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Anemia is low red blood cells.  The test is called Hemoglobin or Hematocrit. Children have smaller cells so we have normal values for children different than adults.  Some can have non-treatable congenital anemia like Thalassemia or Sickle Cell.  What we want to avoid is low iron anemia. We are born with iron stored up in our body but we get that the last month of pregnancy so premes do not have any iron for growth.  The newborn baby destroys all the red blood cells that they have at birth.  They are for exchanging oxygen through the placenta.  They then replace all their red blood cells over 6 months to air breathing red blood cells.  That’s crazy.  They give themselves a complete blood transfusion.  They need iron for this so we have iron in the formula and breast milk and give extra iron to premes.  We need iron for later growth using it for making more blood and muscle.  But also iron is needed for many other functions in our body and most important is brain metabolism.  Low iron causes poor neurological development and poor performance in school.  Too much cow’s milk after age one causes you not to absorb iron that you need.  Preschooler’s do not eat enough red meat and many older children do not eat as much meat as they need.  We tend to eat less red meat to help our heart.  So I recommend vitamins with iron from age 1 to 18.  When our body starts running low on iron, there has to be a big decrease in iron to start having anemia.  So you can have low iron that affects your function long before we see a decrease in red blood cells.  So a typical blood test for anemia does not test to see if you are low on iron.  Ferritin is the best test and also serum iron is good.  I don’t test for anemia every year since I have my patients take chewable vitamins with iron.  If they take them, then there is no low iron and no anemia so why cause pain.  Gummy vitamins do not have iron!!!! Sorry.  Take Flintstone Complete every day.  We adults should definitely take vitamins if you do not eat meat.  Adult men and women with no uterus who eat red meat should take a vitamin without iron since too much iron can damage your liver.  So the “men’s vitamin” in the stores do not have iron.  Moderation in everything.

You can look up the values for iron and anemia on many web sites.  Keep them away from small children since they are toxic in large quantaties.

Roger Knapp MD