A hemoglobin electrophoresis test is a blood test used to measure and identify the different types of hemoglobin in your bloodstream. Hemoglobin is the protein inside red blood cells responsible for transporting oxygen throughout your circulatory system to your tissues and organs.
If your hemoglobin is healthy, it will transport and release oxygen with maximum efficiency. If it’s abnormal in some way, it may cause too little oxygen to reach your tissues and organs.
The types of hemoglobin include the following:
- hemoglobin F: This type is found in growing fetuses and newborns. Soon after birth, it’s replaced with hemoglobin A.
- hemoglobin A: This is the most common type of hemoglobin found in healthy children and adults.
- hemoglobin C, D, E, M, and S: These (and many other, rarer variations) are types of abnormal hemoglobin.
You acquire different abnormal types of hemoglobin by inheriting the genes that produce them. Your doctor may recommend a hemoglobin electrophoresis test to determine if you have a disease that causes the production of abnormal hemoglobin, such as the following.
Sickle Cell Anemia
This disorder is caused by hemoglobin S. Red blood cells become hard and crescent-shaped. They block small blood vessels and prevent blood from circulating properly.
These genetic disorders can cause the production of too much abnormal hemoglobin and too little hemoglobin A.
Your doctor may also want to test your child if you have a family history of abnormal hemoglobin or they have anemia that’s not caused by an iron deficiency.
No special preparations are required for this test.
Your doctor will need to take a sample of blood from your arm or hand. They’ll clean the site with a swab of rubbing alcohol. Then they’ll insert a small needle with a tube attached to collect the blood. When enough blood has been drawn, they’ll remove the needle and cover the site with a gauze pad. They’ll send your blood sample to a laboratory for analysis.
In the laboratory, a process called electrophoresis passes an electrical current through the hemoglobin in your blood sample. This causes the different types of hemoglobin to separate into different bands. Your blood sample is then compared to a healthy sample to determine which types of hemoglobin are present.
The following are healthy levels of hemoglobin in infants and children.
- hemoglobin F (newborn): 50 to 80 percent
- hemoglobin F (6 months): 8 percent
- hemoglobin F (6 months+): 0.8 to 2 percent
The following are healthy levels of hemoglobin in adults.
- hemoglobin A: 95 to 98 percent
- hemoglobin A2: 2 to 3 percent
- hemoglobin F: 0.8 to 2 percent
- hemoglobin S: 0 percent
- hemoglobin C: 0 percent
If your results show abnormal hemoglobin levels, they may be caused by:
- hemoglobin C disease (a genetic disorder that leads to severe anemia)
- rare hemoglobinopathy (a group of genetic disorders causing the abnormal production or structure of red blood cells)
- sickle cell anemia
As with any blood test, there are minimal risks of bruising, bleeding, or infection at the puncture site. In rare cases, the vein may swell after blood is drawn. This condition, known as phlebitis, can be treated with a warm compress several times a day. Ongoing bleeding could be a problem if you have a bleeding disorder or are taking blood-thinning medication, such as warfarin (Coumadin) or aspirin.
If you have abnormal hemoglobin levels, treatment will depend on the underlying disorder. Hemoglobin C disease is usually treated with folic acid supplements to help your body produce red blood cells normally. Sickle cell anemia may be treatable with a bone marrow transplant. Otherwise, your doctor will help you manage the disorder by preventing health crises.
If you have thalassemia, your doctor’s recommended treatment will depend on the nature and severity of the disorder.