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Chokri Ben Lamine: 50 High-Yield Pearls on Hemoglobin Cutoffs for Anaemia from WHO 2024 Guideline
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Apr 19, 2026, 14:34

Chokri Ben Lamine: 50 High-Yield Pearls on Hemoglobin Cutoffs for Anaemia from WHO 2024 Guideline

Chokri Ben Lamine, Adult Hematology and SCT Assistant Consultant at Oncology Center of Excellence at King Faisal Specialist Hospital and Research Center, shared a post on X:

“Anaemia Hb Cutoffs – 50 High-Yield Pearls – WHO 2024

Credits for sharing to Dr Bassim Albeirouti

Anaemia is defined as haemoglobin below the cutoff, leading to decreased oxygen delivery.

  • WHO uses the 5th percentile of a healthy population to define anaemia.
  • The goal is to maximize sensitivity for detecting underlying disease.
  • Adult female cutoff is haemoglobin less than 120 g/L.
  • Adult male cutoff is haemoglobin less than 130 g/L.
  • In pregnancy, anaemia is haemoglobin less than 110 g/L in the 1st and 3rd trimesters.
  • In the 2nd trimester, the cutoff is lower at 105 g/L.
  • Children aged 6 to 23 months: haemoglobin less than 105 g/L.
  • Children aged 24 to 59 months: haemoglobin less than 110 g/L.
  • Children aged 5 to 11 years: haemoglobin less than 115 g/L.

Severity is based on percentage of the cutoff value.

  • Mild anaemia is approximately 85 to 92 percent of the cutoff.
  • Moderate anaemia is approximately 60 to 80 percent.
  • Severe anaemia is less than 60 percent or haemoglobin less than 70 g/L as a critical threshold.
  • Severe anaemia universally defined as haemoglobin less than 70 g/L requires urgent action.
  • Anaemia is a global public health crisis.
  • Around 30 percent of women worldwide are affected.
  • Around 37 percent of pregnant women are affected.
  • Around 40 percent of children are affected.
  • Highest burden is in Africa and Southeast Asia.
  • Causes include iron deficiency (about 60 percent), infections, and genetic disorders.
  • Infections contribute about 10 to 15 percent.
  • Haemoglobinopathies are present in about 5 percent of the global population.
  • Inflammation leads to reduced iron utilization, causing functional deficiency.
  • Anaemia in children is associated with cognitive impairment.
  • Cardiac risk increases with anaemia, including heart failure and ischemia.
  • In pregnancy, anaemia is associated with maternal mortality and low birth weight.
  • Anaemia is a marker, not a diagnosis.
  • Always evaluate the cause, including iron deficiency, vitamin B12 deficiency, bone marrow disorders, and haemolysis.
  • Haemoglobin alone is not sufficient; ferritin, soluble transferrin receptor, and CRP should be added.
  • Preferred sample is venous blood.
  • Gold standard measurement is an automated haematology analyzer.
  • Capillary haemoglobin is variable and has no reliable correction.
  • Strict quality control is needed, including pre-analytical and analytical phases.
  • Haemoglobin measurement must be standardized.
  • Haemoglobin should be adjusted for altitude.
  • Higher altitude leads to higher haemoglobin, so adjustment involves subtracting values.
  • Smoking increases haemoglobin and should be clinically adjusted downward.
  • Do not adjust haemoglobin for inflammation.
  • Do not adjust for ethnicity or race due to insufficient evidence.
  • Haemoglobin is useful for monitoring response to iron therapy.
  • However, it may miss early iron deficiency.
  • Combine haemoglobin with ferritin and inflammation markers.
  • There is a risk of over-supplementation, especially in malaria-endemic regions.
  • Always consider context-specific causes.
  • Public health classification is based on prevalence.
  • Severe public health problem is prevalence greater than or equal to 40 percent.
  • Moderate is 20 to 39.9 percent.
  • Mild is 5 to 19.9 percent.
  • Normal is less than 5 percent.”

Chokri Ben Lamine

More posts featuring Chokri Ben Lamine on Hemostasis Today.

Africa Blood Chokri Ben Lamine CRP Dr Bassim Albeirouti Ferritin Health Hematology Hemoglobin hemoglobinopathy hemolysis Hemophilia Hemostasis Hemostasis News Hemostasis Today Iron-Deficiency Medicine Mild Anemia Moderate Anemia Severe anemia Southeast Asia Transferrin Vitamin B12 Deficiency WHO 2024
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