Anemia: 9 Things Doctors Want You to Know

  • illustration of normal blood cells
    A Common and Often Easily Treated Blood Disorder
    Anemia is a fairly common group of conditions of the blood. The most common type is iron-deficiency anemia, where you don’t have enough healthy red blood cells to carry hemoglobin throughout your body. Hemoglobin carries oxygen, which is vital for tissue health. About 5.6% of people in the United States have this type of anemia. Other types include B12 deficiency anemia, folic acid deficiency anemia, microcytic anemia, macrocytic anemia, and sickle cell anemia, among others. Anemia is often treated by family doctors or internists, but you may be referred to a hematologist, a blood specialist, for testing or further treatment if necessary. Here’s what they want you to know.
  • young female patient talking with female doctor in bright exam room
    1. “The most common cause of anemia among women is menstruation.”
    One of the most common causes of iron-deficiency anemia among women is menstruation. It affects up to 5% of women of childbearing age. “If they have a heavy menstrual cycle or period, it may indicate they are losing red blood cells—or iron, more specifically—which eventually leads to anemia,” explains Michael Langan, MD, an internal medicine specialist at The Ohio State University Wexner Medical Center. However, there are many other reasons why there is anemia, so if women are anemic, they shouldn’t automatically assume it is caused by menstruation even if they have heavy periods.
  • Doctor Listening The Patient's Lungs
    2. “Men can and do get anemia too.”
    Men get iron-deficiency anemia too, just not as often as women. And doctors may have to dig a little deeper to find out why a man is anemic. “In a man, you may be a bit more concerned because they don’t really have a reason to be anemic,” says Jonathan D. Rich, DO, a primary care doctor with Mercy Personal Physicians Downtown in Baltimore, Md. “Bleeding internally is the number one thing you would probably look for,” he adds. And if there is internal bleeding, then you need to find out what is causing it.
  • person giving blood at blood bank
    3. “Donating blood is good, but too much can cause anemia.”
    Regular blood donors are important to the nation’s blood supply and can save many lives. But the rules for how often you can donate blood are there to protect you from losing too much blood, which can affect your own health. When trying to determine why patients may be anemic, Dr. Langan asks how often they may give blood. “Usually [blood donation collectors] screen you for whether or not it's okay for you to continue to give blood,” he explains. “But I have seen people become iron deficient from blood donations.”
  • fruits, vegetables, legumes, nuts and liver with high iron content
    4. “A diet lacking in iron may contribute to anemia.”
    We are what we eat is a common expression and it holds true with anemia. People who don’t consume enough iron in their diet could develop iron-deficiency anemia. “If someone is vegan or they follow a specific diet that doesn’t really include iron, I’ll want to know about those things and what they are consuming,” says Dr. Langan. “I need to make sure they have all the nutrients and iron that are important for making red blood cells and actually preventing anemia.”
  • caucasian woman tired after exercising with baby in stroller in the background
    5. “Shortness of breath can be a symptom of anemia.”
    Fatigue, weakness, dizziness, headaches, pale skin, even shortness of breath can all be signs of iron-deficiency anemia. These are the result of not enough oxygen reaching the body’s tissues. Shortness of breath, for example, occurs because the ability to transport oxygen to the body is compromised, explains Dr. Rich. “You need oxygen to work your muscles and if you don’t have enough oxygen, your muscles don’t work.” Your body then tries to work harder to compensate.
  • medicare-prescription-benefits-pharmacist-with-patient
    6. “Some medications may contribute to anemia.”
    Aggressive immunosuppressant medications can inhibit bone marrow and your body’s ability to make red blood cells. Dr. Langan cautioned that anemia caused by medication isn’t common, but if you’re concerned about your medications, speak with your doctor. If you are on medications that could cause anemia, you will be sent for regular blood tests to monitor your iron levels.
  • female doctor asking senior patient in hospital bed about his medical history and symptoms
    7. “Anemia may be a symptom of an underlying disease.”
    “Anemia could be a sign of an acute injury with [internal] blood loss,” explains Dr. Rich. “It could be a sign of a cancer that’s causing problems with your blood system, or it could be a sign of advanced kidney failure.” In other words, anemia can be very serious as it can be the end point of other diseases. Anemia may not be anything serious, but it’s important to know why your hemoglobin count is low. “You want to know why you’re anemic, not just that you are anemic,” Dr. Rich says.
  • illustration of sickle cell anemia blood, with both normal and sickle-shaped cells
    8. “There are different types of anemia.”
    Microcytic anemia is related to the red blood cells and how they are too small to carry hemoglobin throughout your body. It’s most often caused by iron-deficiency anemia. Macrocytic anemia, on the other hand, is most often caused by not having enough vitamin B12 or folate. Sickle cell anemia, a genetic disease, occurs when hemoglobin is abnormal, which causes red blood cells to adopt a sickle shape. And thalassemia is an inherited blood disorder that causes red blood vessels to be destroyed, so there are not enough to carry the hemoglobin through the body. “[People] need to know why they are anemic, so it can be treated,” says Dr. Rich.
  • Pregnant Woman with Morning Sickness
    9. “Untreated or uncontrolled anemia can cause complications.”
    “If you suspect you have anemia, or you do have anemia, the most important thing is to address it with a physician and not ignore it,” says Dr. Langan. “Most of these issues with anemia are actually very fixable and very treatable.” Complications from anemia could include severe fatigue, complications in pregnancy, rapid or irregular heartbeat, heart failure, even death.
Anemia: 9 Things Doctors Want You to Know
Contributors
  • Jonathan D. Rich, DO
    Primary care doctor with Mercy Personal Physicians Downtown in Baltimore, Md.
  • Michael Langan, MD - Healthgrades - Anemia: 9 Things Doctors Want You to Know
    Internal medicine specialist at The Ohio State University Wexner Medical Center.

About The Author

Marijke Vroomen Durning, RN, has been writing health information for the past 20 years. She has extensive experience writing about health issues like sepsis, cancer, mental health issues, and women’s health. She is also author of the book Just the Right Dose: Your Smart Guide to Prescription Medications and How to Take Them Safely.
  1. Anemia. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/anemia/symptoms-causes/syc-20351360
  2. Anemia. MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/anemia.html
  3. What is anemia? Kids Health from Nemours. https://kidshealth.org/en/parents/anemia.html
  4. Le CH. The Prevalence of Anemia and Moderate-Severe Anemia in the US Population (NHANES 2003-2012). PLoS ONE 2016;11(11): e0166635. https://www.ncbi.nlm.nih.gov/pubmed/27846276
  5. Iron Deficiency Anemia. WomensHealth.gov. https://www.womenshealth.gov/a-z-topics/iron-deficiency-anemia








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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 10
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