To diagnose anemia, your doctor may ask you about your medical and family history, perform a physical exam, and run the following tests:
Complete blood count (CBC). A CBC is used to count the number of blood cells in a sample of your blood. For anemia your doctor will be interested in the levels of the red blood cells contained in the blood (hematocrit) and the hemoglobin in your blood.
Normal adult hematocrit values vary from one medical practice to another but are generally between 40 and 52 percent for men and 35 and 47 percent for women. Normal adult hemoglobin values are generally 14 to 18 grams per deciliter for men and 12 to 16 grams per deciliter for women.
- A test to determine the size and shape of your red blood cells. Some of your red blood cells may also be examined for unusual size, shape and color.
Additional diagnostic tests
If you receive a diagnosis of anemia, your doctor may order additional tests to determine the underlying cause. For example, iron deficiency anemia can result from chronic bleeding of ulcers, benign polyps in the colon, colon cancer, tumors or kidney problems.
Occasionally, it may be necessary to study a sample of your bone marrow to diagnose anemia.
Anemia treatment depends on the cause.
Iron deficiency anemia. Treatment for this form of anemia usually involves taking iron supplements and making changes to your diet.
If the underlying cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and stopped. This may involve surgery.
Vitamin deficiency anemias. Treatment for folic acid and B-12 deficiency involves dietary supplements and increasing these nutrients in your diet.
If your digestive system has trouble absorbing vitamin B-12 from the food you eat, you may need vitamin B-12 shots. At first, you may receive the shots every other day. Eventually, you'll need shots just once a month, which may continue for life, depending on your situation.
- Anemia of chronic disease. There's no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. If symptoms become severe, a blood transfusion or injections of synthetic erythropoietin, a hormone normally produced by your kidneys, may help stimulate red blood cell production and ease fatigue.
- Aplastic anemia. Treatment for this anemia may include blood transfusions to boost levels of red blood cells. You may need a bone marrow transplant if your bone marrow is diseased and can't make healthy blood cells.
- Anemias associated with bone marrow disease. Treatment of these various diseases can include medication, chemotherapy or bone marrow transplantation.
Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating related infections and taking drugs that suppress your immune system, which may be attacking your red blood cells.
Depending on the severity of your anemia, a blood transfusion or plasmapheresis may be necessary. Plasmapheresis is a type of blood-filtering procedure. In certain cases, removal of the spleen can be helpful.
Sickle cell anemia. Treatment for this anemia may include the administration of oxygen, pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent complications. Doctors also may recommend blood transfusions, folic acid supplements and antibiotics.
A bone marrow transplant may be an effective treatment in some circumstances. A cancer drug called hydroxyurea (Droxia, Hydrea) also is used to treat sickle cell anemia.
- Thalassemia. This anemia may be treated with blood transfusions, folic acid supplements, medication, removal of the spleen (splenectomy), or a blood and bone marrow stem cell transplant.
Preparing for your appointment
Make an appointment with your primary care doctor if you have prolonged fatigue or other signs or symptoms that worry you. He or she may refer you to a doctor who specializes in treating blood disorders (hematologist), the heart (cardiologist) or the digestive system (gastroenterologist).
Here's some information to help you get ready for your appointment.
What you can do
Before your appointment make a list of:
- Symptoms you've been having and for how long
- Key personal information, including any major stresses, implanted medical devices, exposure to toxins or chemicals, and recent life changes
- All medications, vitamins and supplements you take, including the doses
- Questions to ask your doctor
For anemia, some basic questions to ask your doctor include:
- What's the most likely cause of my symptoms?
- Are there other possible causes?
- Do I need any tests?
- Is my anemia likely temporary or long lasting?
- What treatments are available, and which do you recommend?
- What side effects can I expect from treatment?
- I have these other health conditions. How can I best manage them together?
- Do I need to follow any dietary restrictions?
- Do I need to add any foods to my diet? How often do I need to eat these foods?
- Do you have any brochures or other printed materials I can take with me? What websites do you recommend?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did you begin having these symptoms?
- Do your symptoms come and go or are they constant?
- How severe are your symptoms?
- Does anything seem to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Are you a vegetarian?
- How many servings of fruits and vegetables do you usually eat in a day?
- Do you drink alcohol? If so, how often, and how many drinks do you usually have?
- Are you a smoker?
- Have you recently donated blood more than once?