This conversation was led by Cynthia Beall, Distinguished University Professor and S. Idell Pyle Professor of Anthropology at Case Western Reserve University. The hemoglobin oxygen transport function is stressed under high-altitude hypoxia. Vertebrates show a variety of hemoglobin adaptations to meet their physiological needs for oxygen. Indigenous highland human populations of the East African, Central Asian, and Andean Plateaus show a variety of hemoglobin responses and associated genetic underpinnings at high altitudes. These evolutionary differences in adaptation to the same stress of high-altitude hypoxia result in substantial overestimation of anemia prevalence at high-altitudes and the potential to waste scarce resources and subject some highlanders to unnecessary treatment.
Resources discussed:
- Sarna et al. 2020, “Current WHO hemoglobin thresholds for altitude and misdiagnosis of anemia among Tibetan highlanders“
- Cheong et al. 2017, “Alternative hematological and vascular adaptive responses to high-altitude hypoxia in East African highlanders“
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