Have you had your hemoglobin checked? Let's talk about the Hemoglobin Electrophoresis test!

Hello! Today we are going to talk about a blood test that may be a little new to you, but it is very important in diagnosing some diseases. This is a test called Hemoglobin Electrophoresis . Maybe your doctor has asked you to do this test, or you have heard this name somewhere. Even though the name is a little long, don't be afraid! It is very simple. We will talk about it all clearly in this article today.

What is Hemoglobin Electrophoresis?

Simply put, this is a method of analyzing a protein called hemoglobin inside our red blood cells. You may recall that hemoglobin is an important protein that carries oxygen throughout our bodies and gives red blood cells their red color. The proper production of this hemoglobin is controlled by our genes.

However, sometimes, certain changes, or mutations, can occur in the genes that control hemoglobin. When this happens, instead of healthy red blood cells, damaged, dysfunctional red blood cells begin to form. These damaged cells break down quickly, which can lead to conditions like anemia , or serious blood-related diseases like sickle cell anemia and thalassemias .

So, this hemoglobin electrophoresis test allows doctors to find out if such conditions exist. Also, this test is one of the few tests performed on newborns. It helps in early detection of rare but potentially serious diseases like sickle cell anemia.

What is the difference between a hemoglobin test and hemoglobin electrophoresis?

This is also where many people get confused. A normal hemoglobin test measures the amount of hemoglobin in your red blood cells. That is, it checks whether your hemoglobin is low, high, or normal.

However, the hemoglobin electrophoresis test does something much deeper than that. It analyzes the different types of hemoglobin in your red blood cells, and how much of each type is present. Do you understand the difference? One looks at the amount, the other looks at the types and amounts of those types.

So, what are these types of hemoglobin?

Doctors usually focus on four main types of hemoglobin in this test. Let's learn a little about them.

• Hemoglobin A1 and A2 (HgbA1 and HgbA2): This type of hemoglobin, called hemoglobin A1, is the most abundant type in the red blood cells of a healthy adult. Hemoglobin A2 is a small type, making up about 2% to 3% of the total hemoglobin. These are also called "adult hemoglobins."

• Hemoglobin F (HgbF): This is called "fetal hemoglobin." As the name suggests, this type of HgbF is found in the red blood cells of unborn babies, newborns, and children up to about 3 years of age. However, having a much higher than normal level of HgbF in the blood of an adult may be an abnormality.

• Hemoglobin S (HgbS): This type of hemoglobin is a major feature of sickle cell anemia . Sickle cell anemia is a serious condition that belongs to the group of sickle cell diseases . This condition is especially common in people of African descent . HgbS causes red blood cells to change into a sickle shape, which can block blood vessels.

• Hemoglobin C (HgbC): This type of hemoglobin is associated with a condition called hemolytic anemia . This is a condition in which red blood cells are destroyed more quickly than normal cells or their lifespan is shortened. Like sickle cell anemia, this HgbC condition is also more common in people of African descent .

Now it's clear to you that there are several types of hemoglobin, and each type has specific functions and effects.

How is this test done? How is the blood sample taken?

To do this test, we only need a blood sample. Doctors, there are several ways to take this blood sample. Let's see what they are.

1. Venous blood draw

This is the usual method used to collect blood from adults and older children. You may have given blood this way.

• First, a nurse or doctor will clean the area where your vein is located on your arm with alcohol.
• Then, they put a tourniquet on your arm and tighten it, and ask you to squeeze your arm. This will make the veins easier to see and the blood easier to draw.
• Next, the nurse inserts a needle into the vein. At this point, you may feel a little pain, like being bitten by an ant. But it only lasts a few seconds.
• Collect the required amount of blood in a small vial and send it to the lab for testing.
• After the blood is drawn, a small plaster is applied to the area where the needle was inserted. The area may be slightly bruised and may even turn blue for a few days. This is normal, don't worry.

2. Finger stick

This method is often used to take a blood sample from young children.

• This involves pricking the child's fingertip with a small instrument and taking a few drops of blood.
• The blood sample is placed on a specially designed test strip or in a small bottle.
• Sometimes, there are devices that can collect blood and deposit it at the same time. This is a very quick and easy method.

3. Heel stick

This is done as part of the newborn health screening. This test is usually done within 48 hours of the baby's birth.

• In this, a small needle is inserted into the underside of the baby's heel and a few drops of blood are obtained.
• At this time, either the mother or the father can hold the baby. Then the baby will also feel comforted.
• The blood sample is collected and sent to the lab after being smeared on a strip of paper.
• These tests are used to screen newborns for signs of rare but treatable conditions like sickle cell anemia, which means they have abnormal hemoglobin variants.

How will this blood sample be analyzed in the lab?

Okay, now we've taken the blood sample. What happens next? In the lab, these hemoglobin types are separated and identified in a very interesting way. That's called using electrical charges . The main types of hemoglobin have different electrical charges.

Here's how this test usually works:

• First, the red blood cells are separated from the blood sample and dissolved. This dissolved red blood cell sample is placed on a special strip, such as a cellulose strip .
• Then, the strip containing the sample is placed in a machine called an electrophoresis chamber . This machine passes an electric current through the sample.
• In response to the electric current, hemoglobin types with different electrical charges separate from each other and move along the strip at different speeds.
• Eventually, these separated hemoglobin types appear as different colored bands on the strip.
• Next, medical technicians compare these test results with the results of a normal hemoglobin sample from a healthy person.
• If the level of a particular type of hemoglobin is much higher or much lower than normal, it can be a sign of a blood disorder. For example, if your hemoglobin S (HgbS) type looks different from the HgbS of a normal person, it could be a sign that you have sickle cell anemia.

Think of it this way, just like when you throw pebbles of different weights into a stream of water, the pebbles travel different distances depending on their weight. Here, electricity acts like that "stream of water."

What is the difference between isoelectric focusing (IEF) and electrophoresis?

Isoelectric focusing (IEF) is another technique used to identify abnormal hemoglobin types. Both IEF and electrophoresis use electric currents to separate hemoglobin types. However, there are some technical differences between the two methods. Sometimes, both methods can be used to more accurately identify hemoglobin types.

How long does it take for the report to arrive?

The test may take about an hour to complete at the lab. However, it may take a few days for your doctor to receive the results, review them, and explain them to you. So don't expect the report right away after the test. The doctor will tell you the day you need to come to collect the report.

What does my report mean? How do I understand it?

This is the most important thing. Your hemoglobin electrophoresis report will list certain ranges for each hemoglobin type. For example, if your hemoglobin F (HgbF) level is much higher than normal, it could be a sign of some type of thalassemia.

But, you need to remember this well:

Don't make a decision about any disease based on the numbers in the report. That's only one part of the diagnosis. The best person to understand exactly what's in your report and how it affects your health is your doctor . He or she will consider everything from your symptoms, other test results, and your medical history to make an accurate diagnosis.

If there are abnormalities in my report, should I call the doctor?

Yes, absolutely. If you had this hemoglobin electrophoresis test because of any symptoms (e.g., frequent fatigue, paleness, shortness of breath), you should see your doctor immediately to discuss the results of the report.

A hemoglobin electrophoresis test gives us a snapshot of the types of hemoglobin in your blood at that moment. Hemoglobin levels are a way to assess this important protein in our red blood cells. An abnormal change in the level of a particular type of hemoglobin can be a sign that you may have a medical condition.

If your or your child's test results suggest a serious illness, it's easy to get overwhelmed and scared just by looking at the picture. Especially if it's about the health of your young child or newborn, it's normal to feel overwhelmed. But try to look at the big picture instead of panicking. The best person to help you with that is your doctor. He or she can explain how this "picture" fits into your overall health and what you need to do next.

Take-Home Message

I hope you now have a good understanding of the hemoglobin electrophoresis test we discussed today. Here are a few things to keep in mind:

• Hemoglobin electrophoresis is a special blood test that identifies the different types of hemoglobin in the blood and their amounts.
• This helps diagnose blood-related diseases like sickle cell anemia and thalassemia .
• This is also done as part of newborn health screenings .
• Hemoglobin types are separated by taking a blood sample and using an electric current .
• Always talk to your doctor before trying to understand the results of the report on your own.
• If the results are abnormal, don't panic and follow your doctor's instructions. Early detection is the first step to successful treatment.

We hope you find this information useful. Stay healthy!

` Hemoglobin Electrophoresis, Hemoglobin, Red Blood Cells, Anemia, Sickle Cell Anemia, Thalassemia