Hemoglobin (Hb), Vitamin B-12 and Vitamin D tests are designed to screen & measure the levels of these specific vital components in the body and suggest corrective action & treatment plans.

Hemoglobin, sometimes abbreviated as Hgb, is a protein in red blood cells that carries iron. It’s measured in grams per deciliter (g/dL) of blood. This iron holds oxygen, making hemoglobin an essential component of your blood. High hemoglobin levels could be due to polycythemia. This is where the body makes excess red blood cells and can lead to clots, heart attacks, and stroke without treatment. Anemia is a group of medical conditions that undermine the body’s ability to get oxygen. This is because people with anemia do not have enough hemoglobin or red blood cells to distribute oxygen throughout the body. People with symptoms of anemia, a history of anemia, or at high risk of anemia should consult a doctor for regular anemia testing [1-4].

Vitamin B12 is an essential nutrient involved in erythropoiesis and in maintaining a healthy nervous system. Deficiency of this vitamin might cause several health problems and hence checking the levels of this vitamin is important. Normal range for vitamin B12 is 200-900ng/mL. Normal range and unit of measurement may vary between different laboratories. Early detection and treatment of B12 deficiency is important; if left untreated, it can cause severe neurologic problems and blood disorders [5-10].

Vitamin D is necessary for maintaining health. It helps your body absorb minerals like calcium, magnesium, and phosphorus from your diet. Vitamin D also helps maintain proper levels of calcium, phosphate, and parathyroid hormone in your blood. Vitamin D plays an important role in helping the body absorb calcium, which makes it crucial to maintaining bone health. The normal range of vitamin D is measured as nanograms per milliliter (ng/mL). Many experts recommend a level between 20 and 40ng/mL. Vitamin D testing is used to determine whether you have enough vitamin D in your body to support normal bodily functions. The main function of vitamin D is to aid in the absorption of calcium during bone formation. Maintaining adequate levels of vitamin D supports healthy bones. In addition, vitamin D has anti-inflammatory and other properties that play a role in maintaining normal muscle, immune, and nervous system functions. An inadequate level of vitamin D is called a deficiency. Vitamin D testing used to diagnose vitamin D deficiencies or to monitor treatment for a known deficiency. Vitamin D blood testing can be used to check your levels so a deficiency can be corrected. Less commonly, vitamin D testing may be used to detect vitamin D toxicity, a condition in which there is an excess of vitamin D in the body [11-15].

There is a paucity of studies which analyzed the Laboratory Records for Hemoglobin (Hb), Serum Vitamin B-12 and Vitamin D tests. Against this backdrop, the study was conducted to analyze the results of Hemoglobin (Hb), Serum Vitamin B-12 and Vitamin D tests done at a Private Laboratory in New Delhi.

Objectives of the Study

To analyze the results of Hemoglobin (Hb), Serum Vitamin B-12 and Vitamin D tests done at a Private Laboratory in New Delhi

Research Approach

Descriptive survey.

Study Design

A retrospective review.

Setting of the Study

Labcorp Diagnostics Pvt Ltd, New Delhi.

Study Duration

Between 1^st to 31^st January 2022.

Study Population

Participants who were undergone Hemoglobin (Hb), Vitamin B-12 and Vitamin D tests.

Sample Size

All study participants who were undergone Hemoglobin (Hb), Vitamin B-12 and Vitamin D tests during the study period.

Permission

obtained from the concerned authorities of Laboratory.

Data Analysis

Laboratory data during the study period was retrieved, entered in MS Excel and analyzed using Epi Info V7 Software with appropriate statistical test in terms of frequencies and percentage.

In the present retrospective review, laboratory data of 169 study participants who were undergone Hemoglobin (Hb), Vitamin B-12 and Vitamin D tests was analyzed. 

Mean Haemoglobin (Hb) level was 12.53±2.082 g/dL. 109(64.5%) had their Hb level in normal range, 56(33.1%) had Hb level below the normal range while only 4(2.4%) study participants had their Hb level above the normal range.

Mean Serum B12 Level was 370.02±357.223ng/mL. 96(56.8%) had their Serum B12 Level in normal range, 61(36.1%) had Serum B12 Level below the normal range while only 12(7.1%) study participants had their Serum B12 Level above the normal range. 

Mean Serum Vit D3 Level was 24.28±24.268ng/mL. 41(24.3%) had their Serum Vit D3 Level in normal range, 127(75.1%) had Serum Vit D3 Level below the normal range while only 1(0.6%) study participants had their Serum Vit D3 Level above the normal range. 

Present study was done to analyze the results of hemoglobin (Hb), serum vitamin B-12 and vitamin D tests done at a private laboratory in New Delhi. 

In the present study, 109(64.5%) had their Hb level in normal range, 56(33.1%) had Hb level below the normal range while only 4(2.4%) study participants had their Hb level above the normal range. A variety of factors affect your hemoglobin levels, including age, gender and medical history. In adults, the average hemoglobin level is slightly higher for men than it is for women. High hemoglobin levels generally accompany high red blood cell counts. Remember, hemoglobin is found in red blood cells, so the higher your red blood cell count, the higher your hemoglobin level and vice versa. A high red blood cell count and hemoglobin level can indicate several things, including congenital heart disease, dehydration, kidney tumors, lung disease and polycythemia vera. You may also be more likely to have high hemoglobin levels if you have a family history of disorders that affect red blood cell counts, such as altered oxygen sensing, live at a high altitude, recently received a blood transfusion and smoking. A low hemoglobin level is referred to as anemia or low red blood count. A lower-than-normal number of red blood cells are referred to as anemia and hemoglobin levels reflect this number. A low hemoglobin level is usually seen with low red blood cell counts. Some medical conditions that can cause this include bone marrow disorders, kidney failure, uterine fibroids, conditions that destroy red blood cells including sickle cell anemia, thalassemia, G6PD deficiency, and hereditary spherocytosis. You may also be more likely to have low hemoglobin levels if you have a condition that causes chronic bleeding, such as gastric ulcers, colon polyps, or heavy menstrual periods have a folate, iron, or vitamin B-12 deficiency, pregnancy and in a traumatic accident, such as a car accident [1-4].

Table 1: Analysis of the Results of Hemoglobin (Hb), Serum Vitamin B-12 and Vitamin D Tests

There are several things you can do to raise your hemoglobin count through dietary changes, nutritional supplements, blood transfusions, symptom management, and treatment for underlying medical conditions. Depending on the underlying cause and the changes you make, it can take anywhere from a few weeks to almost a year to raise your hemoglobin count [1-4].

In current study, 96 (56.8%) had their serum B12 Level in normal range, 61(36.1%) had serum B12 Level below the normal range while only 12(7.1%) study participants had their serum B12 Level above the normal range. Vitamin B12 is an essential nutrient playing a vital role in overall health. The test is often recommended to people who show signs and symptoms of a deficiency or are at a higher risk of vitamin B12 deficiency. Deficiency can be avoided by a balanced diet, oral supplements, or injections of the vitamin. Discuss with your healthcare provider before starting any supplements. Vitamin B12 levels higher than 900ng/mL indicates abnormally high levels of Vitamin B12. This could indicate liver or kidney problems, diabetes, or certain forms of leukemia. It could also indicate body’s failure to utilize vitamin B12. However, high levels can also be observed when a person undergoes test soon after taking B12 supplements. High levels of vitamin B12 occur very rarely, as excess B12 is often removed through urine. Conditions that can increase B12 levels may include Liver diseases such as cirrhosis or hepatitis myeloproliferative disorders such as polycythemia vera and chronic myelogenous leukemia. Other conditions where B12 may be higher than normal include recent B12 injection or B12 supplement, kidney disease, inflammatory conditions such as rheumatoid arthritis, lupus, hematologic cancers and hematopoietic disorders, increased levels of transcobalamin, obesity, Infection such as AIDS. Intrinsic factor antibodies can interfere with vitamin B12 test and cause a false elevation in the levels of vitamin B12. Estrogen, vitamin C and vitamin A can also increase vitamin B12 levels. Lower than 200 ng/mL of Vitamin B12 in blood indicates vitamin B12 deficiency. It can also indicate body’s failure to absorb the vitamin and inability to meet the vitamin B12 needs. Vegetarian diet is the major reason for vitamin B12 deficiency as plant-sourced foods do not contain enough cobalamin to meet the body’s requirement. Certain health conditions can also affect the levels of vitamin B12 in blood. Vitamin B12 may be decreased in cases such as pernicious anemia. A recent small intestine surgery, gastritis, celiac disease, and inflammatory bowel disease (IBD), chronic alcoholism, use of metformin tablets to treat diabetes, Autoimmune disorders such as Graves’ disease or lupus, certain medications like heartburn medicines and H2 blockers [5-10].

Vitamin B12 deficiency can be prevented by introducing enough meat, poultry, seafood, dairy products, and eggs into the diet. Vegetarians can add foods fortified with vitamin B12 to their diet. Taking vitamin V12 in a multivitamin or direct vitamin B12 supplement can also help maintain the levels and prevent deficiency. It is often advised for individuals with low vitamin B12 levels to take regular doses of the vitamin via injections. This is also helpful for people with medical conditions that hinder the absorption of the vitamin. In cases of elevated vitamin B12, underlying condition is treated to maintain the levels [5-10].

In our study, 41(24.3%) had their serum Vit D3 Level in normal range, 127(75.1%) had serum Vit D3 Level below the normal range while only 1(0.6%) study participants had their serum Vit D3 Level above the normal range. A vitamin D test is used to screen for low levels of vitamin D in your blood so you can treat it with supplements before it causes health problems. Vitamin D testing is ordered to determine if a deficiency, insufficiency, or toxic level of vitamin D is present or to monitor treatment for a previously diagnosed deficiency. Inadequate levels of vitamin D can lead to abnormal bone development, bone weakness, and pain. Your health care provider may order a vitamin D blood test for you if you are experiencing symptoms of a vitamin D deficiency, such as, weakening of the bones, abnormal bone development, bone deformity, bone pain, muscle weakness or cramps, seizures, dental abnormalities. Sometimes vitamin D tests are used as screening tests for individuals at increased risk of a vitamin D deficiency. Screening tests are conducted before any symptoms occur. The following are factors that may increase your risk of developing a vitamin D insufficiency or deficiency like age over 65, obesity, history of weight loss surgery, osteoporosis, reduced ability to make vitamin D in the skin due to limited sun exposure, sunscreen use, or dark skin pigmentation, digestive diseases that make it difficult to absorb nutrients from food, including celiac disease and Crohn’s disease, kidney and liver disease, Use of certain medications. Vitamin D tests may also be ordered if your health care provider suspects that you may have abnormally high vitamin D levels, known as vitamin D toxicity. This occurs as a result of taking too much vitamin D in supplements rather than from too much sun exposure or dietary intake. Excess vitamin D in supplement form may cause your body to absorb more calcium from food and to reabsorb calcium from the bones into the blood. This results in excess calcium in the blood, also known as hypercalcemia, which can lead to symptoms like fatigue, confusion, bone pain, nausea and vomiting, frequent urination, and kidney problems [11-15].

A health care provider who is familiar with your medical history is in the best position to determine whether you might benefit from vitamin D testing. Your doctor may recommend supplements or other treatment options if you’re very deficient. Eating foods that contain vitamin D in addition to adding supplements to your regimen can help keep your vitamin D levels stable [11-15].

Present study concluded that almost one third of the study participants had their Hemoglobin (Hb) and serum Vitamin B-12 level below the normal range while almost three fourth of the study participants had their Serum Vit D3 Level below the normal range.

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