Anemia Diagnosis

To diagnose anemia, your doctor may ask you questions about your risk factors and order blood tests or other diagnostic tests. Your doctor may also ask about your medical history, what you eat, and whether other people in your family have been diagnosed with anemia. Your doctor may also do a physical exam to look for symptoms of anemia, such as a pale tongue or brittle nails. If you have anemia, your doctor may ask you to visit a hematologist (a doctor who specializes in blood diseases).

Blood tests

The complete blood count is one of the most common blood tests. It's often done as part of a routine checkup. This test measures many different parts of your blood, including red blood cells, white blood cells, and platelets.

Red blood cell levels that are higher or lower than normal could be a sign of anemia. Red blood cells carry oxygen from your lungs to the rest of your body.
Hemoglobin levels that are higher or lower than normal may be a sign of anemia. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen.
Hematocrit levels that are too low may be a sign of anemia. Hematocrit is a measure of how much space red blood cells take up in your blood.
Mean corpuscular volume (MCV) levels that are higher or lower than normal may be a sign of anemia. MCV is a measure of the average size of your red blood cells.

Blood test results

The table below shows some normal ranges for adults for different parts of the complete blood count (CBC) test. Some of the normal ranges differ between men and women. Other factors, such as age, high altitude, and race, also may affect normal ranges. Talk to your doctor about your results and whether they are outside an acceptable range based on your individual needs.

Blood Test	Normal Ranges
Red blood cell (varies with altitude)
Normal Range Results*	Adult men: 5 to 6 million cells/mcL Adult women: 4 to 5 million cells/mcL
Hemoglobin (varies with altitude)
Normal Range Results*	Adult men: 14 to 17 gm/dL Adult women: 12 to 15 gm/dL
Hematocrit (varies with altitude)
Normal Range Results*	Adult men: 41% to 50% Adult women: 36% to 44%
Mean corpuscular volume
Normal Range Results*	80 to 95 femtoliter†

* Cells/mcL = cells per microliter; gm/dL = grams per deciliter. † A femtoliter is a measure of volume.

Bone marrow tests

Bone marrow tests check whether your bone marrow is healthy and making normal amounts of blood cells. The two bone marrow tests are called aspiration and biopsy, and both are often done at the same time.

Aspiration is usually done first. During this procedure a small amount of bone marrow fluid is collected through a needle.
Biopsy tests involve collecting a small amount of bone marrow tissue through a larger needle.

Biopsy and aspiration tests can help find the cause of low or high blood cell counts. Before getting them, be sure to tell Before getting these tests, be sure to tell your doctor about current medicines you are taking, known allergies to medicines, if you are pregnant.

Bone marrow tests may require you to go to the hospital or a surgery center. Sometimes, however, they can be done in the doctor’s office or clinic. You will be awake for your test and may be given medicine to relax you during the test. You will lie on your side or stomach. Your doctor will clean and numb the top ridge of the back of a hipbone, where the needle will be inserted. You may feel a brief, sharp pain when the needle is inserted and when the bone marrow is aspirated. The bone marrow samples will be studied in a laboratory.

After your test, you will have a small bandage on the site where the needle was inserted. Most people go home the same day. You will need a ride home if you received medicines to relax you during the test. You may have mild discomfort for about a week. Your doctor may have you take an over-the-counter pain medicine. Call your doctor if you are in serious pain or if you develop symptoms including:

Fever
Redness
Swelling
Discharge at the needle injection site

Other diagnostic tests

Your doctor may order other tests to learn whether you have any complications from anemia or to rule out other conditions.

Colonoscopy looks for bleeding or other problems such as tumors in your colon. For this test, you will be given medicine to help you relax, and a small camera will be put into your colon to view the colon directly. Your doctor may also check your stool for blood.
Endoscopy looks for bleeding in the esophagus, stomach, and the first part of the small intestine. This involves inserting a tube with a tiny camera through your mouth down to your stomach and upper small intestine.
genetictests look for changes in the genes that control how your body makes red blood cells.
Urine tests check whether your kidneys are working properly. They can also tell whether there is any bleeding in your urinary tract, which is the body’s drainage system for removing urine.