When is a South Indian Really Anemic?

To determine the normal range of Hemoglobin and cutoff values in healthy adults of Southern India, blood samples were analyzed for parameters of RBC and iron metabolism in 177 male and 203 female medical students. The data were compared with the American white population (NHANES III) and the WHO criteria for detection of anemia. The mean values for hemoglobin and hematocrit in male students differed minimally from American white males. However, values for parameters of iron metabolism were lower except total iron binding capacity (TIBC) which was higher. In female students, hemoglobin, hematocrit and parameters of iron metabolism were lower than American white females, except TIBC which was higher. Lower 5th percentile cutoff point (Mean - 1.645 SD) in males and females were 13.5 and 10 g/dl respectively. In conclusion, South Indian adult males have Hb values similar to American male adults, but South Indian females have considerably lower Hb levels than American females, raising the questions about appropriateness of WHO or US criteria for detection of anemia in Indian females.