Hemoglobin Electrophoresis

Why this test may be ordered

• To help diagnose anemia, sickle cell disease, and other hemoglobin disorders.
• As part of routine newborn screening to check for serious inherited conditions.
• During pregnancy if you are at risk of having a child with an inherited hemoglobin disorder (e.g., family history or certain ethnic backgrounds).
• If you have symptoms of anemia (shortness of breath, weakness, fatigue, headache, dizziness, irregular heartbeat) or sickle cell disease (painful swelling of hands/feet, fatigue, jaundice, severe pain).

Preparation and collection

No special preparation is needed.

A health care professional will take a blood sample from a vein in your arm using a small needle. For a newborn, the heel is pricked with a small needle to collect a few drops of blood.

There is very little risk to having a blood test. You may have slight pain or bruising at the needle site, but most symptoms go away quickly. Your baby may feel a little pinch when the heel is poked, and a small bruise may form; this should go away quickly.

Understanding results

Your results will show the types of hemoglobin found and the levels of each. Your healthcare provider will interpret your results along with your symptoms, medical history, and other blood tests (such as a complete blood count and blood smear). Let your provider know if you have had a blood transfusion in the last 12 weeks, as this can affect results.

• Normal hemoglobin levels: No abnormal hemoglobin types detected. Hemoglobin A (Hgb A) is the most common type in healthy adults. Hemoglobin F (Hgb F, fetal hemoglobin) is normally found in newborns and is usually replaced by Hgb A by age one to two years. Limitation: This result does not rule out all hemoglobin disorders. Your provider will consider your overall health and other test results. Next step: If you have no symptoms, no further action may be needed. Discuss any concerns with your healthcare provider.
• Abnormal hemoglobin types or levels: May indicate a hemoglobin disorder such as: thalassemia (your body makes normal hemoglobin but not enough), sickle cell trait (one sickle cell gene and one normal gene, usually no health issues but can pass the gene to children), sickle cell disease, hemoglobin C disease (mild anemia, sometimes enlarged spleen and joint pain), or hemoglobin S-C disease (mild or moderate sickle cell disease). Your results may also show whether a specific disorder is mild, moderate, or severe. Limitation: This test alone does not diagnose the severity of a condition. Your provider will use your symptoms, medical history, and other tests to make a diagnosis. Next step: Talk to your provider about treatment options. New therapies are available for sickle cell disease. If you are at risk of having a child with an inherited hemoglobin disorder, consider speaking with a genetic counselor.

• A blood transfusion within the last 12 weeks can affect your results.
• Your provider must consider your symptoms, medical history, and other blood tests to interpret results.
• This test does not provide a complete diagnosis on its own.

What to do next

If you have questions about your results, talk to your healthcare provider. If you are at risk of having a child with an inherited hemoglobin disorder, you may want to speak to a genetic counselor.

• What do my hemoglobin levels mean for my health?
• Do I need any follow-up tests?
• If I have a hemoglobin disorder, what treatment options are available?
• Should I or my family members see a genetic counselor?

Evidence source

U.S. National Library of Medicine: Hemoglobin Electrophoresis