What is the Diagnosis of Iron Deficiency?

If you have signs and symptoms suggestive of iron deficiency anaemia your doctor will examine you and recommend tests to confirm the diagnosis. Read to know more on how iron deficiency anaemia is diagnosed.

History and Physical Examination

Your doctor will take a complete medical history and do a thorough physical exam to look for signs of iron-deficiency anaemia. He may ask you questions regarding your diet, family history of anaemia, bleeding and many other associated symptoms. During the physical exam, your doctor will examine you for pallor (skin, gums, and nail beds), blood pressure, pulses, breathing and examine your abdomen to check the size of liver and spleen.

Complete Blood Count (CBC)

This is mostly the first test done in a person with anaemia. The test counts the different number of blood cells (red blood cells, white blood cells, and platelets) and haemoglobin in a sample of your blood. Haemoglobin is the substance present in red blood cells which helps to transport oxygen to all the organs and cells in the body and removes harmful gasses (that is carbon dioxide). Based on the values of different cell types, and your haemoglobin count compared to normal counts, your doctor can diagnose the type and severity of anaemia.

Reticulocyte Count

This test may be done to check if your bone marrow is making red blood cells at the correct rate. The young, immature red blood cells are called reticulocytes. They mature to become red blood cells that carry oxygen to different parts of your body.

Peripheral Blood Smear Examination

A blood smear (examination of the blood cells under a microscope) may be performed to determine the size and shape of your red blood cells. This can help to make a diagnosis of iron deficiency anaemia (the red blood cells appear smaller and paler in colour than normal) or other type of anaemia such as vitamin B12 deficiency anaemia and sickle cell anaemia.

Some Tests in Iron Deficiency Anaemia

Some tests which may be done to measure iron levels in your body include:

• Serum iron: This test determines the amount of iron in your blood. As the level of iron may be normal even if the total amount of iron in your body is low other tests iron tests also are done.
• Serum ferritin:  Ferritin is a type of protein that helps your body to store iron. Evaluation of the ferritin level helps to determine how much of your body's stored iron has been used. In iron deficiency anaemia serum ferritin is decreased.
• Transferrin level (or total iron-binding capacity): Transferrin carries iron in your blood and the total iron-binding capacity test determines the amount of transferrin in your blood that isn't carrying iron. The amount of transferrin that has no iron is high in iron-deficiency anaemia.

These are some of the tests that are done in a person with anaemia. If needed, your doctor may recommend other tests such as test to check your hormone levels (especially your thyroid hormone), endoscopy and colonoscopy to determine if there bleeding in your gastrointestinal tract.

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