Anemia is a condition characterized by a deficiency of healthy red blood cells or hemoglobin in the blood. Hemoglobin, a vital protein within red blood cells, is responsible for carrying oxygen from your lungs to all parts of your body. When you have anemia, your body doesn’t receive enough oxygen-rich blood, which can lead to feelings of fatigue, weakness, and shortness of breath.
Anemia is not a single disease but rather a symptom of various underlying health issues. It can be temporary or long-lasting, and its severity can range from mild to severe. In some instances, anemia can signal a more serious medical condition. While treatments vary depending on the cause and severity, they often include dietary changes, supplements, or medical procedures. In some cases, adopting a healthy diet can be a preventive measure against certain types of anemia.
Symptoms of Anemia
The signs and symptoms of anemia vary depending on the underlying cause and the degree of anemia. In mild cases, you might not experience any noticeable symptoms initially. However, as anemia progresses, symptoms tend to emerge and intensify.
If anemia is a consequence of another medical condition, the symptoms of that condition might overshadow those of anemia, making it harder to detect. In such cases, anemia might be discovered incidentally during tests conducted for other health concerns. Certain types of anemia also have specific symptoms that can provide clues to the underlying cause.
Common symptoms of anemia can include:
- Persistent fatigue and unusual tiredness
- General weakness and lack of energy
- Shortness of breath, especially with exertion
- Pale or yellowish skin tone, which may be more apparent in individuals with lighter skin tones
- Irregular heartbeat or palpitations
- Dizziness or lightheadedness, particularly upon standing
- Chest pain
- Cold extremities, such as hands and feet
- Frequent headaches
When to Seek Medical Advice
If you are experiencing persistent fatigue or unexplained shortness of breath, it is important to consult with your healthcare provider to determine the underlying cause.
A key indicator of anemia is a low level of hemoglobin, the protein in red blood cells that carries oxygen. Often, individuals discover they have low hemoglobin levels when they attempt to donate blood and are informed of their ineligibility due to this reason. If you are told you cannot donate blood because of low hemoglobin, it’s crucial to schedule a medical appointment for further evaluation and diagnosis.
Main Causes of Anemia
Anemia arises when your blood lacks sufficient red blood cells or hemoglobin. This can occur due to several reasons, broadly categorized as:
Reduced Red Blood Cell Production
The body may not be producing enough red blood cells or hemoglobin. This can be due to various factors affecting the bone marrow, where blood cells are made, or the necessary nutrients for red blood cell production.
Iron Deficiency Anemia
Iron deficiency anemia is the most prevalent type of anemia worldwide. It occurs when the body doesn’t have enough iron. Iron is essential for the bone marrow to produce hemoglobin. Without adequate iron, the body cannot manufacture sufficient hemoglobin for red blood cells.
Pregnant women are particularly susceptible to iron deficiency anemia if they don’t receive iron supplements. Blood loss is another significant cause. Chronic blood loss can stem from heavy menstrual periods, ulcers, cancers, or regular use of certain pain relievers, especially aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).
Vitamin Deficiency Anemia
Besides iron, the body requires folate and vitamin B-12 to produce a sufficient amount of healthy red blood cells. A diet lacking in these essential vitamins and other key nutrients can impair red blood cell production, leading to anemia.
Furthermore, some individuals have difficulty absorbing vitamin B-12 from their diet. This malabsorption can result in vitamin B-12 deficiency anemia, also known as pernicious anemia.
Anemia of Inflammation
Chronic inflammatory diseases can interfere with the body’s ability to produce red blood cells, leading to anemia of inflammation. These conditions include chronic infections, cancer, autoimmune disorders like rheumatoid arthritis, kidney disease, and inflammatory bowel diseases such as Crohn’s disease.
Aplastic Anemia
Aplastic anemia is a rare and life-threatening condition where the bone marrow fails to produce enough new blood cells, including red blood cells, white blood cells, and platelets. Causes of aplastic anemia can include infections, certain medications, autoimmune disorders, and exposure to toxic chemicals. In some cases, the cause remains unknown (idiopathic).
Anemias Linked to Bone Marrow Disease
Diseases that directly affect the bone marrow, such as leukemia, myelodysplastic syndromes, and myelofibrosis, can disrupt blood cell production and cause anemia. The severity of anemia in these conditions can vary widely, ranging from mild to life-threatening depending on the specific disease and its progression.
Increased Red Blood Cell Destruction
In some types of anemia, red blood cells are destroyed faster than the bone marrow can replace them. This premature destruction of red blood cells is called hemolysis.
Hemolytic Anemias
Hemolytic anemias encompass a group of conditions where red blood cells are destroyed at an accelerated rate. This can be caused by inherited blood disorders, autoimmune diseases, infections, medications, or certain toxins. Some forms of hemolytic anemia are hereditary, passed down through families.
Sickle Cell Anemia
Sickle cell anemia is an inherited and sometimes severe type of hemolytic anemia. It is caused by a genetic mutation that affects the shape of hemoglobin. The abnormal hemoglobin causes red blood cells to become rigid and crescent-shaped, resembling a sickle. These sickle cells are fragile and have a shorter lifespan than normal red blood cells, leading to chronic anemia. They can also get stuck in small blood vessels, causing pain and other complications.
Blood Loss
Significant blood loss, whether sudden or chronic, can lead to anemia. Acute blood loss, such as from trauma or surgery, can quickly deplete red blood cells. Chronic blood loss, often less obvious, can occur over time from conditions like gastrointestinal bleeding (ulcers, hemorrhoids, or cancers) or heavy menstrual periods.
Risk Factors for Anemia
Several factors can increase your risk of developing anemia:
- Dietary deficiencies: A diet consistently low in iron, vitamin B-12, folate, and vitamin C increases the risk of nutrient deficiency anemias.
- Intestinal disorders: Conditions that affect nutrient absorption in the small intestine, such as celiac disease and Crohn’s disease, can increase the risk of anemia.
- Menstruation: Women with heavy menstrual periods are at higher risk of iron deficiency anemia due to blood loss.
- Pregnancy: Pregnant women have an increased need for iron and folate. If these needs are not met through diet or supplements, they are at a higher risk of developing anemia.
- Chronic conditions: Chronic diseases like cancer, kidney disease, diabetes, and rheumatoid arthritis are associated with an increased risk of anemia of chronic disease. These conditions can interfere with red blood cell production or lifespan.
- Family history: Having a family history of inherited anemias, such as sickle cell anemia or thalassemia, increases your risk of developing these conditions.
- Other factors: A history of certain infections, autoimmune diseases, blood disorders, alcoholism, exposure to toxic chemicals, and certain medications can also elevate the risk of anemia.
- Age: Individuals over the age of 65 are at an increased risk of anemia, often due to a combination of factors such as chronic conditions, poor nutrition, and reduced bone marrow function.
Potential Complications of Untreated Anemia
If left untreated, anemia can lead to various health complications, some of which can be serious:
- Severe fatigue: Severe anemia can cause debilitating fatigue that interferes with daily activities and quality of life.
- Pregnancy complications: Anemia during pregnancy, particularly folate deficiency anemia, increases the risk of complications such as premature birth and low birth weight.
- Heart problems: Anemia can lead to rapid or irregular heartbeats (arrhythmias). To compensate for reduced oxygen-carrying capacity, the heart has to pump harder and faster, potentially leading to an enlarged heart or heart failure over time.
- Increased risk of infections: Some types of anemia, particularly those affecting white blood cells as well, can weaken the immune system and increase susceptibility to infections.
- Developmental delays in children: In children, untreated anemia can lead to delayed growth and development.
- Death: Severe anemia, especially from acute blood loss or certain inherited anemias like sickle cell anemia, can be life-threatening.
Prevention Strategies for Anemia
While not all types of anemia are preventable, you can take steps to prevent certain types, particularly iron deficiency and vitamin deficiency anemias, by adopting a healthy and balanced diet. Focus on incorporating foods rich in:
- Iron: Good sources include red meat, poultry, fish, beans, lentils, spinach, iron-fortified cereals, and dried fruits.
- Folate: Find folate in citrus fruits and juices, dark green leafy vegetables, beans, peanuts, and enriched grains (bread, pasta, rice).
- Vitamin B-12: Include meat, poultry, fish, dairy products, eggs, and fortified cereals and soy products in your diet.
- Vitamin C: Vitamin C enhances iron absorption. Consume citrus fruits, berries, peppers, tomatoes, broccoli, and melons.
If you are concerned about getting enough vitamins and minerals through diet alone, especially if you have risk factors for anemia, consult your healthcare provider about whether a multivitamin or specific supplements are recommended for you.
By Mayo Clinic Staff
