Understanding Anemia -- Diagnosis and Treatment

How Do I Know If I Have Anemia?

To diagnose anemia, your doctor will likely do the following:

• Take your medical history
• Perform a physical exam
• Order laboratory tests

You can help by providing detailed answers about your symptoms, family medical history, diet, medications you take, alcohol intake, and ethnic background. Your doctor will look for symptoms of anemia and other physical clues that might point to a cause.

Blood tests will not only confirm the diagnosis of anemia but also help point to the underlying condition. Blood tests may include the following:

• Complete blood count (CBC), which determines the number, size, volume, and hemoglobin content of red blood cells
• Blood iron level and your serum ferritin level, the best indicators of your body's total iron stores
• Levels of vitamin B-12 and folate
• Special blood tests to detect rare causes of anemia, such as an immune attack on your red blood cells, red blood cell fragility, and defects of enzymes, hemoglobin and clotting
• For suspected hemolytic anemia, tests to identify the breakdown products of red blood cells in your blood and urine

Only in rare cases will a doctor need to remove a sample of bone marrow to determine the cause of your anemia.

What Are the Treatments for Anemia?

Your doctor will not treat your anemia until the underlying cause has been established. The treatment for one type of anemia may be both inappropriate and dangerous for another type of anemia.

Anemia Caused by Blood Loss
If you suddenly lose a large volume of blood, you may be treated with fluids, blood transfusion, oxygen, and possibly iron to help your body build new red blood cells. Chronic blood loss is treated by identifying the source of bleeding, stopping the bleeding, and, if necessary, giving treatment for iron-deficiency anemia.

Anemia Caused by Decreased Red Blood Cell Production
The type of treatment you receive depends on the cause of decreased red blood cell production.

With iron deficiency anemia your doctor will probably recommend iron supplements that contain the ferrous form of iron, which your body can absorb easily. Timed-release iron supplements are not a good choice for most people because iron is primarily absorbed in the upper part of the digestive tract. If you use iron supplements, remember the following cautions:

• Always consult with your doctor before taking iron supplements. Excess iron intake can be harmful. Symptoms of iron overload include fatigue, vomiting, diarrhea, headache, irritability and joint problems.
• Iron supplements -- like all supplements and any medication -- should be kept out of the reach of children. Iron poisoning is the most common cause of accidental poisoning in young children. Eating even a few tablets can prove fatal in a matter of hours. Symptoms of poisoning in a child include dizziness, confusion, nausea, vomiting, and diarrhea. Seek medical help immediately.
• Watch for side effects. You may need to continue taking iron supplements for up to one year. Taking iron supplements with food can help prevent common side effects, which may include nausea, diarrhea, constipation, and stomach pain. Let your doctor know if you continue to have side effects. Different formulations are available.
• Watch for medication interactions. Tell your doctor if you are being treated for another condition. For example, calcium supplements interfere with iron absorption so it is best to take them at different times of the day.