Anemia - What Tests Should I Get? Decoding

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-17 02:10

What tests should I take for anemia?

To establish a diagnosis of anemia, it is necessary to donate blood for analysis. This study will not only determine that a person is developing anemia, 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.

Content:

• What tests do you need to take to detect anemia?
• Indicators of norm and deviation
• Ferritin and transferritin for anemia
• Ancillary diagnostic tests

What tests do you need to take 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 a person develops anemia. 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 general analysis is taken from a finger. Its 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" erythrocytes.
• Hemoglobin level 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 diagnose and suspect the cause of the anemia. If a general blood test indicates a decrease in hemoglobin levels, then the patient is referred for a biochemical blood test.

This study will provide information on the following parameters:

• Serum iron level.
• Blood transferritin level.
• The binding capacity of blood.
• Ferritin level.

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

Indicators of norm and deviation

To determine that the patient is developing anemia, the data obtained should be compared with the indicators of the norm. They differ depending on the sex and age of the subject.

Category of citizens	Hemoglobin level in blood in g / l	Erythrocyte level mln / μl	Blood color index	The number of reticulocytes as a percentage
For men	130-160	3.8-5.6	0.83-1.05	5.1-18.0
For women	120-140	3.7-5.3		125-145	3.7-5.2	4.8-18.0
For children aged 10-14	120-140	3.8-5.0		4.8-18.0
For children aged 5-10	110-135	3.9-5.1		4.8-18.0

Hemoglobin as an indicator of blood

Hemoglobin stains blood red. This substance is part of 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, they are distinguished:

• Hemoglobin level 110-90 g / l - mild anemia.
• 90-70 g / l - moderate anemia.
• The hemoglobin level in the blood is below 70 g / l - anemia is severe.

However, counting only the hemoglobin of the blood will not allow a diagnosis to be made. It will be necessary to study other indicators of this life-supporting fluid.

Red blood cell levels and anemia

Red blood cells are also called red blood cells. They are represented by disc-shaped formations, thanks to this structure, erythrocytes are able to penetrate even the smallest blood vessels. They transport oxygen molecules from the lungs to organs and tissues, and from them they take carbon dioxide and carry it to the lungs for further removal 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 retculocytes

Red blood cells do not appear in the blood by themselves, they develop and mature in the bone marrow. There they are presented in the form of reticulocytes, which are young erythrocytes. 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 quantity in the blood, it is also possible to assess the severity of this disorder.

Blood color index

To assess the degree of saturation of blood with hemoglobin, a blood test is performed for its color index. Its fall below the existing standards 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.
• When its value increases to 1.05 or more, experts talk about hyperchromic anemia.

Thus, you can determine the type of anemia. If the values of the color index of 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 blood decreases, then with a high degree of probability the patient develops iron deficiency anemia.

Erythrocyte index - what is it?

In a 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 erythrocyte carries. This indicator has a diagnostic value similar to the diagnostic value of the blood color index.

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 - indicators of the norm for children aged 10 years and up to adulthood.

If the MCH level is not overestimated or underestimated, 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 reduced, then doctors talk about the hypochromic type of anemia, which characterizes an iron deficiency in the body.

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

The next erythrocyte index is MCHC. It reflects the degree of saturation with hemoglobin 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 with MCHC values 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 reflecting the average volume of an erythrocyte. It is represented by the abbreviation MCV. The received data can be interpreted as follows:

Type of anemia	Indicators MCV in fl	Type of anemia
Normocytic	80-100	Hemolytic
Microcytic	Below 80	Iron deficiency
Macrocytic	Above 100	Folic acid and vitamin B12 deficiency

Ferritin and transferritin for anemia

In iron deficiency anemia, transferritin and ferritin indicators are of particular importance. These values can be determined by performing 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 μg / L, and in women at the level of 10-120 μg / L. If the ferritin values are below the specified limits, then this is a sign of iron deficiency anemia.

Transferritin and anemia

Transferritin is required 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 tranferritin 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 a maximum of information about how the exchange of iron in the body actually occurs and whether there are any violations 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 test is indicated in the presence of rheumatic or autoimmune disease.
• Counting the number of folites and vitamin B12.

It is imperative to conduct a comprehensive diagnosis of the body in order to prescribe an adequate treatment. The fact is that iron supplements should not be used for all types of anemia. Therefore, first you need to establish its variety.

Research that can be assigned:

• Microscopic examination of a blood smear.
• Ultrasound examination of internal organs.
• Bone marrow puncture.
• EGD of the stomach and intestines.
• Urine collection for analysis.
• ECG.

The studies conducted will establish what exactly triggered the development of anemia. If folate deficiency anemia is suspected, this vitamin is counted in erythrocytes. If necessary, the diagnosis is clarified using a 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 it is impossible to conduct a study, an aspiration biopsy is performed.

For hemolytic anemia, you will need to pass urine, in which the level of bilirubin is determined. They also clarify its values in blood serum, conduct a Kumbas test.

Analyzes and studies that must 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 a latent inflammatory response.

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 be prescribed adequate and effective treatment.

The author of the article: Shutov Maxim Evgenievich | Hematologist

Education: In 2013 he graduated from the Kursk State Medical University and received a diploma "General Medicine". After 2 years, completed residency in the specialty "Oncology". In 2016 completed postgraduate studies at the National Medical and Surgical Center named after N. I. Pirogov.