Iron-Deficiency Anemia - Diagnosis - Diagnosis

Your doctor may ask about your medical history and any symptoms you are experiencing, and do a physical exam to look for any of the following signs that may help diagnose iron-deficiency anemia:

• Check for bleeding.
• Look to see whether your tongue, nails, or inner lining of your eyelids are pale.
• Check your fingernails to see whether they are pale or brittle, and how quickly they refill with blood.
• Listen to your heart for rapid or irregular heartbeats.
• Listen to your lungs for rapid or uneven breathing.
• Feel your abdomen to check the size of your liver and spleen.

Based on results from blood tests to screen for iron-deficiency anemia, your doctor may order the following blood tests to diagnose iron-deficiency anemia:

• Complete blood count (CBC) to see if you have lower than normal red blood cell counts, hemoglobin or hematocrit levels, or mean corpuscular volume (MCV) that would suggest anemia.
• Iron to measure the amount of iron in your blood. The level of iron in your blood may be normal even if the total amount of iron in your body is low. For this reason, other iron tests are also done.
• Ferritin measure to find out how much of your body’s stored iron has been used. Ferritin is a protein that helps store iron in your body.
• Reticulocyte count to see if you have lower than normal numbers of these very young red blood cells.
• Peripheral smear to see if your red blood cells look smaller and paler than normal when viewed under a microscope.

To help diagnose iron-deficiency anemia, your doctor will consider your CBC, hemoglobin, blood iron levels, MCV, and ferritin levels to determine if you have iron-deficiency anemia or another type of anemia. You may be diagnosed with iron-deficiency anemia if you have low iron or ferritin levels in your blood.

More testing may be needed to rule out other types of anemia.

To see if gastrointestinal bleeding is causing your iron-deficiency anemia, your doctor may order the following procedures to guide treatment.

• Fecal occult blood test to check for blood in the stool. Blood in the stool would suggest bleeding in the GI tract and may require further testing.
• Upper endoscopy to look for bleeding in the esophagus, stomach, and the first part of the small intestine. A tube with a tiny camera is inserted through your mouth down to your stomach and upper small intestine to view the lining of your upper digestive tract.
• Colonoscopy to look for bleeding or other abnormalities, such as growths or cancer of the lining of the colon. For this test, a small camera is inserted into the colon under sedation to view the colon directly.

What if my doctor thinks something else is causing my iron-deficiency anemia?

• Return to Causes to review how blood loss, not consuming the recommended amount of iron, and medical conditions can lead to iron-deficiency anemia. 
• Return to Risk Factors to review family history, lifestyle, unhealthy environments, or other factors that increase your risk of developing iron-deficiency anemia.
• Return to Signs, Symptoms, and Complications to review common signs and symptoms of iron-deficiency anemia.
• Return to Screening and Prevention to review tests to screen for and strategies to prevent iron-deficiency anemia.