When to Seek Medical Care:

Consult a hematologist or physician for HPLC testing if your Mentzer Index is under 13.

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