Your fatigue has a lab value. Let's find it.
Heavy periods, pregnancy, and restrictive diets put women at the highest risk.
This panel goes beyond a basic CBC to classify the type and cause of anemia — testing iron stores, B12, folate, and red blood cell production markers to get you the right treatment.
Why this matters for women
Iron deficiency is the most common nutritional deficiency in the world, and women bear the highest burden. Heavy menstrual periods, pregnancy, breastfeeding, and plant-based diets all deplete iron stores. But here's the problem: most doctors only test hemoglobin — and by the time hemoglobin drops, your iron stores (ferritin) have been depleted for months or years. You can have "normal" hemoglobin and still be severely iron deficient, with all the symptoms: crushing fatigue, brain fog, breathlessness, dizziness, and restless legs. This panel tests the full iron pathway (ferritin, TIBC, transferrin) to catch deficiency early, plus B12, folate, and reticulocyte count to identify the type of anemia. We also include haptoglobin and LDH to rule out hemolytic anemia (when red blood cells are being destroyed faster than they're made), and a CBC with differential that provides 34 markers for comprehensive blood cell analysis.
Symptoms to watch for
What we test
CBC with Differential
A comprehensive analysis of 34 blood cell markers including red blood cells, white blood cells, hemoglobin, hematocrit, and platelet count. The foundation for diagnosing anemia type (microcytic, macrocytic, or normocytic).
Iron, TIBC & Ferritin
The complete iron picture. Ferritin (stored iron) is the most important — optimal is above 50 ng/mL for women, though many labs call anything above 12 "normal." TIBC reveals how hard your body is trying to find iron.
Transferrin
The protein that transports iron through your blood. Elevated transferrin means your body is producing more carriers to scavenge for scarce iron — an early sign of deficiency.
Vitamin B12 & Folate
Deficiency in either causes macrocytic (large cell) anemia. B12 deficiency also causes neurological symptoms. Common in women on birth control, metformin, or plant-based diets.
Reticulocyte Count
Measures new red blood cell production. Low reticulocytes with anemia means your bone marrow isn't producing enough cells. High reticulocytes mean your body is trying to compensate for blood loss or destruction.
Haptoglobin
A protein that binds free hemoglobin. Low haptoglobin indicates hemolytic anemia — red blood cells are being destroyed. Important for ruling out autoimmune hemolytic anemia.
LDH
Lactate dehydrogenase — released when cells are damaged or destroyed. Elevated LDH with low haptoglobin confirms hemolysis. Also elevated in megaloblastic anemia from B12/folate deficiency.
Who should consider this panel
- Women with heavy menstrual periods
- Anyone experiencing persistent fatigue, weakness, or dizziness
- Pregnant women or those planning pregnancy
- Women on plant-based or restrictive diets
- Those with a history of anemia or iron deficiency
Cited sources
Assessment of iron deficiency in US preschool children and nonpregnant females of childbearing age: National Health and Nutrition Examination Survey 2003-2006
Cogswell ME, et al. American Journal of Clinical Nutrition, 2009.
Iron Deficiency in Adults: A Review
Auerbach M, et al. JAMA, 2025.
Vitamin B12 deficiency
Stabler SP. New England Journal of Medicine, 2013.
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Iron Deficiency Without Anemia: Why Your Labs Look "Normal"
You can be iron deficient without being anemic. Learn why ferritin matters and what levels to aim for.
Fatigue isn't normal. Find out what your blood is trying to tell you.