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Hematology

Hemoglobin electrophoresis, iron and beta-thalassaemia in adults

According to the NVKC, haemoglobin carries oxygen from the lungs to the organs, and according to Erfelijkheid.nl the causes of beta-thalassaemia are changes in the HBB gene, which mean not enough haemoglobin is made.

According to Erfelijkheid.nl, older children and adults with beta-thalassaemia have a high chance of problems from iron overload in the body. The forms of haemoglobin can only be determined by a blood test.

Unilabs uses 2.2 - 3.2 % for HbA2 and, above the age of 1 year, less than 1.0 % for HbF.

Doctor's Assessment Included

Hemoglobin electrophoresis measures the share of HbA, HbA2, HbF and abnormal forms such as Hb-S. According to the NVKC, the test detects inherited disorders of haemoglobin, such as thalassaemia and sickle cell disease.

  • Star-SHL uses 2.2 - 3.2 % for HbA2, Certe 2 - 3.2 % and Unilabs 2.2 - 3.2 %.
  • According to the NVKC, a raised HbA2 characterises a beta-thalassaemia.
  • According to the NVKC, if both parents carry a haemoglobinopathy, the children can get the disease, with a 25% chance.

Reference Ranges

No established reference range

A haemoglobin electrophoresis does not produce a single number but a pattern of fractions (HbA, HbA2, HbF and any variants such as HbS or HbC). One reference interval for the test as a whole cannot be interpreted: a clinically important raised HbA2 — the marker of beta-thalassaemia carriership — would be wrongly reported as "low". The result is assessed per fraction.

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Hemoglobin Electrophoresis: what this test measures

Hemoglobin electrophoresis gives the share of HbA2 and HbF in percent; Unilabs calls the panel Hb typering, with separate tests in EDTA blood.

Hemoglobin Electrophoresis: why this value matters

Hemoglobin electrophoresis matters because, according to Erfelijkheid.nl, beta-thalassaemia is most common in families with (fore)parents from the Mediterranean, the Middle East or parts of Asia or Africa.

Hemoglobin Electrophoresis: how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

Hemoglobin Electrophoresis: when is testing worthwhile?

According to Erfelijkheid.nl, beta-thalassaemia can also be found later, when someone has features of the disease; then a blood test is done and DNA testing can follow, and according to the NVKC hemoglobin electrophoresis establishes inherited disorders of haemoglobin.

Hemoglobin Electrophoresis: symptoms of a high or low value

Low Levels

According to the NVKC, in a beta-thalassaemia with iron deficiency or another haemoglobinopathy alongside it, HbA2 need not be raised.

High Levels

According to the NVKC, in a beta-thalassaemia the percentage of HbA2 is higher than normal; Unilabs uses 2.2 - 3.2 % for HbA2.

Hemoglobin Electrophoresis: causes of a low or high value

What lowers the value

  • Sickle cell carriership (HbA)

    Sickle cell carriership is characterised by a lowered percentage of HbA, 45 to 55%, and in sickle cell disease HbA is absent.

  • Alpha-thalassaemia (HbA2)

    An alpha-thalassaemia is characterised by a normal to lowered HbA2, a raised number of red blood cells and a low MCV.

  • Iron deficiency alongside a beta-thalassaemia (HbA2)

    If there is iron deficiency or another haemoglobinopathy alongside a beta-thalassaemia, HbA2 need not be raised.

What raises the value

  • Beta-thalassaemia carriership or disease (HbA2)

    A beta-thalassaemia is characterised by a raised percentage of HbA2, a raised number of red blood cells and a low MCV.

  • Sickle cell carriership or disease (Hb-S)

    In sickle cell carriership 35 to 45% Hb-S is present, in sickle cell disease more than 50%.

  • Age under one year (HbF)

    In children HbF is high shortly after birth; after a year all HbF should have disappeared.

Hemoglobin Electrophoresis: lifestyle and this value

Discuss an abnormal hemoglobin electrophoresis with your GP; according to Erfelijkheid.nl, the advice is that someone with thalassaemia goes to an expertise centre for thalassaemia for a check-up at least once a year.

Hemoglobin Electrophoresis: frequently asked questions

How is severe beta-thalassaemia treated?

According to the NVKC, severe beta-thalassaemia is treated with (regular) blood transfusions.

Hemoglobin Electrophoresis: sources

  1. NVKC, Alles over testen: Hemoglobinopathie, allesovertesten.nl, geraadpleegd 2026-10-19 (retrieved 2026) allesovertesten.nl

Tests with related values

These panels measure values from the same category as this marker.

Medical reviewer

Medical standards

Dr. Naimi oversees the medical standards behind our content and assessments.

Medical policy
CIBG Ministerie van Volksgezondheid,
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Hemoglobin Electrophoresis

€81,-