How Is Anemia Diagnosed?

Your doctor will diagnose anemia based on your medical and family histories, a physical exam, and results from tests and procedures.

Because anemia doesn’t always cause symptoms, your doctor may find out you have it while checking for another condition.
Medical and Family Histories

Your doctor may ask whether you have any of the common signs or symptoms of anemia. He or she may ask whether you’ve had an illness or condition that could cause anemia.

Your doctor also may ask about the medicines you take, your diet, and whether you have family members who have anemia or a history of it.
Physical Exam

Your doctor will do a physical exam to find out how severe your anemia is and to check for possible causes. He or she may:

* Listen to your heart for a rapid or irregular heartbeat
* Listen to your lungs for rapid or uneven breathing
* Feel your abdomen to check the size of your liver and spleen

Your doctor also may do a pelvic or rectal exam to check for common sources of blood loss.
Diagnostic Tests and Procedures

Your doctor may order various tests or procedures to find out what type of anemia you have and how severe it is.
Complete Blood Count

Often, the first test used to diagnose anemia is a complete blood count (CBC). The CBC measures many different parts of your blood.

This test checks your hemoglobin and hematocrit (hee-MAT-oh-crit) levels. Hemoglobin is the iron-rich protein in red blood cells that carries oxygen to the body. Hematocrit is a measure of how much space red blood cells take up in your blood. A low level of hemoglobin or hematocrit is a sign of anemia.

The normal range of these levels may be lower in certain racial and ethnic populations. Your doctor can explain your test results to you.

The CBC also checks the number of red blood cells, white blood cells, and platelets in your blood. Abnormal results may be a sign of anemia, a blood disorder, an infection, or another condition.

Finally, the CBC looks at mean corpuscular (kor-PUS-kyu-lar) volume (MCV). MCV is a measure of the average size of your red blood cells and a clue as to the cause of your anemia. In iron-deficiency anemia, for example, red blood cells usually are smaller than normal.
Other Tests and Procedures

If the CBC results show that you have anemia, you may need other tests such as:

* Hemoglobin electrophoresis (e-lek-tro-FOR-e-sis). This test looks at the different types of hemoglobin in your blood. It can help diagnose the type of anemia you have.
* A reticulocyte (re-TIK-u-lo-site) count. This test measures the number of young red blood cells in your blood. The test shows whether your bone marrow is making red blood cells at the correct rate.
* Tests for the level of iron in your blood and body. These include serum iron and serum ferritin tests. Transferrin level and total iron-binding capacity also test iron levels.

Because anemia has many causes, you also may be tested for conditions such as kidney failure, lead poisoning (in children), and vitamin deficiencies (lack of vitamins, such as B12 and folic acid).

If your doctor thinks that you have anemia due to internal bleeding, he or she may suggest several tests to look for the source of the bleeding. A test to check the stool for blood may be done in your doctor’s office or at home. Your doctor can give you a kit to help you get a sample at home. He or she will tell you to bring the sample back to the office or send it to a lab.

If blood is found in the stool, other tests may be used to find the source of the bleeding. One such test is endoscopy (en-DOS-ko-pe). For this test, a tube with a tiny camera is used to view the lining of the digestive tract.

Your doctor also may want to do bone marrow tests. These tests show whether your bone marrow is healthy and making enough blood cells.

How Is Anemia Treated?

Treatment for anemia depends on the type, cause, and severity of the condition. Treatments may include dietary changes or supplements, medicines, or procedures.
Goals of Treatment

The goal of treatment is to increase the amount of oxygen that your blood can carry. This is done by raising the red blood cell count and/or hemoglobin level. Another goal is to treat the underlying condition or cause of the anemia.
Dietary Changes and Supplements

Low levels of vitamins or iron in the body can cause some types of anemia. These low levels may be due to poor diet or certain diseases or conditions.

To raise your vitamin or iron levels, your doctor may ask you to change your diet or take vitamin or iron supplements. Common vitamin supplements are vitamin B12 and folic acid (folate). Vitamin C is sometimes given to help the body absorb iron.
Iron

Your body needs iron to make hemoglobin. Your body can more easily absorb iron from meats than from vegetables or other foods. To treat your anemia, your doctor may suggest eating more meat—especially red meat, such as beef or liver—as well as chicken, turkey, pork, fish, and shellfish.

Nonmeat foods that are good sources of iron include:

* Spinach and other dark green leafy vegetables
* Peanuts, peanut butter, and almonds
* Eggs
* Peas; lentils; and white, red, and baked beans
* Dried fruits, such as raisins, apricots, and peaches
* Prune juice

Iron is added to some foods, such as cereal, bread, and pasta. You can look at the Nutrition Facts label on a food to find out how much iron it contains. The amount is given as a percentage of the total amount of iron you need every day.

Iron can be given as a mineral supplement. It’s usually combined with multivitamins and other minerals that help your body absorb iron.
Vitamin B12

Low levels of vitamin B12 can lead to pernicious anemia. This type of anemia is often treated with vitamin B12 supplements.

Good food sources of vitamin B12 include:

* Breakfast cereals with added vitamin B12
* Meats such as beef, liver, poultry, fish, and shellfish
* Egg and dairy products (such as milk, yogurt, and cheese)

Folic Acid

Folic acid (folate) is a form of vitamin B that’s found in foods. Your body needs folic acid to make and maintain new cells. Folic acid also is very important for pregnant women. It helps them avoid anemia and promotes healthy growth of the fetus.

Good sources of folic acid include:

* Bread, pasta, and rice with added folic acid
* Spinach and other dark green leafy vegetables
* Black-eyed peas and dried beans
* Beef liver
* Eggs
* Bananas, oranges, orange juice, and some other fruits and juices

Vitamin C

Vitamin C helps the body absorb iron. Good sources of vitamin C are vegetables and fruits, especially citrus fruits. Citrus fruits include oranges, grapefruits, tangerines, and similar fruits. Fresh and frozen fruits, vegetables, and juices usually have more vitamin C than canned ones.

If you’re taking medicines, ask your doctor or pharmacist whether you can eat grapefruit or drink grapefruit juice. This fruit can affect the strength of a few medicines and how well they work.

Other fruits rich in vitamin C include kiwi fruit, mangos, apricots, strawberries, cantaloupes, and watermelons.

Vegetables rich in vitamin C include broccoli, peppers, tomatoes, cabbage, potatoes, and leafy green vegetables like romaine lettuce, turnip greens, and spinach.
Medicines

Your doctor may prescribe medicines to increase the number of red blood cells your body makes or to treat an underlying cause of anemia. Some of these medicines include:

* Antibiotics to treat infections.
* Hormones to treat adult and teenaged women who have heavy menstrual bleeding.
* A man-made version of erythropoietin to stimulate your body to make more red blood cells. This hormone has some risks. You and your doctor will decide whether the benefits of this treatment outweigh the risks.
* Medicines to prevent the body’s immune system from destroying its own red blood cells.
* Chelation (ke-LAY-shun) therapy for lead poisoning. Chelation therapy is used mainly in children. This is because children who have iron-deficiency anemia are at increased risk for lead poisoning.

Procedures

If your anemia is severe, you may need a medical procedure to treat it. Procedures include blood transfusions and blood and marrow stem cells transplants.
Blood Transfusion

A blood transfusion is a safe, common procedure in which blood is given to you through an intravenous (IV) line in one of your blood vessels. Transfusions require careful matching of donated blood with the recipient’s blood.

For more information, see the Diseases and Conditions Index Blood Transfusion article.
Blood and Marrow Stem Cell Transplant

A blood and marrow stem cell transplant replaces your abnormal or faulty stem cells with healthy ones from another person (a donor). Stem cells are found in the bone marrow. They develop into red and white blood cells and platelets.

During the transplant, which is like a blood transfusion, you get donated stem cells through a tube placed in a vein in your chest. Once the stem cells are in your body, they travel to your bone marrow and begin making new blood cells.

For more information, see the Diseases and Conditions Index Blood and Marrow Stem Cell Transplant article.
Surgery

If you have serious or life-threatening bleeding that’s causing anemia, you may need surgery. For example, you may need surgery to control ongoing bleeding due to a stomach ulcer or colon cancer.

If your body is destroying red blood cells at a high rate, you may need to have your spleen removed. The spleen is an organ that removes worn-out red blood cells from the body. An enlarged or diseased spleen may remove more red blood cells than normal, causing anemia.

    

I had mild anemia while pregnant. I was told not to mix my iron rich foods with my vitamin C as will counteract the absorption. However, to take calcium with the iron to help it. My anemia went away quickly after giving birth.