What tests should be done for anemia?

To establish the diagnosis of anemia, it is necessary to donate blood for analysis. This study will not only determine that anemia develops in a person, but also clarify the type of disorder, as well as its severity. Thanks to laboratory studies, even minor deviations from the norm can be established.

What tests should be done to detect anemia?

It is simply impossible to clarify the diagnosis of anemia without laboratory tests. Therefore, patients are prescribed a general and biochemical blood test. If their results indicate a decrease in the level of hemoglobin in the blood, and / or a decrease in the number of red blood cells, then this confirms the fact that anemia develops in a person. With this violation, all internal organs will suffer from hypoxia (oxygen starvation). After all, it is hemoglobin that is the substance that is responsible for transporting oxygen molecules to organs and tissues.

Blood for a general analysis is taken from a finger. Her fence is carried out in the morning, on an empty stomach.

The results will display the following values:

• The number of red blood cells in the blood.

• The size of erythrocytes, their diameter and compliance with the specified standards.

• The level of reticulocytes in the blood, which are “young” red blood cells.

• The level of hemoglobin in the blood.

• Determination of the proportions of platelets and leukocytes.

• Blood hematocrit.

Evaluation and interpretation of the data obtained will allow the doctor to establish a diagnosis and suspect the cause of anemia. If a general blood test indicates a decrease in hemoglobin levels, then the patient is sent for a biochemical blood test.

This study will provide information on the following parameters:

• Serum iron level.

• The level of transferritin in the blood.

• The binding capacity of the blood.

• ferritin level.

Evaluation of the data obtained will clarify the nature of anemia and its pathogenesis. To perform a biochemical study of blood, it is taken from a vein.

Indicators of norm and deviation

To determine that a patient develops anemia, the obtained data should be compared with the normal values. They differ depending on the gender and age of the subject.

Hemoglobin as an indicator of blood

Hemoglobin colors blood red. This substance is part of the erythrocytes, which are involved in the transport of oxygen molecules to organs and tissues. If hemoglobin in the blood begins to decrease, then this will indicate the development of anemia of varying severity.

Depending on the specific values, there are:

• Hemoglobin level 110-90 g/l – mild anemia.

• 90-70 g / l – anemia of moderate severity.

• The level of hemoglobin in the blood is below 70 g/l – severe anemia.

However, the calculation of blood hemoglobin alone will not allow a diagnosis to be made. You will need to study other indicators of this life-supporting fluid.

Red blood cells and anemia

Erythrocytes are also called red blood cells. They are represented by disc-shaped formations, thanks to this structure, erythrocytes have the ability to penetrate even the smallest blood vessels. They transport oxygen molecules from the lungs to organs and tissues, and carbon dioxide is taken from them and transferred to the lungs for further excretion from the body. A drop in the number of red blood cells in the blood will be a sign of developing anemia of any type.

About reticulocytes

Red blood cells do not appear in the blood on their own, they develop and mature in the bone marrow. There they are presented in the form of reticulocytes, which are young red blood cells. Normally, they can also circulate in the bloodstream, but their number should not exceed the above values.

If the level of reticulocytes begins to increase, then this is a clear sign of the progression of anemia. By their number in the blood, it is also possible to assess the severity of this disorder. 

color indicator of blood

To assess the degree of saturation of blood with hemoglobin, a blood test is carried out for its color index. Its fall below the existing norms indicates the development of anemia.

The following evaluation criteria are available:

• If the color index falls below 0,8, then this indicates hypochromic anemia.

• If the values ​​of the color index remain at the level of 0,8-1,05, then this is a sign of normochromic anemia.

• With an increase in its value to 1,05 or more, experts speak of hyperchromic anemia.

This way you can determine the type of anemia. If the values ​​​​of the color index of the blood are exceeded, then the placenta is diagnosed with folate deficiency anemia and B12 deficiency anemia. With posthemorrhagic anemia, the color index of the blood may remain within the normal range. If the color index of the blood decreases, then with a high degree of probability the patient develops iron deficiency anemia.

Erythrocyte index – what is it?

In the blood test, you can find such abbreviations as: MCV, MCH, MCHC – these are the so-called erythrocyte indices, which give the doctor specific information.

MCH reflects the amount of hemoglobin that one red blood cell carries. This indicator has a diagnostic value similar to the diagnostic value of a blood color indicator.

Its norm values ​​are as follows:

• 27-34 ng – indicators of the norm for a woman.

• 27-35 ng – indicators of the norm for a man.

• 26-34 ng – normal indicators for children aged 10 years and up to adulthood.

If the MCH level is not too high or too low, but there are signs of anemia, then this indicates its normochromic type. Similar indicators characterize hemolytic and aplastic anemia. Most often, such anemia can be diagnosed with massive bleeding.

If the MCH is lowered, then doctors speak of a hypochromic type of anemia, which characterizes iron deficiency in the body.

With an increase in the MCH value, megaloblastic and hypoplastic anemia are diagnosed.

The next erythrocyte index is MCHC. It reflects the degree of hemoglobin saturation of each erythrocyte cell.

Its values ​​can be as follows:

• Iron deficiency anemia will be diagnosed when this indicator drops to 29 g/dl.

• Microspherocytic anemia develops when MCHC values ​​are above 37 g/dl.

Hematocrit allows you to determine the severity of anemia. This indicator will indicate the level of plasma and red blood cells in the blood. Severe anemia is diagnosed when the hematocrit drops to 15-20%.

The third erythrocyte index is an indicator that reflects the average volume of an erythrocyte. It is represented by the abbreviation MCV. You can interpret the received data as follows:

Ferritin and transferritin for anemia

In iron deficiency anemia, transferritin and ferritin are of particular importance. These values ​​can be determined by conducting a biochemical blood test.

ferritin and anemia

Ferritin is responsible for the storage and synthesis of iron for cells. If you calculate the amount of this substance in the blood, you can clarify the level of iron in the body as a whole.

In healthy men, this value remains at the level of 20-250 mcg/l, and in women at the level of 10-120 mcg/l. If the ferritin values ​​are below the specified limits, then this is a sign of iron deficiency anemia.

transferritin and anemia

Transferritin is needed by the body to transport iron to its destinations. If the amount of this protein component of the blood falls, then the level of iron decreases. At the same time, it can enter the body in sufficient volumes, but it will not bind in the blood.

Normally, the level of transferritin remains at around 2,0-4,0 g / l. If these values ​​are exceeded, then iron deficiency anemia can be suspected. With aplastic and hypoplastic anemia, the level of ferritin decreases.

It is the level of transferritin that gives the doctor maximum information about how iron metabolism in the body actually occurs and whether there are certain disorders in this process. To conduct a study, the laboratory must have special equipment, which is not always available. Therefore, sometimes doctors resort to the study of the iron-binding ability of blood. Normally, this indicator should be in the range of 20-63 µmol / l.

Ancillary Diagnostic Tests

To clarify the diagnosis, the doctor may refer the patient to additional tests, including:

• Determination of markers of inflammation. This study is indicated in the presence of rheumatic or autoimmune disease.

• Calculation of the number of folates and vitamin B12.

Be sure to conduct a comprehensive diagnosis of the body in order to prescribe adequate treatment. The fact is that iron preparations should not be used for all types of anemia. Therefore, first you need to install its variety.

Studies that may be assigned:

• Microscopic examination of a blood smear.

• Ultrasound examination of internal organs.

• Performing a bone marrow puncture. 

• FGDS of the stomach and intestines.

• Urine collection for analysis.

• ECG.

The conducted research will allow to establish what exactly provoked the development of anemia. If folate deficiency anemia is suspected, this vitamin is counted in erythrocytes. If necessary, the diagnosis is clarified by bone marrow puncture.

If there is a suspicion of the development of B12-deficiency anemia, then the level of this vitamin in the blood is determined. If the study is not possible, an aspiration biopsy is performed.

For hemolytic anemia, you will need to pass urine, in which the level of bilirubin is determined. Also, its values ​​in the blood serum are specified, the Coombas test is carried out.

Analyzes and studies that need to be performed if hemolytic anemia is suspected: determination of bilirubin in the blood and urine, ultrasound of the liver and spleen.

If the doctor assumes that anemia is provoked by an inflammatory reaction, then in addition to standard studies, he will prescribe the patient to donate blood for ferritin and determine the level of C-reactive protein. This will reveal the latent inflammatory reaction.

Without laboratory diagnostics, it is impossible to identify anemia and clarify its nature. Only a high-quality and complete examination will allow the patient to prescribe adequate and effective treatment.