Lab Tests Explained: Hemoglobin A1c

Today we are launching a new series of videos breaking down how various lab tests work and what they mean. In the first of these videos, Dr. Strobel explains what the Hemoglobin A1c (abbreviated HbA1c or A1c) test measures, as well as some reasons why the results may not be as straightforward as they first appear.

When glucose enters your bloodstream, some of it bonds to the hemoglobin in your red blood cells, essentially giving it a sugar coating. If your blood sugar level is higher, a greater percentage of the blood cells will be sugared, or glycated.

The body normally retires and replaces its red blood cells about every three months. A percentage measurement of how much Hemoglobin A1c is sugar-coated gives an estimate of the average blood sugar for the previous three months.

The normal range of a healthy individual is between 4.0%-5.6% of the hemoglobin in your blood being sugared. HbA1c results between 5.7%-6.4% are generally seen as a sign of prediabetes, while higher than 6.5% indicates diabetes.

That's not always the case, as Dr. Strobel explains. There are many ways the numbers can be thrown off. Chronic anemia can cause the body to make more new blood cells to replace what it has lost, which can throw off an A1c test's blood measurement. That blood hasn't had as much time to be sugared as you would expect, resulting in a lower percentage result than may be accurate.

A condition called hypothyroidism can cause the opposite inaccuracy. Because someone with hypothyroidism retires and replaces their blood cells more slowly, their hemoglobin tends to be older, which allows more time to be sugared, causing their A1c result to be higher than it should be.

In both of these situations, the test on its own is not enough to give you a full picture of your health. When dealing with tests that can be skewed by something as simple as recent blood donation, having a trusted expert who knows your medical history is essential. This is yet another reason why a personal connection with your doctor can make such a huge difference in taking ownership of your health.

Hemoglobin A1c is just one of the 50+ lab tests available at no cost to HELPcare Clinic members. For more information on what tests are included with a HELPcare Clinic membership, check out our blog, or, if you've seen enough already, you can just apply for membership online now!

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John Aase

John is part of HELPcare’s content development team and lives with his wife Bella in Plymouth, Minnesota. He is an MFA candidate at Hamline University.