How to test anemia?


Doctors conduct several types of blood tests to help them understand your case of aplastic anemia and create a treatment plan. Blood test results and lab reports are something every patient should learn how to read.

Complete Blood Count (CBC)

One key test is a complete blood count (CBC). It uses a number of methods to measure how many of each blood cell type are in your blood sample. If the CBC shows a low number of red blood cells, white blood cells or platelets, your doctor may also do a blood smear test, which means examining your cells under a microscope.

Getting a CBC on a regular basis is important for aplastic anemia patients. It allows doctors to monitor blood counts over time and compare them with previous results. Based on this record, doctors can determine a patient’s progress and refine treatment plans accordingly.

Reticulocyte Count

A reticulocyte 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. People who have aplastic anemia have low reticulocyte levels.

EPO level

EPO, or erythropoietin, is a protein made by your kidneys. It is created in response to low oxygen levels in the body, typically caused by low red cell counts and anemia. EPO causes your bone marrow to make more red blood cells.

Your doctor will order an EPO level to see if a shortage could be causing your anemia. A low EPO level may indicate a problem other than aplastic anemia, or it may make anemia worse in people who have MDS. Your doctor may prescribe a pharmaceutical form of EPO if yours is low.

Iron level

If you have anemia, your doctor may also check the level of iron in your blood. If a shortage of iron is causing anemia, it can be easily treated with iron supplements.

In some cases, blood tests may show that you have too much iron in your body. This is called iron overload. It can be caused by genetic conditions, or from getting lots of red blood cell transfusions. There are a number of treatments that can remove iron from your body.

Vitamin B12 and folate levels

If you have red blood cells with an abnormal shape, size or look, your doctor will check your blood levels of vitamin B12 and folate (folic acid). A shortage of these vitamins can cause dysplasia, or cells that are not normal. These abnormal looking cells don’t work right, and this can lead to anemia.

How to increase red blood cell count

Share on PinterestA person may increase their RBC count by eating more nutrient-dense foods.

A low RBC count usually occurs when a person does not eat enough essential nutrients. Eating more nutrient-dense foods can give the body the necessary tools to create functional RBCs.

People can also take these essential vitamins and minerals as supplements, although it is best to get nutrients from healthful foods in the diet if possible. It is best to consume foods that provide the following nutrients:


Iron is the nutrient with most links to anemia. The body uses iron to make hemoglobin, which stores oxygen in the blood cells. Without iron, these cells may die or become unable to send oxygen around the body.

Eating foods with plenty of iron can help prevent symptoms of anemia and nourish the blood. Good sources of iron include:

  • shellfish, such as oysters, clams, and mussels
  • fortified cereals
  • oysters
  • spinach
  • chocolate with 45–69% cacao solids
  • chickpeas
  • tuna
  • sardines
  • baked potato with the skin attached
  • beef liver
  • beef
  • tofu
  • chicken liver
  • white beans
  • lentils

Vitamin B-12

Vitamin B-12 is important for brain function and creating new RBCs. Low vitamin B-12 levels can prevent RBCs from fully maturing.

A B-12 deficiency can trigger the development of abnormal RBCs called megaloblasts, which may lead to a condition doctors call megaloblastic anemia.

Vitamin B-12 binds to protein in food and naturally occurs in red meat, fish, and shellfish. Dairy products, such as milk and cheese, also contain vitamin B-12.

Manufacturers often fortify breakfast cereals, milk substitutes, and nutritional yeast with vitamin B-12. Eating these foods can supplement a person’s daily intake, particularly if they do not eat meat or dairy.

Vitamin B-9

Vitamin B-9 is also known as folic acid or folate. It is an essential nutrient for the nervous system and adrenal glands. Folate also helps to create new cells in the body.

People with low levels of folate may develop anemia. Foods high in folic acid include:

  • beef liver
  • asparagus
  • brussels sprouts
  • green, leafy vegetables, such as spinach and mustard greens
  • oranges and orange juice
  • peanuts
  • black-eyed peas
  • kidney beans
  • enriched breads and grains

Vitamin C

While vitamin C does not directly affect RBCs, it is still important, because it helps the body absorb more iron. Iron increases the number of RBCs that the body makes.

Vitamin C occurs in a variety of foods, including:

  • kiwifruit
  • red and green peppers
  • broccoli
  • strawberries
  • tomatoes
  • baked potatoes
  • oranges
  • grapefruit juice

Some manufacturers also fortify food with vitamin C.


Copper is an essential mineral that helps the body use the iron in the blood. If someone is deficient in copper, their body has difficulties absorbing iron into the blood cells.

The following foods are good sources of copper:

  • beef liver
  • shellfish, such as oysters and crabs
  • cashews
  • chocolate
  • sunflower seeds
  • sesame seeds
  • potatoes
  • mushrooms
  • avocados
  • chickpeas
  • tofu

Vitamin A

Retinol, or vitamin A, supports a person’s RBC count similarly to copper. It may help the cells absorb the iron they need to function at full capacity.

Foods that can supply vitamin A include:

  • beef liver
  • some fish, including salmon
  • sweet potato
  • carrot
  • dark leafy greens, such as kale, collards, and spinach
  • broccoli
  • carrots
  • squash
  • certain fruits, including cantaloupe, apricots, and mango
  • cod liver oil

Anemia Panel – Comprehensive

When the blood lacks enough healthy red blood cells or hemoglobin, a condition called anemia develops. Hemoglobin is a component of blood that binds to oxygen. With too low red blood cells and/or hemoglobin, your body’s cells do not get enough oxygen.

This test panel is used to detect and identify a wide range of blood disorders.

There are more than 400 types of anemia, all of which are classified into the following three categories:

  • Anemia caused by blood loss
  • Anemia caused by decreased or faulty red blood cell production
  • Anemia caused by destruction of red blood cells

Our Comprehensive Anemia Panel includes:

  • Hematocrit – The amount of red blood cells in the blood.
  • Hemoglobin – A protein that transports oxygen or carbon dioxide in the blood.
  • Mean corpuscular volume (MCV) – Measures the average volume of red blood cells in the blood.
  • Mean corpuscular hemoglobin (MCH) – The amount of hemoglobin per red blood cell.
  • Mean corpuscular hemoglobin concentration (MCHC) – The amount of hemoglobin concentrated in a given volume of red blood cells.
  • Red cell distribution width (RDW) – Measures the difference of red blood cell size or volume in blood sample.
  • Percentage and absolute differential counts – Measures the amounts of different white blood cell types within the blood.
  • Platelet count (RBC) – Measures the amount of platelets (fragments and particles of cells) in the blood that are crucial for blood clotting.
  • White blood cell count (WBC) – Measures the amounts of different white blood cell types within the blood.
  • Iron – The iron blood test measures the amount of iron in the blood. Iron is a mineral that is needed by your body for the production of hemoglobin, energy, and maintaining proper muscle and organ function.
  • Total iron-binding capacity (TIBC) – Is used to differentiate between anemia types and gives more iron statistics than the Iron test alone.
  • Ferritin – Ferritin is present in small concentrations that correlate with total-body iron stores, making its measurement valuable for the assessment of disorders relating to iron metabolism.
  • Folic acid (Folates) – This test measures levels of folic acid (folate). Folic acid is a B vitamin that plays an important role in DNA synthesis and producing red blood cells. Folic acid is absorbed through the small intestine and stored in the liver and must be ingested through diet since it cannot be made by the body itself.
  • Vitamin B12 – This test measures levels of vitamin B12, also known as Cobalamin. B12 plays an important role in the normal functioning of the central nervous system, metabolism, and the formation of red blood cells. Deficiencies may occur in individuals with digestive disorders like celiac disease or irritable bowel syndrome.

How Anemia Is Diagnosed

When your doctor suspects that you have anemia, a condition caused by the blood’s inability to deliver enough oxygen to the body, the first step is usually a diagnostic test.

Blood tests can tell your physician whether you are truly anemic, said Raymond Liu, MD, a hematologist with Kaiser Permanente Hospital in San Francisco, along with what is causing the anemia.

Anemia Test No. 1: Complete Blood Count (CBC)

If you’re experiencing symptoms of anemia, the most common diagnostic test is a complete blood count, known as a CBC. A CBC involves taking a small blood sample and analyzing its components, including the red blood cells, white blood cells, and platelets. “It tests at all the elements of the blood, but mainly we’re looking at the red blood cells because a low red blood cell count can mean anemia,” Dr. Liu said.

The CBC also measures levels of hematocrit (the percentage of red blood cells found in whole blood) and hemoglobin (an oxygen-carrying protein in the blood). Low levels of either hematocrit or hemoglobin can indicate an anemic condition.

The complete blood count is the main test used to make a general diagnosis of anemia, Liu said, after which other diagnostic tests can be ordered as needed. “After we’ve determined there is anemia, we can determine the cause,” explained Liu.

Anemia Test No. 2: Reticulocyte Count

One such diagnostic test is a reticulocyte count, which measures the number of immature red cells in the blood. These cells are produced by bone marrow, and a high reticulocyte count could mean that your symptoms of anemia are due to blood loss, either through hemorrhaging, heavy menstrual periods, or sources of blood loss.

“If your bone marrow is responding very well and producing lots of red blood cells, then the reticulocyte count should be high because the red blood cell factory is working overtime to make up for those lost red blood cells,” said Liu.

A low reticulocyte count, on the other hand, means that your bone marrow is not producing enough red blood cells. This is most commonly caused by a nutritional deficiency. “If you don’t have enough iron or vitamin B12, you can’t make red blood cells,” Liu explained. Folate deficiency can also be a cause of a low reticulocyte count, though it’s less common in the Western world because many foods, such as bread, are fortified with folate. People who have cancer or are undergoing radiation therapy may also experience low reticulocyte counts, as well as those whose kidney function is impaired.

Once the cause of the low reticulocyte count has been determined, your doctor can decide how to treat your anemia, Liu said. If a low reticulocyte count is caused by nutritional gaps, you can take supplements of appropriate vitamins, such as iron, B12, or folate. If your reticulocyte production has been suppressed due to kidney problems, a physician may treat you with injections of erythropoietin, a hormone produced by the kidneys that tells the bone marrow to produce more red blood cells.

Anemia Test No. 3: Blood Smear

Another test that helps search for anemia causes is a blood smear. This test, which is performed by spreading a drop of blood on a slide and staining it with a special dye, can detect irregularities in red blood cells, white blood cells, and platelets. Abnormal red blood cells can tell your doctor more about your anemia. For example, unusually large red blood cells can indicate anemia caused by a vitamin deficiency, while crescent-shaped red blood cells can mean you have sickle-cell anemia, an inherited disease.

The treatments that your physician prescribes after a blood smear will depend on the test results. If your blood smear reveals vitamin deficiencies, changes in diet or taking vitamin supplements may be the only treatment you need. There is no cure for sickle-cell anemia, but patients are often told to stay hydrated and in good health because being in less-than-ideal physical condition can cause painful episodes, known as “sickle cell crises” that occur when misshapen red blood cells form clumps in the bloodstream. “Anything that stresses the body out can lead to crisis,” Liu says. People with moderate to severe sickle-cell anemia may also be prescribed a drug called hydroxyurea to prevent episodes of pain.

Anemia Test No. 4: Iron Panel

If your doctor suspects that your anemia is due to an iron deficiency, she may order an iron panel, a blood test that measures the level of iron in your blood. This test is often used when your doctor believes that your iron deficiency is caused by blood loss, such as bleeding in the gastrointestinal tract. “If we suspect there is blood loss related to an iron deficiency, we definitely do an iron panel,” Liu said. “If someone’s anemic, it can help us estimate how long their recovery time will be.”

Treatment for iron deficiency involves taking iron supplements, usually in pill form. Those who cannot tolerate oral iron supplements can also take it intravenously or by an injection into the muscle.

If you suspect you have symptoms of anemia, talk to your doctor. Once simple blood tests determine the cause of your anemia, you and your doctor can work together to get you back to optimal health.

How and When Doctors Test for Iron-Deficiency Anemia


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If you have iron-deficiency anemia, it means your red blood cells are not carrying enough oxygen to the cells in your body. Iron deficiency makes it hard for your body to make the protein hemoglobin. Your red blood cells need hemoglobin to carry oxygen.

Iron-deficiency anemia is the most common type of anemia. It can cause symptoms like fatigue, shortness of breath, headaches, cold hands and feet, and dizziness. Iron-deficiency anemia may also be a warning sign of other serious medical problems like bleeding or a problem with digestion. But early and mild iron-deficiency anemia may have no signs or symptoms, so how do doctors diagnose it?

Iron-deficiency anemia is the most common type of anemia. Learn these interesting facts about the condition.

Medical Reviewers: William C. Lloyd III Last Review Date: 2017 Oct 4

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Transcript open 5 Things You Didn’t Know About Anemia 1. Iron-deficiency anemia is the most common type of anemia.There are several different types of anemia, but as much as 50 percent of people with the condition are iron-deficient. 2. Anemia moves slowly. At first, symptoms of anemia can be tough to spot. But as it gets worse, you may experience severe fatigue and weakness. 3. Iron-deficiency anemia is more common in women.Women who are pregnant or have heavy menstrual periods are at a higher risk for iron-deficiency. 4. Your diet might have something to do with low iron levels.Our bodies absorb iron in animal-based foods like chicken and fish. If you don’t eat meat, choose foods high in iron, such as beans, spinach or tofu. 5. Untreated iron-deficiency anemia can cause serious health problems.With anemia, your body isn’t making enough healthy red blood cells. This can cause damage to your organs and make your heart work too hard. Share this video to help educate others about anemia!Finding the best doctor to treat anemia can increase your quality of life. Turn to to search for the right doctor for you.

Testing for Iron-Deficiency Anemia

Blood tests can show iron-deficiency anemia before symptoms develop. These tests include a complete blood count, which will measure your hemoglobin level. Iron-deficiency anemia makes your red blood cells appear smaller under a microscope. Blood tests can also measure the amount of iron in your blood and the amount stored in your body.

Testing Without Symptoms

Doctors test for iron-deficiency anemia in all pregnant women. Pregnancy increases the demand for iron. Iron-deficiency anemia during pregnancy can lead to problems with pregnancy and problems for a developing baby. Doctors also check hemoglobin levels in all children at age one.

If you are not pregnant and not a child, your doctor may still test you for iron-deficiency anemia if you are at increased risk. Here are some conditions that increase your risk of developing iron-deficiency anemia:

  • You are a woman with heavy menstrual periods.
  • You are breastfeeding.
  • You have a condition that interferes with your digestion.
  • You have a condition that causes bleeding such as an ulcer.
  • You are a vegetarian.

Testing With Symptoms

If you have signs and symptoms of iron-deficiency anemia, your doctor will use the same tests to diagnose you. Along with common symptoms, your doctor may suspect iron deficiency if you have signs of anemia during a physical exam. These signs include:

  • Irregular heartbeat or heart sounds
  • Pale color of skin, gums or nail beds
  • An enlarged spleen or liver
  • Brittle nails or hair loss

Testing After Diagnosis

If your doctor diagnoses iron-deficiency anemia with blood tests, more tests may be necessary. Your doctor will want to find out what is causing your anemia. Additional tests may include:

  • Checking your stool and urine for blood
  • Doing imaging studies to look for sources of bleeding
  • Doing a procedure (endoscopy) to look into your digestive tract
  • Doing other blood studies to look for diseases that cause abnormal hemoglobin (such as thalassemia and sickle cell disease)

An iron-rich diet and iron supplements can help replenish iron and eliminate your symptoms, but you may need additional treatments depending on the underlying cause. For instance, if you have a stomach ulcer, your doctor can prescribe medication and perform endoscopy to stop any bleeding.

“Every time we draw blood, we are invading the patient in some way, shape or form. If we don’t already have a line in, we are sticking a needle into their arm, which involves discomfort and infection risk, albeit low,” she says. “It would be really nice to not have to perform a procedure every time we want to answer that question.”

At home test diagnoses anemia in 60 seconds

HemaApp bombards a patient’s finger with different wavelengths of light and infrared energy and creates a series of videos. By analyzing how colors are absorbed and reflected across those wavelengths, it can detect concentrations of hemoglobin and other blood components like plasma.

To ensure that it works on different skin tones and body masses, the team developed processing algorithms that use the patient’s pulse to distinguish between the properties of the patient’s blood and the physical characteristics of his or her finger.

Next research steps include wider national and international testing of HemaApp, collecting more data to improve accuracy rates, and using smartphones to try to detect abnormal hemoglobin properties that could help screen for sickle cell disease and other blood disorders.

“We’re just starting to scratch the surface here,” Patel says. “There’s a lot that we want to tackle in using phones for non-invasively screening disease.”

Researchers will present a paper on the technology on September 15 at the Association for Computing Machinery’s 2016 International Joint Conference on Pervasive and Ubiquitous Computing (UbiComp 2016) in Germany.

The Washington Research Foundation funded the work.

Source: University of Washington

How to Make a Smartphone Detect Anemia

In places where medical resources are lacking, smartphones could become indispensable medical equipment.

A new way of detecting anemia, a condition caused by a lack of oxygen-carrying red blood cells, using a smartphone camera hints at how such devices might be used to provide early warning of an illness without the need for expensive equipment or a hospital visit.

Researchers at the University of Washington will present a simple anemia-tracking technique using a smartphone and a light source at a conference later this month. Their tests suggest the device’s accuracy rivals that of an off-the-shelf, FDA-approved anemia test. The technology was developed in the lab of Shwetak Patel, a professor in the university’s electrical engineering department (see “Innovators Under 35, 2009: Shwetak Patel”).

The app provides a hemoglobin reading.

Anemia, which can be caused by malnutrition or parasitic infection, is incredibly common in poorer countries. The World Health Organization estimates that some two billion around the world are anemic. Symptoms including dizziness, weakness, and severe headaches. Those with certain chronic conditions, such as sickle cell anemia, need to be constantly monitored, usually with frequent blood tests.

Patel is exploring various ways of harnessing the sensors on a smartphone to make simple health tests more accessible. He has developed another app that uses the device’s microphone to track a person’s breathing while he or she sleeps, and another that can detect jaundice in a newborn baby using a smartphone’s camera and a color-coded reference card. All of his systems rely on machine-learning algorithms to recognize symptoms from sensor readings.

Patel and colleagues found that the camera in a Nexus 5 smartphone could measure hemoglobin by capturing light passing through a person’s finger. The system records video as light from the phone’s flash, a small additional array of LED lights, and an incandescent lightbulb shines through a fingertip. The system was trained to recognize changes in color as blood pumps through the finger that might indicate a deficiency of red blood cells.

In tests of 31 people that were conducted in collaboration with Seattle Children’s Hospital, it was found that the new system worked as well as a commercial LED-based anemia test, the Masimo Pronto. It was not nearly as accurate as a conventional blood test, however.

A smartphone’s flash illuminates a finger—a trick that lets HemaApp measure hemoglobin.

Ulrich Timm, a professor at the University of Rostock in Germany who has studied the use of LED-based sensing systems for hemoglobin tracking, says the technology would have lots of practical use—providing it works as well as promised. “Such a system would be very useful for blood donation centers or home care,” he says. “Pregnant women could monitor their hemoglobin level without additional hardware.” However, Timm also questions how accurate the approach would be in practice, given the spectral resolution of most smartphone cameras.

Caroline Buckee, an assistant professor and epidemiologist at Harvard who studies ways for mobile devices to be used for global health (see “Innovators Under 35, 2013: Caroline Buckee”), says the system seems promising, but warns that it is not always simple to deploy and scale such a solution. And she agrees that accuracy would be a key concern.

“There is the issue of the penetration of smartphones,” Buckee says. “Although it would still be useful in many places where there is high smartphone penetration and lots of anemia, like India; and community health workers could use it in places without high penetration in rural areas where anemia affects many people, such as West Africa.”

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