• 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
    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.)


    Anemia—differential diagnosis. Updated September 23, 2015. Accessed September 29, 2015.

    Culleton, BF, Manns, BJ, Zhang J, et al. Impact of anemia on hospitalization and mortality in older adults. Blood. 2006;107(10):3841-3846.

    Decreased erythropoiesis. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hematology-and-oncology/anemias-caused-by-deficient-erythropoiesis/decreased-erythropoiesis. Updated May 2013. Accessed September 29, 2015.

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

    How is anemia diagnosed? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/anemia/diagnosis. Updated May 18, 2012. Accessed September 29, 2015.

    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;109(11):4663-4670.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart 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.