Anemia - Dietary Factors

Diagnosis

Because anemia may be the first symptom of a serious illness, it is very important to determine its cause. This may be difficult, particularly in the elderly, malnourished, or people with chronic diseases, whose anemia may be caused by one or more factors. A detailed medical, personal, and dietary history should report:

• Any family or personal history of anemia
• A history of gallbladder disease, jaundice, or enlarged spleen
• Heavy menstrual bleeding in women
• Any occurrence of blood in the stool or other signs of internal bleeding
• Dietary history, particularly in people who are elderly, poor, or both

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The doctor should examine the patient carefully, especially checking for swollen lymph nodes, an enlarged spleen, and pale skin and nail color.

A complete blood count (CBC) blood test is performed to determine the presence of anemia. Other iron status blood tests are also used.

Complete Blood Count (CBC)

A complete blood count (CBC) is a panel of tests that measures red blood cells, white blood cells, and platelets. For diagnosis of anemia, the CBC provides critical information on the size, volume, and shape of red blood cells (erythrocytes). CBC results include measurements of hemoglobin, hematocrit, and mean corpuscular volume.

Hemoglobin. Hemoglobin is the iron-bearing and oxygen-carrying component of red blood cells. The normal value for hemoglobin varies by age and gender. Anemia is generally considered when hemoglobin concentrations fall below 11 g/dL for pregnant women, 12 g/dL for non-pregnant women, and 13 g/dL for men.

The severity of anemia is categorized by the following hemoglobin concentration ranges:

• Mild anemia is considered when hemoglobin is between 9.5 - 13.0 g/dL
• Moderate anemia is considered when hemoglobin is between 8.0 - 9.5 g/dL
• Severe anemia is considered for hemoglobin concentrations below 8.0 g/dL

Hematocrit. Hematocrit is the percentage of blood composed of red blood cells. People with a high volume of plasma (the liquid portion of blood) may be anemic even if their blood count is normal because the blood cells have become diluted. Like hemoglobin, a normal hematocrit percentage depends on age and gender. In general, doctors diagnose anemia when hematocrit falls below: