Exams and Tests

Doctors can easily detect anemia by drawing a blood sample for a complete blood count. Based on the results of the test and thorough evaluation of the patient, the doctor may order more tests to determine the exact cause of anemia. The complete blood count may be done as part of a routine general check-up or based upon the presence of signs and symptoms that can be related to anemia.

Because anemia is only a symptom of a disease, doctors will want to determine what is causing the anemia. Some people may need many tests, and some people may need very few. For example, an anemic person with known stomach ulcers may not need multiple blood tests but, may need to have his or her stomach visually evaluated and have the ulcers treated. On the other hand, a person with a family history of anemia and without an obvious source of blood loss may need multiple laboratory tests and other types of testing. Doctors also take into consideration the severity of the anemia when deciding the tests to order. When a person has severe anemia, the cause must be determined rapidly so that it can be treated appropriately.

Lab tests for anemia may include the following:

• Complete blood count: Determines the severity and type of anemia (microcytic anemia or small sized red blood cells, normocytic anemia or normal sized red blood cells, or macrocytic anemia or large sized red blood cells) and is typically the first test ordered.
  
  
• Stool 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.
  
  
• Hemoglobin electrophoresis: Sometimes used when a person has a family history of anemia; this test provides information on sickle cell anemia or thalassemia.
  
  
• Reticulocyte count: A measure of new red blood cells produced by the bone marrow
  
  
• Liver function tests: A common test to determine how the liver is working, which may give a clue to other underlying diseases causing anemia.
  
  
• Bone marrow biopsy: Evaluates production of red blood cells and may be done when a bone marrow problem is suspected.

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