Iron is a mineral that is needed for human growth and development. Iron-deficiency anemia occurs when the body does not have enough healthy red blood cells due to a lack of iron in the body.
The body uses iron to make important compounds, such as hemoglobin and myoglobin. These are key proteins in red blood cells that are responsible for transporting oxygen throughout the body in the blood. The body also uses iron to make some hormones.
The adult male body needs about 8 milligrams (mg) of iron per day, and adult menstruating women need 18 mg of iron per day. After age 51, the requirement for women decreases to 8 mg.
People with iron-deficiency anemia may not get enough iron in their diet. The body may also lose iron due to bleeding, pregnancy or chronic illness. Certain conditions may also prevent the body from absorbing iron.
People with mild to moderate iron-deficiency anemia may not have any signs or symptoms. More severe iron-deficiency anemia may show symptoms, including fatigue, unhealthy skin and nails, and heart or respiratory problems.
Testing for iron-deficiency anemia
Various tests can help diagnose iron-deficiency anemia.
Complete blood count test for iron-deficiency anemia
A complete blood count (CBC) test is important for many blood-related problems.
The CBC test gives a complete picture of the blood, measuring several important components, such as.
- Red blood cell (RBC) count, which are the cells that carry oxygen
- White blood cell (WBC) count, which are the cells that fight infection
- Hemoglobin, the protein in blood cells that carries oxygen
- Hematocrit, the percentage of red blood cells in the total blood
- Platelets, which are compounds that help blood clot
- Mean red blood cell volume (MCV), a measure of the average size of red blood cells.
Depending on the test, your doctor may take a drop of blood for testing or a vial of blood for analysis.
Depending on how many markers are present and how many other tests are needed, they may take more vials of blood for testing. The technician will take a vial of blood from the person and send it for testing.
The blood will then be sent to a lab for analysis and the doctor will schedule another appointment to discuss the results.
A low red blood cell count may be a sign of iron-deficiency anemia.
The CBC test alone is generally not conclusive, but it can help guide the doctor on how to follow up with other tests.
Serum iron test for iron-deficiency anemia
A serum iron test measures the amount of iron in the blood. Low levels of serum iron may indicate an iron-deficiency anemia.
This is a general test, and your doctor may use other tests to better understand why and how low levels occur.
The serum iron test measures the amount of iron in the serum. Serum is the fluid that remains from the blood after the red blood cells and clotting factors are removed.
A serum iron test can show abnormally low or high blood iron levels. Your doctor will likely order this test after another lab test shows abnormal results.
Too much (or not enough) iron can lead to serious health problems. This test will help your doctor provide you with a more accurate diagnosis.
Ferritin test for iron-deficiency anemia
The ferritin blood test measures the amount of ferritin in the blood. Ferritin is an iron-containing protein in the blood.
The level of ferritin can help your doctor know how much iron is stored in your body. Low ferritin levels indicate low iron stores and iron-deficiency anemia.
Total Iron Binding Capacity test for iron-deficiency anemia
Total iron binding capacity (TIBC) is a blood test that checks the amount of iron in the blood. Your doctor may perform this test along with a transferrin test to check for signs of anemia.
A high TIBC level may indicate a low level of iron in the blood due to iron-deficiency anemia. In some other cases of anemia, TIBC levels may also be low, such as anemia due to red blood cell destruction.
TIBC is usually higher than normal when the body's iron supplies are low. This can occur with:
- Iron-deficiency anemia
- Pregnancy (late)
Lower-than-normal TIBC may mean:
- Anemia due to red blood cells being destroyed too quickly (hemolytic anemia)
- Lower-than-normal level of protein in the blood (hypoproteinemia)
- Inflammation
- Liver disease, such as cirrhosis
- Malnutrition
- Decrease in red blood cells from the intestines not properly absorbing vitamin B12 (pernicious anemia)
- Sickle cell anemia
There is little risk involved with having your blood taken. Veins and arteries vary in size from one person to another and from one side of the body to the other. Taking blood from some people may be more difficult than from others.
Other risks associated with having blood drawn are slight, but may include:
- Excessive bleeding
- Fainting or feeling lightheaded
- Multiple punctures to locate veins
- Hematoma (blood buildup under the skin)
- Infection (a slight risk any time the skin is broken)
Soluble transferrin receptor test for iron-deficiency anemia
Iron enters cells by binding to a protein called transferrin. Having enough transferrin in the body is important to ensure that iron can enter the cells.
When iron levels are low, the body increases the amount of transferrin in the body to increase the availability of iron in the body.
High levels of transferrin may be a sign of iron-deficiency anemia, doctors can check these levels using the soluble transferrin receptor (sTfR) test.
Peripheral Smear test for iron-deficiency anemia
A peripheral blood smear test is a technique healthcare providers use to examine your red and white blood cells and your platelets. Unlike some blood tests that are analyzed by a machine, healthcare providers do the analysis by looking at blood cells under a microscope.
Your healthcare provider may order a peripheral blood smear along with a complete blood count (CBC), or if you already had CBC and it shows abnormal blood cell activity, they might order a PBS. For example, your CBC results may indicate your white blood cells, red blood cells and/or platelets appear abnormal or that you have an abnormal number of any given type of cell. A microscopic view of your cells may help your healthcare provider find out how and/or why your blood cells look abnormal or you have an abnormal number of cells.
Results from a peripheral blood smear test aren’t a diagnosis. Healthcare providers make diagnoses based on your medical history, physical examination and results from laboratory tests, like a PBS.
To understand what PBS tests show, it may help to have more information about the role your blood cells and platelets play:
- Red blood cells: Your red blood cells carry oxygen from your lungs to your tissues. Your tissues use oxygen to create energy. When your tissues create energy, they release carbon dioxide. Your red blood cells carry carbon dioxide back to your lungs. When you exhale, you’re getting rid of the carbon dioxide.
- White blood cells: Your white blood cells are part of your immune system that helps protect your body from infection. There are five different white blood cell types. Each type fights infection in different ways.
- Platelets: Platelets help your blood to clot. Too few platelets may be a sign of cancer, infections or other health problems.
A peripheral blood smear test shows how your blood cells and platelets look under a microscope. Looking through a microscope, your healthcare provider may see:
- Changes in your blood cell and platelet size and shape may be a sign of a blood disorder or blood cancer.
- Changes in the number or count of your blood cells and platelets. Changes in blood cell and platelet count may be a sign something is happening in your bone marrow, which produces blood cells and platelets.
- Abnormal changes in any of your different white blood cell types.
- Signs you may have parasites in your blood.
At-home tests for iron-deficiency anemia
There are a number of at-home iron tests that can help people get a general idea of their iron levels, including testing for the following
- Iron
- TIBC
- Ferritin
- Transferrin saturation
It is important to note that these tests are not diagnostic tests. They can provide a general idea of iron levels, or help a person understand their symptoms and why they need to see a doctor for a full diagnosis.
Other tests for iron-deficiency anemia
Blood tests are only one part of the process of diagnosing iron-deficiency anemia. Your doctor will want to use other tests to help identify and treat the underlying causes and factors.
This may include physical exam to look for signs of disorders. Doctors may check the health of a person's skin, nails and hair. They may also check for other symptoms, such as an irregular heartbeat or uneven breathing patterns.
The doctor will ask medical questions to help guide their diagnosis. Based on this, the doctor may order tests to check.
- Causes of internal bleeding
- Helicobacter pylori infection
- Blood in the stool or urine
- Atypical features in the gastrointestinal tract
- Atypical gynecological features in women
- Potential genetic disorders
- Other chronic diseases
- Inflammatory conditions
- Levels of important B vitamins
Treatment of iron-deficiency anemia
Treatment of iron-deficiency anemia depends largely on the underlying cause, as well as the severity of the symptoms.
Your doctor may recommend Trusted Source to treat mild iron deficiency by changing your diet to include more iron-rich foods. They may also recommend iron supplements to help raise levels. In severe cases, your doctor may recommend intravenous iron or a blood transfusion using iron-rich blood.
The underlying cause of the anemia will require its own treatment. While diagnosis and treatment may take time, a thorough diagnosis and proper treatment may help avoid complications.
Abstract
Iron-deficiency anemia occurs when the body does not have enough iron. Doctors have a number of tests they can use to help diagnose iron deficiency anemia and its underlying causes.
In some cases, finding the underlying cause of the problem may take time, but it is crucial to finding the right treatment for the patient.
In some simple cases, increasing the intake of iron or supplementing the diet with iron may treat the anemia. In other cases, it may be necessary to treat the underlying disease in addition to finding a way to increase iron.
Working closely with your doctor in each case will help find the best treatment option.
References:
1. Anemia Rash: Causes, Pictures, and Treatment - Healthline
2. Iron Deficiency Anemia: Coping, Support, and Living Well
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