September 19, 2025
Diagnostics of Anaemia: Tests and Markers In a Nutshell
Anaemia is a complex condition that indicates a reduction in red blood cells (RBCs) or haemoglobin levels in the body. Accurate diagnosis is essential to identify the underlying cause and begin effective treatment. At Chequers Health, we support patients throughout the testing process and provide guidance to help them understand and interpret their results.
Blood tests to Aberrant Anaemia
- Full Blood Count (FBC)
- Checks the haemoglobin levels, haematocrit and the RBCs
- Measures the average volume of red cells
- Distinguishes between those cells that may be: too small (microcytic), too large (macrocytic), or of normal size (normocytic)
Ferritin Test
- Determines the serum level of the ferritin that shows the amount of iron that is stored in the body
- Low ferritin can be an indicator of the iron deficiency even when there are normal levels of haemoglobin
Iron Studies
- Includes a serum iron, transferrin, iron saturation of transferrin, and the total iron-binding capacity (TIBC)
- Helps to distinguish between chronic disease and iron deficiency
- Folic Acid and Folate Testing
- Identifies the deficits that can result into macrocytic anaemia
Reticulocyte Count
Measures bone marrow activity by counting the number of newly produced red blood cells (RBCs), helping determine whether the body is producing enough new cells.
Explaining Your Results
- Low MCV- This is common with iron deficiency and thalassaemia
- High MCV-Suggests vitamin B12 or Folate deficiency
- Low haemoglobin with a normal MCV may indicate anaemia of chronic disease or anaemia caused by blood loss
UK Seeing Pathways
Typically:
- Your family doctor reorders a FBC and a ferritin
- Examination of ferritin that suggests a deficiency condition may encourage additional tests regarding potential causes of bleeding, including bowel screening in patients beyond 50
- In unexplained anaemia, direct referral to haematologist may be done
When additional tests are required
In cases of unexplained anaemia, your doctor may consider:
- Endoscopy or colonoscopy to check for internal bleeding
- Bone marrow biopsy if a marrow disorder is suspected
- Advanced imaging to evaluate abnormal organs or sources of bleeding
When to See a Doctor
In case of the following health problems, general practitioners can be called to action:
- Weakness/fatigue
- Gasping for air whilst doing light activities too
- Unexplained bleeding
- Progressively worsening symptoms
Internal Links
From this page, go to:
Causes, Symptoms, Treatment of Iron Deficiency Anaemia
Vitamin B12 Deficiency Anaemia: What You Should Know
Anaemia Prognosis
FAQs About The Diagnosis Of Anaemia
Yes. Anaemia is frequently tested with a full blood count.
Yes, ferritin is generally a more sensitive indicator of iron deficiency than haemoglobin. Here’s why:
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Haemoglobin (Hb) measures the oxygen-carrying capacity of the blood. Low haemoglobin indicates anaemia, but it only falls after iron stores are already depleted, so it may miss early iron deficiency.
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Ferritin reflects the body’s iron stores. A low ferritin level can detect iron deficiency before haemoglobin drops, making it an earlier and more reliable marker.
Key point: Ferritin is especially useful for diagnosing iron deficiency without anaemia, whereas haemoglobin alone detects iron deficiency only once anaemia develops.
It usually takes between 5-7 working days to get test results from the GP. Private healthcare can deliver your results in 24-48 hours.
This is termed as iron deficiency without anaemia and could lead to worse conditions if left untreated.
More tests are often conducted to determine the cause, but not always
