What We Know About COPD and Anemia

Medically Reviewed By William C. Lloyd III, MD, FACS

Chronic obstructive pulmonary disease (COPD) refers to a group of lung inflammation disorders, including emphysema, that cause frequent coughing and trouble breathing. It's progressive, which means your symptoms continue to get worse over time. About 24 million people in the United States have this debilitating disease. Most of them are current or former smokers.

If you have COPD, it’s not uncommon to have other chronic health problems, too. When two or more diseases occur in your body at the same time, doctors call them comorbidities or comorbid conditions.

Anemia is an example of a comorbid condition seen in people with COPD.  It's a problem with your red blood cells that prevents the body's organs and tissues from getting enough oxygen-rich blood.  Research suggests anemia occurs more often in COPD patients than doctors once thought – and it can have a big impact on how you feel.

What's the Link?

How anemia develops in patients with COPD is not quite clear. It may be what’s called an “anemia of chronic disease.” This is common in diseases like cancer and those that involve an abnormal immune response. It is not the same as iron-deficiency anemia. Instead, scientists believe inflammation-causing proteins, called cytokines, shorten the normal lifespan of red blood cells and make it harder for the bone marrow to make more of them.   

Breathlessness Times Two

If you have COPD, it is hard to breathe and you will likely feel very tired. Anemia also causes shortness of breath and fatigue, because it starves your body of oxygen. This double whammy can greatly impact your quality of life. Scientists are only now starting to understand the relationship between the two diseases. So far, they've learned that people who have both conditions seem to be more severely ill than those who just have COPD by itself.

If you have COPD and anemia, you are more likely to have:

  • Increased lung inflammation

  • More hospital admissions and higher healthcare costs

  • More wheezing and breathing problems

  • Poorer overall health

  • Poorer outcome after any surgery

Other Causes

If blood work shows you have anemia, your doctor may ask you questions or run more tests to make sure it’s caused by your COPD, and not something else that might require immediate attention. Other things that can cause anemia are: 


If you have anemia, treating it might improve your breathlessness and fatigue. You might receive:

  • Supplemental erythropoietin, a hormone secreted by the kidneys that increases red blood cell production

  • Iron supplements

  • Blood transfusions   

Always talk to your doctor about your treatment options if you have COPD and anemia, especially if you are planning surgery. Patients with both conditions tend to do more poorly after surgery, so it’s important to correct the condition before you have an operation. And even if you’re not considering surgery, talk to your doctor about treating both conditions so you can improve your quality of life.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Oct 13
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