Types of Anemia

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Anemia is a common blood disorder, affecting more than 3 million people in the United States, but did you know there are several types of anemia? Some are mild while others can be life threatening. Some types are temporary and some are life-long. All types of anemia have one thing in common: they affect how your red blood cells carry oxygen throughout your body, nourishing the tissues and organs. Learn about the more common types of anemia, what causes them, and some treatment options.

Iron-Deficiency Anemia

Iron-deficiency anemia is the type of anemia most people know about. It’s the most common type of anemia in the world. 

Hemoglobin, an iron-rich protein in your red blood cells, carries oxygen from your lungs to the body tissues. If you don’t have enough hemoglobin, you may have iron-deficiency anemia. You may not notice the symptoms at first, as it can come on slowly. The most common causes of iron-deficiency anemia include:

  • Diet low in iron. If your diet doesn’t include enough iron-rich foods, you could develop anemia. Examples of iron-rich food include those from animal sources, such as chicken and beef liver, turkey, lean beef, and eggs. Plant-based foods like beans and lentils, tofu, cashews, and leafy greens (think spinach) are also high in iron, as are brown rice and whole-grain and enriched breads. 

  • Pregnancy. Women can develop anemia during pregnancy if they don’t take iron supplements.

  • Inability to absorb iron. Diseases like celiac disease or procedures like gastric bypass surgeries may prevent your body from absorbing iron from your foods.

  • Blood loss. Women with heavy menstrual periods or who have recently given birth, and people with conditions that may cause chronic blood loss may develop anemia. Blood loss can occur from diseases or conditions that affect your colon, such as colorectal cancer, peptic ulcer disease, ulcerative colitis, or Crohn’s disease. Blood loss and anemia can also occur following a physical trauma or major surgery.

If you have been diagnosed with iron-deficiency anemia, your doctor may refer you to a nutritionist to help you improve your intake of iron-rich foods. Your doctor may also prescribe an iron supplement. You may have to undergo some tests if your doctor isn’t sure why you have anemia. If a condition is causing the blood loss, you will be treated for that as well.

Sickle Cell Anemia

Sickle cell anemia affects about 100,000 people in the United States, mostly people of African descent, or African American. A mutation in your blood causes the blood cells to be sickle-shaped instead of round, and “sticky.” As the blood cells try to circulate, the sickle shape causes them to get stuck, particularly in the joints. This causes severe pain and limits the oxygen the blood cells can carry through the bloodstream. If several sickle-shaped cells bunch together, they could block blood flow completely.

There is no cure for sickle cell disease, but there are treatments that may help reduce the pain and complications associated with the disease. People with sickle cell disease are encouraged to drink water to stay as hydrated as possible. Treatments may include:

  • Medications to ease the pain, ranging from over-the-counter pain relievers like ibuprofen to prescription medications like opioids.

  • Blood transfusions may be administered for severe anemia.

  • Antibiotics, because people with sickle cell anemia are at risk for developing infections including bacterial infections.

  • Vaccinations to avoid preventable infections like childhood infectious diseases and influenza.

Bone marrow transplants, or stem cell transplants, are a potential cure for sickle cell anemia, but it’s a difficult treatment and not always successful. Bone marrow contains stem cells that develop into blood cells, including red blood cells. When a bone marrow transplant is successful, the marrow from a healthy donor should form normal, round red blood cells. But a matching donor must first be found and the recipient must undergo high doses of chemotherapy to wipe out their own bone marrow before receiving the new marrow. 

Researchers are also investigating how gene therapy may help cure sickle cell anemia but this is still in the experimental stage.

Pernicious Anemia

Pernicious anemia, also called Biermer’s disease, is less common than iron-deficiency anemia or sickle cell anemia. It’s a type of vitamin B12 anemia because your body doesn’t absorb enough vitamin B12 to make red blood cells. This means there isn’t enough hemoglobin circulating, carrying oxygen throughout your body. Pernicious anemia can run in families, and is most common in people of northern European ancestry. Gastric bypass surgery can also cause it.

Treatment for pernicious anemia includes monthly injections of vitamin B12. Some people with milder forms of pernicious anemia may be able to take large doses of vitamin B12 by mouth.

Aplastic Anemia

Aplastic anemia is another rare anemia, but it is very serious. With aplastic anemia, your bone marrow stops making or slows down its production of red blood cells. This can happen suddenly or it can develop over time. Causes include autoimmune diseases, pregnancy, chemotherapy and radiation therapy for cancer treatment, exposure to certain chemicals (such as pesticides), and some medications. 

If your case is mild, your doctor may take a watchful waiting approach—do no treatment and wait to see if it worsens or improves on its own. If you have severe aplastic anemia, some treatment options include:

  • Blood transfusions of either red blood cells or platelets

  • Bone marrow transplant

  • Bone marrow stimulants—medications that stimulate the marrow to produce blood cells

  • Immunosuppressant medications 

  • Antibiotics and antivirals to help treat infections

If you have aplastic anemia caused by pregnancy, it usually will improve once you give birth.

Hemolytic Anemia

Hemolytic anemia is an umbrella term for several types of anemia that cause your immune system to malfunction and attack your red blood cells, destroying them faster than your bone marrow can produce them. It’s a disease you can inherit or develop later in life. Hemolytic anemia causes include:

  • Sickle cell anemia

  • Thalassemia

  • Cancer 

  • Infections

  • An overactive spleen

  • Autoimmune disorders

  • A severe reaction to a blood transfusion or receiving blood that doesn’t match yours

Treatment for hemolytic anemia depends on the cause. If you have severe hemolytic anemia, you could receive a blood transfusion right away. After that, some options include:

  • Corticosteroid medications

  • Immunosuppressant medications to suppress your immune system

  • Iron supplements

  • Splenectomy (removal of the spleen)

Anemia is a common disorder, but what type of anemia you have will determine the treatment you need. If you have been diagnosed with any type of anemia, speak with your doctor or healthcare team to learn about your options and what you can expect. For some types of anemia, you may need to work with a hematologist, a doctor who specializes in blood disorders and diseases.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jun 28
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  10. Hemolytic Anemia. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/hemolytic-anemia

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