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Tests and diagnosis
By Mayo Clinic staffDoctors diagnose iron deficiency anemia mainly through blood tests. You doctor will check your blood for:
- Red blood cell size and color. With iron deficiency anemia, red blood cells are smaller and paler in color than normal.
- Hematocrit. This is the percentage of your blood volume made up by red blood cells. Normal levels are generally between 34.9 and 44.5 percent for adult women and 38.8 to 50 percent for adult men. These values may change depending on your age.
- Hemoglobin. Normal levels of hemoglobin range between 11.1 and 15.0 grams per deciliter (111 to 150 grams per liter), depending on your age, sex and race. A lower than normal hemoglobin level indicates anemia.
- Ferritin. This protein helps store iron in your body, and a low level of ferritin usually indicates a low level of stored iron.
Additional diagnostic tests
If your blood work indicates iron deficiency anemia, your doctor may order additional tests to identify an underlying cause. If your doctor suspects a source of bleeding within your body, you may need to have your stools tested for traces of blood. Blood in the stools is often an indicator of internal bleeding.
You may need these additional diagnostic tests:
- Endoscopy. Doctors often check for bleeding from a hiatal hernia, bleeding ulcers and stomach bleeding with the aid of endoscopy. In this procedure, a thin, lighted tube equipped with a video camera is passed down your throat to your stomach. This allows your doctor to view your esophagus — the tube that runs from your mouth to your stomach - and your stomach to look for sources of bleeding.
- Colonoscopy. To rule out lower intestinal sources of bleeding, your doctor may recommend a procedure called colonoscopy. A thin, flexible tube equipped with a video camera is inserted into the rectum and guided to your colon. You're usually sedated during this test. A colonoscopy allows your doctor to view some or all of your colon and rectum to look for internal bleeding.
- Ultrasound. Women may also have a pelvic ultrasound to look for the cause of excess menstrual bleeding, such as uterine fibroids.
Your doctor may order these or other tests after a trial period of treatment with iron supplementation.
- Iron-deficiency anemia. National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/ida/ida_all.html. Accessed Jan. 22, 2009.
- Schrier SL. Causes and diagnosis of anemia due to iron deficiency. http://www.uptodate.com/home/index.html. Accessed Jan. 19, 2009.
- Schrier SL. Approach to the adult patient with anemia. http://www.uptodate.com/home/index.html. Accessed Jan. 19, 2009.
- Mesa R (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 28, 2009.
- Schrier SL. Treatment of anemia due to iron deficiency. http://www.uptodate.com/home/index.html. Accessed Jan. 19, 2009.
