What Is a Hemoglobin Electrophoresis Test?

    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 that is responsible for transporting oxygen throughout your circulatory system to your tissues and organs.

    If your hemoglobin is of a healthy, “normal” type, it will transport and release oxygen with maximum efficiency. If it is abnormal in some way, it may cause too little oxygen may reach your tissues and organs.

    The types of hemoglobin include:

    • hemoglobin F: This type is found in growing fetuses and newborns. Soon after birth, it is 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.

    What the Test Addresses

    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 are suffering from a disease that causes the production of abnormal hemoglobin, such as:

    Sickle Cell Anemia

    This disorder is caused by hemoglobin S. It causes your red blood cells to become hard and crescent-shaped. They block small blood vessels and prevent blood from circulating properly.

    Thalassemias

    These genetic disorders can cause the production of too much abnormal hemoglobin and too little hemoglobin A.

    Testing Children

    Your doctor may also want to test your child if he or she has a family history of abnormal hemoglobin or suffers from anemia that is not caused by an iron deficiency.

    Where and How the Test Is Administered

    Your doctor will need to take a sample of blood from your arm or hand. First, the site will be cleaned with a swab of rubbing alcohol. A small needle will then be inserted into a vein, and a tube will be attached to collect the blood. When enough blood has been drawn, the needle is removed and the site is covered with a gauze pad. The blood sample will then be sent to a laboratory for analysis.

    In the laboratory, a process called electrophoresis is used to pass 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.

    Understanding the Results

    Normal Results

    In infants and children, a normal, healthy level of hemoglobin is:

    • hemoglobin F (newborn): 50 to 80 percent
    • hemoglobin F (6 months): 8 percent
    • hemoglobin F (6 months+): 0.8 to two percent

    In adults, healthy levels are:

    • hemoglobin A: 95 to 98 percent
    • hemoglobin A2: 2 to 3 percent
    • hemoglobin F: 0.8 to two percent
    • hemoglobin S: 0 percent
    • hemoglobin C: 0 percent

    Abnormal Results

    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
    • thalassemia

    What Are the Risks of the Test?

    As with any blood test, there are minimal risks of experiencing bruising, bleeding, or infection at the puncture site. In rare cases, the vein may become swollen after blood is drawn. This condition, known as phlebitis, can be treated with a warm compress several times each day. Ongoing bleeding could be a problem if you suffer from a bleeding disorder or are taking blood-thinning medication, such as warfarin (Coumadin) or aspirin.

    Preparing for the Test

    There are no special preparations required for this test.

    What to Expect After the Test

    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.