Blood testing for hemaglobin


#1

I interested in testing my hemoglobin. Have any of you tested and tracked yours for (A) races?
If so, was it a combination of nutrition and live high and train low?
I’m finding Hematology extremely complex.
Of course non EPO, that’s illegal.


#2

I haven’t tested/tracked mine for races…mostly cuz I just started racing again this year. But the last 5 years I have donated blood and they check it for you. My natural hemo is below the average low range, however, I don’t notice anything severe in terms of performance etc. In 2016 it was at an all-time low of 128 g/L; start of 2018 I started taking iron supplements and recorded 153 g/L in the summer – again, no noticeable performance difference between the high and low levels. Sooo…that’s MY answer… :slight_smile:


#3

An adapted endurance athlete will tend to have low normal levels of hemoglobin. This is not because they are lacking in Hgb. It’s because your blood volume, specifically plasma volume, increases as your body adapts to training. The same amount of total Hgb distributed in a greater volume will give you a lower Hgb lab result because it’s generally a measurement of concentration, eg, grams per deciliter.

For the most part, you’re not going to be able to manipulate your hgb levels and the natural homeostatic state. This is principle that the biological passport is based on.

However, it is possible to have an abnormally low Hgb. The most common cause of depletion would be with females and blood loss during the menstrual cycle. Other causes for depletion are far less common, such as GI bleeds and disease states that affect iron absorption. Checking your Hgb levels for performance reasons isn’t that useful unless you and your physician suspect something is wrong.


#4

I would reiterate what Minty is saying: What’s your actionable item? Hgb will reflect a lot of different things, and is usually paired with additional studies. If you are trying to assess whether you have some sort of anemia which is limiting your performance then you are going to want to assess more than just your hgb. If you are trying to assess whether you want to look into altitude training, then I would say you need both a hgb and a hct. I will also reiterate that this data is just data, and can reflect a lot of different things. As minty pointed out as an athlete you may have a relatively H/H secondary to increased plasma, additionally this may be the result of relatively low testosterone (depending on your level of training, and athleticism).


#5

You’re not entirely correct. Trained endurance athletes have an increased mass of heamoglobin, but a reduced heamatocrit.

FWIW, measuring Hb is pointless unless you suspect there is an issue or you’re intending to manipulate the level.


#6

You’re not entirely correct. Trained endurance athletes have an increased mass of heamoglobin, but a reduced heamatocrit.

I believe what you’re referring to is tHg, total hemoglobin, and you’re going to get a lot of weird looks if you tried to get that test done lol. The typical blood draw will be testing for Hgb (g/dl).


#7

In case of assessing a chance for an anemic state, I would also consider controlling the ferritin level.


#8

OP asked about testing for haemoglobin. Without trying to be pedantic, haemoglobin is the protien in red cells that is responsible for oxygen delivery to the tissues. This can be measured with a cell counter and ETDA tube. Haematocrit is the ratio by volume of red blood cells to total blood volume. This is measured by centifruge. Often can be measured more quickly.

A trained endurance athelete will have an increased total heamoglobin so that more oxygen can be delivered to the tissues. The plasma volume is also increased, thereby effectively reducing the heamatocrit.

In my view, even thinking about measuring this stuff without good cause is treading on shaky ground.


#9

OP asked about testing for haemoglobin. Without trying to be pedantic, haemoglobin is the protien in red cells that is responsible for oxygen delivery to the tissues. This can be measured with a cell counter and ETDA tube.

Yup, I’m involved with the testing as a part of my work and my point is that hgb is measured in mg/dl so it is a concentration measurement. The way to measure total hemoglobin in a human body is impractical (I think the method involves respiration of carbon monoxide?) and not a test offered in most labs so I’ll just assume this person is talking about a Hgb measurement through a blood draw, probably in EDTA, and processed through an analyzer like you mentioned. Could be a finger stick too!

Since 99% of the testing for Hgb is through a blood test and in the spirit of answering his question, I want to reiterate that it’s well documented that Hgb is lower in well trained endurance athletes. This way, people don’t think that they’re low on Hgb when they get their lab tests back. They are actually well adapted for hard work. :smiley:

For example, in a hypothetical situation, I could be untrained and have a Hgb of oh, let’s say 17.0 g/dl which is in the normal range. After training for a year, I could have a blood test done, and then my Hgb level is now on the lower end of normal, 14.0 g/dl. Does that mean I have low hemoglobin? Nope, probably same or more total hgb, but I just have even more blood volume and since the blood test is a measurement of concentration, it is lower.

Conversely, in another hypothetical situation, let’s say my tested Hgb is 15.0, then I enter into a dehydrated state, have my blood drawn for Hgb and now it’s 18.0. Did I just gain more Hgb? Nope, I just lost some water, now my blood volume is lower and my concentration of Hgb is higher.

In my view, even thinking about measuring this stuff without good cause is treading on shaky ground.

Well, I disagree and would say that measuring hgb is an important part of your routine health check. It’s how we sometimes catch and notice things are wrong, before more severe symptoms set it. In a Complete Blood Count with differential, we can also check if your red cells are normochromic. All of which is important to just have a good idea of your blood health. Does it matter if you do lots of extra testing for hemoglobin if you are normal, healthy and not deficient nutritionally? (eg. iron, folic acid), probably not.

And yes, hematocrit is lower, because >blood volume, >plasma = lower concentration of red blood cells


#10

What’s your background?


#11

I’m a medical laboratory scientist.


#12

Fantastic wealth of information,all.
Maybe I just fell into the marketing of a YouTube, (Cycling Strong’s Cecacor “Ember”).
Thank You


#13

I wonder if we are using different terms for different things here? I’m UK based with a medical background.

As part of health checks under certain circumstances entirely appropriate, but with the aim of improving performance in sport I’m not so sure. It’s definatley in the grey area for me.


#14

Sorry, but the measurement of Hg in the UK is the same. You’re just mixing up absolute hg and relative hg in the context of our discussion. You weren’t accounting for changes in blood volume.


#15

Blockquote[quote=“salty, post:12, topic:3538”]
Maybe I just fell into the marketing of a YouTube, (Cycling Strong’s Cecacor “Ember”).
[/quote]

Oooh why didn’t you mention that in the first place? Now what they have going on is very interesting. In that context, then yes, it may be very important to be measuring hgb. They are essentially blood doping not through EPO, but through altitude training. Well not exactly doping, but trying to get the same effects. It is then very important to monitor their hgb to see how they respond and how quickly they lose that potential advantage. You’ll need the resources to do all the altitude stuff, either through travel, tent or mask. Hgb gains don’t seem to be the only thing factoring into acclimatization but if you’re spending all that to do altitude training, it would be a no brainer to track hgb as a part of the protocol. Cool stuff!


#16

You’re right. I am referring to total haemoglobin. My understanding is that athletes will have an increase in red cell production and plasma volume.


#17

I’m sorry. I didn’t want to embarrass myself, but did manage that in the end.
Living @ 5000 ft. with 10,000 ft. miles away, I was tarrying with the idea high/low.
Reason being my (A) events; Iron Horse; Mt. Evans; Pikes Peak Hill Climb elevations really stress this old body.
Historically, 30 years ago I lived and worked (timber industry) at elevation 9 months a year. There always seemed to be so much air at 5000 ft. elevation when venturing down to town.
This might just be a Flight of Fancy, but I’m really only competing with myself.
Super grateful for the forum and TR plans. I start on Monday.
Thank You!


#18

I didn’t think you did at all! I really liked the question especially once you gave the context of where that question came from because there’s some really interesting new stuff on the market being introduced here.

Unfortunately altitude training seems to be just the icing on the cake to a really fine tuned athlete. You will be waaay better off doing structured training.

If you’re at the level where Improvements on a magnitude of 2-3% are big gains, then all this new stuff will be interesting for you.


#19

To get the benefit, you need to live high, train low. Is this what you had in mind?

One caveat about this however - 10k feet is pretty high to live at. Some people at these elevations sleep poorly, which may negate the hematocrit benefit from living at altitude.

FWIW - when I moved from about sea level to 7k feet, my hematocrit increased by about 3pp.


#20

I think I can,I think I can!
With that being said, I want to try, 12 hours a day at 10k ft. and the rest at work and my TR plan. I’ve never had any issues with living and sleep up high.
So, I could be dead tomorrow, next week or next year. I’m not getting any younger and want to push the envelope for my self. If I can work out the details I will give it a go.
Thank you for replying Dave. Best wishes. It will be April -May if I can.