Hemoglobin 113-105 g/L Indicates Mild Anemia
A hemoglobin level of 113-105 g/L represents mild anemia in adult males, falling below the diagnostic threshold of 130 g/L, and warrants clinical evaluation to identify the underlying cause. 1
Diagnostic Classification
For adult males, the World Health Organization and British Society of Gastroenterology define anemia as hemoglobin below 130 g/L, making your range of 113-105 g/L clearly anemic. 1
This is mild anemia - it does not meet criteria for severe anemia (which requires hemoglobin <110 g/L for urgent fast-track referral in suspected malignancy). 1
In chronic kidney disease patients specifically, anemia is defined as hemoglobin <135 g/L, so this range would also be anemic in that population. 1
Clinical Significance and Next Steps
Investigation is Required
Any level of anemia warrants investigation for underlying causes, particularly when iron deficiency is present, as even mild anemia can indicate serious pathology including colorectal cancer in men. 1
The evaluation should focus on:
- Iron studies (serum ferritin, transferrin saturation, total iron binding capacity) - ferritin <30 mcg/L or transferrin saturation <16% confirms iron deficiency in the absence of inflammation. 2
- Vitamin B12 and folate levels - macrocytic anemia (MCV >100 fL) suggests B12 or folate deficiency. 2
- Assessment for blood loss, particularly gastrointestinal sources, as this is the most common cause of iron deficiency anemia in adults. 2
- Evaluation for malabsorption syndromes (celiac disease, inflammatory bowel disease) which can cause both iron and B12 deficiency. 2
Important Clinical Context
In certain disease states (heart failure, chronic liver disease), anemia at this level may reflect plasma volume expansion rather than true hemoglobin mass deficiency, though this distinction requires specialized testing. 3
For CKD patients with anemia, if erythropoiesis-stimulating agent therapy is initiated, target hemoglobin should generally be in the range of 110-120 g/L, meaning your current level of 105-113 g/L is at or near appropriate treatment targets. 4
Critical Pitfalls to Avoid
Do not dismiss mild anemia as clinically insignificant - investigation is mandatory regardless of symptom severity, as underlying pathology (particularly malignancy) may be present. 1
Laboratory-specific reference ranges should align with WHO-defined thresholds of 130 g/L for males to ensure consistent diagnosis. 1
Do not assume anemia always reflects hemoglobin deficiency - in conditions like heart failure or liver disease, expanded plasma volume may be the primary mechanism. 3