From the Guidelines
If you're experiencing heaviness in your legs, I recommend asking your doctor for an Ankle-Brachial Index (ABI) test to check for peripheral artery disease (PAD), as an ABI <0.90 is diagnostic for LEAD, with 80% sensitivity and 95% specificity in all populations 1. When it comes to diagnosing the cause of leg heaviness, several tests can be helpful.
- A complete blood count (CBC) to check for anemia
- Comprehensive metabolic panel to assess kidney and liver function
- Lipid profile to evaluate cholesterol levels
- Thyroid function tests, as hypothyroidism can cause leg heaviness
- A D-dimer test may be ordered if deep vein thrombosis is suspected
- For circulation issues, a venous Doppler ultrasound to check for blood clots or venous insufficiency
- Electrolyte panels to identify imbalances that affect muscle function
- Vitamin B12 and folate levels to reveal deficiencies causing neurological symptoms
- If autoimmune conditions are suspected, tests for inflammatory markers like ESR and CRP may be helpful According to the 2019 ESC guidelines on diabetes, pre-diabetes, and cardiovascular diseases, screening for LEAD is indicated on a yearly basis, with clinical assessment and/or ABI measurement 1. The ABI test is a useful diagnostic tool, and an ABI <0.90 is diagnostic for LEAD, irrespective of symptoms 1. In case of symptoms suggestive of intermittent claudication with normal ABI, a treadmill test and post-exercise ABI should be considered 1. It's also important to note that the toe-brachial index (TBI) can be used to establish the lower extremity PAD diagnosis in patients in whom the ABI test is not reliable due to noncompressible vessels, usually patients with long-standing diabetes or advanced age 1. I strongly recommend consulting a doctor to determine the best course of action, as they can help determine whether your leg heaviness stems from vascular problems, nerve issues, electrolyte imbalances, or other medical conditions, and provide appropriate treatment to address the underlying cause rather than just managing symptoms 1.
From the Research
Laboratory Tests for Heaviness in Legs Feeling
The feeling of heaviness in legs can be associated with various medical conditions, including anemia. Laboratory tests can help diagnose the underlying cause of this symptom.
- Complete Blood Count (CBC): This test is used to evaluate anemia and provides clues to its diagnosis, including red cell indices 2, 3.
- Reticulocyte Count: This test serves as a useful screen for hemolysis or blood loss, which can contribute to anemia 2, 3.
- Iron Panel: This test includes measurements of ferritin and iron levels, total iron-binding capacity, and transferrin saturation, and can help diagnose iron-deficiency anemia 3.
- Vitamin B12 and Folate Levels: These tests can help diagnose vitamin deficiencies that can cause anemia 3.
- Erythrocyte Sedimentation Rate (ESR) and C-reactive Protein (CRP): While not directly related to anemia, these tests can help detect inflammation, which can contribute to various medical conditions, including those that cause heaviness in legs 4.
- Peripheral Blood Smear: This test can help examine the morphology of red blood cells and provide clues to the diagnosis of anemia 3.
- Bone Marrow Examination: In some cases, examination of the bone marrow may be required to diagnose the underlying cause of anemia 2.