Expert: Dana Krempels, Ph.D. - 12/4/2011

Question
QUESTION: I went for a flu shot back in September 2011. My PCP took routine blood tests but I did not hear from her about the test results until today - three months later. She said my hemoglobin was elevated slightly and she wants me to come back in 2012 after the holidays for another blood test. Do I really have to go back? I mean if she did not contact me until three months later and said I dont have to come in immediately and do I have anything to worry about?

ANSWER: Dear Debbie,

When she said "slightly" elevated hemoglobin, did she give you a number?  If your hemoglobin is very high, your physician might be concerned for your long-term heart health.  But it's hard for me to say if your hemoglobin is high without knowing the number.  You can read the Mayo Clinic's overview here:

http://www.mayoclinic.com/health/high-hemoglobin-count/MY00112

You're right that your physician is probably not really worried that you are facing an immediate health crisis.  She probably just wants to re-check the hemoglobin levels to be sure they were not an artifact.  But as to whether you "really need" to come back, the best person to discuss this with you would be your physician.

There are various causes for high hemoglobin levels, and you can see an overview here:

http://www.buzzle.com/articles/high-hemoglobin-levels.html

Because your physician has suggested you wait three months to check again, she apparently does not feel that you are high risk for these problems.  But you should check with her to be sure, and for your own peace of mind.

Hope this helps.

Dana



---------- FOLLOW-UP ----------

QUESTION: It was a tenth of a point higher than the normal amount.

No she did not call me until three months later -in other words she did not call me about the test results until three month after she did routine blood tests. And she told me to come back to retake after the New Year.

ANSWER: Dear Debbie,

Well, as almost all web sites (including NIH and other reliable sources) will tell you, the "normal" range depends on what the practitioner learned in med school, and that can differ widely.

From what I've read, if your hemoglobin is below 16, you are in the normal range.  A tenth of a percentage point is not much outside the range, but if your hemoglobin is 16.1, then you might want to have it re-checked (and hydrate yourself well before the blood draw) to be sure it's stable.

Hope this helps.

Dana

---------- FOLLOW-UP ----------

QUESTION: But why call me three months later about the routine blood tests and why tell me to come in after the holidays. BTW she never said when after the holidays.  She just said come in after the holidays.

I dont think I was hydrated enough.  But now I am going to drink more water throughout the day.

Also What is your reason for saying: "and hydrate yourself well before the blood draw"? Can being dehyrated elevate other things as well in a test, such as thyroid hormone levels - just curious about this?

Answer
Dear Debbie,

I can't tell you why your physician waited so long to contact you.  Only she can tell you that.  I do know from my own experience, though, that many physicians just don't bother to contact their patients in a timely fashion, even about very important things.  Whether this is because they are overworked or irresponsible is anyone's guess.  But I, personally, have had very bad experiences with most physicians.  I finally found a fantastic one, and fly all the way from Miami, FL to southern California to see her twice a year.  That's how bad things are in Miami.  :(

But that said:  If you are not well hydrated, many blood values can read artificially high, since your blood will be more concentrated than normal.  If only your hemoglobin was elevated, and not your other values (e.g., electrolytes, creatinine, B.U.N., etc.), then the high hemoglobin might not be an artifact of dehydration.  That might be why she wants to do a re-check.  So many factors are involved that it is impossible to recount them here.

If she were really concerned about your somewhat elevated hemoglobin, one would hope she would have you come in right away.  So the fact that she's not having you do that is a good thing, one would hope.

And yes, cynical person that I am, I also have to consider the possibility that she wants you to come in for another blood draw after the holidays because...she gets paid for it by your insurance company.  

What a world we live in.

I hope you will be well and happy for the holidays and beyond.  For now, I would not be anxious about this.  Just go in for another blood draw after the holidays, and I'll bet everything will be fine.

Take care,

Dana