February 4, 2008
A1c (Glycohemoglobin, HgbA1c), Other
Question from Maryland, USA:
For the past six weeks, I’ve been anemic. My hemoglobin, hematocrit and other parts of my CBC were normal. Recent blood work showed that I’m still anemic and, in addition, my total bilirubin, alkaline phosphatase, ESR (erythrocyte sedimentation rate), and monocytes were all elevated. Lymphocytes were decreased. My latest a1c was 8.7 so I’m wondering if that would explain any of the above results (diabetes control not being the best). I feel okay overall, just tired from the anemia.
Answer:
One question to ask would be whether the anemia has caused a falsely low hemoglobin A1c. When the anemia is related to decreased red blood cell survival, the hemoglobin A1c will be lower than it would if the red blood cell survival was normal. A hemoglobin A1c of almost three percentage points above normal can cause some overall fatigue, especially in those who have had previously better control. However, I do not feel that the elevated blood sugars are likely to be the cause of the other abnormalities.
JTL
