To diagnose anemia, your doctor will likely ask you about your medical history, perform a physical exam, and order blood 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.
There are basically three different causes of anemia: blood loss; decreased or faulty red blood cell production; or destruction of red blood cells.
Blood tests will not only confirm the diagnosis of anemia, but also help point to the underlying condition. Tests might include:
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 B12 and folate, vitamins necessary for red blood cell production
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
Reticulocyte count, bilirubin, and other blood and urine tests to determine if you have a hemolytic anemia, where your red blood cells have a shortened life span
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, a 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, providing 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.
Anemia Caused by Iron Deficiency Without adequate iron, the body is unable to produce normal red blood cells. In young women, iron deficiency anemia can result from heavy menstrual bleeding. Non-menstruating women or men who develop iron deficiency need to have a colon exam (colonoscopy or barium enema) to help identify the source of chronic bleeding.
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, heart disease, 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 drug 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.
The body absorbs iron best when taken in a mildly acidic medium, so taking iron with a half-glass of orange juice or with vitamin C is helpful.