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menstruation, injury, illness, or a bleeding ulcer) Your body can’t absorb iron properly: This affects your ability to produce healthy red blood cells You’re not getting enough essential nutrients: A lack of iron, vitamin B12, and vitamin B9 (folate) can limit red blood cell production Medical Conditions That Can Affect Hemoglobin Levels Certain medical conditions can also play a role: Lymphoma (cancer of the lymphatic system) Leukemia (blood cancer) Aplastic anemia Pernicious anemia Multiple myeloma (plasma cell cancer) Myelodysplastic syndromes Chronic kidney disease Antiretroviral medications Chemotherapy Bleeding ulcer Enlarged spleen (splenomegaly) Sickle cell anemia (inherited blood disorder) Thalassemia (inherited blood disorder) If your hemoglobin level remains abnormal, it’s wise to consult your GP for further evaluation