Anemia test

Your doctor will recommend an anaemia profile if you have the following symptoms:

• Fatigue 
• Light-headedness
• Weakness
• Headache
• Rapid, strong and irregular heartbeat (palpitations) and increased heart rate (tachycardia)
• Pallor or jaundice
• Chest pain
• Cold extremities
• Pain and difficulty in walking caused by reduced blood flow to the limbs (claudication)
• Shortness of breath
• Irritability
• Difficulty in concentration
• Reduced appetite
• Cracked tongue
• Pounding or whooshing in ears

These signs and symptoms associated with anaemia may vary in magnitude and prevalence from individual to individual.

Doctors also recommend this test if you belong to the high-risk population, which includes the following:

• Menstruating women
• Pregnant women and breastfeeding mothers
• Premature babies
• Individuals with rheumatoid arthritis, cancer, stomach ulcer, or liver, kidney or thyroid diseases
• Athletes
• Individuals on fad, vegetarian or vegan diets

No special preparations are needed for anaemia profile. However, your doctor may ask you to fast for several hours before the test. They may also ask you to drink sufficient water for proper hydration before the blood sample collection as the protein levels appear to be higher in dehydrated conditions, affecting the results.

Ensure to inform your doctor if you are taking any prescription or over-the-counter medicines, including herbal and vitamin supplements and any illegal drugs. Also, tell him/her if you have had any blood transfusions recently (in last three months) as it alters the results of Hb electrophoresis.

A small quantity of blood will be collected for this test, usually from a vein on the inner side of your elbow. It is a simple procedure and takes less than five minutes. In babies, the blood is generally collected from the heel using a tiny needle (lancet).

The blood test may cause slight pain and discomfort at the site of injection. It may also pose certain other risks like dizziness or fainting, multiple punctures to locate veins, excessive bleeding from the site of injection, haematoma characterised by blood clot formation under the skin, and infection. However, these risks are not common.

The results of the anaemia profile may differ based on various parameters, including gender, age and medical history of the individual and the method used for the test. 

Normal results:

• CBC: The following are the normal values of CBC:
• RBC count: 3.93-5.69 million cells/mm³
• Hb levels: 13.5-17.5 g/dL in men and 12-16 g/dL in women
• Haematocrit: 40%-55% in men and 36%-48% in women
• Platelet count in adult: 147,000-347,000 cells/mm³
• WBC count: 3,300-8,700 cells/mm³ 
• PS: The size and shape of each blood cell are observed and compared with the normal size and shapes. For example, RBC is biconcave disc-shaped and measures about 7-8 µm in diameter. 
• Iron profile: In men, the normal level of iron is 65-175 µg/dL; in women, it is 50-170 µg/dL and in children, it is 50-120 µg/dL. For both men and women, normal results for TIBC are 250-450 µg/dL. The normal transferrin range is 200-360 mg/dL, and transferrin saturation level is 20%-50% in men and 15%-50% in women. 

The paediatric ranges for serum iron levels are 110-270 μg/dL (age: 0-4 months), 30-70 μg/dL (age: 5-23 months), 20-124 μg/dL (age: 24-35 months) and 53-119 μg/dL (age: 3-11 years). For children aged 12 years and older, adult values are to be considered.

The paediatric ranges for transferrin saturation levels are 56%-74% (age: 0-10 days), 17%-34% (age: 11 days-12 months), 22%-39% (age: 13 months-10 years) and 27%-44% (age: 11-17 years).

• CRP: Values less than 10 mg/dL of CRP is considered normal.
• Total protein, albumin and A:G ratio: Normal level of albumin is 39-51 g/L of blood. The normal values of globulins depend on the specific type of globulin. The normal reference value for total globulin is 23-35 g/L of blood.
• Hb electrophoresis by HPLC: The normal range of different types of Hb in adults is as follows:
  • HbA: 95%-98% 
  • HbA2: 2%-3% 
  • HbF: 0.8%-2% 
  • HbE: Absent
  • HbS: Absent
  • HbC: Absent

The normal range of HbF in infants and children is as follows:

• HbF (newborn): 50%-80% 
• HbF (6 months): 8%
• HbF (over 6 months): 1%-2%

Abnormal results:

• CBC: The following CBC results indicate abnormalities:

  • Lower-than-normal levels of RBCs indicate anaemia. A low level of Hb may indicate iron deficiency anaemia, while low haematocrit levels may also indicate the presence of heart disease, or blood or bone marrow disorder.
  • Abnormally higher levels of platelet count indicate the presence of iron deficiency anaemia, haemolytic anaemia, or inflammatory or infectious diseases.
  • Higher-than-normal levels of WBCs are observed in the presence of some underlying condition that may lead to anaemia. Read more: WBC count
  • Abnormally larger RBCs in MCV results indicate pernicious anaemia caused by folate or vitamin B12 deficiency, while abnormally smaller RBCs indicate iron deficiency anaemia or thalassaemia.
  • In MCH results, larger-than-normal RBCs have more oxygen-carrying Hb, while smaller-than-normal RBCs have less.
  • Abnormal values in MCHC results help in the determination of the type of anaemia or the presence of other possible conditions.
• PS: Immature blood cells in PS point towards the possible causes of anaemia that can be identified with other tests.
• Iron profile: Lower than normal levels of iron indicate iron deficiency anaemia, other types of anaemia, blood loss, long-term infections and last three months of pregnancy. Abnormal levels of various parameters in the iron profile test are also useful in the diagnosis of various diseases.
• CRP: The CRP levels of more than 10 mg/dL is due to the presence of infection in about 80% of cases.
• Total protein, albumin and A:G ratio: Abnormally lower levels of protein indicate the presence of kidney or liver disease; whereas, abnormally higher levels of protein indicate problems of the digestive tract. The low or high levels of A:G ratios aid in the diagnosis of other medical conditions like cancers and genetic diseases. These diseases could be the underlying cause of anaemia.
• Hb electrophoresis by HPLC: Significant variations from the normal range for different types of Hb may be due to sickle-cell anaemia, Hb C disease, rare haemoglobinopathy and inherited blood disorder like thalassaemia.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.