Also Known As
HPT, Haemoglobin-binding Protein, Hp
This article was last reviewed on
This article waslast modified on 3 January 2025.
At a Glance
Why Get Tested?

To help diagnose and monitor haemolytic anaemia (when your red blood cells are being destroyed faster than they can be replaced). 

When To Get Tested?

When you have signs of jaundice, or of anaemia such as weakness, paleness, breathlessness, headache or dizziness that your healthcare professional suspects may be due to haemolytic anaemia. 

Sample Required?

A blood sample taken from a vein in your arm.

Test Preparation Needed?

No test preparation is needed.

On average it takes 7 working days for the blood test results to come back from the hospital, depending on the exact tests requested. Some specialist test results may take longer, if samples have to be sent to a reference (specialist) laboratory. The X-ray & scan results may take longer. If you are registered to use the online services of your local practice, you may be able to access your results online. Your GP practice will be able to provide specific details.

If the doctor wants to see you about the result(s), you will be offered an appointment. If you are concerned about your test results, you will need to arrange an appointment with your doctor so that all relevant information including age, ethnicity, health history, signs and symptoms, laboratory and other procedures (radiology, endoscopy, etc.), can be considered.

Lab Tests Online-UK is an educational website designed to provide patients and carers with information on laboratory tests used in medical care. We are not a laboratory and are unable to comment on an individual's health and treatment.

Reference ranges are dependent on many factors, including patient age, sex, sample population, and test method, and numeric test results can have different meanings in different laboratories.

For these reasons, you will not find reference ranges for the majority of tests described on this web site. The lab report containing your test results should include the relevant reference range for your test(s). Please consult your doctor or the laboratory that performed the test(s) to obtain the reference range if you do not have the lab report.

For more information on reference ranges, please read Reference Ranges and What They Mean.

What is being tested?

This test measures the amount of haptoglobin in the blood. Haptoglobin is a protein produced by the liver. Its purpose is to bind free haemoglobin released from red cell destruction and prevent it from causing toxic effects. This forms a haemoglobin-haptoglobin complex which is rapidly removed from the circulation by the liver and the iron from the haemoglobin is recycled.  

Haemoglobin is a protein that transports oxygen throughout the body. It is normally found inside red blood cells (RBCs), very little is found free, except when RBCs are destroyed and the haemoglobin inside them is released. When large numbers of RBCs are destroyed, haptoglobin concentrations in the blood will temporarily decrease as the amount of haptoglobin used to bind the free haemoglobin exceeds the amountproduced by the liver. 

Increased RBC destruction may be due to inherited or acquired conditions that cause haemolysis of RBCs. Causes of haemolysis include: transfusion reactions, certain drugs, and/or mechanical breakage, such as may be seen with some artificial heart valves. Acquired haemolysis may also result from auto-immune disorders in which the immune system causes the body to destroy its own cells. The destruction may be mild or severe, acute or chronic, and it can lead to haemolytic anaemia. Patients with haemolytic anaemia may experience symptoms such as tiredness, weakness, shortness of breath, headaches and dizziness and their skin may be pale or jaundiced. 

Liver disease may also result in low haptoglobin as liver damage may reduce both the production of haptoglobin and the removal of the haptoglobin-haemoglobin complexes. 

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Common Questions
  • How is it used?

    Haptoglobin testing is used mainly to help diagnose and monitor haemolytic anaemia and to distinguish it from anaemia due to other causes. It is important to note that haptoglobin cannot be used to diagnose the cause of the haemolysis. 

  • When is it requested?

    Haptoglobin may be requested if you have symptoms and signs of anaemia, such as paleness and weakness, along with findings suggestive of haemolytic anaemia, such as jaundice and dark urine. The test may be used alongside a reticulocyte count and a blood film when you have an abnormally low RBC count, haemoglobin, and/or haematocrit test result. It may also be used with a direct antiglobulin test when you have had a blood transfusion and are suspected of having a transfusion reaction or to investigate a suspected autoimmune haemolytic anaemia. Your healthcare professional may also request the test alongside a total or indirect bilirubin test.

  • What does the test result mean?

    When haptoglobin isdecreased, along with an increased reticulocyte count and a decreased RBC count, haemoglobin, and haematocrit, then it is likely that you have some degree of haemolytic anaemia. 

    If the haptoglobin is normal and the reticulocyte is increased, then RBC destruction may be occurring in organs such as the spleen and liver (called “extravascular” rather than “intravascular” haemolysis). As the freed haemoglobin is not released into the bloodstream, the haptoglobin does not bind to it and is therefore normal. 

    If the haptoglobin levels are normal and the reticulocyte count is not increased, then it is likely that the anaemia present is not due to RBC destruction. 

    If haptoglobin levels are low without any signs of haemolytic anaemia, this could indicate liver disease which has resulted in insufficient production of haptoglobin. It can also be associated with myelofibrosis and in very rare cases, a genetic condition known as anhaptoglobinaemia. 

  • Is there anything else I should know?

    Haptoglobin is an “acute-phase” protein; this means that it will be increased in many inflammatory diseases, such as ulcerative colitis, acute rheumatic disease, heart attack, and severe infection. This can complicate the interpretation of the haptoglobin results. Haptoglobin testing is not used to help diagnose or monitor these conditions.

    Haptoglobin levels may be affected by massive blood loss and by conditions associated with kidney dysfunction, liver disease, myelofibrosis and rare genetic conditions 

    Drugs that can increase haptoglobin levels include androgens and corticosteroids such as prednisolone. Drugs that can decrease haptoglobin concentrations include chlorpromazine, diphenhydramine, indomethacin, isoniazid, quinidine, streptomycin, and birth control pills. 

  • If haptoglobin levels are decreased, when will they return to normal?

    It depends on the cause of the decrease. If it is due to acute haemolysis, such as may be seen with a transfusion reaction, then it will return to normal once the donor blood has been cleared from the system. If it is due to chronic haemolysis, then the levels should return to normal levels if the underlying condition can be treated. If the underlying condition cannot be treated or if the decreased levels of haptoglobin are due to reduced production due to liver disease, then levels may continue to be lower than normal.