Anemia 101: What to Know About This Blood Disorder

Anemia is a condition where the body is low on hemoglobin, a substance contained within your red blood cells. When you breathe in, the oxygen in the air goes to the lungs where it attaches to the hemoglobin contained within your red blood cells. The red blood cells move throughout your body and the oxygen is dropped off to places such as the brain and the heart that need it for energy. When your body does not have enough hemoglobin or red blood cells, it is unable to effectively carry oxygen to all of your organs. This causes a range of problems that affect your body’s ability to function normally.

Anemia is a broad condition that can have many causes and symptoms. Mild anemia can be subtle and hard to notice. On the other hand, severe anemia can cause debilitating fatigue and can sometimes be life-threatening. In this article we will cover the common symptoms of anemia, types of anemia, how anemia is diagnosed and treatments for anemia.

What Are the Symptoms of Anemia?

The symptoms from anemia can vary depending on the severity of anemia and the type of anemia you have. In very mild cases of anemia, you may barely notice any symptoms. However, in severe cases of anemia, the symptoms can be severe and cause you difficulty in getting through your daily routine. The most common symptoms of anemia include:

Fatigue (or feeling more tired than usual)
Excessive sleepiness
Headaches
Feeling lightheaded or dizzy
Fainting
Yellow skin or eyes
Pale skin
Cold hands and feet
Spoon-shaped nails
Irregular heart beats
Weakness
Chest pain
Shortness of breath
Difficulty exercising
Cravings for ice or other non-food items

While these are the most common symptoms of anemia, the symptoms above can be caused by other conditions as well. If you have some of these symptoms and are concerned about the possibility of anemia, it is important to schedule a visit with your primary care doctor. They can perform additional examinations and tests to determine if anemia could explain the symptoms you have.

How Do Doctors Diagnose Anemia?

A diagnosis of anemia is made based on several factors. Your doctor may ask you questions about your current symptoms, medical history, medications and family history. They will also perform a physical exam. While this information can provide very helpful clues, further testing is typically required to diagnose the type and cause of anemia.

Tests that are performed to diagnose anemia are usually blood tests. To complete these tests, you will get blood drawn from your arm at a lab or a doctor’s office. The most common blood tests that will be done to help diagnose anemia are the following:

● Complete blood count: measures the amount of hemoglobin, red blood cells and other components contained within your blood

● Blood smear: a closer look at the blood under the microscope to determine the size and shape of the blood cells

● Iron panel: measures the level of iron contained in the blood, a key component of hemoglobin

● Vitamin B12 level: measures your B12 level, a necessary vitamin for your body to produce red blood cells

● Vitamin B9 (folate) level: measures your folate level, another necessary vitamin for your body to produce red blood cells

● Complete metabolic panel: measures electrolytes, kidney function and liver function

● Reticulocyte count: a count of the number of reticulocytes (cells from the bone marrow that eventually turn into red blood cells) in the blood

Your doctor may only order some of these tests at first depending on your symptoms, health history and examination. In certain cases where a less common form of anemia is suspected, additional testing may be ordered so treatment can be tailored to the exact cause. These may include autoimmune panels, genetic screening or bone marrow testing.

What Are the Types and Causes of Anemia?

Anemia is a very broad condition that can have a number of causes. The causes can include dietary deficiencies, excessive bleeding, autoimmune causes, inherited disorders, infections and certain medications. We will cover the most common categories of anemia:

● Iron Deficiency Anemia: Iron is what gives your blood its distinctive red color and it is necessary for hemoglobin to carry oxygen properly. Iron levels can become low for two main reasons. The first reason can be due to lack of iron in your diet. Foods that are rich in iron include meat, eggs, shellfish, vegetables, certain fruits and beans. Another cause for iron deficiency anemia is bleeding. This can occur in those who have bleeding from their intestines or colon. Often, the bleeding in the intestinal system is unnoticeable and painless. In older adults, iron deficiency anemia can be an early sign of colon cancer, so your doctor may recommend getting a colonoscopy. Iron deficiency anemia can also occur in women with very heavy periods. Of all the types of anemia, iron deficiency anemia is the most common type of anemia in adults.

● Vitamin Deficiency Anemia: A few specific vitamins are necessary for your body to produce red blood cells. The most important are Vitamin B12 and folate. When you are lacking in these vitamins, your body struggles to produce enough red blood cells, causing anemia. Vitamin B12 deficiency can be caused by certain autoimmune conditions or certain vegan diets. Folate deficiency often results from dietary deficiency and is more common in those who have excessive alcohol intake.

● Inherited Anemia: Certain types of anemia can be genetic, meaning they are inherited from your parents. These include conditions such as thalassemia, sickle cell disease, hereditary spherocytosis and G6PD deficiency. Some inherited forms of anemia tend to be more common in people from African American or Mediterranean descent. In many of these conditions, your body produces different forms of hemoglobin that are less effective at carrying oxygen to the rest of your body.

● Anemia of Chronic Disease: This form of anemia occurs as a defense mechanism against long-term inflammation in your body. In response to long-term inflammation, your body produces less hemoglobin. The most common causes of anemia of chronic disease are active autoimmune conditions such as rheumatoid arthritis, cancer and long-term infections.

● Kidney disease-associated anemia: Your kidneys, when healthy, produce a substance called erythropoietin. Erythropoietin tells your body to make more red blood cells. If you have severe kidney disease, the kidneys stop producing as much of this substance, causing anemia.

● Aplastic Anemia: Hemoglobin and red blood cells are normally produced within your bones by the bone marrow. Aplastic anemia occurs when the bone marrow stops working normally, resulting in anemia. Aplastic anemia has a variety of causes including radiation, autoimmune, infection with certain pathogens and some prescription medications.

● Hemolytic Anemia: Hemolysis means destruction of blood cells. Hemolytic anemia occurs when your red blood cells are being broken down by your body. This can happen for several reasons, including infection with certain pathogens, heart valve conditions, autoimmune disorders, medication-induced or some of the inherited anemias mentioned above.

While these are the most common types of anemia, other forms of anemia exist. Speaking with your doctor and undergoing the tests they recommend is usually necessary to diagnose whether you have anemia and what type of anemia you have.

What Are the Treatments for Anemia?

Once you find out that you have anemia, can it be treated? The good news is typically yes; most types of anemia have effective treatments. With treatment, you will generally have improvement of your symptoms and be able to live a normal life. If your anemia is mild, your doctor may recommend supplements, dietary changes or medication. However, for severe anemias that can be life-threatening, your doctor may suggest that you go to the hospital for close monitoring and possibly a blood transfusion.

For anemias caused by deficiencies in Iron, Vitamin B12 or folate, your doctor will generally recommend that you replace these with a supplement or eat a diet that is higher in these nutrients. In some cases, your doctor may recommend B12 injections. For anemia caused by heavy periods, hormone-based birth control can help reduce the amount of bleeding you experience. If you have anemia from severe kidney disease, replacing erythropoietin through injections will signal to your body to make more red blood cells and resolve the anemia. Anemia of chronic disease typically resolves when the underlying condition causing the anemia is treated.

Inherited anemias and hemolytic anemias can be more challenging to treat, and tend to require a combination of close monitoring, vitamin supplementation, disease-specific medications, surgical removal of the spleen and/or blood transfusions. Aplastic anemia can also be challenging to treat, often requiring blood transfusions, medications to stimulate the bone marrow and sometimes bone marrow transplantation.

Next Steps for Living With Anemia

After being diagnosed with anemia, there are some steps you can try to take daily to prevent recurrence of anemia and help manage your symptoms. Your doctor may also likely schedule followups to check lab tests and make sure your anemia has resolved or improved.

Some steps you can take daily:

● Be consistent: Remember to take any supplements or medication your doctor prescribed. Life gets busy, and it can be easy to forget to take your medications every day. Try to incorporate taking your medication into your daily routine and use aids such as phone reminders, calendars and pill organizers.

● Stay well-hydrated: You should aim to drink about 3 liters of water per day. Dehydration can contribute to the level of fatigue you’re already experiencing from anemia.

● Try to build a sleep routine: Getting the recommended eight hours of sleep per night can help ensure you are well-rested and awake throughout the day. Lack of sleep can also contribute to fatigue.

● Reduce or eliminate alcohol and caffeine: Both alcohol and caffeine can negatively affect sleep and cause fatigue.

● Eat a well-rounded diet: Try to add foods to your diet that are rich in iron, vitamin B12 and folate. These include greens, beans, red meat, shellfish and whole grains.

● Exercise: While exercise can be difficult if you have any fatigue, getting up and moving around can help reduce fatigue and stimulate your body to produce more red blood cells. While you might not feel up to running or lifting weights, starting with 15-20 minutes of walking can go a long way.

● Stay positive: The symptoms of anemia can take a toll on your mental health, causing stress, low mood and depression. If you are feeling down, seek help. Therapy, support groups and mindfulness activities such as meditation may be helpful.

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