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Diagnosis of anemia: modern methods and interpretation of tests

Anemia — one of the most common pathological conditions in modern clinical practice. According to WHO, almost every third person in the world has a low hemoglobin level. However, anemia is not always a simple lack of iron. Its etiology is multifaceted, so effective anemia diagnosis requires a comprehensive approach.
Symptoms that may indicate anemia
Chronic fatigue and weakness
Pale skin
Dizziness and headache
Heart palpitations during exercise
Brittle hair and nails
Impaired memory and concentration
These manifestations may be nonspecific, so laboratory tests play a key role.

What tests are needed to diagnose anemia?
Complete blood count (ZAK)
A major study that reveals:
Hemoglobin (Hb) level
Red blood cell count (RBC)
Hematocrit (HCT)
MCV (mean corpuscular volume)
MCH, MCHC — hemoglobin content and concentration in erythrocytes
These indicators allow preliminary classification of anemia by erythrocyte size: microcytic, normocytic, macrocytic.
Biochemical analyses
Serum iron – decrease is characteristic of iron deficiency anemia
Ferritin – reduced when iron stores are depleted
Transferrin and TIBC – exhibit compensatory reactions
B12 and folic acid – decrease inherent in macrocytic anemias
How to distinguish between different types of anemia
| Indicator | Iron deficiency | B12-deficient | Anemia of chronic disease |
|---|---|---|---|
| Hb | ↓ | ↓ | ↓ |
| MCV | ↓ | ↑ | N or ↓ |
| Ferritin | ↓ | N or ↑ | N or ↑ |
| B12 | N | ↓ | N |
| Bone marrow status | Hyperplasia | Megaloblastosis | Hypoplasia or normo |
Additional tests for suspected anemia
Erythropoietin level — for the assessment of hematopoiesis
Fecal occult blood test — elimination of blood loss
Abdominal ultrasound, gastroscopy, colonoscopy — search for sources of blood loss
Bone marrow puncture — if aplastic conditions are suspected
How to prepare for the examination
Fasting blood sample (at least 8 hours without food)
For 24 hours - avoid alcohol and physical exertion
Tell your doctor about taking iron, vitamins, or medications.
Early detection of anemia can prevent complications, from heart problems to cognitive changes. Don't delay your visit to the lab: early diagnosis is the basis for effective treatment.
