Treatment of a low hemoglobin in a well-nourished pregnant woman is usually unnecessary, unless there is other evidence of iron deficiency such as a low iron stores (ferritin) or a decreased mean cell volume of the red blood cells.

Two well-designed studies showed a possible association between higher hemoglobins and an increased incidence of premature delivery and low birth weight babies.

Tests For Iron Deficiency Anemia

To find out whether you are anemic, the first screening test is usually the amount of hemoglobin present in your blood. To perform this test, blood is usually taken from a vein in your arm. Hemoglobin can also be determined, although with less accuracy, with blood taken by pinprick from your finger.

The hematocrit is another blood test which shows the percentage of cells, mostly red blood cells, that make up the total blood volume. This test is more accurate after you hemorrhage, because the hemoglobin will not change right away, and this test takes into account the blood volume lost. Some doctors feel it is a better screening test than hemoglobin.

These days the complete blood count is often done routinely. This includes the hemoglobin, the hematocrit, the white blood count and the red blood count, and other computer-calculated ratios of red blood cell volumes and concentrations.

A decrease in the ratio known as the mean red blood cell volume is also a very accurate indicator of anemia. If it falls, it means that the red cells have become smaller.

A blood smear, which involves looking at the red and white blood cells under the microscope, can also give a lot of information. In iron deficiency anemia, the red blood cells will appear paler, thinner and smaller. Their shapes can also be distorted.

If the hemoglobin or hematocrit is found to be low, the next step is to find the cause. It should not be assumed that every anemia is due to iron deficiency, although this is by far the most common cause in women. If an iron deficiency is suspected, blood iron levels as well as the iron binding capacity of the blood should be done. In iron deficiency anemia, the blood iron level is decreased and the iron binding capacity of the blood is increased.

Another very important test is that of the blood ferritin levels which is a measure of the amount of iron reserves in the body.

Some women have normal or low normal hemoglobins with lower than normal iron stores. In such cases, I advise increasing the iron in the diet, and the use of a natural iron supplement once or twice a day for six months.

If iron lack is found to be the cause of the anemia, it is still important to discuss with your doctor what caused the iron deficiency in the first place, and what you can do to prevent a reoccurrence of the problem.

Pregnant women should have a complete blood count at their first prenatal visit and monthly starting at about six months. The blood count should also be checked at the six week visit after the birth, especially if there was prolonged bleeding at or after the birth. Any women with chronic fatigue or prolonged or heavy periods should also have her complete blood count measured.

Iron deficiency anemias are usually treated with an iron rich diet combined with iron supplements.

Dietary Sources Of Iron

Iron can be obtained in food through dark green leafy vegetables such as spinach, chard, turnip greens, kale, lamb's quarters, dandelion greens, broccoli, and alfalfa sprouts. The rule of thumb is that the darker green the colour of the vegetable, the higher in chlorophyll and thus in iron.

Beets, and fruits such as black cherries, blackberries, blueberries, apricots and bananas are also good sources of iron. Sunflower seeds, black beans, sesame seeds, whole grains and egg yolks are also excellent ways to increase the iron in your diet. Seaweeds such as dulse and nori (used to wrap sushi in) are also high in iron.

However, the iron found in red meat, poultry and fish is in a form that is easier to absorb than iron found in other foods. All red meats contain iron in high quantities, especially kidney, heart, liver and bone marrow.