19069 Health Library | Health and Wellness | Wellmont Health System
  • Diagnosis of Nutritional Anemia

    Many types of anemia are diagnosed early by routine blood tests during regular physical exams. If not, anemia may be diagnosed when you describe your symptoms to a doctor. The doctor will ask about your symptoms and medical history and perform a physical exam. If your symptoms suggest anemia or other blood conditions, you will have a blood test called a complete blood count (CBC). A CBC determines the number of red blood cells and the amount of hemoglobin in your blood. If you have too few red blood cells or too little hemoglobin, you are considered to have anemia.
    The next task for your doctor is to determining what type of anemia you have and what is causing it. Based on your medical history and your CBC, your doctor may be able to determine the cause. A careful assessment of your dietary intake, medical and surgical history, and bowel function may be helpful. Common causes of nutritional anemia include:
    • Iron deficiency, which can be detected in the results of your CBC
    • Hidden blood loss, which may appear to be iron deficiency according to your CBC if the leak is slow enough
    • B12 deficiency
    • Folic acid deficiency
    • Anemia associated with chronic illnesses such as rheumatoid arthritis , though this is not strictly from nutritional causes
    Tests to determine the type and cause of anemia include:
    CBC —Counts your red and white blood cells, your platelets, and measures your hemoglobin.
    Blood Smear —Blood is taken from your finger and smeared on a microscope slide so that red blood cells can be examined directly. Red blood cells have a different appearance depending on the type of anemia. They can be deformed, too big, too small, too variable in size or shape, or filled with visible abnormalities.
    Reticulocyte Count —Counts young red blood cells to determine how fast they are being made. Red blood cells only a few days old look different from older ones.
    Serum Iron , Iron Binding Capacity , and Ferritin —Tests to determine if you have enough iron in your blood.
    Folic Acid and B 12 Levels —Blood tests of these nutrients.
    Hemoglobin Electrophoresis —Determines if you have a genetic/hereditary abnormality of your hemoglobin such a sickle cell trait.
    Red Cell Fragility —Identifies red blood cells that can be destroyed too easily.
    Coombs Tests —Detects antibodies that increase the fragility of red blood cells.
    Bone Marrow Biopsy —Removal of a sample of bone marrow tissue to examine the blood-making cells under a microscope.
    Your evaluation may be more focused if other organs are involved. For instance, the kidneys make the hormone erythropoietin, which is necessary for red blood cell production. Chronic kidney disease causes a unique kind of anemia that has a specific and effective treatment. (This is not a form of nutritional anemia.)


    Culleton, BF, Manns, BJ, Zhang, J, et al. Impact of anemia on hospitalization and mortality in older adults. Blood. 2006; 107:3841.

    Harrison's Principles of Internal Medicine . 16th ed. McGraw-Hill; 2004.

    Patel, KV, Harris, TB, Faulhaber, M, et al. Racial variation in the relationship of anemia with mortality and mobility disability among older adults. Blood. 2007.

    The Merck Manual of Diagnosis and Therapy 18th ed. Merck & Co; 2006.

    National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.