Introduction

The haemoglobin level is often the first number people check in a blood report. It shows how well oxygen is reaching your body. When it drops, you may feel tired all day, get breathless on the stairs, or struggle to focus. Low haemoglobin is very common in India. The National Family Health Survey (2019–21) found anaemia in 57% of women aged 15 to 49, 59% of adolescent girls and 67% of children under five. Most causes can be found and treated.

What Is Haemoglobin?

Haemoglobin (written as Hb on reports) is an iron-containing protein inside your red blood cells. It picks up oxygen from your lungs and carries it to every part of your body. To make it, your body needs iron, vitamin B12, folate and protein from food, healthy bone marrow, where blood cells are made, and kidneys that signal for more red cells. Missing any of these can cause a haemoglobin deficiency.

Normal Haemoglobin Levels

Haemoglobin is measured in grams per decilitre (g/dL), as part of a common blood test called the CBC or complete blood count. The normal haemoglobin level differs for men, women and children.

Group	Normal haemoglobin range (g/dL)	Below this is anaemia
Men (15 years and above)	13.0 – 17.0	13.0
Women, not pregnant (15 years and above)	12.0 – 15.0	12.0
Pregnant women	11.0 – 14.0	11.0
Children, 6 months to 5 years	11.0 – 14.0	11.0
Children, 5 to 11 years	11.5 – 14.5	11.5
Children, 12 to 14 years	12.0 – 15.0	12.0

Ranges vary slightly between labs, so compare your result with the range on your own report. Smoking, high altitude and dehydration push it up; in pregnancy it naturally falls, as blood volume increases.

Causes of Low Haemoglobin

Low haemoglobin has three broad causes: too few red cells being made, blood being lost, or red cells breaking down too fast.

Not making enough red cells

Iron deficiency, the most common cause of all.
Too little vitamin B12, common in people who eat no animal foods, in older adults, after stomach surgery and with long-term metformin use.
Too little folate, from low intake or overcooking of greens, alcohol use, poor absorption or pregnancy.
Long-term kidney disease, chronic illness, infection, some cancers or bone marrow problems.

Losing blood

Heavy or long periods.
Slow, unnoticed bleeding from ulcers, piles or long-term painkiller use.
Worm infections, surgery, injury or donating blood too often.

Red cells breaking down too fast

Thalassaemia and sickle cell disease, inherited and seen in many parts of India.
Some infections and medicines.

Pregnancy and the teenage growth spurt also raise iron needs.

Symptoms of Low Haemoglobin and Anaemia

If haemoglobin falls slowly, you may notice little at first. Common low haemoglobin symptoms include:

Constant tiredness and weakness
Pale skin, lips, nails or inner eyelids
Breathlessness on walking or climbing stairs
A fast or pounding heartbeat
Dizziness, headache or trouble concentrating
Cold hands and feet, hair fall, and brittle nails

Iron deficiency may also cause cracks at the corners of the mouth, a sore tongue, restless legs or an urge to eat ice, mud or chalk.

Is Low Haemoglobin the Same as Anaemia?

Yes, in simple terms. Anaemia means haemoglobin below the normal range for your age and sex, but it is not one disease. Doctors tell the types of anaemia apart using red cell size, shown as "MCV" on your report.

Type of anaemia	Red cell size (MCV)	Usual causes
Small cell type	Below 80	Low iron, thalassaemia, long-term illness
Normal cell type	80 to 100	Sudden blood loss, kidney disease, long-term illness
Large cell type	Above 100	Low vitamin B12 or folate, thyroid problems, liver disease, alcohol

This is why taking iron on your own for every low report is unwise: it will not help if the real problem is low vitamin B12, and in thalassaemia trait extra iron can do harm.

How to Increase Haemoglobin

Food helps your body make haemoglobin, but rarely corrects a deficiency that has set in. Treat diet as support alongside treatment, not a replacement.

Iron from animal foods (absorbed best): Chicken, mutton, liver, fish.
Iron from plant foods: Green leafy vegetables, dals and beans, chana, ragi, bajra, til, dates and jaggery.
Vitamin C: Amla, guava, orange, lemon, tomato and capsicum help improve iron absorption.
Vitamin B12: Milk, curd, paneer, eggs and fish.
Folate: Palak, methi, broccoli, dals and peanuts.
Pair iron-rich foods with Vitamin C: Add lemon to dal or include amla, guava or oranges with meals to improve iron absorption.
Avoid tea and coffee around meals: They can reduce iron absorption. Keep them about 1 hour before and up to 2 hours after meals.
Vegetarian or vegan diet: Speak to your doctor about whether a Vitamin B12 supplement is needed.

Two habits help a lot. Have a vitamin C food with your meal, such as lemon squeezed over dal. And avoid tea, coffee or calcium tablets for about an hour before a meal and up to two hours after, as they block iron absorption. If you are vegetarian or vegan, ask your doctor about a B12 supplement.

Anaemia Treatment

Anaemia treatment depends on the cause and may include:

Iron tablets or syrup, continued for a few months after haemoglobin normalises, to refill iron stores.
Iron through a drip, if tablets upset your stomach or the level must rise quickly.
Vitamin B12 and folic acid.
Treating the source of bleeding, or medicines that boost red cell production in kidney disease.
A transfusion if the level is very low; specialist care for thalassaemia and sickle cell disease.

Your doctor will repeat the test to check treatment is working. Never start or stop a supplement on your own.

When to See a Doctor

See a doctor if you feel tired, breathless or dizzy for weeks together, look pale, or your report shows a haemoglobin level below the normal range. Get help quickly if you have chest pain, breathlessness at rest, fainting, black or tarry stools, blood in stool or vomit, very heavy periods, or a haemoglobin level below 8 g/dL. Low haemoglobin in pregnancy, in babies and in older adults should always be checked.

Narayana Health's haematology, general medicine and obstetrics teams offer complete testing and anaemia treatment across our hospitals.

Frequently Asked Questions

Q. What is a normal haemoglobin level?
A. 13.0–17.0 g/dL in men, 12.0–15.0 g/dL in non-pregnant women, and 11.0 g/dL or above in pregnancy.

Q. What causes low haemoglobin?
A. Most often iron deficiency, then low vitamin B12 or folate, blood loss, kidney disease and thalassaemia.

Q. What are the symptoms of low haemoglobin?
A. Tiredness, pale skin, breathlessness, a pounding heartbeat, dizziness, headache, poor concentration and hair fall.

Q. How can I increase my haemoglobin level?
A. Get the cause treated, take prescribed supplements, and eat iron-rich foods with vitamin C foods.

Q. When is low haemoglobin a concern?
A. Below 8 g/dL, when it falls quickly, causes chest pain or breathlessness at rest, or occurs in pregnancy or infancy.