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Blood Tests for Anaemia

  • Anemia Test

Though different types of anemia have different causes, the signs and symptoms can be very similar. Mild or moderate forms of anemia may cause few, if any, symptoms. Some of the most common symptoms are:

  • General feeling of tiredness or weakness (fatigue)
  • Lack of energy
  • Pale skin (pallor)
  • Dizziness
  • Headache

Iron Deficiency Anemia

Iron deficiency anemia is the most common type of anemia and it has many causes. Symptoms are related to the overall decrease in the number of red blood cells (RBCs) and/or the level of hemoglobin. If the iron deficiency anemia is mild to moderate, there may be no signs or symptoms.

Blood Tests for Iron defeciency anaemia

  • Initial blood tests typically include;
  • Complete Blood Count (CBC)
  • Serum iron
  • Ferritin – A protein used to store iron
  • Transferrin and Total Iron-Binding Capacity (TIBC) – transferrin is a protein that binds to and carries iron through the blood
  • Reticulocyte count – Reticulocytes are young, immature red blood cells; the number of reticulocytes in iron deficiency anemia is low because there is insufficient iron to produce new RBCs

Pernicious Anemia and Other B Vitamin Deficiencies

Anemia resulting from vitamin B12 or folate deficiency are often referred to as “megaloblastic anemia” because red blood cells and the cells that make them are larger than normal.

Blood Tests

  • Complete Blood Count (CBC)
  • Vitamin B12 Level
  • Folic Acid Level
  • Homocysteine
  • Reticulocyte Count
  • Antibodies against intrinsic factor and/or parietal cell

Aplastic Anemia

Aplastic anemia is a rare disease caused by a decrease in the number of all types of blood cells that the bone marrow produces.

Laboratory Tests

  • Complete Blood Count (CBC)
  • Reticulocyte Count
  • Erythropoietin
  • Bone marrow aspiration or biopsy
  • Tests for infections such as Hepatitis, HIV, EBV, CMV
  • ANA – To determine if the cause is autoimmune disease

Hemolytic Anemia

The different causes of Hemolytic Anemia fall into two main categories:

  • Inherited forms in which a gene or genes are passed from one generation to the next that result in abnormal RBCs or hemoglobin
  • Acquired forms in which some factor results in the early destruction of RBCs

Sickle Cell Anemia is a disorder where the body makes abnormal hemoglobin.

Thalassemia is an inherited blood disorder where there is a decrease in haemoglobin production that results in anemia and smaller red blood cells.

Other less common types of inherited forms of Hemolytic Anemia include:

 Inherited Hemolytic Anemia

Glucose-6-Phospate Dehydrogenase (G6PD) Deficiency – G6PD is an enzyme that is necessary for RBC survival and, if deficient, RBCs come into contact with certain substances in the blood stream, the cells rupture. Those substances could include naphthalene, antimalarial medications or fava beans.

Laboratory Tests

  • CBC and Blood Smear
  • Hb Electrophoresis
  • G6PD Test
  • Osmotic Fragility Test

Acquired Hemolytic Anemia

Some of the conditions or factors involved in acquired forms of hemolytic anemia include:

  • Autoimmune disorders – A condition in which the body produces antibodies against its own red blood cells.
  • Transfusion reaction – A result of blood donor-recipient incompatibility; this occurs very rarely, but when it does, it can have some serious complications.
  • Infections, such as malaria and infectious mononucleosis.
  • Mother-baby blood group incompatibility – may result in hemolytic disease of the newborn.
  • Medications – Certain medications such as penicillin can trigger the body to produce antibodies directed against RBCs or cause the direct destruction of RBCs.
  • Physical destruction of RBCs by, for example, an artificial heart valve or cardiac bypass machine used during open-heart surgery.
  • Paroxysmal Nocturnal Hemoglobinurina (PNH) – A rare condition in which the different types of blood cells including RBCs, WBCs and Platelets are abnormal due to lack of certain surface proteins.

Laboratory Tests

  • CBC and/or Blood Smear
  • ANA
  • DCT/  ICT
  • Reticulocyte Count – typically high

 Anemia Caused by Chronic Diseases

Some chronic (long-term) illnesses can cause anemia which, goes undetected until a routine test such as a Complete Blood Count (CBC) reveals abnormal results. Some examples of chronic condition include:

  • Kidney disease
  • Anemia of chronic disease – Whenever there are chronic diseases that stimulate the body’s inflammatory response, the ability of the bone marrow to respond to erythropoietin is decreased. For example, rheumatoid arthritis, HIV or Tuberculosis (TB).

Laboratory Tests

  • CBC and Blood Smear
  • Reticulocyte Count
  • Complete Metabolic Panel (CMP)
  • CRP
  • Erythropoietin (Chronic kidney diseases)
  • HIV and TB testing
  • Iron and Transferrin (TIBC) – Are typically both low


  1. Kawaljit Kaur, Euro J Zool Res, 2014, 3 (1):32-36
  2. Ramesh Chellan etal, JOURNAL OF POPULATION AND SOCIAL STUDIES Volume 19 Number 1 July 2010

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