Testing your hemoglobin without taking your blood has been a possibility for quite some time. We have been using this technology in the operating room for some years. Basically, it consists of using several wavelengths of light that measure the absorption of light in the blood, much like a pulse oximeter. But the device that measures hemoglobin has more wavelengths of lights to measure hemoglobin. Somewhat complex, just know that measuring your hemoglobin with this device is accurate, albeit not quite as accurate as direct blood testing. The system which measures non-invasive hemoglobin is called the Ember Device.

I have been testing and using the Ember system for many months. The Ember system is a machine that non-invasively measures your heart rate, pulse oximetry, respiratory rate, pulse strength, hemoglobin and even PVI, which is an indirect measure of plasma volume. Recently the device now has the capability of measuring carbon monoxide. Sports teams such as the professional cycling team Lotto-Jumbo have been using the device.

With so many options available to measure athletic performance, it’s about finding something meaningful to you and that makes sense. Ember is a powerful tool that when used correctly, it can help you learn about what’s actually happening inside your body at rest, after training, and competition. The real power of Ember is that athletes can track several values over time, such as hemoglobin, pulse, oxygenation, and hydration, and all without getting blood work. I like to think that Ember is not merely a spot check, but a historical picture. By measuring your values and looking at them over time, you make Ember your own.

For most athlete’s, training and racing is about whether you feel good or you feel bad. It’s also about how to train as efficiently as possible, saving energy and building fitness to target sometimes a few major events each year. Many athletes have numerous blood tests every month or so and try to build a history of how their body responded to the training or racing they have accumulated. For those who desire to know out what’s going on with their body, the Ember device is an i-phone sized laboratory that goes with you everywhere, and best of all you don’t need to stick a needle in your arm.

Hemoglobin is all about plasma volume shifts

Hemoglobin, many athletes obsess over how much of it they have; most think of hemoglobin as oxygen carrying cars. It’s thought that the more “oxygen carrying cars” available, the harder and faster one can train and compete. While there is truth to this, study after study show that hemoglobin is more about how your plasma volume shifts rather than the hemoglobin number (Bejder et al., Swanka et al., Brun et al. ) There is much more happening than just increasing red blood cells. To put this in perspective, each red blood cell carries about 270 million hemoglobin molecules and each hemoglobin molecule carries 4 oxygen molecules. Hemoglobin carries much more than just oxygen, it carries nitrogen, acid, bases, carbon dioxide, carbon monoxide, and much more. How your plasma volume and hemoglobin adapt when exposed to training and different environments are the reasons you can push your body harder and faster over time. As summarized by Ernst et al. : “the fitter the athlete the more fluid his blood.

To understand how exercise affects your health and body, you need to understand the underlying physiological elements. Did you know that plasma volume shifts are among the main reasons you adapt to exercise and not the actual rise in red blood cells (Bejder et al., Brun et al.)? Women’s plasma volume may change differently than men’s (Martin et al.) Most think of hemoglobin in the traditional sense, that it is an oxygen-carrying molecule and that more hemoglobin equates to better performance. Using the Ember, you can start thinking past hemoglobin and start thinking about how plasma volume shifts affect you as an athlete. Every time you exercise or race, your plasma volume shifts massively, by liters at a time, and these changes can be detected using the Ember. For example, after a hard training session your plasma volume will decrease, and the hemoglobin will increase. Then as you recover, the plasma volume will stabilize, and the hemoglobin drops back towards normal (Brun et al.) Those day to day shifts of hemoglobin are attributable to plasma volume shifts, and large ones at that! Hopefully you can discover what causes these.