Definition

Anemia is a blood disorder that occurs when red blood cell levels (RBCs) become abnormally low in the blood. It can also occur when the RBCs do not have enough hemoglobin, a protein that delivers oxygen from the lungs throughout the body. With anemia, the blood can’t deliver enough oxygen to the rest of the body, causing tiredness and other symptoms characteristic of anemia.

There are several specific types of anemia, including:

Red Blood Cells

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Causes

The main causes of anemia are:

  • Blood loss, such as that caused by:
    • Heavy menstrual periods
    • Bleeding in the digestive tract
    • Bleeding in the urinary tract
    • Surgery
    • Trauma
    • Cancer
  • Abnormally low RBC production, due to:
  • Abnormally high RBC destruction, caused by inherited disorders such as:
    • Sickle cell anemia
    • Thalassemia—difficulty in manufacturing hemoglobin
    • Enzyme deficiencies

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors may increase your risk of anemia:

  • Women of childbearing age
  • Pregnancy
  • Older adults with other medical condition
  • Infants younger than two years
  • Poor diet low in iron, vitamins, and minerals
  • Blood loss (eg, due to surgery or injury)
  • Chronic or serious illness
  • Chronic infections
  • Family history of inherited anemia (eg, sickle cell anemia, thalassemia)

Symptoms

Symptoms of anemia may include:

  • Tiredness
  • Lethargy
  • Feeling faint
  • Paleness
  • Shortness of breath
  • Dizziness
  • Headache
  • Coldness in the hands and feet
  • Pale skin
  • Chest pain
  • Rapid or irregular heartbeat

Diagnosis

Your doctor will ask about your symptoms and medical history, and perform a physical exam. Other tests may include:

  • Complete Blood Count (CBC)—a test that measures levels of hemoglobin and RBCs
  • Other blood tests
  • Blood smear
  • Stool sample
  • Bone marrow aspiration or biopsy

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include:

Nutrition

If you have low levels of vitamins or iron, your doctor may recommended making changes to your diet or taking vitamin or iron supplements. Changes to your diet may include eating more iron-rich foods, as well as foods that are good sources of vitamin C, vitamin B12, and folate.

Medications

Depending on the cause of your anemia, your doctor may prescribe antibiotics, hormone treatment, epoetin, medications that act on the immune system, or chelation therapy (for lead poisoning) to help treat your anemia or symptoms.

Blood Transfusions

In some cases, a blood transfusion may be necessary.

Bone Marrow or Stem Cell Transplant

Serious cases of anemia, such as aplastic anemia, may need to be treated with marrow or stem cell transplants.

Surgery

Life-threatening bleeding may need to be treated with surgery. In addition, in cases of abnormally high RBC destruction, your spleen may need to be surgically removed.

Prevention

Most inherited forms of anemia cannot be prevented. But the following steps may be taken to prevent certain types of anemia:

  • Eat a diet rich in iron and vitamins.
  • Take iron or vitamin supplements, as recommended by your doctor.
  • Treat underlying causes of anemia.
  • Report signs and symptoms, especially chronic fatigue, to your doctor.