Anaemia is extremely common in India — and the number alone does not tell you why.
What haemoglobin measures
Haemoglobin is the protein in red blood cells that carries oxygen from your lungs to the rest of your body. When it falls below the expected range, that is anaemia. Common symptoms include fatigue, breathlessness on exertion, pallor, dizziness and hair fall — though mild anaemia often causes no symptoms at all.
WHO haemoglobin thresholds for anaemia
MCV: the clue to the cause
Your CBC report includes MCV (mean corpuscular volume) — the average size of your red blood cells. It is one of the most useful numbers for narrowing down why anaemia is present.
- Low MCV (small cells) — commonly iron deficiency, or thalassaemia trait, which is not rare in parts of India
- Normal MCV — may accompany chronic disease, sudden blood loss, or kidney disease
- High MCV (large cells) — often vitamin B12 or folate deficiency, both common in vegetarian diets
Follow-up tests doctors commonly order
Finding anaemia is only the first step. Iron deficiency in an adult man or a post-menopausal woman in particular usually prompts a search for a source of blood loss, rather than simply starting supplements.
- Serum ferritin — the most useful single measure of iron stores
- Serum iron, TIBC and transferrin saturation
- Vitamin B12 and folate, particularly when MCV is high
- Haemoglobin electrophoresis if thalassaemia trait is suspected
- Stool occult blood or further investigation if chronic blood loss is possible
What to ask your doctor
- What type of anaemia do my results suggest?
- Should my ferritin, B12 and folate be checked?
- Do I need investigation for a source of blood loss?
- How long should I take any supplement, and when should we re-test?
Common questions
Should I start iron tablets if my haemoglobin is low?
Not without knowing the cause. Iron only helps if the anaemia is due to iron deficiency — and taking it unnecessarily can cause side effects and, in some conditions, harm. It can also mask an underlying problem such as slow blood loss that needs investigating. Confirm the cause with your doctor first.
Can a vegetarian diet cause anaemia?
It can contribute. Plant-based (non-haem) iron is absorbed less efficiently than iron from animal sources, and vitamin B12 occurs almost exclusively in animal foods, so long-term vegetarian and vegan diets carry a higher risk of B12 deficiency. Vitamin C alongside iron-rich meals improves absorption.
How quickly does haemoglobin improve with treatment?
When iron deficiency is correctly identified and treated, haemoglobin often begins rising within two to four weeks, but replenishing iron stores usually takes several months. Doctors typically re-test rather than stopping treatment as soon as symptoms improve.
This article is general health information, not medical advice. Reference ranges differ between laboratories — always read the range printed on your own report and discuss results with a qualified doctor.
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