Anemia

Diagnosis

Diagnosing anemia usually starts with a medical history review and exam by your doctor. Next, your doctor may request one or more of the tests below to determine the type of anemia you have and whether it is related to a more serious condition.

Mayo Clinic offers rapid diagnostic testing and assessments by a team of experts. Blood disorder specialists (hematologists) work with skilled pathologists (specialists in assessing blood and bone marrow) to identify anemias in Mayo Clinic's renowned hematopathology laboratory. The lab serves as an international reference lab, providing doctors around the world with information and test results on complex, specialized analyses that are not available at all medical centers.

Blood tests

The first test you will receive is a complete blood count, which measures the number of white blood cells, red blood cells and platelets in a blood sample. If test results show you have anemia, other blood tests may be done to identify the type and cause, including:

• Hemoglobin electrophoresis. This test helps diagnose anemia by checking different proteins called hemoglobin in your blood.
• Reticulocyte count. A reticulocyte count shows the number of young red blood cells in your blood to determine if your bone marrow is making them at the right rate.
• Serum iron and serum ferretin. These tests check the amount of iron in your blood and body.
• Peripheral blood smear. A peripheral smear assesses whether the shape of your red blood cells have changed due to anemia.
• Osmotic fragility. This test determines if your red blood cells have become more fragile than usual.

Tests related to underlying conditions

If your doctor suspects that an underlying chronic disease or iron deficiency is causing your anemia, one or more of the following tests may be recommended to diagnose your condition.

• Stool sampling. If your doctor thinks you are bleeding internally, you may need to provide a stool sample for testing.
• Urine analysis. Urine analysis can reveal the presence or absence of specific substances that help identify which anemia-related condition you have.
• Endoscopy. Endoscopy is a procedure used to visually examine your upper digestive system for signs of bleeding, using a tiny camera on the end of a long, flexible tube. If necessary, cell samples can be taken for examination under a microscope (biopsy) by a pathologist.
• Colonoscopy. This test involves passing a lighted tube through the rectum to search for tumors or other problems in the large intestine and surrounding areas. Cell samples may be taken for review by a pathologist.
• Imaging tests. Mayo Clinic has an international reputation for top-quality imaging and rapid test results. To help find abnormalities that cause anemia, your doctor may recommend X-rays, an ultrasound, a computerized tomography (CT) scan or magnetic resonance imaging (MRI).
• Bone marrow biopsy. A bone marrow sample may be taken for examination by a pathologist to determine if your bone marrow, the body's blood factory, is working correctly or has abnormalities.
• Genetic tests and counseling. If your doctor suspects that your anemia is related to a genetic condition, a consultation with a genetic counselor may be recommended.