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Basic Anemia Profile

Anemia

68 parameters

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Fasting Required

Details

Basic anemia screening panel (CBC, iron studies).

₹1,999₹2,999

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Parameters

  • List of Tests
    • Calcium
    • Alkaline Phosphatase
    • SGOT
    • SGPT
    • Uric Acid
    • Ferritin
    • Folic Acid
    • Vitamin B12
    • BUN, Creatinine, BUN/Creatinine
    • GGT
    • Iron Studies (Iron, TIBC, Transferrin)
    • Bilirubin - Total, Indirect & Direct
    • Lipid Profile (Cholesterol/HDL, LDL/HDL, Non-HDL, VLDL, Total Cholesterol, Triglycerides, HDL, LDL)
    • Total Protein, Albumin, Globulin, A/G ratio
    • Thyroid Profile - Total T3, Total T4, TSH
    • HbA1c, Estimated Average Glucose
    • CBC - Complete Hemogram (28)
    • Serum Electrolyte (Na, K, Cl)
    • LDH Serum
    • Vitamin D 25 OH

Basic Anemia Profile - Comprehensive Medical Guide

  • Why is it done?
    • Comprehensive evaluation of anemia etiology by measuring hemoglobin, hematocrit, red blood cell indices, and iron metabolism parameters including ferritin, iron studies (iron, TIBC, transferrin), vitamin B12, and folic acid levels
    • Assessment of liver function through hepatic enzymes (SGOT, SGPT, alkaline phosphatase, GGT), bilirubin levels, and protein metabolism to identify hemolysis or chronic liver disease contributing to anemia
    • Evaluation of kidney function through BUN, creatinine, and BUN/creatinine ratio to detect renal disease that impairs erythropoietin production
    • Diagnosis of nutritional deficiency anemias including iron deficiency anemia, vitamin B12 deficiency anemia, and folate deficiency anemia
    • Evaluation of metabolic and endocrine status through thyroid function tests (TSH, Total T3, Total T4), glucose metabolism (HbA1c, estimated average glucose), and vitamin D status
    • Assessment of cardiovascular and metabolic risk through lipid profile (total cholesterol, HDL, LDL, VLDL, triglycerides, cholesterol/HDL ratio, LDL/HDL ratio, non-HDL)
    • Evaluation of bone metabolism and mineral homeostasis through calcium, alkaline phosphatase, and vitamin D 25-OH levels
    • Assessment of electrolyte balance through serum sodium, potassium, and chloride measurements
    • LDH measurement to detect hemolysis, tissue damage, and cellular turnover contributing to anemia
    • Evaluation of purine metabolism through uric acid measurement to assess for gout or other metabolic disorders
  • Normal Range
    • Complete Hemogram (CBC): Hemoglobin 12-16 g/dL (females) / 13.5-17.5 g/dL (males); Hematocrit 36-46% (females) / 41-53% (males); RBC 4.0-5.5 million/μL (females) / 4.5-6.0 million/μL (males); MCV 80-100 fL; MCH 27-33 pg; MCHC 32-36 g/dL; WBC 4,500-11,000/μL; Platelets 150,000-400,000/μL
    • Iron Studies: Serum Iron 60-170 μg/dL; TIBC 250-425 μg/dL; Transferrin saturation 20-50%; Ferritin 24-336 ng/mL (females) / 24-488 ng/mL (males)
    • Vitamin B12: 200-1000 pg/mL or 148-738 pmol/L
    • Folic Acid: >5.4 ng/mL or >12.2 nmol/L
    • BUN: 7-20 mg/dL (2.5-7.1 mmol/L); Creatinine 0.6-1.2 mg/dL (females) / 0.7-1.3 mg/dL (males); BUN/Creatinine ratio 10-20
    • SGOT (AST): 10-40 U/L; SGPT (ALT): 7-56 U/L
    • Alkaline Phosphatase: 30-120 U/L
    • GGT: 8-61 U/L (females) / 9-69 U/L (males)
    • Total Bilirubin: 0.1-1.2 mg/dL; Direct Bilirubin: 0.0-0.3 mg/dL; Indirect Bilirubin: 0.1-1.0 mg/dL
    • Total Protein: 6.0-8.3 g/dL; Albumin: 3.5-5.0 g/dL; Globulin: 2.3-3.5 g/dL; A/G ratio: 1.0-2.5
    • LDH (Serum): 140-280 U/L
    • Uric Acid: 3.5-7.2 mg/dL (females) / 3.5-7.2 mg/dL (males)
    • Serum Electrolytes: Sodium 135-145 mEq/L; Potassium 3.5-5.0 mEq/L; Chloride 96-106 mEq/L
    • Calcium: 8.5-10.2 mg/dL (2.1-2.55 mmol/L)
    • Thyroid Profile: TSH 0.4-4.0 mIU/L; Total T3 80-200 ng/dL; Total T4 4.5-12.0 μg/dL
    • HbA1c: <5.7% (non-diabetic); Estimated Average Glucose: <100 mg/dL (fasting) or <140 mg/dL (postprandial)
    • Lipid Profile: Total Cholesterol <200 mg/dL; LDL Cholesterol <100 mg/dL; HDL Cholesterol >40 mg/dL (males) / >50 mg/dL (females); Triglycerides <150 mg/dL; VLDL <30 mg/dL; Total Cholesterol/HDL <5.0; LDL/HDL <3.0; Non-HDL Cholesterol <130 mg/dL
    • Vitamin D 25-OH: 30-100 ng/mL (75-250 nmol/L) considered sufficient; 20-29 ng/mL considered insufficient; <20 ng/mL considered deficient
  • Interpretation
    • Hemoglobin below 12 g/dL (females) or 13.5 g/dL (males) indicates anemia; severity correlates with degree of reduction; combined with MCV determines anemia type (microcytic, normocytic, macrocytic)
    • MCV below 80 fL indicates microcytic anemia (iron deficiency, thalassemia); MCV 80-100 fL indicates normocytic anemia (hemolysis, acute bleeding); MCV above 100 fL indicates macrocytic anemia (B12 deficiency, folate deficiency)
    • Serum iron below 60 μg/dL with elevated TIBC and low ferritin (<15 ng/mL) confirms iron deficiency anemia; ferritin is most sensitive marker for iron stores
    • Vitamin B12 below 200 pg/mL indicates deficiency causing megaloblastic anemia and neurological symptoms; levels 200-400 pg/mL are borderline and may warrant investigation with methylmalonic acid and homocysteine
    • Folic acid below 5.4 ng/mL indicates deficiency; combined with elevated homocysteine and methylmalonic acid, confirms folate deficiency as cause of macrocytic anemia
    • Elevated BUN (>20 mg/dL) with elevated creatinine (>1.2 mg/dL females, >1.3 mg/dL males) indicates kidney disease; BUN/creatinine ratio >20 suggests prerenal azotemia or dehydration
    • Elevated SGOT and SGPT (>40 U/L) indicate hepatocellular injury; SGOT/SGPT ratio >2 suggests alcohol-related liver disease; AST more specific for liver damage
    • Elevated alkaline phosphatase (>120 U/L) indicates cholestasis or bone disease; GGT elevation confirms hepatic origin
    • Elevated total bilirubin (>1.2 mg/dL) with elevated indirect bilirubin suggests hemolysis; elevated direct bilirubin suggests cholestasis or biliary obstruction
    • Low albumin (<3.5 g/dL) indicates liver disease, malnutrition, or nephrotic syndrome; low total protein with normal albumin suggests immunoglobulin deficiency
    • Elevated LDH (>280 U/L) indicates hemolysis, tissue damage, or myocardial infarction; LDH/AST ratio helps differentiate hemolysis from hepatic injury
    • Elevated uric acid (>7.2 mg/dL) indicates gout risk, hyperuricemia, or tumor lysis syndrome; low uric acid suggests xanthine oxidase deficiency
    • Hyponatremia (<135 mEq/L) causes neurological symptoms and convulsions; hyperkalemia (>5.0 mEq/L) indicates renal dysfunction or cell death; hypochloremia suggests alkalosis
    • Hypocalcemia (<8.5 mg/dL) causes tetany and paresthesias; hypercalcemia (>10.2 mg/dL) causes weakness and cardiac arrhythmias
    • Elevated TSH (>4.0 mIU/L) with low total T4 indicates primary hypothyroidism; decreased TSH with elevated T4/T3 indicates hyperthyroidism; affects erythropoietin production and oxygen delivery
    • HbA1c 5.7-6.4% indicates prediabetes; ≥6.5% indicates diabetes; estimated average glucose reflects 3-month glucose control and correlates with anemia risk
    • Total cholesterol >200 mg/dL, LDL >100 mg/dL, or low HDL indicate dyslipidemia and cardiovascular risk; elevated triglycerides (>150 mg/dL) increase pancreatitis risk
    • Vitamin D <20 ng/mL indicates deficiency affecting bone health, immune function, and potentially contributing to anemia through reduced intestinal mineral absorption
  • Associated Organs
    • Complete Hemogram - Bone Marrow and Blood: Evaluates erythroid production, detects anemias (iron deficiency, megaloblastic, hemolytic), leukemias, infections, and thrombocytopenia; abnormalities may indicate primary bone marrow disorders
    • Iron Studies (Serum Iron, TIBC, Ferritin, Transferrin) - Bone Marrow, Liver, Gut: Iron deficiency anemia diagnosed through low iron and high TIBC; ferritin reflects body iron stores; decreased absorption in celiac disease, chronic diarrhea; liver stores excess iron in hemochromatosis
    • Vitamin B12 - Bone Marrow, Gastrointestinal Tract, Liver: B12 deficiency causes megaloblastic anemia and neurological damage; pernicious anemia from autoimmune gastritis; malabsorption in ileal disease; deficiency in vegans and strict vegetarians
    • Folic Acid - Bone Marrow, Gastrointestinal Tract, Liver: Folate deficiency causes megaloblastic anemia and elevated homocysteine; malabsorption in celiac disease, tropical sprue; deficiency in pregnancy, alcoholism; interaction with methotrexate
    • BUN, Creatinine, BUN/Creatinine - Kidneys: Elevated values indicate chronic kidney disease reducing erythropoietin production; BUN/Cr ratio differentiates prerenal from intrinsic kidney disease; decreased creatinine in malnutrition
    • SGOT (AST), SGPT (ALT) - Liver: Elevated in hepatitis, cirrhosis, fatty liver disease; contributes to anemia through reduced nutrient metabolism and hemostatic dysfunction
    • Alkaline Phosphatase - Liver, Bone, Intestine: Elevated in cholestasis, bone disease, intestinal pathology; indicates liver dysfunction or impaired bone metabolism contributing to anemia
    • GGT - Liver, Biliary System: Elevated in hepatic dysfunction, alcoholism, biliary obstruction; more specific liver marker than alkaline phosphatase
    • Total and Direct Bilirubin - Liver, Biliary System, Blood: Elevated indirect bilirubin indicates hemolysis or liver dysfunction; elevated direct bilirubin indicates cholestasis; hepatic disease impairs coagulation and nutritional status
    • Total Protein, Albumin, Globulin, A/G Ratio - Liver, Immune System: Low albumin indicates liver disease or malnutrition; elevated globulins suggest chronic infection or autoimmune disease; impairs oxygen transport capacity
    • LDH (Lactate Dehydrogenase) - Heart, Liver, Kidney, Muscle, Blood: Elevated in hemolysis (indicator of anemia), myocardial infarction, hepatitis, muscle damage; LDH particularly high in hemolytic anemias
    • Uric Acid - Kidneys, Joints, Purine Metabolism: Elevated in kidney disease, gout, leukemia (tumor lysis), and high-purine diet; low levels suggest xanthine oxidase deficiency or very low purine intake
    • Serum Electrolytes (Sodium, Potassium, Chloride) - Kidneys, Heart, Nervous System: Abnormalities indicate kidney disease, dehydration, or hemolysis; essential for blood pressure regulation and oxygen delivery
    • Calcium - Bones, Teeth, Intestines, Kidneys: Essential for bone mineralization and muscle function; low calcium impairs organ function; vitamin D and PTH regulate absorption
    • Thyroid Profile (TSH, Total T3, Total T4) - Thyroid Gland, Bone Marrow, Metabolic Rate: Hypothyroidism reduces erythropoietin production and oxygen utilization; affects metabolism of nutrients needed for RBC production
    • HbA1c, Estimated Average Glucose - Pancreas, Blood, Multiple Organs: Evaluates glycemic control; diabetes impairs wound healing and increases infection risk affecting bone marrow function and anemia risk
    • Lipid Profile - Heart, Liver, Vascular System: Dyslipidemia correlates with cardiovascular disease and inflammation affecting blood delivery to tissues; impacts oxygen-carrying capacity
    • Vitamin D 25-OH - Intestines, Kidneys, Bones, Immune System: Deficiency impairs intestinal calcium and phosphorus absorption; affects immune function and bone marrow erythroid production
  • Follow-up Tests
    • Abnormal CBC findings may require: Peripheral blood smear, bone marrow aspiration/biopsy, flow cytometry for leukemia/lymphoma diagnosis, reticulocyte count to assess bone marrow response
    • Low ferritin and elevated TIBC indicating iron deficiency require: Fecal occult blood test to detect GI bleeding, esophagogastroduodenoscopy (EGD) or colonoscopy if GI bleeding suspected, celiac serology (tissue transglutaminase antibodies) for malabsorption
    • Low B12 requiring follow-up: Methylmalonic acid and homocysteine levels to confirm B12 deficiency, intrinsic factor antibodies for pernicious anemia, Schilling test in select cases, upper endoscopy if gastric pathology suspected
    • Low folic acid with B12 deficiency requiring: Plasma homocysteine and methylmalonic acid, dietary assessment, evaluation for malabsorption syndromes (celiac disease, Crohn's disease)
    • Elevated creatinine and BUN requiring: Cystatin C for GFR estimation, 24-hour urine creatinine clearance, renal ultrasound to assess kidney structure, referral to nephrology for CKD management, repeat measurements to assess disease progression
    • Elevated liver enzymes requiring: Hepatitis serology (HAV, HBV, HCV, EBV, CMV), autoimmune hepatitis markers (ANA, anti-smooth muscle, anti-LKM), iron studies (hemochromatosis), abdominal ultrasound or CT to assess liver structure
    • Elevated alkaline phosphatase and bilirubin requiring: Abdominal imaging (ultrasound/CT), GGT measurement, 5'-nucleotidase, bone-specific alkaline phosphatase (if bone disease suspected), hepatology referral if cholestasis confirmed
    • Low albumin with normal total protein requiring: Protein electrophoresis, 24-hour urine protein for nephrotic syndrome assessment, prealbumin (transthyretin) for nutritional status, albumin infusion if critically low
    • Elevated LDH with elevated indirect bilirubin requiring: Haptoglobin levels, direct and indirect antiglobulin test (Coombs test), peripheral blood smear, reticulocyte count to confirm hemolytic anemia
    • Elevated uric acid requiring: 24-hour urine uric acid collection, kidney function assessment, imaging for gout complications, dietary modification counseling
    • Abnormal electrolytes requiring: Repeat measurement to confirm, 24-hour urine electrolytes, ECG if potassium abnormal, fluid status assessment, medication review
    • Abnormal calcium requiring: Ionized calcium measurement, PTH level, phosphate level, magnesium level, vitamin D 25-OH (if not already measured), alkaline phosphatase, bone imaging (DEXA scan) if osteoporosis suspected
    • Abnormal thyroid function requiring: Free T4, free T3, TPO antibodies, thyroglobulin antibodies, thyroid ultrasound if thyroid nodules suspected, TSH monitoring at 6-8 week intervals if on replacement therapy
    • Elevated HbA1c requiring: Fasting glucose, 2-hour glucose tolerance test, C-peptide level to assess pancreatic function, repeat HbA1c at 3-6 month intervals, metabolic screening panel monitoring
    • Dyslipidemia requiring: Lipoprotein(a) level, LDL particle number/size (if available), homocysteine and lipoprotein(a) for additional risk assessment, cardiovascular imaging (coronary calcium score) if high risk, treatment initiation with statins per guidelines
    • Vitamin D deficiency requiring: Baseline vitamin D 25-OH recheck after 3 months of supplementation, bone density assessment (DEXA scan) if osteoporosis risk, PTH and calcium monitoring, repeat testing annually
    • General follow-up: Repeat complete basic anemia profile at 4-6 week intervals to assess treatment response; more frequent monitoring (every 1-2 weeks) if critical values; long-term monitoring annually in stable patients with known chronic conditions
  • Fasting Required?
    • Yes, fasting is required for the Basic Anemia Profile package to ensure accurate results, particularly for lipid panel, glucose, and some hepatic function tests
    • Required fasting duration: 8-12 hours (minimum 8 hours, preferably 10-12 hours overnight fast) to obtain valid lipid profile and glucose measurements; fasting from midnight if early morning draw
    • Allowed during fasting: Plain water, black coffee or tea without sugar, milk, or cream; medications should be taken as usual unless specifically instructed otherwise by physician
    • Medications to discuss with physician before testing: Lipid-lowering drugs (statins, fibrates) may be held per protocol; thyroid medications should be taken as usual; iron supplements should ideally be held 24 hours before iron studies; vitamin B12 and folate supplements should be withheld if testing for deficiency
    • Dietary restrictions before testing: No food consumption for 8-12 hours; avoid alcohol for at least 24 hours before test as it affects liver enzymes and lipid values; avoid high-fat meals evening before test
    • Other patient preparation requirements: Draw blood in early morning (7:00-9:00 AM preferred) when possible; patient should rest sitting for 5 minutes before blood draw; avoid strenuous exercise 24 hours before testing as it affects lipids and liver enzymes
    • Special considerations: If patient is menstruating, note this as hemoglobin may be lower; inform laboratory of recent blood transfusion; note recent infections as CBC and LDH may be elevated; patient should provide detailed medication list including over-the-counter supplements
    • Timing considerations: Tests should ideally be drawn at same time each visit for consistency in repeat testing; CBC results may vary based on posture (sitting vs supine), so standardize collection position; avoid collecting during infection or acute illness if baseline values needed

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