Hemoglobin

Parasites, certain molds, even bacteria love to eat certain v- vitamins, minerals, and nutrients from your body.

The liver also stores a vitamin known as B6, and B6 helps make a substance called heme, which makes hemoglobin.

Hemoglobin is in your red blood cells.

It attaches to iron.

Iron then attaches to oxygen.

That's how you oxygenate your blood.

But hemoglobin also, remember, your liver's taking that B vitamin, making hemoglobin.

Hemoglobin also is used to make a molecule called porphyrin, and porphyrin is a molecule that helps with your eyes' light sensitivity.

Where we are seeing about this anemia or like less HP, less iron.

rather than Hb we are seeing the ferritin levels which is very important for women and i have seen like if people are having good Hb still they feel tired because randomly we think about the Hb only but there is a little more factor which we call ferritin levels your iron levels then if that only better then you can have like a good health or like a proper energy otherwise they are tired the whole day Many women say, I'm tired every time.

I'm tired in my menstrual phase.

I'm tired in my mental phase.

Worryingly, we are seeing this more and more in younger generations.

Now, one of the markers I want women to understand is particularly women over 50, is hemoglobin A1c, sometimes written on your, if you look at your blood work results, and you can go and get them after this episode, is written as HB, big H, little b, A1c.

Now, I just call it A1c to abbreviate.

A1c gives you an estimate of your average blood glucose exposure over approximately the previous two to three months.

This measures the size of your red blood cells, and it can point toward a B9 or B12 deficiency when it's sub optimally high.

Hemoglobin also plays a role here.

CO2, sometimes called bicarbonate, in your anion gap can reflect how well your body is actually utilizing the B vitamins and minerals that you're taking in, not just whether you have enough of them on paper.

That distinction really matters.

this is telling us the number of the red blood cells that we actually have circulating through our blood, through our body.

And then we've got our hemoglobin.

So that's the HB on your pathology report.

And this is how much oxygen carrying seats do we have? As we've already said, how many seats are actually on the bus? And as we've also already mentioned, the hemoglobin is the iron containing protein responsible for carrying the oxygen throughout the body.

And then another one, hematocrit, which is your HCT on your report.

That's what prompted the emergency department visit.

When I checked his labs, his HGB was in the four range, which is low enough to make me raise my eyebrows.

Normal is 13 to 15.

You'd start feeling weak or tired around 10 usually.

So if there is a loss of blood in the brain, may want to transfuse them.

If the HB is low, correct any anemia at that time, and ensure that our cardiac output is maintained.

Hence why we try and m- aim for a higher MAP as well, 'cause that will also help with our oxygen delivery.

That is five minutes.

Then it burns through the iron in transit.

Only when the cupboard is truly bare does your hemoglobin number start to fall.

Hemoglobin is really the last domino, which means if your hemoglobin is the only thing we're measuring, we are catching this at the end of the story, right? So let's talk about the test that you're probably not getting.

At your first prenatal visit, you get a CBC, a complete blood count.

That's standard pretty much everywhere.

Fifth, know the timeline so you know whether it's working.

Your bone marrow starts responding within about a week.

Hemoglobin typically climbs about a gram over two to four weeks, and that part happens pretty fast.

So we see hepcidin will decrease.

So the first trimester HB and ferritin predict later anemia risks as well.

We also see serum B12s falls across the pregnancy due to hemodilution, decreased binding of protein, and increased renal excretion, so higher GFR and direct fetal transfer.

There's a few different reasons why we're seeing a serum B12 is decreasing across a pregnancy.

At about nine weeks, that was kind of the average, 40% of them, 40.3 exactly, had depleted iron stores.

4.5 h- had an iron deficiency anemia, and they also had B12 and folate deficiencies as well.

Okay? So your trimester comparison studies here as well, we see progressive declines in HB, iron, ferritin, B12, and folate.

We also see vitamin D deficiency is pretty common in early in pregnancy, 82.8% below su-sufficiency in one Indonesian first trimester cohort, and then we're seeing 10% in a Swedish cohort, and we could also put that down to diet as well.

I'm deputy editor of the JEC Asia.

I'm pleased to introduce new accepted paper, Hemoglobin Decline after Oral Anticoagulation Initiation and Subsequent Cancer Detection in Patients with Atrial Fibrillation.

This study read by Dr. Boyoung Jung, Severance Cardiovascular Hospital, and Dr. Jong Hong Song, Cha Bundang Medical Center.

In clinical practice, decline in hemoglobin level without overt bleeding is not uncommon among patients with atrial fibrillation receiving oral anticoagulation.

In this study, they also evaluated six thousand seven hundred eighty-nine patients with AFib newly initiated oral anticoagulation and underwent serial health examination with a hemoglobin measurement within one year before and after OAC initiation.

This study based on Korean National Health Insurance Service database and the National Health Exam data.

A significant hemoglobin decline more than two gram deciliter was observed in approximately eight percent of patients.

This phenomenon was associated with a forty-two percent increase of new diagnosed cancer.