How is Anemia diagnosed?

Anemia is a medical condition characterized by a decrease in the number of red blood cells or a decrease in the amount of hemoglobin in the blood. It can result from various causes, including nutritional deficiencies, chronic diseases, genetic disorders, or certain medications. To diagnose anemia, healthcare professionals employ a combination of medical history assessment, physical examination, and laboratory tests.

Medical History Assessment

The first step in diagnosing anemia involves a thorough medical history assessment. The healthcare provider will ask the patient about their symptoms, such as fatigue, weakness, pale skin, shortness of breath, dizziness, or rapid heartbeat. They will also inquire about any underlying medical conditions, family history of anemia, dietary habits, and medications being taken. This information helps in identifying potential risk factors and narrowing down the possible causes of anemia.

Physical Examination

During the physical examination, the healthcare provider will carefully examine the patient for signs of anemia. They may check for pale skin, rapid heart rate, low blood pressure, and abnormal heart sounds. The provider will also assess the size and texture of the patient's spleen and liver, as certain types of anemia can cause enlargement of these organs. Additionally, they may look for other physical signs that could indicate an underlying cause of anemia.

Laboratory Tests

Laboratory tests play a crucial role in confirming the diagnosis of anemia and determining its underlying cause. The most commonly ordered tests include:

1. Complete Blood Count (CBC)

A complete blood count (CBC) provides essential information about the patient's red blood cells, white blood cells, and platelets. It measures several parameters, including:

• Hemoglobin (Hb) level: Hemoglobin is the protein in red blood cells that carries oxygen. A low hemoglobin level is a key indicator of anemia.


• Hematocrit (Hct) level: Hematocrit represents the percentage of blood volume occupied by red blood cells. A low hematocrit level is another indication of anemia.


• Red blood cell (RBC) count: This measures the number of red blood cells in a given volume of blood. A decreased RBC count suggests anemia.


• Mean corpuscular volume (MCV): MCV measures the average size of red blood cells. It helps classify anemia into different types, such as microcytic, normocytic, or macrocytic.


• Mean corpuscular hemoglobin (MCH): MCH measures the average amount of hemoglobin in red blood cells. It aids in determining the type of anemia.


• Mean corpuscular hemoglobin concentration (MCHC): MCHC measures the concentration of hemoglobin in red blood cells. It can provide insights into the cause of anemia.

2. Peripheral Blood Smear

A peripheral blood smear involves examining a drop of blood under a microscope to evaluate the size, shape, and appearance of red blood cells. It helps identify any abnormalities, such as changes in cell size or shape, which can aid in diagnosing specific types of anemia.

3. Additional Blood Tests

Depending on the suspected cause of anemia, additional blood tests may be ordered. These can include:

• Iron studies: Iron levels, ferritin, transferrin, and total iron-binding capacity (TIBC) are measured to assess iron-deficiency anemia.


• Vitamin B12 and folate levels: These tests help diagnose anemia caused by deficiencies in these vitamins.


• Reticulocyte count: Reticulocytes are immature red blood cells. Measuring their count can determine if the bone marrow is producing an adequate number of red blood cells.


• Additional genetic or immunological tests: In certain cases, genetic or immunological tests may be necessary to diagnose inherited or autoimmune-related anemias.

Consultation and Further Evaluation

Once the diagnosis of anemia is confirmed and its underlying cause is determined, the healthcare provider will discuss the results with the patient. They will explain the type of anemia, its potential causes, and the appropriate treatment options. In some cases, further evaluation or referral to a specialist may be required to investigate and manage the underlying condition contributing to anemia.

It is important to note that the diagnosis of anemia should always be made by a qualified healthcare professional based on the individual's specific symptoms, medical history, and laboratory results.