Anemia Testing Overview
Diagnosing Iron-Deficiency Anemia
When the blood does not contain enough healthy red blood cells, a blood disorder called anemia can develop. Red blood cells are responsible for carrying oxygen to the body's tissues. Iron-deficiency anemia is the most common form of anemia, and occurs when there is not enough iron in the body to produce adequate supplies of hemoglobin, the substance in red blood cells that gives them the ability to carry oxygen. An anemia test is the first step in diagnosing this disorder, and may be done as part of a regular health checkup or in response to anemia symptoms.
What causes iron-deficiency anemia?
As implied by the name of this form of anemia, its basic cause is iron deficiency, or a lack of adequate levels of iron in the body. Low levels of iron can stem from a number of causes, including:
- Not getting enough iron in your diet – Your body gets iron from foods. When you are eating plenty of iron-rich foods – such as meats, eggs, and leafy green vegetables, for instance – your body stores away enough iron to meet its needs. When you aren't, the body's iron stores can become depleted over time, leading to iron deficiency.
- Blood loss – Since red blood cells contain iron, losing blood means losing iron. For example, women with heavy menstrual flow may become deficient in iron, as can people who lose blood daily due to peptic ulcers or suffer gastrointestinal bleeding from regular aspirin use.
- Poor iron absorption – Iron is absorbed into the bloodstream through the small intestine. People who have intestinal disorders, such as celiac disease or Crohn's disease, or have had intestinal surgeries may not absorb iron efficiently.
- Pregnancy – Iron levels can sink during pregnancy as it increases demand for iron. This happens due to increased blood volume in the mother, as well as the need to make hemoglobin for the unborn child.
A GUIDE: Anemia: The Basics
What are the symptoms?
Mild iron-deficiency anemia typically does not cause obvious symptoms. As the condition becomes more severe over time, symptoms may appear as anemia deprives tissues throughout the body of the oxygen they need for proper health and function. These may include:
- Chest pain
- Rapid heartbeat
- Shortness of breath
- Dizziness, lightheadedness
- Pale skin
- Swelling and/or soreness in the tongue
- Cold hands, feet
- Poor appetite
Iron deficiency anemia that is severe enough to cause symptoms can, when left untreated, lead to other health problems over time. These may include enlarged heart and/or heart failure as the heart is overworked to compensate for low oxygen levels in the blood, pregnancy complications, and delayed growth and development in children.
Who is at risk?
People who are greater risk than the average person for developing iron-deficient anemia include:
- Women of childbearing age – Since they lose blood, and therefore iron, every month with their menstrual period, women of childbearing age are more likely to develop iron-deficiency anemia than are men or menopausal women.
- Infants and children – Infants in general, but especially those born prematurely or with a low birth weight, are at risk for this form of anemia if they aren't getting enough iron from breast milk or formula. Children who are not eating a healthy, balanced diet may also be at risk.
- Vegetarians or vegans – People on these diets may be at risk if they aren't careful to compensate for the lack of meat and other animal products with other iron-rich foods.
- Frequent blood donors – People who regularly donate blood can experience depleted iron reserves in the body, increasing risk of iron-deficient anemia.
People who fall into any of these risk groups should consider getting tested for anemia regularly. Routine anemia screening is a matter of simple blood tests that can easily be done as part of an annual physical exam.
How is it diagnosed?
Iron-deficient anemia is identified through blood testing. Among the tests most commonly used in the diagnosis of the condition include:
- Complete Blood Count (CBC) with Differential test – This blood test measures vital components of the blood, including white blood cells, red blood cells, hematocrit, hemoglobin, and platelets. It also analyzes red cells for size, color and other important characteristics. Iron-deficient anemia is indicated if results show that red blood cells are smaller and paler in color than usual, hematocrit values are abnormal and/or hemoglobin levels are lower than normal.
- Ferritin test – This blood test measures the amount of ferritin in the blood, which is a protein that regulates iron storage in the body. Lower than normal ferritin levels in tested blood indicate deficient iron levels.
- Iron & Total Iron Binding Capacity (TIBC) test – This test checks levels of iron in the bloodstream as well as how much of that iron is available to bind to proteins in the blood, which helps determine how much iron is available to help in oxygen transport.
If the presence of iron-deficiency anemia is indicated by blood test results, your doctor may order further testing to identify any potential underlying causes of your condition.
How is iron-deficiency anemia treated?
Iron supplementation to bring iron levels within the body back up to healthy levels is generally the first course of treatment for iron-deficiency anemia. Restoring the body's iron reserves typically requires taking supplemental iron for several months or more, but symptoms of anemia often begin to fade within a week or so of starting treatment. Blood tests will be done periodically during treatment to assess iron levels. Other treatments recommended by your doctor will likely be related to resolving any underlying health issues that contributed to the development of anemia.
Featured Tests And Packages
Includes a complete blood count (CBC) of red and white cells, iron, iron-binding capacity, and reticulocyte count to screen for anemia
Lab Tests (A-Z)
Measures red and white blood cells, hematocrit, hemoglobin and platelets
Measures level of ferritin to assess iron deficiency or iron overload.
The Hemoglobin Solubility test is used to help measure and detect normal and abnormal forms of hemoglobin.
Measures level of iron to assess iron deficiency or iron overload
Measures the amount of iron available to bind to proteins, providing additional information about possible iron deficiency or iron overload
This blood test is used to measure the amount of Methylmalonic acid in your body and to help detect Vitamin B12 deficiency.
This urine test is used to measure the amount of Methylmalonic acid in your body and to help detect Vitamin B12 deficiency.
This test measures the amount of reticulocytes, which are immature red blood cells produced by bone marrow.
This test is used to measure Total and Direct Bilirubin levels in the blood.
This test is used to directly measure the level of Transferrin in the blood.
Measures the amount of B12 to screen for nutrition or absorption issues and certain types of anemia
Measures the amount of B12 and folate (folic acid) to screen for nutrition or absorption issues and certain types of anemia