High Hemoglobin

[IVILA]

I'd like to hear what Morley Robbins says.

that's symptoms of low hemoglobin pretty much.

 

[yerrag]

that's symptoms of low hemoglobin pretty much.

Is there a timestamp? I can't suffer through a whole video to prove you are right.

 

[IVILA]

Is there a timestamp? I can't suffer through a whole video to prove you are right.

you can start from the 20th minute until you get the picture.

 

[yerrag]

that's symptoms of low hemoglobin pretty much.

just to be clear, am I watching the video to hear him talk of symptoms of low hemoglobin and not high hemoglobin? Am I going to hear him say that high iron causes high hemoglobin? Or to hear him say low iron causes low hemoglobin?

 

[IVILA]

just to be clear, am I watching the video to hear him talk of symptoms of low hemoglobin and not high hemoglobin? Am I going to hear him say that high iron causes high hemoglobin? Or to hear him say low iron causes low hemoglobin?

this is proof that hemoglobin is an indicator of iron status in the body. You can also educate yourself on the many aspects of iron in the body and how it works.

 

[yerrag]

this is proof that hemoglobin is an indicator of iron status in the body. You can also educate yourself on the many aspects of iron in the body and how it works.

thanks. I agree low hemoglobin can be an indication of low iron, but was he specific in saying high hemoglobin can also be an indication of high iron?

 

[IVILA]

thanks. I agree low hemoglobin can be an indication of low iron, but was he specific in saying high hemoglobin can also be an indication of high iron?

yeah around the 20th minute

 

[yerrag]

yeah around the 20th minute

OK thanks I'll look at it.

 

[yerrag]

yeah around the 20th minute

Yes, he did agree to the interviewers question as to whether hemoglobin and iron are positively correlated such that the higher the hemoglobin, the higher the amount of iron in the body. And he goes on to say that the right way to measure iron status is to look at three markers - hemoglobin, serum iron, and serum ferritin. I am to make the conclusion that the way I measure iron status is wrong, where hemoglobin is not used, and that aside from serum iron and serum ferritin, transferrin saturation is used.

Honestly, I have a hard time understanding transferrin saturation and just use it with serum iron and serum ferritin to determine iron status. The explanations I've read about the use of these three markers run circles around my head. That said, it is hard to accept hemoglobin as a marker because using Hgb as a marker fails already. Mainly because Hgb is a measure of concentration of hemoglobin, specifically amount of hemoglobin protein over blood volume, For that matter, the same can be said for serum iron and serum ferritin.

On a relative basis, they are equally affected in that when blood volume is low, all values are higher than what they really should be treated. When blood volume low, all values are lower. As really, what we are really measuring is the concentration of hemoglobin, iron, and ferritin in a person with NORMAL blood volume.

Let's say the normal blood volume (Vn) is 5 liters. And high blood volume (Vh) is 6, and low blood volume (Vl) is 4.

And let's assume that the amount of hemoglobin in the blood is the same, Hn = Hh = Hl. Note that this is a reasonable assumption, as blood volume variation is very much dependent of the plasma, which is the liquid that the red blood cells bathe in. The volume of plasma is very much dependent on the amount of albumin in blood, as albumin determines how much salt is in blood, and salt determines how much water is attracted to form plasma.

Assume Hn = Hh = Hl = 75

So, in a normal (or should I say health-optimized) person, Hgb(n) = 75/5 = 15;

In a low blood volume person, Hgb (l) = 75/4 = 18.75

In a high blood volume person, Hgb (h) = 75/6 = 12.5 (Note that these values are exaggerated, but I use them only for convenience)

In this scenario, it can hardly be said that the person with high serum Hgb is high in iron. Nor can the person with low serum Hgb is low in iron.

I do not agree with Morley Robbins in his automatic categorization of high Hgb as high in iron.

 

[yerrag]

On a relative basis, they are equally affected in that when blood volume is low, all values are higher than what they really should be treated. When blood volume low, all values are lower.

Correction: "all values are lower" should read as "all values are higher."

But the rest of the interview is still very informative. His view on serum ferritin as the protein fragments of tissue ferritin being cleaved and released into the blood, with the iron contents being left in the tissues, is something I agree with.

 

[yerrag]

I do not agree with Morley Robbins in his automatic categorization of high Hgb as high in iron.

I have to qualify this though, as I got to thinking more about it.

If RBC and Hematocrit are normal, and Hgb is high, then he maybe right that there is high iron.

If RBC and Hematocrit and Hemoglobin are all high, then there is much less a case for high iron. It's strong case for dehydration, or low blood volume.