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WHO anaemia haemoglobin thresholds adults pregnancy 2024 guideline
This CBC shows significant anemia, plus an increased white blood cell count.
| Test | Visible result | Meaning |
|---|---|---|
| Hemoglobin (Hb) | 7.3 g/dL, low | Marked anemia. This needs prompt medical assessment. |
| RBC count | 2.85 x 10¹²/L, low | Supports anemia. |
| Hematocrit (Hct) | 27.4%, low | Low proportion of blood made up by red cells. |
| MCH 25.6 and MCHC 26.6 | Low | Red cells contain less hemoglobin than expected, described as hypochromia. |
| RDW-SD 57.6 | High | Red cells vary more in size than usual, called anisocytosis. |
| MCV 96.1 fL | Near normal | Average red-cell size is normal, so this is not a straightforward microcytic anemia. Iron deficiency can still be present early or together with another cause. |
| WBC | 15.25 x 10⁹/L, high | Leukocytosis, often from infection, inflammation, stress, some medicines, or less commonly blood disorders. |
| Neutrophils 7.91, lymphocytes 4.93, mixed cells 2.41 | High | Suggests an active inflammatory or infectious process, but the CBC alone cannot identify the cause. |
| Platelets | 149 x 10⁹/L | Borderline low or low-normal depending on the laboratory reference range. |
Overall interpretation
The pattern is moderate-to-severe anemia with hypochromia and high RDW. Common possibilities include:
- Iron deficiency, often due to menstrual blood loss, gastrointestinal bleeding, inadequate intake, or poor absorption
- A mixed deficiency, such as iron deficiency plus vitamin B12 or folate deficiency, which can make the MCV look normal
- Anemia associated with inflammation/chronic illness
- Recent or ongoing blood loss
- Less commonly, hemolysis or a bone marrow problem
The low MCH/MCHC and raised RDW can occur with iron deficiency; textbook descriptions note hypochromia and raised RDW as iron deficiency progresses. The WHO hemoglobin guideline classifies Hb below 8 g/dL in adults as severe anemia.
What to do
Arrange urgent in-person medical review today, especially if this is a new result. Seek emergency care now if there is shortness of breath at rest, chest pain, fainting, severe dizziness, rapid heartbeat, black/tarry stool, vomiting blood, heavy bleeding, or pregnancy.
A clinician will commonly confirm this with a repeat CBC and peripheral smear, then consider:
- Ferritin, serum iron, TIBC/transferrin saturation
- Reticulocyte count
- Vitamin B12 and folate
- Kidney function and inflammation tests
- Assessment for menstrual, gastrointestinal, or other bleeding
- Evaluation of the high WBC for infection or inflammation
Do not start high-dose iron or assume this is simply iron deficiency without medical review, particularly with hemoglobin 7.3 g/dL and raised white cells.
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