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Anemia Overview

What is anemia?

Anemia is a common blood disorder. It occurs when you have fewer red blood cells than normal or not enough hemoglobin in your blood. Hemoglobin is the iron-rich protein in red blood cells. It carries oxygen from your lungs to all parts of your body.

When you have anemia, your blood can’t carry enough oxygen to your body. Without enough oxygen, your body can’t work as well as it should.

There are several different types of anemia. Each has its own cause and treatment. They include:

  • Iron-deficiency anemia

  • Vitamin B-12 deficiency anemia

  • Anemia of folate deficiency

  • Hemolytic anemia

  • Sickle cell anemia

  • Cooley's anemia (beta thalassemia)

  • Aplastic anemia

  • Anemia due to chronic inflammatory disease

  • Kidney failure associated anemia

What causes anemia?

Anemia is often a symptom of another disease. Anemia often occurs when you have:

  • Too much blood loss

  • Not enough red blood cells being made

  • Too many red blood cells being destroyed

  • More than 1 of these problems at the same time

Anemia may often be caused by several problems, including:

  • Certain infections

  • Certain diseases

  • Certain medicines

  • Poor nutrition

  • Blood loss

Who is at risk for anemia?

Anyone can get anemia. But it's more common in women of childbearing age. It's also more common during pregnancy, infancy, and in older adults. Risk factors include:

  • A diet low in iron-rich foods, such as red meat, liver, seafood, beans, nuts, dark green leafy vegetables, whole grains, and iron-fortified foods (like cereals and breads)

  • Heavy menstrual periods

  • Lifelong (chronic) diseases, such as kidney disease, rheumatoid arthritis, HIV, Crohn's disease, and heart, liver, or thyroid disease

What are the symptoms of anemia?

Most anemia symptoms occur because of less oxygen getting to the body’s cells and tissues (hypoxia). The hemoglobin in red blood cells carries oxygen. So having fewer red blood cells leads to hypoxia. If you have mild anemia, you may not have many symptoms.

Each person’s symptoms will vary. Symptoms may include:

  • Being very pale

  • Faster heart rate

  • Having trouble catching your breath

  • Lack of energy or tiring easily (fatigue)

  • Feeling dizzy or faint, especially when standing

  • Headache

  • Being irritable

  • Irregular menstruation cycles

  • Delayed menstruation, or not having a period

  • Sore or swollen tongue

  • Yellowing of skin, eyes, and mouth (jaundice)

  • Enlarged spleen or liver

  • Not easy for wounds or tissue to heal

Anemia symptoms may look like other blood disorders or health problems. Anemia is often a symptom linked to another disease. So be sure your healthcare provider knows about symptoms you may have. Always see your provider for a diagnosis.

How is anemia diagnosed?

Your healthcare provider may think you have anemia based on your symptoms, health history, and a physical exam. Anemia is often confirmed using blood tests. These tests check your hemoglobin level and your red blood cell count.

You may have additional tests, such as:

  • Other blood tests

  • Bone marrow aspiration or biopsy. A small amount of bone marrow fluid (aspiration) or solid bone marrow tissue (called a core biopsy) is taken. The sample is often taken from the hipbones. It's checked for the number, size, and maturity of blood cells or abnormal cells.

How is anemia treated?

Treatment will depend on the type of anemia as well as your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

  • Treating any underlying cause

  • Vitamin and mineral supplements

  • Change in diet

  • Medicine

  • Blood transfusion

  • Bone marrow transplant

  • Surgery to remove the spleen, if it's linked to hemolytic anemia

  • Antibiotics if an infection is the cause

What are possible complications of anemia?

Mild anemia may cause no problems. But if your body’s organs don't get enough oxygen, you may have organ damage. The heart can be damaged by the increased stress of pumping faster. It can also be damaged by working too hard to carry oxygen to the body. In some cases, the underlying cause of the anemia may be deadly.

Can anemia be prevented?

Preventing anemia includes eating a well-balanced diet with iron-rich foods. It also includes managing any lifelong (chronic) or underlying conditions that may be causing the anemia. For young women and women with heavy menstrual periods, using birth control medicines may help manage anemia.

Living with anemia

Some types of anemia can’t be cured. Work with your healthcare provider to make a treatment plan that can reduce the effects of these diseases.

Key points about anemia

  • Anemia is a common blood disorder. It happens when you have fewer red blood cells than normal.

  • When you have anemia, your blood can’t carry enough oxygen to your body. Without enough oxygen, your body can’t work as well as it should.

  • Anyone can get anemia. But it's more common in women of childbearing age.

  • Preventing anemia includes eating a well-balanced diet with iron-rich foods.

  • Some types of anemia can’t be cured.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • Bring someone with you to help you ask questions and remember what your provider tells you.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

  • Ask if your condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if you do not take the medicine or have the test or procedure.

  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your provider if you have questions.

Medical Reviewers:

  • Dan Brennan MD
  • Jessica Gotwals RN BSN MPH
  • Todd Gersten MD