Anemia: A Treatable Blood Condition
What is anemia?
Anemia is when the blood doesn't have enough healthy red blood cells to carry oxygen to tissues throughout your body. Doctors describe it as having a low blood count. Having anemia can make you feel tired and weak.
Anemia has many different causes from not making enough red blood cells to blood loss, such as during menstruation. Treatments range from taking dietary supplements to undergoing medical procedures. You might be able to prevent some types of anemia by eating a healthy diet.
Types of anemia include:
- Aplastic anemia
- Iron deficiency anemia
- Sickle cell anemia
- Vitamin deficiency anemia
- Hemolytic anemia
How can I tell if I’m anemic?
Ask your doctor what is the cause of your iron deficiency anemia. And ways to treat and prevent it in the future. —Dr. Anis Rehman
Anemia can range from mild to severe. If mild, it may cause no symptoms or you may feel fatigue, general weakness, dizziness. If it’s more severe, it could cause lightheadedness, headache, chest pain, shortness of breath, or loss of consciousness. Go to the emergency room if you are experiencing lightheadedness, chest pain, shortness of breath, or lose consciousness.
- General weakness
- Feeling cold
- Palpitations—rapid, strong, or irregular heartbeat
- Chest pain, especially with exercise or exertion
- Shortness of breath, especially with exercise or exertion
- Loss of consciousness
Other symptoms you may have
You may have symptoms specific to what is causing your anemia:
- Slow bleeding in the intestines
- Black or bloody stools
- Abdominal pain
- Pale skin
- Medication that leads to increased breakdown of red blood cells
- Yellow skin
- Dark urine
What causes a person to become anemic?
People are surprised to learn that iron deficiency anemia can be a presentation of hidden cancer. —Dr. Rehman
There are three main reasons people become anemic: not making enough red blood cells, increased destruction of red blood cells, or blood loss.
Not making enough red blood cells
Your body requires many nutrients including iron, vitamin B12, and folate to make red blood cells, so anemia can be caused by not getting enough of those in your diet.
- Not enough iron in your diet
- Not enough folic acid, vitamin B12, or vitamin C in your diet.
- Problems in the bone marrow where red blood cells are made.
- Thyroid and growth hormone deficiencies.
- Anemia from chronic disease such as cancers, autoimmune diseases, or certain chronic infectious diseases.
Increased destruction of red blood cells by the body
- Genetic conditions, such as sickle cell disease, thalassemia, or spherocytosis.
- Medication side effects from certain antibiotics such as cephalosporins, penicillins, and chemotherapies including platinum-based drugs such as oxaliplatin.
- Enlarged spleen.
- You have heavy menstrual periods.
- Injuries from trauma, like violence or an accident, resulting in blood loss.
- Gastrointestinal bleeding.
- You have a tendency to bleed more because you’re taking blood thinners or have problems with blood clotting.
If you are having mild symptoms you should schedule an appointment with your doctor. You should call 911 or go to the emergency room if you are having severe symptoms or any chest pain, shortness of breath, or loss of consciousness.
Left untreated, anemia can cause many health problems, such as:
- Severe fatigue. Severe anemia can make you so tired that you can't complete everyday tasks.
- Heart problems. Anemia can lead to a rapid or irregular heartbeat (arrhythmia). When you're anemic, your heart must pump more blood to make up for the lack of oxygen. This can lead to an enlarged heart or heart failure.
- Death. Some inherited anemias, such as sickle cell anemia, can lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal.
Treatment for anemia
Usually, several vitamins such as B12, folic acid, and vitamin C play a major role in the formation of blood cells. Having a balanced diet is very important to prevent iron deficiency anemia. —Dr. Rehman
Your doctor is likely to ask you about your medical and family history, perform a physical exam, and run the following tests:
- Complete blood count (CBC) blood test to find the levels of red blood cells (hematocrit) and the hemoglobin in your blood. Normal adult hematocrit values are generally between 40% and 50% for men and 35% and 47% for women. Normal adult hemoglobin values are generally 14 to 18 grams per deciliter for men and 12 to 16 grams per deciliter for women, according to the National Institutes of Health.
- A blood test to determine the size, shape, and color of your red blood cells.
Treatment can depend on its severity and cause.
If your diet lacks certain vitamins and minerals, like iron, you may develop anemia. Eating a healthy diet with fruits, vegetables, and leafy greens can help.
If your anemia is caused by an iron deficiency, your doctor will recommend you take an iron supplement. If you have severe iron deficiency anemia, your doctor may recommend intravenous (IV) iron replacement.
They may also recommend other supplements like folic acid, vitamin B12, and vitamin C. These are generally available over the counter.
Aplastic anemia may require blood transfusions to boost levels of red blood cells. You might need a bone marrow transplant if your bone marrow can't make healthy blood cells.
Medications are a mixed bag. A cancer drug called hydroxyurea (Droxia, Hydrea, Siklos) can be used to treat sickle cell anemia. However, some medications such as diclofenac (an NSAID) and certain antibiotics (penicillin and cephalosporin), may attack your red blood cells.
Anemia reduces red blood cells that carry oxygen. Giving patients extra oxygen can help reduce the effects of less oxygen in severely anemic patients while in the hospital.
You will need to get your hemoglobin (blood count) checked every 1 to 6 months (your doctor will decide how often) after treatment is started to make sure treatment is working.
The most common cause of anemia is nutritional deficiency, especially iron deficiency. The best way to avoid this is to make sure that you are eating a balanced diet that includes fruits, vegetables, and leafy greens.
Daniel DuPont is from Wayne, Pennsylvania. He is a member of the Emergncy Residency class of 2022 Perelman School of Medicine at the University of Pennsylvania.