At Needles, Herbs & Labs, Dr. Naylous takes a broader approach to evaluating iron status and anemia. Rather than looking only at hemoglobin or a single iron value, he may review a more complete set of laboratory markers to better understand whether iron deficiency, nutrient deficiencies, blood loss, absorption concerns, inflammation, or other factors may be contributing to a patient’s symptoms.

This can be especially helpful for patients who continue to experience fatigue, weakness, dizziness, shortness of breath, poor exercise tolerance, headaches, hair changes, cold hands and feet, or other symptoms even when a basic blood count does not appear dramatically abnormal.
 

Looking Beyond Hemoglobin Alone

Hemoglobin is an important marker, but it does not always tell the whole story about iron status.

A patient may still have a hemoglobin value within the laboratory reference range while their stored iron, reflected by ferritin, is already declining. Looking at ferritin together with serum iron, transferrin or TIBC, transferrin saturation, red blood cell indices, and other relevant markers can provide a more complete picture of iron metabolism.

This is why Dr. Naylous looks at patterns between laboratory values rather than relying on one number or whether the report simply marks a result as “normal.”
 

What We May Evaluate

Depending on the patient’s history and symptoms, an iron and anemia evaluation may include markers such as:

• Complete blood count (CBC)

• Hemoglobin

• Hematocrit

• Red blood cell count

• MCV

• MCH and MCHC

• RDW

• Ferritin

• Serum iron

• TIBC or transferrin

• Transferrin saturation

• Reticulocyte count

• Vitamin B12

• Folate

• Copper

• Zinc

• Inflammatory markers

• Additional testing when appropriate

The exact testing is individualized based on the patient’s symptoms, previous results, diet, medical history, and clinical picture.
 

Looking for the “Why”

When iron levels are low, the next question is not simply, “How much iron should you take?” It is also important to consider why iron stores became low in the first place.

Possible contributors may include:

• Inadequate dietary intake

• Heavy menstrual bleeding

• Gastrointestinal blood loss

• Digestive or absorption concerns

• Low stomach acid or impaired digestion

• Increased nutritional demands

• Chronic inflammation

• Other nutrient deficiencies

• Medication use

• Gastrointestinal conditions

• Other underlying health concerns

Understanding the possible contributor can help guide a more individualized approach instead of focusing only on replacing iron.
 

Iron Is Only One Piece of the Anemia Picture

Not all anemia is caused by iron deficiency.

Other nutrients and physiologic factors can influence red blood cell production, which is why Dr. Naylous may also consider markers related to vitamin B12, folate, copper, inflammation, thyroid function, kidney function, and other relevant areas when appropriate.

This broader evaluation can help identify patterns that may be missed when anemia is assessed using only hemoglobin and serum iron.
 

Connecting the Results Back to Your Symptoms

Symptoms associated with low iron or anemia can overlap with many other health concerns.

Dr. Naylous reviews laboratory findings alongside symptoms such as:

• Persistent fatigue

• Weakness

• Shortness of breath or reduced exercise tolerance

• Dizziness or lightheadedness

• Headaches

• Brain fog

• Hair thinning or increased shedding

• Feeling cold frequently

• Cold hands and feet

• Rapid heartbeat or palpitations

• Poor stamina

• Restless legs

• Difficulty recovering from physical activity

The goal is to determine whether iron or anemia appears to be part of the patient’s broader health picture and whether additional investigation may be appropriate.
 
Who May Benefit From an Iron & Anemia Evaluation?

A more comprehensive evaluation may be considered for patients with:

• Previously low ferritin or iron

• A history of anemia

• Heavy menstrual cycles

• Persistent fatigue or weakness

• Hair loss or changes in hair growth

• Shortness of breath or poor exercise tolerance

• Dizziness or lightheadedness

• Dietary restrictions

• Digestive or absorption concerns

• Previous abnormal CBC findings

• Persistent symptoms despite being told their blood work is “normal”

• Patients currently taking iron who want a more detailed evaluation of their status

Not every patient requires the same testing. Dr. Naylous determines which markers may be appropriate based on the individual clinical picture.
 
How It Works

After your consultation, Dr. Naylous will determine which blood tests may be appropriate based on your symptoms, history, previous laboratory results, diet, medications, supplements, and other relevant factors.

He will then place the laboratory order, and you can have your blood drawn at a participating laboratory such as Quest Diagnostics or another designated lab location.

Once the results are available, Dr. Naylous reviews the full pattern rather than focusing on a single marker. Your results are discussed during a follow-up visit, where he can explain relevant findings and determine whether additional evaluation or an individualized care plan may be appropriate.

Recommendations may include nutrition, targeted supplementation, lifestyle support, Chinese herbal medicine, acupuncture, or referral for additional medical evaluation when appropriate.
 
A More Complete Look at Iron & Blood Health

The goal of an iron and anemia evaluation is not simply to determine whether a patient is technically anemic. It is to better understand iron stores, iron transport, red blood cell production, nutrient status, and potential contributors to abnormal findings or ongoing symptoms.

At Needles, Herbs & Labs, Dr. Naylous uses laboratory testing as one part of the bigger picture—helping connect symptoms, nutrient status, and possible underlying contributors to create a more personalized path forward.