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Haptoglobin, bilirubin, and liver function tests. When red blood cells break down, they release hemoglobin into the bloodstream. The hemoglobin combines with a chemical called haptoglobin. A low level of haptoglobin in the bloodstream is a sign of hemolytic anemia.
According to the Mayo Clinic, some anemias, such as iron deficiency anemia or vitamin B-12 deficiency, will cause extreme fatigue due to low hemoglobin. However, fatigue can often be the cause of many other health issues (i.e., internal bleeding).