Altitude matters! did you know where you grew up might affect your levels of hemoglobin?

 I was born and raised in Colombia a country in South America which is very near to the equator, I moved to Denver around seven years ago, I remember that a couple of years ago after having routine tests ran on my blood, my primary care giver saw something unusual on my results, very elevated hemoglobin levels. After careful consideration they decided to send me to Anschutz's oncology wing, after more tests and a little scare, hematologists explained to me that the elevated levels of hemoglobins in my blood where thanks to where I grew up, since the moment I moved to colorado the drastic change in altitude caused my body to adapt to the altitude and the lack of oxygen by producing higher amounts of hemoglobin in my blood.

did you know that Hemoglobin levels increase in response to higher altitudes primarily due to the body's adaptation to lower oxygen availability?. At elevated altitudes, the reduced oxygen pressure prompts the body to enhance its oxygen-carrying capacity through increased production of erythropoietin, a hormone that stimulates the production of red blood cells in the bone marrow. This rise in red blood cell count leads to higher hemoglobin levels, improving oxygen transport throughout the body. But this higher levels are not only seen in South American people that move to states like Colorado, Notably, populations from South America, particularly Andean highlanders (the highest mountains), exhibit a more pronounced increase in hemoglobin levels as well compared to other ethnic groups. This adaptation is influenced not only by environmental factors but also by genetic traits specific to these populations, allowing them to thrive in high-altitude conditions with greater oxygen efficiency.

Elevated hemoglobin levels, particularly in high-altitude populations , can have significant health implications. While increased hemoglobin improves oxygen transport, it may lead to chronic mountain sickness , This can strain the heart and complicate oxygen delivery to tissues. In pregnant women, improper hemoglobin monitoring can affect maternal and fetal health. Moreover, using standard reference ranges without considering altitude can result in misdiagnosis of anemia which I found interesting taking into consideration that this is what almost happened to me. All of this information further proves that understanding the variability in hemoglobin levels among different ethnic groups is crucial for accurate health assessments and effective management strategies. 

References:

Gassmann, M., Mairbäurl, H., Livshits, L., Seide, S., Hackbusch, M., Malczyk, M., Kraut, S., Gassmann, N. N., Weissmann, N., & Muckenthaler, M. U. (2019). The increase in hemoglobin concentration with altitude varies among human populations. Annals of the New York Academy of Sciences, 1450(1), 204–220. https://doi.org/10.1111/nyas.14136