Lab Reports Decoded

Hb Electrophoresis: Spot Thalassemia vs Iron Deficiency (Video)

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Read the full written guide: Hb Electrophoresis Report: Thalassemia Minor or Iron Deficiency? →

Learn how a single column on your hemoglobin electrophoresis report can tell the difference between thalassemia minor and iron deficiency. We break down the key numbers, what to look for, and the crucial step to avoid missing a hidden carrier state. This quick guide gives you practical tips you can use today, but remember it’s general information, not a substitute for professional medical advice.

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Transcript

Can a 3.5% HbA2 level hide a genetic trait?

Can a 3.5% HbA2 level hide a genetic trait?

Understanding Hb Electrophoresis

In this video we'll show you how a single lab column can reveal a hidden carrier state, and the key tip to avoid missing it.

What the test measures

Haemoglobin comes in several types. Most adult hemoglobin is HbA, a small slice is HbA2, and a trace is HbF, the baby form that fades after birth. The lab separates them by electric current or HPLC, creating distinct bands.

Key columns explained

The report lists four main columns. HbA makes up most of the hemoglobin, around 95 to 98 percent. HbA2 sits at about two to three and a percent and rises in beta thalassemia trait. HbF stays under two percent, higher in infants or some thalassemias. Any unusual bands like HbS, HbE or HbD signal other traits.

HbA2 cutoff

Most labs flag HbA2 above 3.5 percent as a sign of beta thalassemia trait.

Thalassemia vs iron deficiency

Both thalassemia minor and iron deficiency give small, pale red cells. Thalassemia often shows a normal or high red cell count with very tiny cells, while iron deficiency usually shows a lower count and a wider size spread. Doctors may use quick CBC formulas for a hint, but ferritin together with electrophoresis settles the diagnosis.

HbF normal range

HbF normally stays under two percent, but can rise in some thalassemias or in young babies.

Important reminder

A normal HbA2 in someone who is short of iron isn't the final word.

The one key tip

The crucial step is to verify ferritin first; if iron is low, treat it and repeat the electrophoresis a few months later to unmask a hidden thalassemia trait.

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Read the full guide

The full guide is on thecareonline.com. General information only, so check with your doctor for your own case.

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