Key takeaways
- Anemia occurs when the body has a shortage of red blood cells. This leads to reduced oxygen flow to organs and tissueswhich can cause fatigue and weakness.
- Various factorssuch as deficiencies in iron or vitaminsblood lossgenetic conditionsand chronic diseasescan disrupt red blood cell production and cause anemia.
- Anemia can be managed through diet changessupplementsmedicationsor blood transfusions. Treatment depends on the underlying cause and severity of the condition.
Anemia happens when the number of healthy red blood cells in your body is too low. Red blood cells are blood cells that carry oxygen to the organs and tissues of your body.
Every part of your body needs enough oxygen to function effectively.
Red blood cells contain an iron-rich protein called hemoglobin. Hemoglobin binds to oxygen in the lungsallowing red blood cells to carry and deliver it throughout the body. Anemia is measured according to the amount of hemoglobin in the blood.
There are many different types and causes of anemia. Some types of anemia are mild and can be easily treatedwhile others can cause potentially serious health complications.
This article will explore the different causes and symptoms associated with anemia and explain how it is diagnosed and treated.
While there are many types of anemiathey cause similar symptoms. Many symptoms of anemia are associated with a lack of oxygen supply to the body’s organs and tissues.
If you have a type of anemiayou may experience general symptoms like:
- fatigue
- weakness
- lightheadedness or dizzinessespecially when active or standing up
- headache
- shortness of breath
- pale skingumsor nails
- cold hands and feet
- a heartbeat that’s very quick or irregular
- chest pains
- fainting
- a heart murmur with severe anemia
If you have symptoms of anemiait’s important to get medical attentionespecially if you experience fainting or chest pain.
Other symptoms may happen with certain types of anemia. These depend on the type:
Iron deficiency anemia
Iron deficiency anemia is the most common type of anemiaand it occurs when you don’t get enough iron. An estimated
You may have lower iron levels in your body due to:
- blood lossincluding heavy menstrual periods
- not getting enough iron in your diet
- health conditions that affect iron absorption
Many people with mild or moderate iron-deficiency anemia have no symptoms. Howeveranemia is often detected during routine blood tests.
Severe iron deficiency anemia symptoms can include:
- fatigue
- shortness of breath
- chest pain
- unusual cravingssuch as wanting to eat iceclayor dirt
- brittle nails
Untreatedthis type of anemia can cause potentially serious complications.
Vitamin-deficiency anemia
Vitamin deficiency anemia is caused by having lower-than-normal folate or vitamin B12 levels. You may get this type of anemia from a low dietary intake of these nutrients.
In addition to some of the general symptoms of anemiaanemia caused by low folate levels may also cause:
- soreness of your mouth and tongue
- color changes in your skinhairor nails
Pernicious anemia is a specific type of anemia caused by low levels of vitamin B12. Individuals with pernicious anemia often lack a protein made in the stomach called intrinsic factor that helps your body absorb vitamin B12 or have issues with the small intestine absorbing vitamin B12.
In addition to general anemia symptomssymptoms more specific to deficiency in vitamin B12 include:
- numbness and tingling in your hands or feet
- muscle weakness
- a smooththick red tongue
- problems with reflexes or movement
- depression
- trouble with memory
- trouble concentrating
- confusion
- cracks at the sides of the mouth
- digestive symptomssuch as:
Hemolytic anemia
In hemolytic anemiared blood cells are destroyed faster than your body can replace them. Causes of hemolytic anemia include:
- autoimmune activityin which your body produces antibodies that attack and destroy red blood cells
- inherited conditionssuch as sickle cell disease and thalassemia
- physical damage to red blood cellssuch as through the use of a heart-lung bypass machine or artificial heart valves
- side effects from certain types of medicationssuch as acetaminophen or penicillin
- infections like malaria
- exposure to toxins
In addition to general anemia symptomssome additional symptoms more specific to hemolytic anemia include:
Aplastic anemia
Aplastic anemia happens when your bone marrow does not produce enough red blood cells. It results from damage to stem cells in the bone marrow that would normally develop into red blood cells. Because of this damagefewer red blood cells are made.
Aplastic anemia usually results in the immune system damaging bone marrow stem cells. Other potential causes include:
- medications
- exposure to toxins
- inherited genetic changes
Aplastic anemia can also affect white blood cell and platelet production. In addition to a low red blood cell countthis type of anemia can cause low counts of white blood cells and platelets.
In addition to general anemia symptomsaplastic anemia can cause:
- frequent infections due to a low white blood cell count
- enlarged lymph nodes due to infections
- easy bruising or bleeding due to low platelets
- skin rashes
- nausea
Anemia of inflammation or chronic disease
Anemia of inflammation or chronic disease happens when underlying health conditions cause inflammation in the body. This may cause anemia. For examplepeople with this type of anemia may:
- have low levels of iron in the blood despite having a high amount of stored iron
- produce less erythropoietina hormone that’s made in the kidneys and stimulates red blood cell production
- have bone marrow that doesn’t respond well to erythropoietin
- have red blood cells that have a life span that’s shorter than normalmeaning they die faster than they’re replaced
Many health conditions can cause anemia of inflammation or chronic disease. Some examples include:
- cancer
- autoimmune diseases
- chronic kidney disease
- infections like HIV or tuberculosis
- IBDincluding ulcerative colitis and Crohn’s disease
Red blood cells are produced in your bone marrow and have an average life span of
About
Any process that negatively affects this can cause anemia.
Experts categorize causes of anemia into those that:
- decrease red blood cell production
- increase red blood cell destruction or loss
Factors that decrease red blood cell production
When red blood cell production is reducedmore red blood cells leave the body than enter circulationpotentially leading to anemia.
Factors that decrease red blood cell production can be divided into two categories: acquired and inherited.
Acquired factors that can decrease RBC production include:
- inadequate dietary intake of nutrients for red blood cell productionsuch as ironvitamin B12or folate
- kidney disease
- some types of cancersuch as leukemialymphomaand multiple myeloma
- autoimmune diseases like lupus or rheumatoid arthritis
- certain kinds of infectionssuch as HIV and tuberculosis
- hypothyroidism
- inflammatory bowel disease (IBD) like ulcerative colitis and Crohn’s disease
- aplastic anemia
- certain types of medications or treatmentsparticularly chemotherapy and radiation therapy for cancer
- exposure to toxinssuch as lead
Some types of genetic (inherited) conditions may also decrease the production of healthy red blood cells. These include:
- Fanconi anemia
- Schwachman-Diamond syndrome
- Diamond-Blackfan anemia
- dyskeratosis congenita
- amegakaryocytic thrombocytopenia
Factors that increase red blood cell destruction or loss
Anything that causes destruction or loss of red blood cells at a rate faster than they’re made can also cause anemia.
Acquired causes of increased red blood cell destruction can include:
- blood losswhich can happen due to:
- accidents or injuries
- surgery
- heavy menstrual bleeding
- childbirth
- endometriosis
- gastrointestinal lesionssuch as ulcers or those due to IBD or cancer
- heavy nosebleeds
- frequent blood donation
- hemolysiswhich is when red blood cells break down too soon due to things like:
- autoimmune activity
- certain infections
- medication side effects
- exposure to toxins
- enlarged spleen
- liver diseasesuch as hepatitis or cirrhosis
- infections like malaria
Inherited causes of increased red blood cell destruction can include:
- sickle cell disease
- glucose-6-phosphate dehydrogenase (G6PD) deficiency
- thalassemia
- pyruvate kinase deficiency
- hereditary spherocytosis
- hereditary elliptocytosis
Certain factors may increase the risk of developing anemia. These include:
- a diet that doesn’t include sufficient ironfolateor vitamin B-12
- having menstrual periods
- pregnancy
- being over 65 years of age
- certain gastrointestinal disorderssuch as Crohn’s disease or celiac disease
- certain chronic health conditionssuch as cancerkidney diseaseliver diseaseor an autoimmune disease
- a family history of genetic conditions that can cause anemia
- certain types of medications or undergoing chemotherapy or radiation therapy to treat cancer
- heavy consumption of alcohol
- frequent exposure to toxic chemicals
A diet rich in key nutrients may help prevent or manage some types of anemia.
Daily requirements for vitamins and iron vary according to sexageand pregnancy status. Some people may need to take supplements to get the recommended amount.
These nutrients include:
- iron
- vitamin C
- folate
- vitamin B12
You may need more iron while you are menstruating or if you become pregnant.
Need a supplement?If you know you have anemiaor aren’t getting enough of the above nutrientsyou can find supplements in stores or online:
Before taking any supplementstalk to your healthcare professional to make sure the supplements you want to take are safe for you.
To diagnose anemiaa doctor may ask about your health history and family health history. Be sure to let your doctor know if you have a family history of anemia or a history of exposure to toxins in the home or workplace. They may also perform a physical exam.
Laboratory tests usually diagnose anemia. Some tests a doctor may order include:
- complete blood count (CBC) to measure red and white blood cells
- reticulocyte count to measure immature red blood cells
- serum iron test to measure the amount of iron in your blood
- ferritin test to analyze iron stores in your body
- vitamin B12 testa blood test that measures vitamin B12 levels
- folic acid testa blood test that measures folate levels
- Coombs test which looks for autoantibodies targeting your red blood cells
- fecal occult blood testwhich determines if blood is present in your stool
- bone marrow aspirate or biopsy to see if it’s functioning normally
Untreatedanemia can cause potentially serious complications. These may include:
- heart problemssuch as:
- peripheral nerve damage
- restless leg syndrome
- depression
- problems with memory
- confusion
- a weakened immune systemwhich can lead to more frequent infections
- pregnancy complications like premature birth or low birth weight
- developmental delays in children
- multi-organ failurewhich can result in death
It’s important to get treatment for anemia to avoid complications.
Treating anemia depends on what’s causing it. It usually involves treating the underlying cause of anemia. This can improve anemia.
Anemia caused by inadequate dietary ironvitamin B12or folate intake may be treated with nutritional supplements. Sometimesyou may need vitamin B12 injections if it isn’t absorbed properly from the digestive tract.
Your doctor or a nutritionist may work with you to prescribe a diet containing the appropriate amounts of vitaminsmineralsand other nutrients you may lack.
If anemia is severedoctors may use drugs called erythropoiesis-stimulating agents to increase red blood cell production in the bone marrow. These drugs work similarly to the hormone erythropoietinwhich your kidneys naturally produce.
If severe bleeding occurs or hemoglobin levels are very lowdoctors may recommend a blood transfusion. During ityou’ll receive blood donated by an individual with a matching blood type.
The outlook for anemia depends on the cause and the response to treatment. Anemia is often treatable.
The outlook for anemia due to deficiencies in iron or vitamins is typically good if you receive a timely replacement of these important nutrients.
If you develop anemia due to a lack of key nutrientsyou can pay attention to your diet to ensure you get the recommended daily amounts of ironfolateand vitamin B12.
The outlook for anemia due to other causes can vary. Some people need long-term treatment to manage anemia or the underlying health conditions that cause it.
A doctor can tell you what to expect in your situationincluding if you’re considering supplementation and whether it’s right for you.
Anemia is when you have low levels of red blood cells. When this happensyour organs and tissues have a harder time getting oxygen. As a resultyou may experience symptoms like fatigueweaknessand shortness of breath.
Your body replaces millions of red blood cells in circulation each day. When this process is disruptedanemia can occur.
One of the more common causes of anemia is not getting enough nutrientssuch as ironfolateor vitamin B12. Howeveranemia can also be caused by blood loss and various underlying health conditions.



