Anemia

Conditions that may lead to anemia include

• Heavy periods
• Pregnancy
• Ulcers
• Colon polyps or colon cancer
• Inherited disorders
• A diet that does not have enough iron, folic acid, or vitamin B12
• Blood disorders such as sickle cell anemia and thalassemia, or cancer
• Aplastic anemia, a condition that can be inherited or acquired
• G6PD deficiency, a metabolic disorder

Anemia can make you feel tired, cold, dizzy, and irritable. You may be short of breath or have a headache.

Your doctor will diagnose anemia with a physical exam and blood tests. Treatment depends on the kind of anemia you have.

Prevention

You might be able to prevent repeat episodes of some types of anemia, especially those caused by lack of iron or vitamins. Dietary changes or supplements can prevent these types of anemia from occurring again.

Treating anemia’s underlying cause may prevent the condition (or prevent repeat episodes). For example, if medicine is causing your anemia, your doctor may prescribe another type of medicine.

To prevent anemia from getting worse, tell your doctor about all of your signs and symptoms. Talk with your doctor about the tests you may need and follow your treatment plan.

You can’t prevent some types of inherited anemia, such as sickle cell anemia. If you have an inherited anemia, talk with your doctor about treatment and ongoing care.

Risk Factors

Anemia occurs in all age, racial, and ethnic groups. Both men and women can have anemia. However, women of childbearing age are at higher risk for the condition because of blood loss from menstruation.

Anemia can develop during pregnancy due to low levels of iron and folic acid and changes in the blood. During the first six months of pregnancy, the fluid portion of a woman’s blood, the plasma, increases faster than the number of red blood cells, which dilutes the blood and can lead to anemia.

During the first year of life, some babies are at risk for anemia because of iron deficiency. At-risk infants include those who are born too early and infants who are fed breast milk only or formula that isn’t fortified with iron. These infants can develop iron deficiency by 6 months of age.

Infants between 1 and 2 years of age also are at risk for anemia. They may not get enough iron in their diets, especially if they drink a lot of cow’s milk. Cow’s milk is low in the iron needed for growth.

Drinking too much cow’s milk may keep an infant or toddler from eating enough iron-rich foods or absorbing enough iron from foods.

Older adults also are at increased risk for anemia.

Factors that raise your risk for anemia include:

• A diet that is low in iron, vitamins, or minerals
• Blood loss from surgery or an injury
• Long-term or serious illnesses, such as kidney disease, cancer, diabetes, rheumatoid arthritis, HIV/AIDS, inflammatory bowel disease (including Crohn’s disease), liver disease, heart failure, and thyroid disease
• Long-term infections
• A family history of inherited anemia, such as sickle cell anemia or thalassemia

Causes

The three main causes of anemia are:

• Blood loss
• Lack of red blood cell production
• High rates of red blood cell destruction

Blood loss is the most common cause of anemia, especially iron-deficiency anemia. Blood loss can be short term or persist over time.

Heavy menstrual periods or bleeding in the digestive or urinary tract can cause blood loss. Surgery, trauma, or cancer also can cause blood loss. If a lot of blood is lost, the body may lose enough red blood cells to cause anemia.

Acquired conditions and factors that can lead to anemia include poor diet, abnormal hormone levels, some chronic diseases, and pregnancy. Aplastic anemia also can prevent your body from making enough red blood cells. This condition can be acquired or inherited.

A diet that lacks iron, folic acid, or vitamin B12 can prevent your body from making enough red blood cells. Your body also needs small amounts of vitamin C, riboflavin, and copper to make red blood cells. Conditions that make it hard for your body to absorb nutrients also can prevent your body from making enough red blood cells.

Chronic diseases, like kidney disease and cancer, can make it hard for your body to make enough red blood cells. People who have HIV/AIDS may develop anemia due to infections or medicines used to treat their diseases.

Some cancer treatments may damage the bone marrow or damage the red blood cells’ ability to carry oxygen. If the bone marrow is damaged, it can’t make red blood cells fast enough to replace the ones that die or are destroyed.

Anemia can occur during pregnancy due to low levels of iron and folic acid and changes in the blood. During the first 6 months of pregnancy, the fluid portion of a woman’s blood increases faster than the number of red blood cells. This dilutes the blood and can lead to anemia.

Some infants are born without the ability to make enough red blood cells. This condition is called aplastic anemia. Infants and children who have aplastic anemia often need blood transfusions to increase the number of red blood cells in their blood.

Hemolytic anemia is another example of a condition in which your body destroys too many red blood cells. Inherited or acquired conditions or factors can cause hemolytic anemia. Examples include immune disorders, infections, certain medicines, or reactions to blood transfusions.

Symptoms

The most common symptom of anemia is fatigue If you have anemia, you may find it hard to find the energy to do normal activities.

Other signs and symptoms of anemia include:

• Shortness of breath
• Dizziness
• Headache
• Coldness in the hands and feet
• Pale skin
• Chest pain

These signs and symptoms can occur because your heart has to work harder to pump oxygen-rich blood through your body.

Mild to moderate anemia may cause very mild symptoms or none at all.

Some people who have anemia may have arrhythmias. Anemia also can damage other organs in your body because your blood can’t get enough oxygen to them.

Anemia can weaken people who have cancer or HIV/AIDS. This can make their treatments not work as well.

Anemia also can cause many other health problems. People who have kidney disease and anemia are more likely to have heart problems. With some types of anemia, too little fluid intake or too much loss of fluid in the blood and body can occur. Severe loss of fluid can be life threatening.

Diagnosis

Your doctor will diagnose anemia based on your medical and family histories, a physical exam, and results from tests and procedures.

Your doctor may ask whether you have any of the common signs or symptoms of anemia. He or she also may ask whether you’ve had an illness or condition that could cause anemia.

Because anemia doesn’t always cause symptoms, your doctor may find out you have it while checking for another condition.

Your doctor will do a physical exam to find out how severe your anemia is and to check for possible causes. He or she may:

• Listen to your heart for a rapid or irregular heartbeat
• Listen to your lungs for rapid or uneven breathing
• Feel your abdomen to check the size of your liver and spleen

Your doctor also may do a pelvic or rectal exam to check for common sources of blood loss.

Often, the first test used to diagnose anemia is a complete blood count (CBC) that measures many parts of your blood.

Because anemia has many causes, you also might be tested for conditions such as kidney failure, lead poisoning, and vitamin deficiencies.

If your doctor thinks that you have anemia due to internal bleeding, he or she may suggest several tests to look for the source of the bleeding.

Treatment

Treatment for anemia depends on the type, cause, and severity of the condition. Treatments may include dietary changes or supplements, medicines, procedures, or surgery to treat blood loss.

The goal of treatment is to increase the amount of oxygen that your blood can carry. This is done by raising the red blood cell count and/or hemoglobin level. Another goal is to treat the underlying cause of the anemia.

Low levels of vitamins or iron in the body can cause some types of anemia. These low levels might be the result of a poor diet or certain diseases or conditions.

To raise your vitamin or iron level, your doctor may ask you to change your diet or take vitamin or iron supplements. Common vitamin supplements are vitamin B12 and folic acid. Vitamin C sometimes is given to help the body absorb iron.

Your body needs iron to make hemoglobin. Your body can more easily absorb iron from meats than from vegetables or other foods. To treat your anemia, your doctor may suggest eating more meat—especially red meat (such as beef or liver), as well as chicken, turkey, pork, fish, and shellfish.

Low levels of vitamin B12 can lead to pernicious anemia. This type of anemia often is treated with vitamin B12 supplements.

Folic acid is a form of vitamin B that’s found in foods. Your body needs folic acid to make and maintain new cells. Folic acid also is very important for pregnant women. It helps them avoid anemia and promotes healthy growth of the fetus.

Vitamin C helps the body absorb iron. Good sources of vitamin C are vegetables and fruits, especially citrus fruits.

Your doctor may prescribe medicines to help your body make more red blood cells or to treat an underlying cause of anemia.

If your anemia is severe, your doctor may recommend a medical procedure. Procedures include blood transfusions and blood and marrow stem cell transplants.

If you have serious or life-threatening bleeding that’s causing anemia, you may need surgery.

Recovery

Often, you can treat and control anemia. If you have signs or symptoms of anemia, seek prompt diagnosis and treatment. Treatment may increase your energy and activity levels, improve your quality of life, and help you live longer.

With proper treatment, many types of anemia are mild and short term. However, anemia can be severe, long lasting, or even fatal when it’s caused by an inherited or chronic disease or trauma.