Anemia: diagnosis, test

Doctor diagnosed anemia with the help of a medical history, a physical exam and blood tests, may include the following:

Complete blood count (CBC): Complete blood counts in the first batch of blood tests in the diagnosis of an anemia. Apart from reporting the number of red blood cells and the hemoglobin level, the automatic counters also measure the size of the red blood cells by flow cytometry, which is an important tool in distinguishing between the causes of anemia. Examination of a stained blood smear using a microscope can also be helpful, and is sometimes a necessity in regions of the world where automated analysis is less accessible.

Hemoglobin test: Tests for blood in stool which may detect bleeding from the stomach or the intestines.

Peripheral blood smear: Looks at the red blood cells under a microscope to determine the size, shape, number, and color as well as evaluate other cells in the blood.

Iron level: An iron level may tell the doctor whether anemia may be related to iron deficiency or not. This test is usually accompanied by other tests that measure the body's iron storage, such as transferrin level and ferritin level.

Transferrin level: Evaluates a protein that carries iron around the body.

Ferritin: Evaluates at the total iron available in the body.

Folate: A vitamin needed to produce red blood cells, which is low in people with poor eating habits.

Vitamin B12: A vitamin needed to produce red blood cells, low in people with poor eating habits or in pernicious anemia.

Bilirubin: Useful to determine if the red blood cells are being destroyed within the body which may be a sign of hemolytic anemia.

Lead level: Lead toxicity used to be one of the more common causes of anemia in children.

Reticulocyte count: A measure of new red blood cells produced by the bone marrow.

Bone marrow biopsy: Evaluates production of red blood cells and may be done when a bone marrow problem is suspected.

If you receive a diagnosis of anemia, the doctor may order additional tests to determine the cause. For example, iron deficiency anemia can result from chronic bleeding of known or unknown ulcers, benign polyps in the colon, colon cancer, tumors, or kidney failure.