Your Guide to Anemia

Medically Reviewed By Angelica Balingit, MD
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Anemia is a condition wherein you do not have enough red blood cells. The most common type of anemia is iron deficiency anemia. Anemia is a common blood disorder, affecting more than 3 million people in the United States. Anemia can occur in all age groups and populations.

Read on for more information about anemia. This guide includes information about causes, symptoms, treatments, and more.

What is anemia?

A young person is leaning against a metal post with their eyes closed.
Lucas Ottone/Stocksy United

Anemia occurs when you have too few red blood cells in your body. The most important element of red blood cells is hemoglobin, which is a protein that carries oxygen in the blood from the lungs to the body’s cells.

The condition can occur if the body is making too few healthy red blood cells, if you are losing blood, or if the body is destroying circulating red blood cells.

Anemia is a very common condition. It affects around 12% of females ages 12–49 years. In addition, up to 20% of pregnant people experience anemia.

What are the different types of anemia?

There are many different types of anemia. These can occur due to low

red blood cell production, the destruction of red blood cells, or severe bleeding.

The most common types of anemia are:

  • Iron deficiency anemia: This is the result of blood loss or an inability to absorb iron, which is necessary to produce red blood cells. Learn more.
  • Vitamin deficiency anemia: This is caused by a lack of vitamin B12 or folic acid from the diet or pernicious anemia, in which the body cannot absorb vitamin B.
  • Sickle cell anemia: This is a genetic disorder, also known as sickle cell disease, that stiffens red blood cells so that they have difficulty flowing through the smallest blood vessels.
  • Aplastic anemia: This is when bone marrow does not produce enough red blood cells.
  • Hemolytic anemia: This is an inherited or acquired disorder in which the body destroys red blood cells faster than the body can make them. Learn more.

Learn more about the different types of anemia here.

What are the symptoms of anemia?

If you have mild anemia, you may not notice any symptoms. Symptoms of anemia are also similar for many types.

Symptoms of anemia can include:

Falling due to anemia

Anemia and falls are closely linked in older adults. Anemia can cause dizziness and other problems that make it difficult to maintain balance during everyday activities. However, older adults may become accustomed to these symptoms over time and not realize that there is an underlying problem, even after falling.

Contact your doctor if you frequently experience falls that you cannot explain, even if you do not have any symptoms of anemia.

What are the treatments for anemia?

Treatment options for anemia vary according to cause, severity, and general health, among other factors.

Supplements and dietary changes

If you have a vitamin or iron deficiency, your doctor can recommend supplements or injections. Eating a healthy, balanced diet is also important when you have anemia.

If you have anemia due to chronic blood loss from an ulcer or heavy menstrual periods, your doctor will address the underlying cause and recommend supplements or dietary changes.

Blood transfusion or surgery

Aplastic and hemolytic anemia treatment can include medications, blood transfusions, and bone marrow transplants. If the condition is mild, you may not need treatment.

Sickle cell disease is treatable with medication to reduce the symptoms. A blood transfusion or stem cell or bone marrow transplant might also help.

If your blood count becomes very low due to severe bleeding, injury, or another factor that causes a large, sudden loss of blood, it can be life threatening. This requires immediate hospitalization and treatment by stabilization and transfusion.

What are the diet and nutrition tips for anemia?

Your diet could help boost the number of red blood cells you have, particularly if you have a vitamin or iron deficiency.

Foods that may help increase your red blood cell count include:

  • iron-rich foods, such as:
    • meat
    • eggs
    • seafood
    • leafy greens
  • foods high in vitamin B12, including:
    • fish
    • meat
    • poultry
    • eggs
    • dairy
  • foods fortified with iron or vitamin B12

Supplements containing iron or vitamin B12 can also help.

What to avoid if you have anemia

There are some foods and beverages to consider avoiding if you have anemia. These include:

  • Alcohol: Heavy alcohol use can affect bone marrow and suppress the production of red blood cells.
  • Coffee and tea: These beverages can reduce iron absorption, which could contribute to iron deficiency anemia.
  • Folic acid: This is another B vitamin, and it is necessary for a healthy blood cell count. However, if you have too much folic acid in the body, it can mask a vitamin B12 deficiency. Avoid specific vitamin supplements until your doctor confirms a deficiency.

If you have anemia, contact your doctor for guidance before making any significant changes to your diet.

What causes anemia?

Anemia can occur as a result of a variety of diseases, disorders, and conditions. Bleeding is the most common cause of anemia.

Bleeding and hemorrhage

Severe, uncontrolled bleeding (hemorrhage) can rapidly lead to life threatening anemia. Small amounts of repeated bleeding, such as bloody stools due to ulcerative colitis, can also lead to anemia over time.

Conditions that cause bleeding or hemorrhage include:

Other causes of anemia

Some other potential causes of anemia include:

  • a lack of vitamin B12, iron, or folic acid in the diet
  • excessive alcohol use
  • chemotherapy and medications for HIV
  • chronic conditions, such as:
  • hemolytic anemia or sickle cell disease
  • iron deficiency anemia and thalassemia
  • pregnancy

How do doctors diagnose anemia?

If you have symptoms of anemia, such as pallor or fatigue, your doctor may perform a physical exam, take a medical history, and order some tests.

Questions a doctor may ask include:

  • Do you have a family history of anemia?
  • What are your symptoms?
  • When did you first experience or notice your symptoms?
  • What type of diet do you consume?
  • How much protein does your diet contain?
  • What medications, supplements, and vitamins do you take?
  • Have you recently bled from any part of your body?

Tests your doctor may order include:

Your doctor may diagnose anemia if your blood test indicates a hemoglobin value of lower than 13.5 grams per deciliter (g/dl) for a male or 12.0 g/dl for a female. This will vary for children depending on their age.

What are the risk factors for anemia?

A number of factors increase the risk of anemia. Risk factors include:

  • experiencing heavy menstruation
  • being of childbearing age
  • taking certain medications, such as chemotherapy or drugs for HIV
  • having certain chronic conditions, such as:
  • not eating a well-balanced diet with foods high in iron and vitamin B

Reducing your risk of anemia

You can lower your risk of some underlying causes of anemia by:

  • avoiding alcohol or drinking only in moderation
  • eating a well-balanced diet that includes foods high in iron and vitamin B
  • following your treatment plan for any medical conditions you have
  • seeking early and regular prenatal care where necessary

What are the potential complications of anemia?

Untreated anemia or its underlying causes can lead to serious and life threatening complications. Once you have a diagnosis and treatment plan, following the plan can help minimize your risk of complications.

Some possible complications of anemia include:

  • restless legs syndrome
  • heart problems
  • issues during pregnancy
  • developmental delays in children

Contact your doctor if you have symptoms of anemia. The sooner they are able to diagnose anemia, the sooner you can begin treatment to reduce the risk of complications.

How does anemia affect quality of life?

Anemia ranges from mild and temporary to chronic, severe, or life threatening. If you have chronic anemia, you may be tired all the time and lack the energy to go about your daily life. People who are older than 60 years may feel the effects more than younger people, but anemia can impact quality of life at any age.

Chronic or inherited forms of anemia can have different effects. Sickle cell anemia can cause episodes of pain, which are treatable but may be debilitating. 

Hemolytic anemia may be mild or severe. If it is severe, you may need periodic blood transfusions.

Treatment for many forms of anemia can give you back increased vitality and the energy to go about your daily routine. If you have underlying conditions that cause anemia, treatment may help address other symptoms as well.

Some people feel more capable and confident when they learn more about their condition, including its symptoms, causes, and treatments. Contact your doctor if you have any questions about anemia or your symptoms.

Does anemia shorten life expectancy?

Whether or not anemia has an impact on your life expectancy depends on the type you have and several other factors, including your general health.

Types of anemia that may affect life expectancy include:

  • Aplastic anemia: Treatments have improved, but without treatment, about 70% of people die within a year of diagnosis. That said, the 5-year survival rate is now about 80% for people under 20 years of age.
  • Sickle cell anemia: Life expectancy has improved due to treatment advances. Many people with sickle cell anemia live into their 50s and beyond, with the average life expectancy around 20–30 years shorter than it is for a person without sickle cell anemia.
  • Anemia in older age: If you are over 60 years old and have untreated or uncontrolled anemia, you are more likely to develop an arrhythmia, or irregular heart rhythm. This can lead to heart failure, organ damage, or damage to the immune system, which can lead to a shorter life expectancy.

Many people go on to live regular lives after receiving treatment for anemia, especially if it is due to a vitamin or iron deficiency.

If you feel tired even when you are getting enough sleep, and if your skin looks pale, contact your doctor to discuss the possibility of anemia.

Frequently asked questions

Below are some other frequently asked questions about anemia. These questions have all been answered by Dr. Angelica Balingit, M.D.

What is anemia of chronic disease?

Many chronic diseases cause changes in body processes. These include liver disease, kidney disease, chronic infections, and inflammation, such as in rheumatoid arthritis. Anemia in these conditions is characterized by decreased iron use in the body, decreased blood cell production by bone marrow, and a shorter life span of red blood cells.

What is megaloblastic anemia?

“Mega” means large. “Blasts” are immature blood cells. Large immature red blood cells are present with vitamin B12 deficiencies, folic acid deficiencies, and the use of certain medications.

What is microcytic anemia?

“Micro” means small. “Cyst” refers to cells. Small red blood cells occur with iron deficiencies, anemia of chronic disease, and thalassemia.

When do you need a blood transfusion for anemia?

These criteria change over time. There is evidence to suggest that healthy people without symptoms may not need a transfusion until hemoglobin is lower than 7 g/dl. People with heart or lung disease may need a transfusion if hemoglobin is below 8–9 g/dl. The rate of blood loss may also determine if the person may benefit from a transfusion.

How can you test for anemia at home?

There are commercially available home kits that test for a complete blood count. The results of these tests cannot be compared to tests performed at a standard laboratory.

Learn more

Summary

Anemia occurs when you do not have enough red blood cells in your body. The most common type of anemia is iron deficiency anemia.

Anemia is a potentially serious condition. Causes include bleeding, certain diseases, nutritional deficiencies, and cancer.

Common symptoms of anemia include fatigue, shortness of breath, and unusually pale skin. Treating anemia involves diagnosing and addressing the underlying cause.

Contact your doctor if you experience any symptoms of anemia. Blood tests and other analyses can help with diagnosis.

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Medical Reviewer: Angelica Balingit, MD
Last Review Date: 2022 May 16
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