Hematology refers to the study of blood and bone marrow conditions. A person may be referred to a hematologist to find out what the cause of anemia is and to determine a treatment plan.

Anemia occurs when the body is not producing enough red blood cells, or hematocrit. As a result, there is not enough hemoglobin, which is the protein in red blood cells that carries oxygen around the body.

There are different types of anemia, including:

  • nutritional deficiency anemia such as iron deficiency anemia and vitamin deficiency anemia
  • anemia in pregnancy
  • blood loss anemia
  • hemolytic anemia
  • anemia of chronic disease
  • aplastic anemia

This article discusses when a doctor might refer a person to an anemia specialist, or hematologist. It also looks at how hematologists diagnose anemia, what treatment options are available, and more.

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If a doctor suspects anemia but they cannot identify the cause of the condition, they may refer a person to a hematologist.

Aplastic anemia is a type of anemia where the body stops producing blood cells that are important for vital functions that include:

  • controlling infection
  • transporting oxygen
  • repairing tissue after injury

This causes bone marrow failure.

Managing aplastic anemia relies on determining the underlying cause. Without removing the cause, it is difficult to treat the condition.

A bone marrow biopsy is essential when diagnosing aplastic anemia, as this will show if the bone marrow is hypocellular and if the cells that enable bone marrow growth are missing.

For this reason, a doctor may refer a person to a hematologist for diagnosis if they think the person may have a form of aplastic anemia or if they cannot identify the cause of anemia.

Learn more about aplastic anemia.

There are different methods of assessing anemia depending on the type. If the type of anemia may be aplastic anemia, a hematologist will perform a bone marrow biopsy to diagnose the cause.

There are two main things a hematologist looks for when diagnosing aplastic anemia: bone marrow hypocellularity, where there are too few hematopoietic cells compared to marrow fat, and two or more cytopenias, indicating that the blood cell count is too low.

The hematologist may also order blood tests such as a complete blood count.

As with diagnosis, treatment for anemia depends on the underlying cause. A hematologist may be involved if anemia results from problems within the bone marrow or stem cells, as is the case in aplastic anemia.

If the cause is clear and preventable, such as a side effect from certain medications, the first action will be to remove the cause.

However, it is often not possible to find a reversible cause. In this case, treatment will depend on individual factors such as:

  • age of the individual
  • severity of the condition
  • donor availability
  • how well the person is able to perform daily tasks

Treatment may include stem cell transplantation and immunosuppressive therapy.

If anemia occurs due to nutritional deficiency, a doctor may refer a person to a nutritionist. Treatment may involve replenishing nutrients through supplementation and dietary changes. Learn about nutrition deficiency anemia.

If anemia is due to acute blood loss, the priority will be replenishing the blood supply through IV fluids, which means a person receives blood through a tube inserted in one of their veins.

A hematologist typically works in hospitals. They also work in outpatient clinics.

A hematologist works with a range of disorders that involve blood and bone marrow. These can range from sickle cell disease to leukemia. They have involvement in diagnosing and treating conditions, and may also work with blood transfusions.

Learn more about hematology.

Here are some more frequently asked questions about anemia.

What are the 3 stages of anemia?

Iron deficiency anemia has three stages:

  • Stage 1: Serum iron levels are normal, but iron stores are low.
  • Stage 2: Transferrin proteins and serum iron levels also become low.
  • Stage 3: Hemoglobin decreases, iron stores become depleted, and transferrin proteins and serum iron levels decrease.

Which anemia is the most serious?

Different forms of anemia can become serious. Without treatment, anemia can cause multiorgan failure and can lead to mortality. It is best for a person to contact their doctor if they have concerns about any type of anemia.

What are serious signs of anemia?

Severe anemia can cause temporary losses of consciousness, shortness of breath, and low tolerance to exercise. A person should seek immediate medical advice if they or a loved one experiences sudden or serious symptoms of anemia.

Anemia is when there is a low concentration of red blood cells in the body, reducing the amount of oxygen the blood is able to transport. There is a range of types and causes of anemia.

A hematologist works with blood and the tissues that form blood. A doctor will suggest a plan for anemia depending on the individual. In some cases, they may refer a person to a hematologist.

For example, if they think a person has aplastic anemia, a hematologist can perform a bone marrow biopsy to make a diagnosis and recommend suitable treatments.