What Is Haemoglobin Electrophoresis?
Haemoglobin electrophoresis is a laboratory technique that separates the different types of haemoglobin in your blood based on their electrical charge and molecular size. It is the definitive test for identifying haemoglobin variants, including sickle haemoglobin (HbS), haemoglobin C (HbC), and the thalassaemias.
Normal adult blood contains predominantly haemoglobin A (HbA, about 95–97%), with small amounts of haemoglobin A2 (HbA2, 2–3.5%) and haemoglobin F (HbF, <1%). Abnormal haemoglobin variants or altered ratios point to specific inherited conditions that affect oxygen delivery and red blood cell survival.
Why Is This Test Performed?
- Sickle cell screening — confirms sickle cell trait (HbAS) or sickle cell disease (HbSS, HbSC)
- Thalassaemia screening — elevated HbA2 (>3.5%) suggests beta-thalassaemia trait
- Newborn screening — the NHS heel prick test uses HPLC (a form of electrophoresis) to screen all UK newborns
- Antenatal screening — identifying carrier couples at risk of having an affected child
- Unexplained anaemia — particularly microcytic anaemia not responding to iron therapy
- Pre-operative screening — haemoglobin variants require anaesthetic precautions
Normal Results
| Haemoglobin Type | Normal Range |
|---|---|
| HbA (adult) | 95–97% |
| HbA2 | 2.0–3.5% |
| HbF (foetal) | <1% |
| HbS, HbC, etc. | Absent (0%) |
Key Abnormal Patterns
- HbAS (sickle cell trait) — ~60% HbA, ~40% HbS; usually asymptomatic carrier
- HbSS (sickle cell anaemia) — ~80–95% HbS, no HbA; causes chronic haemolytic anaemia and vaso-occlusive crises
- HbSC disease — ~50% HbS, ~50% HbC; milder form of sickle cell disease
- Elevated HbA2 (>3.5%) — beta-thalassaemia trait; usually mild microcytic anaemia
- Elevated HbF (>1%) — seen in beta-thalassaemia major, hereditary persistence of foetal haemoglobin (HPFH), and some sickle cell patients on hydroxycarbamide
Who Should Be Tested?
- People of African, Caribbean, Mediterranean, Middle Eastern, or South/Southeast Asian heritage
- Couples planning pregnancy who want carrier screening
- Patients with unexplained microcytic anaemia not responding to iron
- Family members of known carriers
- Before surgery requiring general anaesthesia if haemoglobin status is unknown
Understanding Your Results
- If you are a carrier (trait) — no treatment needed but important for family planning decisions
- If both partners are carriers — 25% chance of each pregnancy being affected; genetic counselling is recommended
- If you have sickle cell disease or thalassaemia major — specialist haematology care is essential
- Prenatal diagnosis — chorionic villus sampling (CVS) at 11–14 weeks can test the foetus if both parents are carriers
Check Your Sickle Cell Haemoglobin Electrophoresis Levels at Home
The Core Health 45 includes Sickle Cell Haemoglobin Electrophoresis testing along with 44 other biomarkers. Results in 2 working days with a free at-home phlebotomist visit.
View Core Health 45 →Which Lola Health Tests Include Haemoglobin Electrophoresis?
Haemoglobin electrophoresis is available as an add-on test with any Lola Health blood test. It provides a definitive identification of haemoglobin variants including sickle haemoglobin, thalassaemia traits, and other uncommon variants.
Check Your Haemoglobin Levels
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