Anemia

Diagnosis

To diagnose anemia, your health care provider is likely to ask you about your medical and family history, do a physical exam, and order blood tests. Tests might include:

• Complete blood count (CBC). A CBC is used to count the number of blood cells in a sample of blood. For anemia, the test measures the amount of the red blood cells in the blood, called hematocrit, and the level of hemoglobin in the blood.

  Typical adult hemoglobin values are generally 14 to 18 grams per deciliter for men and 12 to 16 grams per deciliter for women. Typical adult hematocrit values vary among medical practices. But they're generally between 40% and 52% for men and 35% and 47% for women.

• A test to show the size and shape of the red blood cells. This looks at the size, shape and color of the red blood cells.

Other diagnostic tests

If you get a diagnosis of anemia, you might need more tests to find the cause. Sometimes, it can be necessary to study a sample of bone marrow to diagnose anemia.

Treatment

Anemia treatment depends on the cause.

• Iron deficiency anemia. Treatment for this form of anemia usually involves taking iron supplements and changing the diet.

  If the cause of iron deficiency is loss of blood, finding the source of the bleeding and stopping it is needed. This might involve surgery.

• Vitamin deficiency anemias. Treatment for folic acid and vitamin B-12 deficiency involves dietary supplements and increasing these nutrients in the diet.

  People who have trouble absorbing vitamin B-12 from food might need vitamin B-12 shots. At first, the shots are every other day. In time, the shots will be shots just once a month, possibly for life.

• Anemia of chronic disease. Treatment for this type of anemia focuses on the disease that's causing it. If symptoms become severe, treatment might include getting blood, called a transfusion, or shots of a hormone called erythropoietin.
• Anemias associated with bone marrow disease. Treatment of these various diseases can include medicines, chemotherapy or getting bone marrow from a donor, called a transplant.
• Aplastic anemia. Treatment for this anemia can include blood transfusions to boost levels of red blood cells. A bone marrow transplant might be needed if bone marrow can't make healthy blood cells.
• Hemolytic anemias. Managing hemolytic anemias includes stopping medicines that might be causing it and treating infections. If the immune system is attacking red blood cells, treatment might involve taking medicines that lower immune system activity.

• Sickle cell anemia. Treatment might include oxygen, pain relievers, and hydration with fluids given through a vein, called intravenous, to reduce pain and prevent complications. Receiving blood, called a transfusion, and taking folic acid supplements and antibiotics might be involved.

  A cancer drug called hydroxyurea (Droxia, Hydrea, Siklos) also is used to treat sickle cell anemia.

• Thalassemia. Most forms of thalassemia are mild and need no treatment. More-severe forms of thalassemia generally require blood transfusions, folic acid supplements, medicines, a blood and bone marrow stem cell transplant, or, rarely, removing the spleen.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

Make an appointment with your primary care provider if you have long-lasting fatigue or other symptoms that worry you. You might end up seeing a doctor who specializes in treating blood disorders, called a hematologist; the heart, called a cardiologist; or the digestive system, called a gastroenterologist.

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

• Your symptoms and when they began.
• Key personal information, including major stresses, medical devices you have in your body, toxins or chemicals you've been around, and recent life changes.
• All medicines, vitamins and other supplements you take, including the doses.
• Questions to ask your health care provider.

For anemia, basic questions to ask include:

• What's the most likely cause of my symptoms?
• Are there other possible causes?
• What tests do I need?
• Is my anemia likely short term or long lasting?
• What treatments are there, and which do you recommend?
• What side effects can I expect from treatment?
• I have other health conditions. How can I best manage them together?
• Do I need to change my diet?
• Do you have brochures or other printed materials I can have? What websites do you recommend?

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

• Do your symptoms come and go or are they constant?
• How bad are your symptoms?
• Does anything seem to make your symptoms better?
• What, if anything, appears to make your symptoms worse?
• Are you a vegetarian?
• How many servings of fruits and vegetables do you eat in a day?
• Do you drink alcohol? If so, how often, and how many drinks do you have?
• Are you a smoker?
• Have you recently donated blood more than once?

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