Anemia Panel

If you have anemia, this panel can help determine potential iron or vitamin deficiency causes.

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PREPARATION: No fasting or other special preparation is needed for this test.

What does this test do?

The Anemia Panel is designed to help determine potential causes of anemia, which is defined as an abnormally low concentration of oxygen-carrying red blood cells. This test measures the concentrations of five different substances that help maintain a normal level of red blood cell production, and includes:

Ferritin is a protein found in the liver, spleen, and bone marrow. It binds and stores iron until it is needed to make new red blood cells. Although only a small amount of ferritin is found in the blood, the measured concentration give an idea of the amount of iron stored in the body.

Folate (RBC) (also known as folic acid) is a B vitamin that is very important in red blood cell production. The direct measurement of folate contained in the red blood cells (or RBC) is a much more sensitive test than measuring blood concentrations, as it is not affected by diet or recent ingestion of supplemental folate.

Iron (Total) is an important mineral for the proper function of muscles and organs, as well as for the formation of hemoglobin. The original source of all the body’s iron is from foods such as liver and other meat, eggs, fish, and leafy green vegetables. Healthy adult men rarely develop an iron deficiency, because they get enough iron from the foods they eat and usually have enough reserves of iron in their bodies to last for several years. Women however can lose large amounts of iron due to menstrual bleeding, pregnancy, or breast-feeding, and are much more likely than men to need an iron supplement. About three-fourths of the body’s iron is found in hemoglobin; the rest is bound to other tissues or proteins such as transferrin and ferritin.

Transferrin is an important protein that is responsible for transporting iron in the bloodstream. When red blood cells die, the iron from their hemoglobin is released and carried by transferrin to the bone marrow, where iron is stored and recycled as needed to make new red blood cells.

Vitamin B12 (also known as cyanocobalamin) is another important precursor in red blood cell production. Like folate, a lack of Vitamin B12 also causes macrocytic anemia. Vitamin B12 is not found in vegetables; instead it is contained in animal products such as meat, shellfish, milk, cheese, and eggs.

Why is this important?

Anemia can result from chronic blood loss (such as with heavy menstrual cycles), or nutritional deficiencies of iron or certain vitamins. Other causes of anemia include excessive alcohol use, liver disease, thyroid deficiency, and bone marrow problems.

What do the results mean?

Ferritin – Low levels of ferritin highly correlate with iron-deficiency anemia, while abnormally high levels of ferritin can be found in anemia caused by other chronic diseases.

Folate (RBC) –  Low levels of folate cause decreased production of red blood cells, and the cells which are produced are typically larger than normal (a macrocytic anemia). Folate deficiency can be caused by diets that do not include enough fruits and vegetables, chronic alcoholism, diseases of the digestive tract (such as Crohn’s, or Celiac disease), and certain medications (phenytoin, sulfasalazine, trimethoprim-sulfamethoxazole). Some rare genetic disorders can lead to abnormally low levels of folate as well.

Iron (Total) – Low levels of iron are a common cause of anemia. Abnormally high levels of iron are found in a disease called hemochromatosis.

Transferrin – High levels of transferrin may indicate iron deficiency as a cause of anemia. Abnormally low levels of transferrin may indicate a state of malnutrition.

Vitamin B12 – Low levels of Vitamin B12 are rarely caused by dietary deficiencies (except in vegans who do not eat any animal products), but more commonly result from absorption problems within the digestive tract (a condition called pernicious anemia).