How Is Iron-Deficiency Anemia Diagnosed?
Your doctor will diagnose iron-deficiency anemia
based on your medical history, a physical exam, and the results from tests and
procedures.
Once your doctor knows the cause and severity of the
condition, he or she can create a treatment plan for you.
Mild to moderate iron-deficiency anemia may have no
signs or symptoms. Thus, you may not know you have it unless your doctor
discovers it from a screening test or while checking for other problems.
Specialists Involved
Primary care doctors often diagnose and treat
iron-deficiency anemia. These doctors include pediatricians, family doctors,
gynecologists/obstetricians, and internal medicine specialists.
A hematologist (a blood disease specialist), a
gastroenterologist (a digestive system specialist), and other specialists also
may help treat iron-deficiency anemia.
Medical History
To learn about your medical history, your doctor
will ask about your signs and symptoms and any past problems youve had
with
anemia
or low iron.
Your doctor also may ask about your diet and whether
youre taking any medicines. If you're a woman, your doctor may ask
whether you could be pregnant.
Physical Exam
Your doctor will do a physical exam to look for
signs of iron-deficiency anemia. He or she may:
- Look at your skin, gums, and nail beds to see
whether they're pale or yellowish
- 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
- Do a pelvic and rectal exam to check for internal
bleeding
Diagnostic Tests and Procedures
A number of tests and procedures are used to
diagnose iron-deficiency anemia. They can help confirm a diagnosis, look for a
cause, and find out how severe the condition 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 varies 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 infection, a blood disorder, 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. The results may be a clue as to the cause of your anemia. In
iron-deficiency anemia, for example, red blood cells usually are smaller than
normal.
Other Blood Tests
If the CBC results confirm you have anemia, you may
need other blood tests to find out what's causing the condition, how severe it
is, and the best way to treat it.
A reticulocyte (re-TIK-u-lo-site) count 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.
Your doctor also may order a peripheral smear. For
this test, a sample of your blood is examined under a microscope. In people who
have iron-deficiency anemia, the red blood cells will look smaller and paler
than normal.
Your doctor may recommend tests to measure iron
levels in your blood and body. These tests can show how much iron has been used
from your body's stored iron. These tests include:
- Serum iron. This test measures the amount of iron
in your blood. The level of iron in your blood may be normal even if the total
amount of iron in your body is low. For this reason, other iron tests also are
done.
- Serum ferritin. Ferritin is a protein that helps
store iron in your body. A measure of this protein helps your doctor find out
how much of your body's stored iron has been used up.
- Transferrin level, or total iron-binding
capacity. Transferrin is a protein that carries iron in your blood. Total
iron-binding capacity measures how much of the transferrin in your blood isn't
carrying iron. If you have iron-deficiency anemia, you'll have a high level of
transferrin that has no iron.
Your doctor also may recommend tests to check your
hormone levels, especially your thyroid hormone. You also may have a blood test
for a chemical called erythrocyte protoporphyrin. This chemical is a building
block for hemoglobin.
Tests and Procedures for Gastrointestinal Blood
Loss
To check whether internal bleeding is causing your
iron-deficiency anemia, your doctor may suggest a fecal occult blood test. This
test looks for blood in the stools and can detect bleeding in the intestines.
If the test finds blood, you may have other tests
and procedures to find the exact spot of the bleeding. These tests and
procedures may look for bleeding in the stomach, upper intestines, and colon or
pelvic organs. |