Hemoglobin is a protein in the blood that helps transport oxygen throughout the body. While most medical problems are caused by a low hemoglobin level, a high hemoglobin level can also indicate a medical or lifestyle problem that should be treated with a doctor's guidance. HbA1c (or A1c) refers to the percentage of hemoglobin to glucose, which is a vital indicator of prediabetes or diabetes. If you want to lower your A1c, you can diet, exercise, and change your diabetes treatment program.
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Method 1 of 3: Seeking Medical Treatment Options
Step 1. Determine the cause of the high hemoglobin level
High hemoglobin levels almost always indicate a medical problem, environmental factors, or lifestyle choices. If you have never identified this cause, ask your doctor for a diagnosis.
- In almost all cases of high hemoglobin, the goal is to treat the cause, which in turn lowers the hemoglobin level.
- A high hemoglobin level is a sign that indicates a variety of conditions that may require treatment. If it is too low and must be increased, or too high and must be lowered, the medical team will try to identify and address the cause.
Step 2. Treat medical conditions that cause high hemoglobin
This depends on whether the condition is relative, such as caused by tobacco use, or polycythemia resulting in an increase in red blood cells (RBC) due to increased serum erythropoietin or RBC production. Many medical conditions can cause an increase in hemoglobin levels. Follow the medical team's advice on the best treatment options for you. Common conditions that require treatment are as follows:
- Dehydration
- Polycythemia vera, a condition when the spinal cord produces too many red blood cells
- Heart problems, especially congenital heart disease
- Lung diseases, such as emphysema, COPD, and pulmonary fibrosis
- Tumor or kidney cancer
- Tumor or liver cancer
- Hypoxia, which is a lack of oxygen in the blood
- Exposure to carbon monoxide, usually from smoking
Step 3. Make the necessary lifestyle changes to lower hemoglobin levels
If it wasn't for a medical condition, it could be environmental factors or lifestyle choices. Ask if your doctor recommends lifestyle changes. The example is:
- Use of tobacco products. If you smoke or use tobacco products, try to quit as soon as possible.
- Taking performance-enhancing drugs such as steroids, specifically “blood doping” to improve athlete performance. It is harmful to health for many reasons.
- Being at high altitudes, which can cause hypoxia (lack of oxygen in the blood). This is more likely for people who go to highlands (such as mountain climbers) than people who do live there.
Step 4. Discuss the phlebotomy procedure with your doctor as needed
In limited cases, doctors can reduce hemoglobin levels directly. If so, you can undergo one or more treatments, which are done by drawing a certain amount of blood from the body.
- If the cause of high hemoglobin has been treated, you will have to produce new blood with low hemoglobin levels. So, over time the hemoglobin level will decrease until it becomes normal again.
- The process is similar to donating blood.
Step 5. Ask your doctor about treatment for polycythemia
If you have polycythemia and it causes an increase in hemoglobin, talk to your doctor about how to deal with it. Your doctor may suggest prescription medication as part of treatment. The drugs commonly used for polycythemia are:
- Hydroxyurea
- Ruxolitininab
- Pegelated interferon
- Anagrelide
Step 6. Talk to your doctor about taking aspirin every day
Aspirin can thin the blood, which is helpful if you have polycythemia. Talk to your doctor if you have this condition. Know the dose you should take and how often. Do not start aspirin therapy without your doctor's knowledge.
Tip: List all prescription or over-the-counter medications that you regularly use.
Method 2 of 3: Lowering HbA1c. Levels
Step 1. Adopt a healthy diet based on specific needs
If your HbA1c level is high, you may be at risk for diabetes or already have diabetes. Therefore, your dietary needs may differ from standard recommendations due to different conditions. Consult the medical team to design the right diet for you.
- In general, a healthy diet requires lots of fruit and vegetables, whole grains, lean protein, and healthy fats, as well as cutting back on packaged and processed foods, sugary drinks, refined flour, and unhealthy fats.
- If you are diabetic or prediabetic, you may be advised to limit your carbohydrate intake, as well as adjust your protein and fat intake based on your needs.
Step 2. Exercise regularly as recommended by the doctor
If high HbA1C levels are due to prediabetes or diabetes, you should work with your medical team to develop an exercise plan that fits your health and needs. To be sure, cardiovascular exercise and strength training is very important for the best results.
- Aim for at least 150 minutes of moderate-intensity aerobic exercise (such as brisk walking or cycling) per week, and do strength training sessions 2–3 times per week for 30–45 minutes.
- If you are taking insulin, adjust the dose according to your exercise schedule. Make a plan with the doctor.
Step 3. Adjust diabetes medication if you are diagnosed with diabetes
All people with high HbA1c levels are advised to change their diet and exercise. If you are diabetic, your doctor will also suggest adjusting your current medication. The goal is to find a balanced treatment that best regulates blood glucose levels (and in turn HbA1c levels.
Tip: Never consider yourself "failed" to overcome diabetes if you have to change drugs or increase the dose. Diabetes care requires constant adjustment.
Step 4. Focus on lowering your HbA1c slowly and steadily
If you make changes to your diet and extreme exercise, your HbA1c levels may drop dramatically in 1-2 months. However, decreasing too quickly can lead to swelling, weight gain, neuropathy (nerve pain), and even bleeding in the retina that can lead to blindness.
- Follow the medical team's advice and make gradual changes to your diet, exercise and medication, unless instructed otherwise.
- The goal is to reduce HbA1c levels in 1-2 years, not 1-2 months.
Method 3 of 3: Testing Hemoglobin and HbA1c. Levels
Step 1. Check the hemoglobin in the blood test
High hemoglobin is asymptomatic so it is usually detected in one of two ways: on a standard blood test ordered by a doctor, or during a blood test that is done as part of the diagnosis of a certain medical condition.
High hemoglobin will be detected on a CBC test or complete blood count (complete blood count), which is a standard blood draw in a hospital or health laboratory
Tip: Perform a CBC blood test whenever the doctor recommends. CBC test helps in early detection of infections, cancers, spinal cord diseases, autoimmune problems, etc.
Step 2. Discuss the ideal hemoglobin range with your doctor
The ideal hemoglobin range is not the same for everyone as it is based on various factors such as age. The following ranges of hemoglobin are commonly used:
- Children 6 months to 4 years: 11 g/dL and above
- Children 5 to 12 years: 11.5 g/dL and above
- Children 12 to 15 years: 12 g/dL and above
- Men over the age of 15: 13.8 to 17.2 g/dL
- Women over 15 years: 12, 1 to 15, 1 g/dL
- Pregnant women: 11 g/dL and above
Step 3. Check HbA1c every 3 months if you are diabetic
Due to the life cycle of hemoglobin, the HbA1c number also indicates the average blood glucose level in the last 3 months, so diabetics should check their HbA1c with a blood test every 3 months.
- The doctor will develop a treatment program based on the latest HbA1c results.
- If you are prediabetes, which means you almost meet the criteria for a diabetes diagnosis, your doctor may also recommend testing every 3 months.
- If you are not diabetic or prediabetic and are not at risk, you may only need to check your HbA1c occasionally as part of a general blood test.
Step 4. Discuss with the physician to determine specific HbA1c goals
HbA1c level is one of the determining factors for diagnosing prediabetes or diabetes. If you have been diagnosed, the medical team will determine the appropriate HbA1c target for you.
- An HbA1c below 5.7% is considered normal for people without prediabetes or diabetes.
- If your HbA1c level is between 5.7% and 6.4%, you may be diagnosed with prediabetes.
- An HbA1c level above 6.5% will be diagnosed with diabetes.
- If you are diabetic, try to keep your HbA1c level below 7%. However, this depends on individual conditions.
