Symptom

Anemia

Overview | Possible Causes | Care and Treatment | HOME REMEDies | When to Call the Doctor | References

Anemia

Overview

Anemia happens when you do not have enough red blood cells. The cells travel with iron and hemoglobin, which is a protein that helps carry oxygen through the bloodstream to your organs all through the body. When someone develops anemia, they are said to be "anemic." Being anemic might mean that you feel more tired or cold than you usually do, or if your skin seems too pale. This is due to your organs not receiving the oxygen they need to do their jobs. Some people find out they are low in iron when they go to donate blood.

There are several different types of anemia, but each of them causes the number of red blood cells in circulation to drop. Red blood cell levels are low due to one of the following reasons:

Your body cannot make enough hemoglobin (low hemoglobin).
Your body makes hemoglobin, but the hemoglobin doesn't work correctly.
Your body does not make enough red blood cells.
Your body breaks down red blood cells too quickly.

Some types of anemia that you may have heard of include iron-deficiency anemia and sickle cell anemia.

Possible Causes

Anemia occurs when your blood doesn't have enough red blood cells.

This can happen if:

Your body doesn't make enough red blood cells
Bleeding causes you to lose red blood cells more quickly than they can be replaced
Your body destroys red blood cells

What red blood cells do

Your body makes three types of blood cells- white blood cells to fight infection, platelets to help your blood clot and red blood cells to carry oxygen throughout your body.

Red blood cells contain hemoglobin- an iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs to be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow- a spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, vitamin B-12, folate and other nutrients from the foods you eat.

Causes of anemia

Different types of anemia have different causes. They include:

Iron deficiency anemia. This most common type of anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells. Without iron supplementation, this type of anemia occurs in many pregnant women. It is also caused by blood loss, such as from heavy menstrual bleeding, an ulcer, cancer and regular use of some over-the-counter pain relievers, especially aspirin, which can cause inflammation of the stomach lining resulting in blood loss.
Vitamin deficiency anemia. Besides iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Also, some people who consume enough B-12 aren't able to absorb the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.
Anemia of inflammation. Certain diseases- such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn's disease and other acute or chronic inflammatory diseases- can interfere with the production of red blood cells.
Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn't produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.
Sickle cell anemia. This inherited and sometimes serious condition is a hemolytic anemia. It's caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.

Care & Treatment

Anemia treatment depends on the cause.

Iron deficiency anemia

Treatment for this form of anemia usually involves taking iron supplements and changing your diet.

If the cause of iron deficiency is loss of blood- other than from menstruation- the source of the bleeding must be located and the bleeding stopped. This might involve surgery.

Vitamin deficiency anemias

Treatment for folic acid and vitamin C deficiency involves dietary supplements and increasing these nutrients in your diet.

If your digestive system has trouble absorbing vitamin B-12 from the food you eat, you might need vitamin B-12 shots. At first, you might have the shots every other day. Eventually, you'll need shots just once a month, possibly for life, depending on your situation.

Anemia of chronic disease

There's no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. If symptoms become severe, a blood transfusion or injections of a synthetic hormone normally produced by your kidneys (erythropoietin) might help stimulate red blood cell production and ease fatigue.

Aplastic anemia

Treatment for this anemia can include blood transfusions to boost levels of red blood cells. You might need a bone marrow transplant if your bone marrow can't make healthy blood cells.

Anemias associated with bone marrow disease

Treatment of these various diseases can include medication, chemotherapy or bone marrow transplantation.

Hemolytic anemias

Managing hemolytic anemias includes avoiding suspect medications, treating infections and taking drugs that suppress your immune system, which could be attacking your red blood cells.

Depending on the cause or your hemolytic anemia, you might be referred to a heart or vascular specialist.

Sickle cell anemia

Treatment might include oxygen, pain relievers, and oral and intravenous fluids to reduce pain and prevent complications. Doctors might also recommend blood transfusions, folic acid supplements and antibiotics.

A cancer drug called hydroxyurea (Droxia, Hydrea, Siklos) also is used to treat sickle cell anemia.

Thalassemia

Most forms of thalassemia are mild and require no treatment. More severe forms of thalassemia generally require blood transfusions, folic acid supplements, medication, removal of the spleen, or a blood and bone marrow stem cell transplant.

Home Remedies

Many types of anemia can't be treated at home without medical guidance. But you can avoid iron deficiency anemia and vitamin deficiency anemia by eating a diet that includes a variety of vitamins and minerals, including:

Iron. Iron-rich foods include beef and other meats, beans, lentils, iron-fortified cereals, dark green leafy vegetables, and dried fruit.
Folate. This nutrient, and its synthetic form folic acid, can be found in fruits and fruit juices, dark green leafy vegetables, green peas, kidney beans, peanuts, and enriched grain products, such as bread, cereal, pasta and rice.
Vitamin B-12. Foods rich in vitamin B-12 include meat, dairy products, and fortified cereal and soy products.
Vitamin C. Foods rich in vitamin C include citrus fruits and juices, peppers, broccoli, tomatoes, melons and strawberries. These also help increase iron absorption.

If you're concerned about getting enough vitamins and minerals from food, ask your doctor whether a multivitamin might help.

When to Call the Doctor

Anemia signs and symptoms vary depending on the cause. If the anemia is caused by a chronic disease, the disease can mask them, so that the anemia might be detected by tests for another condition.

Depending on the causes of your anemia, you might have no symptoms. Signs and symptoms, if they do occur, might include:

Fatigue
Weakness
Pale or yellowish skin
Irregular heartbeats
Shortness of breath
Dizziness or lightheadedness
Chest pain
Cold hands and feet
Headaches

At first, anemia can be so mild that you don't notice it. But symptoms worsen as anemia worsens.

When to see a doctor

Make an appointment with your doctor if you're feeling fatigued and you don't know why.

Fatigue has many causes besides anemia, so don't assume that if you're tired you must be anemic. Some people learn that their hemoglobin is low, which indicates anemia, when they donate blood. If you're told that you can't donate because of low hemoglobin, make an appointment with your doctor.

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