What is Hemoglobin?
Hemoglobin is a protein found inside red blood cells that binds to oxygen in the lungs and delivers it to tissues throughout the body. Each hemoglobin molecule contains iron, which allows it to carry oxygen.
Because hemoglobin sits inside red blood cells (RBCs), it is tightly linked to red blood cell count, iron status, and overall oxygen delivery. Hemoglobin levels are strongly influenced by iron status, inflammation, hormones, and chronic disease. You can also have a normal red blood cell count and still have low hemoglobin.
Why Does Hemoglobin Matter?
Hemoglobin plays a central role in sustaining energy, cognition, and physical performance by:
- Fueling energy production and stamina by transporting oxygen from the lungs to tissues to support ATP creation, your body’s primary energy source
- Preventing fatigue and metabolic waste buildup by carrying carbon dioxide back to the lungs for removal
- Supporting mental clarity and focus by making sure your brain gets enough oxygen1
- Maximizing athletic performance and recovery by efficiently delivering oxygen to improve endurance, aerobic capacity (VO2 max), and post-workout recovery 2
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How to Interpret Hemoglobin Levels
(Ranges may vary slightly by lab)
Standard reference ranges represent the middle 95% of healthy individuals but don’t necessarily reflect levels associated with longevity. Optimal ranges are derived from clinical guidelines, peer-reviewed research, and real-world outcomes data, with an emphasis on levels associated with peak functioning and reduced disease risk.
Benefits of Optimizing Hemoglobin
- Higher, more stable energy levels
- Improved cognitive function and memory
- Better cardiovascular health
- Improved physical performance and endurance
- Faster recovery from exercise and illness
- More efficient oxygen delivery to muscles and the brain
- Support for metabolic and mitochondrial function
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Low Hemoglobin Count (Anemia)
Symptoms:
- Fatigue or weakness
- Shortness of breath
- Dizziness or lightheadedness
- Cold hands and feet
- Brain fog or difficulty concentrating
- Heart palpitations
Causes:
- Iron deficiency (most common)
- Vitamin B12 or folate deficiency
- Chronic inflammation or chronic disease
- Pregnancy
- Celiac disease
- Blood loss (e.g., heavy menstrual bleeding; GI bleeding)
- Genetic hemoglobin disorders (e.g., thalassemia; sickle cell disease)
- Bone marrow disorders (rare)
Healthspan Impacts:
- Chronic fatigue and reduced quality of life
- Cognitive impairment
- Reduced immune resilience
- Lower physical performance and exercise tolerance
- Increased frailty and hospitalization risk in older adults
- Higher cardiovascular strain when severe or prolonged3
High Hemoglobin Count (Polycythemia/Erythrocytosis)
Symptoms:
- Headaches
- Dizziness
- Fatigue
- Blurred vision
- Flushed or reddish skin
- High blood pressure
- Itchy skin, especially after hot showers
Causes:
- Dehydration
- Smoking
- Living at high altitude
- Sleep apnea
- Lung or heart disease
- Performance-enhancing drug use (e.g., anabolic steroids; EPO misuse)
- Blood cancers (rare)
Healthspan Impacts:
- Thicker blood, which can slow circulation and increase clot risk
- Impaired circulation
- Higher risk of blood clots, heart attack, and stroke
- Higher cardiovascular and mortality risk if persistent
How Hone Treats Out of Range Hemoglobin Count
Your Hone physician will evaluate hemoglobin results from your blood test alongside red blood cell count, hematocrit, iron markers, symptoms, and overall health. Treatment depends on whether levels are low or high and what is driving the change.
- B12 injections – for pernicious anemia or severe B12 deficiency
- Iron infusion* – for severe iron deficiency anemia
- Anti-inflammatory or immunomodulatory medications* – for autoimmune or chronic inflammatory conditions
- Erythropoietin (EPO)* – prescribed in clinical settings for chemotherapy-related anemia
- Short-term steroids* – for autoimmune hemolytic anemia
*Your Hone Physician does not prescribe these treatments but will recommend further evaluation and help coordinate care with your primary care provider when medical treatment is indicated.
- Iron
- Vitamin B12
- Folate
- Vitamin C
- Omega-3 fatty acids
- Avoid smoking or secondhand exposure
- Pair iron-rich meals with vitamin C
- Prioritize protein intake
- Stay hydrated
- Get regular aerobic exercise (high-intensity is most effective)4
- Track menstrual blood loss (heavier cycles may increase iron needs)
- Get 7–8 hours of sleep per night5
Chen, W. et al. (2022). Hemoglobin concentration is associated with the hippocampal volume in community-dwelling adults. Archives of Gerontology and Geriatrics.
↑Webb, K. L. et al. (2023). The relationship between hemoglobin and V˙O2max: A systematic review and meta-analysis. PLOS ONE.
↑Kanaujia, S., & Yadav, A. P. (2024). Effects of exercise intensity on hemoglobin levels in athletes: A study on perceived effort and blood adaptations. International Journal of Sports, Health and Physical Education.
↑Kanaujia, S., & Yadav, A. P. (2024). Effects of exercise intensity on hemoglobin levels in athletes: A study on perceived effort and blood adaptations. International Journal of Sports, Health and Physical Education.
↑Liu, X., et al. (2018). Night Sleep Duration and Risk of Incident Anemia in a Chinese Population: A Prospective Cohort Study. Scientific Reports.
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Reviewed for Accuracy by Our Medical Review Board
This biomarker information has been reviewed by a member of Hone’s medical review board. As part of the medical review team, physicians fact-check this content against the latest research and their own experience treating their patients.
Ashley Winter, M.D., is a board-certified urogynecologist trained at Weill Cornell and Cleveland Clinic. She specializes in female and male sexual dysfunction, urinary issues, genital pain, and hormone therapy.
James Staheli, D.O., is the Medical Director for Broad Health, Hone Health’s affiliated medical practice and a family medicine doctor in Atlanta, Georgia.
