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Anaemia - iron deficiency - Management
What investigations should I do to confirm anaemia?
- Check a full blood count (see Interpreting a full blood count).
- For people with a low haemoglobin and low mean cell volume (i.e. microcytic anaemia):
- For a non-pregnant person, check the ferritin level (see Interpreting ferritin levels).
- For a pregnant woman, consider checking ferritin levels. Microcytic anaemia in this group is highly likely to be due to iron deficiency and ferritin results may be less reliable in pregnancy.
- It is less clear in which groups of people vitamin B12 and folate levels should also be checked, and when this should be done. Consider particularly if the person is anaemic and:
- The anaemia is normocytic with a low or normal ferritin level.
- There is an inadequate response to iron supplements in proven iron deficiency anaemia and no reason for this (e.g. poor compliance) is apparent.
- Vitamin B12 or folate deficiency is suspected (e.g. dietary deficiency, malabsorption, lack of folate supplementation in pregnancy).
- The person is in an older age group (more at risk of pernicious anaemia).
- For more information on testing for vitamin B12 or folate levels, and interpretation of the results, see the CKS topic on Anaemia - B12 and folate deficiency.
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