Low Hemoglobin Levels Are Dangerous

Why Low Hemoglobin Levels Are Dangerous

Hemoglobin is an extremely important component of blood, responsible for transporting oxygen from the lungs to the body’s tissues. Its deficiency can reduce the efficiency of oxygen delivery throughout the body, leading to many negative consequences. When I examine elderly people and suspect anemia, I very often hear from relatives: «She has had low hemoglobin for a long time.» That is, this condition is considered almost normal and does not bother the patient’s family at all. I, as a geriatrician, do not think so at all. Let’s discuss this in more detail.

One of the main manifestations of low hemoglobin is anemia, which is characterized by weakness, fatigue, pale skin, and other symptoms. In addition, low red blood cell counts can affect heart function and the body’s ability to fight infections.

What are the possible causes of low hemoglobin levels?

There are several possible causes that can lead to a decrease in hemoglobin levels. One of them is oncological diseases, which can reduce the production of red blood cells or lead to increased destruction of erythrocytes. Moreover, the oncological process in the body can cause intoxication in various ways:

• Intoxication of the body by a developing tumor, the so‑called cancer intoxication.

• Suppression of hematopoiesis (blood formation) in the body — a large group of blood cancers.

• Bleeding or disintegrating tumors cause chronic blood loss.

Therefore, when I see a patient with pale skin, I always first think about a possible oncological process.

Other possible causes of low hemoglobin include:

• Deficiency of total protein in the blood serum. Let us remember that hemoglobin consists of two parts: «heme» (iron) and «globin» (protein). So protein is an important element for hemoglobin synthesis.

• Chronic blood loss, for example, from ulcerative lesions of the stomach or intestines.

• Various blood diseases, such as aplastic anemia or hemolytic anemia.

• Chronic intoxication of the body, for example, in tuberculosis. Another example is a long‑standing purulent focus (abscess or phlegmon), which due to reduced immunity may show no symptoms — no fever or pain.

• A long‑standing wound, such as an extensive burn or bedsore. In this case, a vicious circle arises: the wound itself causes a drop in hemoglobin, and against the background of anemia neither the bedsore nor the edema heals.

• Intoxication with chemicals, such as heavy metals or pesticides.

• Sepsis.

A decrease in hemoglobin levels can lead to various problems: anemia, impaired oxygen exchange in the body, weakness, pallor, dizziness, palpitations, and in severe cases even serious complications — cardiac disorders, respiratory problems, and general deterioration of health. Therefore, it is important to identify and treat the causes of low hemoglobin in a timely manner to prevent possible complications and improve the patient’s overall condition.

Why is anemia dangerous in old age?

In people over 65, anemia can be a symptom of other diseases, such as cancer, chronic kidney disease, heart disease, bowel disease, or bone marrow disorders. Therefore, a geriatrician should first consider whether anemia is a manifestation of an oncological process in the body.

The consequences of anemia in old age can be more dangerous because the body no longer copes so well with cell regeneration and general functions. How does this affect the body?

• Constant weakness and drowsiness.

• Dizziness and impaired coordination of movements, which sometimes leads to injuries. Elderly people often break their femoral neck under such conditions. In combination with low hemoglobin and advanced age, this is almost a death sentence. Even if such a patient undergoes surgery, rehabilitation is often impossible.

• Decreased memory, concentration, learning ability, and other cognitive functions (the ability to assimilate new information).

• Increased risk of developing dementia.

• Worsening of cardiac diseases related to the blood supply to the heart muscle.

• Due to poor oxygen delivery to the brain, dyscirculatory encephalopathy develops.

• Anemia means that if an elderly person gets a skin injury, such a wound will heal very slowly.

Among the main dangers of low hemoglobin in the elderly are a reduced quality of life in the form of weakness, fatigue, memory and concentration problems.

Methods and medications for increasing hemoglobin. When is a blood transfusion necessary?

There are several methods and medications to raise hemoglobin levels.

• Dietary adjustment: it is necessary to eat foods rich in iron, protein, vitamin B12, and folic acid. Many people start eating pomegranates diligently. I should note that although diet is important, it is secondary and supplementary. You cannot raise hemoglobin by diet alone.

• Oral iron supplements (e.g., Sorbifer). There are many such drugs. They are used for moderate anemia.

• Iron preparations administered intravenously or intramuscularly. These drugs work wonders — after a few injections the patient visibly perks up. But this is appropriate when hemoglobin is reduced but still above 70.

• If the level is below 70, the question of blood transfusion arises. This procedure is performed for severe anemia, when hemoglobin is too low and the body cannot cope on its own. I should note that blood transfusion also dramatically improves the patient’s condition and blood counts. However, remember that transfused red blood cells live shorter than native ones, but the effect is immediate.

What examinations are needed to find the cause of low hemoglobin and treat it?

The basis of anemia treatment is to establish the cause. To determine the cause of low hemoglobin and prescribe effective treatment, a comprehensive examination is necessary.

• First of all, a complete blood count (CBC) is performed to determine hemoglobin level, red blood cell count, and other parameters.

• Additional tests: serum iron, vitamin B12, folic acid, and a comprehensive anemia panel.

• To clarify the cause, additional examinations may be required: ultrasound of internal organs, fibrogastroduodenoscopy (FGDS), and other methods aimed at finding a source of blood loss, an oncological process, or intoxication.

• Bone marrow biopsy — indicated when there is a suspicion that hematopoiesis is impaired.

• Based on the results, the doctor determines the cause and prescribes appropriate treatment.

• Women must be examined by a gynecologist.