Do you feel tired all the time? Are you pale and have a yellow complexion? Or does someone in your family have a hereditary blood disease? At times like these, your doctor may recommend that you have a special blood test. One such very important, special blood test that we are talking about today is called Hemoglobin Electrophoresis. Although the name may sound a bit complicated, what it does is very simple. Let's see what it is, why it is done, and what we can learn from it.
What is Hemoglobin Electrophoresis?
Simply put, Hemoglobin Electrophoresis is a special lab test that looks at the types of hemoglobin in your red blood cells, and how much of each type is in them.
Okay, now you're asking, "What is this hemoglobin?" Imagine that the red blood cells inside your body are like little delivery trucks. Then hemoglobin is the 'delivery man' sitting inside that truck, picking up packets of oxygen from the lungs and distributing them to every other cell in the body . Only when this 'delivery man' is working properly can we get enough oxygen to every part of our body.
But sometimes, due to genetic reasons, this protein called hemoglobin undergoes certain changes or defects. Then this 'delivery man' starts behaving a little differently. Due to this defective hemoglobin, the shape of the red blood cells may change, they may break down quickly, and the body may not get the right amount of oxygen. We do this Hemoglobin Electrophoresis test to find out exactly whether there are such different, defective types of hemoglobin.
What is the difference between this and a regular hemoglobin test?
This is something that confuses many people. If you look at an FBC (Full Blood Count) report, there is also a value called Hemoglobin (Hb).
- The general hemoglobin test (found in FBC): This only measures the total amount of hemoglobin in your blood. It's like, in our example, checking how many 'delivery men' you have in your body.
- Hemoglobin Electrophoresis Test: This is a much more in-depth test. It looks at the types of hemoglobin in your blood and the amounts of each type . It's like not only looking at how many 'delivery men' there are, but also looking at whether there are "good" ones, "slightly different" ones, and "defective" ones , and if so, how many.
This test is especially important for diagnosing inherited blood disorders such as sickle cell anemia and thalassemia.
Let's talk about the main types of hemoglobin.
There are several types of hemoglobin that this test mainly looks for. See the table below for a simple understanding of these.
| Hemoglobin type | To put it simply, what is this... |
|---|---|
| Hemoglobin A (HgbA) | This is the most common, "normal" type of hemoglobin in the blood of a healthy adult. It makes up more than 95% of the total hemoglobin in a healthy adult. |
| Hemoglobin F (HgbF) | This is called "fetal hemoglobin." As the name suggests, this is the main type of hemoglobin in fetuses and newborns. As the baby grows, the amount of HgbF decreases and the amount of HgbA increases. A very high level of this in an adult can be a symptom of certain medical conditions. |
| Hemoglobin S (HgbS) | This is the type of defective hemoglobin that causes sickle cell anemia . When this occurs, red blood cells, instead of their normal round shape, become sickle-shaped and can become trapped in the blood vessels. |
| Hemoglobin C (HgbC) | This is another type of defective hemoglobin. This can cause red blood cells to break down prematurely, leading to anemia (a lack of blood in the blood). |
How do you get blood drawn for this test? Is it something to be afraid of?
Not at all. This is just like a regular blood test. The method of taking the blood may vary slightly depending on age and need.
| Blood collection method | Description |
|---|---|
| Venous blood draw | This is the most common method used for adults and older children. A small needle is inserted into a vein in the crook of your elbow and a small amount of blood is drawn. You may feel a slight sting, like being bitten by an ant, but it only lasts for a few seconds. |
| Finger stick | This method is used for small children or when only a few drops of blood are needed. A few drops of blood are collected by pricking the tip of the finger with a small needle. |
| Heel stick | This is done for newborn babies . Within 48 hours of the baby's birth, a small needle is pricked on their heel and a few drops of blood are collected on a special card. This is part of the ``newborn screening`` series of tests that are done on almost every newborn baby in Sri Lanka. This can detect serious, but treatable conditions like Sickle Cell Anemia if detected early. Don't worry about hurting the baby, this can be done while the mother is still holding the baby. |
What happens to this blood sample in the lab?
When your blood sample goes to the lab, the technicians there follow a special procedure.
Imagine that each type of hemoglobin is like people who weigh different amounts and can run at different speeds.
1. First, the hemoglobin is separated from your red blood cells.
2. This hemoglobin mixture is then placed on a special gel or paper strip.
3. Now an electric current is given to this.
4. When electricity is applied, the different types of hemoglobin, depending on their weight and electrical charge, move forward through this gel at different speeds . Just like in a running race, the faster ones end up ahead and the slower ones end up behind.
5. After a while, these hemoglobin types appear as separate colored bands .
6. Finally, the lab staff compares your band pattern to the normal pattern of a healthy person. This allows them to tell exactly what types of hemoglobin are in your blood, and whether the amount is normal or abnormal.
What is the meaning of my report?
You will receive a report within a few days of the test. It will list the percentages and values for each hemoglobin type. For example, if it shows the presence of HgbS or HgbC, it could be a sign of Sickle Cell Disease or a similar condition. If the HgbF level is high in an adult, it could be a sign of a condition like Thalassemia.
But remember one very important thing. Do not draw your own conclusions based on the numbers and letters in this report, or make a diagnosis based on the internet. It can cause unnecessary fear in your mind.
Only your doctor can explain the exact meaning of this report, in relation to your symptoms and other tests. So as soon as you receive the report, meet with the doctor who ordered it and talk about it.
It's normal for parents to feel scared and worried if your baby's report shows something unusual. But don't worry. It means you have an opportunity to start the treatment and care your baby needs early. Your doctor will give you all the advice you need.
Take-Home Message
- Hemoglobin Electrophoresis is a special test that not only measures the amount of hemoglobin in the blood, but also its types .
- This is a great help in diagnosing hereditary blood diseases like sickle cell anemia and thalassemia.
- Having your blood drawn for this test is very simple and safe. There is no reason to be afraid.
- Most importantly: Don't try to understand the report yourself. Always show it to your doctor and ask him for details.
- An abnormal report is not the end of the world. It is just the first step on the journey to an accurate diagnosis and the necessary treatment.
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