Anemia: Laboratory Diagnosis and Types
Anemia is a condition in which hemoglobin levels and/or red blood cell count in the blood are reduced. It is not a standalone diagnosis but a syndrome that requires determining the underlying cause.
Key Biomarkers
| Biomarker | What It Shows | Approximate Normal |
|---|---|---|
| Hemoglobin | Severity of anemia | M: 130–170 g/L, F: 120–150 g/L |
| Ferritin | Iron stores | 20–250 ng/mL |
| Serum Iron | Current iron level | 9–30 μmol/L |
| Vitamin B12 | B12 deficiency | 187–883 pg/mL |
| Folate | Folate deficiency | 3.1–20.5 ng/mL |
| RBC | Red cell count | M: 4.5–5.5×10¹²/L |
| MCV | Mean corpuscular volume | 80–100 fL |
| Reticulocytes | Erythropoiesis activity | 0.5–2.0% |
Types of Anemia by Lab Findings
Iron Deficiency Anemia (most common)
- Hemoglobin ↓, MCV ↓ (microcytic), ferritin ↓, iron ↓, TIBC ↑
- Causes: blood loss, pregnancy, poor nutrition, malabsorption
B12 Deficiency Anemia
- Hemoglobin ↓, MCV ↑ (macrocytic), vitamin B12 ↓
- Causes: autoimmune gastritis, gastrectomy, vegetarianism, Crohn's disease
Anemia of Chronic Disease
- Hemoglobin ↓, ferritin ↑ or normal, iron ↓, TIBC ↓
- Causes: chronic infections, autoimmune diseases, malignancies
FAQ
What test should I get first if anemia is suspected?
CBC (with reticulocytes) + ferritin. This determines the presence and severity of anemia and its likely cause.
Why can ferritin be normal with low iron?
Ferritin is an acute phase reactant — it can be elevated during inflammation, masking iron deficiency. Check CRP concurrently.
Track your anemia biomarkers with Lissa Health — the platform shows trends and helps monitor treatment.