Normal adult blood contains mostly hemoglobin A (HbA), with small amounts of hemoglobin A2 and trace fetal hemoglobin (HbF). Elevated HbA2 (typically above 3.5%) is a hallmark of beta thalassemia trait, while lower-than-normal levels can occur in alpha thalassemia or iron deficiency.
This test is ordered to evaluate microcytic anemia not explained by iron deficiency, screen for hemoglobinopathies in patients of relevant ethnic backgrounds, evaluate family members of known thalassemia carriers, and contribute to prenatal counseling. It is typically part of a broader hemoglobin electrophoresis. Sample type is whole blood in an EDTA tube.
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