What is Hemoglobin Electrophoresis?

Medically Reviewed by Sabrina Felson, MD on December 07, 2022
3 min read

Hemoglobin electrophoresis is a blood test that measures different types of a protein called hemoglobin in your red blood cells. It’s sometimes called “hemoglobin evaluation” or “sickle cell screen.”

Newborns automatically get this test because it’s the law. There are a number of reasons you might get one as an adult:

  • You have symptoms of a blood disorder.
  • You’re at high risk for a blood disorder because of your race.
  • Your child has a blood disorder.
  • One of your other blood tests showed an abnormal result.
  • You have sickle cell disease and you’ve had a transfusion. In this case, the test shows doctors whether you’ve gotten enough normal hemoglobin from the new blood.

You don’t need to do anything special to get ready for this test. But you should tell your doctor if you had a blood transfusion in the past 12 weeks. If so, the test could produce a false result.

The test involves taking blood. The risks are low and may include:

  • Bleeding
  • Passing out or feeling lightheaded
  • Blood building up under your skin (hematoma)
  • Infection

At the lab, a technician will put the blood on special paper and zap it with electricity. The hemoglobins move around and form lines on the paper that show how much of each type you have.

The test can help your doctor figure out if you have a blood disorder and what type of blood disorder it is. Usually it’s done along with other blood tests.

Your doctor might tell you they ordered this test to look for hemoglobinopathy. That’s a catch-all word that means abnormal hemoglobins. Normal hemoglobin carries oxygen and releases it so your muscles and organs can use it. Abnormal hemoglobin carries less oxygen. These blood cells also have a shorter life span than normal hemoglobin. It can lead to something called hemolytic anemia. That’s where your red blood cells die sooner than they should.

Abnormal hemoglobin can also be a sign of other conditions, like:

  • Sickle cell disease. Normally, your blood cells are flat, round, and slightly thinner at the center. They look like a round piece of dough you squished in the middle between your finger and thumb. They’re flexible, and they can pass through tiny blood vessels. In sickle cell disease, they’re shaped like a sickle or a quarter moon. They’re stiff and can get stuck in small blood vessels so blood can’t get through. This can cause a lot of pain when your organs and muscles don’t get the oxygen they need. African-Americans have a higher risk of sickle cell anemia than people of other races.
  • Hemoglobin C disease. This can give you mild anemia and make your spleen bigger. But most of the time it doesn’t cause too much trouble unless you also have other kinds of abnormal hemoglobins. African-Americans have a higher risk of hemoglobin C disease and sickle cell disease. If Hgb C and the sickle cell trait exist together, you can have more symptoms.
  • Thalassemia. If you have it, there is an error in one or more of the protein chains that make up hemoglobin so it doesn't fold well. Thalassemia can give you anemia that’s mild, moderate, or severe. These disorders get passed down from parents to kids through genes. People of Italian, Greek, Middle Eastern, South Asian, and African descent are more likely to have thalassemia.