Anemia: Stages, Blood Test, and Which Doctor to See

Did you see low hemoglobin on a blood test and don't understand what to do about it? Let's go through it calmly, without panic: what anemia is, what stages it has, what tests show, and which doctor to see.

What anemia is and how it is determined

Anemia is a syndrome in which the level of hemoglobin and red blood cells in the blood decreases, and the blood carries oxygen to tissues less effectively. It is not a separate diagnosis in itself but a symptom of various conditions. It is common: in about a third of the world's population, more often in women, children, and older adults. It is identified by a blood test, and the cause is investigated further — sometimes it is an incidental finding in a person without complaints.

Stages of anemia: mild, moderate, and severe

Anemia is described by severity — from mild to severe; the specific hemoglobin thresholds are determined by a doctor taking into account age and sex. With mild anemia there may be weakness, rapid fatigue, and reduced concentration. With more pronounced anemia, shortness of breath with slight exertion, heart rhythm disturbances, headache, ringing in the ears, and disturbances of sleep and appetite appear. With very severe anemia or with concomitant diseases, heart failure is possible.

Anemia on a complete blood count: which parameters are checked

On a complete blood count (full cell count), the red blood cell count and hemoglobin level are checked. Additionally, the color index is assessed: normally it is 0.86–1.1. At a value below 0.86, hypochromic anemia is indicated (for example, iron deficiency), at 0.86–1.1 — normochromic, above 1.1 — hyperchromic (for example, with vitamin B12 or folate deficiency). Reticulocytes are also checked — young red blood cells, normal 0.5–2%.

What the anemia panel includes

If the cause of anemia is unclear, the doctor may order additional tests. Such a panel includes, for example, a ferritin test, iron tests, vitamin B12 and folate, a blood smear examination, hemoglobin electrophoresis, and if necessary — a stool test for occult blood. The set of tests is selected by the doctor based on the blood picture and complaints.

• complete blood count with hemoglobin and red blood cells
• color index and reticulocytes
• ferritin and iron metabolism parameters
• vitamin B12 and folate
• stool test for occult blood

Why severe anemia is dangerous

If anemia is not treated, it increases the risk of infections, since iron deficiency affects immunity. Complications from the heart and lungs are possible — rapid heartbeat or heart failure. During pregnancy, untreated anemia increases the risk of complications before and after childbirth.

Which doctor to see for anemia: general practitioner and hematologist

You can start with a family doctor or general practitioner: they will ask about your well-being and lifestyle, refer you for a blood test, and if the cause is unclear — for additional tests. If the cause is not obvious or the picture is complex, the patient is referred to a specialist, including a hematologist. A hematologist deals with blood diseases and helps determine the type of anemia.

Anemia in itself is not a reason to call an ambulance. Call 103 or 112 if, against the background of anemia, signs of a life-threatening condition appear, for example severe shortness of breath or heart rhythm disturbances.

This material is for reference and does not replace a doctor's consultation: only a specialist can make sense of your test results and the cause of anemia.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer