Anemia

What is anemia?
Anemia is the most common blood
disorder in the United States. It affects
your red blood cells and hemoglobin.
Hemoglobin is the protein in red blood
cells that carries oxygen from your lungs
to the rest of your body. You need iron in
order to make hemoglobin. Most people
who have anemia have a shortage of iron.
This condition is called iron deficiency
anemia.

There are a few other types of anemia,

including:

Aplastic anemia. This occurs when

your bone marrow has damaged stem
cells. Your body fails to produce enough
new blood cells. The condition affects
your red blood cells, white blood cells,
and platelets. Sometimes it is called
bone marrow failure.
Hemolytic anemia. This occurs when
your body destroys red blood cells
before they should. The normal lifespan
of red blood cells is 120 days.
Normocytic anemia. This occurs when
your red blood cells are normal in size,
but low in count.
Pernicious anemia. This occurs when
your body lacks vitamin B12. It causes
a shortage of healthy red blood cells.
Sickle cell anemia (a form of sickle cell disease ).
This is a genetic disease that affects
your red blood cells. It occurs when
you are born with 2 abnormal
hemoglobin genes.
Symptoms of
anemia
Mild forms of anemia may not cause any
symptoms. Fatigue, or feeling tired, is a
common symptom. This is because the
hemoglobin in red blood cells carries
oxygen. A lack of oxygen reduces energy.
It can cause your heart to work harder to
pump oxygen. Other common anemia
symptoms include:

Paleness
Shortness of breath

Cold hands and feet

Headaches

Dizziness
Fast, slow, or uneven heartbeat
 Brittle nails or hair loss

Strange food cravings (known as pica )

Contact your doctor if you have any of
these symptoms. They can diagnose the
type and cause of the condition.

What causes
anemia?
There are three main reasons why anemia
occurs.

1.Your body can’t

produce enough red
blood cells.
Not being able to produce enough red
blood cells can happen for several
reasons, including diet, pregnancy,
disease, and more.

Diet

Your body may not produce enough red

blood cells if you lack certain nutrients.
Low iron is a common problem. People
who don’t eat meat or follow “fad” diets
are more at risk of low iron. Infants and
toddlers are at risk of getting anemia from
a low-iron diet. Not having enough vitamin
B12 and folic acid can cause anemia as
well.

Absorption difficulty

Certain diseases affect your small

intestine‘s ability to absorb nutrients. For
example, Crohn’s disease and celiac disease can
cause low iron levels in your body. Some
foods, like milk, can prevent your body
from absorbing iron. Taking vitamin C can
help this. Medicines, such as antacids or
prescriptions to reduce acid in your
stomach, can affect it as well.

Pregnancy

People who are pregnant or breastfeeding

can get anemia. When you’re pregnant,
you need more blood (up to 30% more) to
share with the baby. If your body lacks
iron or vitamin B12, it can’t produce
enough red blood cells.

The following factors may increase your

risk of anemia during pregnancy:

Vomiting a lot from morning sickness

 Having a diet low in nutrients
Having heavy periods before
pregnancy
Having 2 pregnancies close together
Being pregnant with multiple babies at
once
Becoming pregnant as a teenager
Losing a lot of blood from an injury or
surgery
Growth spurts

Children younger than 3 years of age are

prone to anemia. Their bodies grow so fast
that they can have a hard time getting or
keeping enough iron.

Normocytic anemia

Normocytic anemia can be congenital

(from birth) or acquired (from a disease or
infection). The most common cause of the
acquired form is a chronic (long-term)
disease. Examples include kidney disease,
cancer , rheumatoid arthritis , and thyroiditis . Some medicines
can cause normocytic anemia, but this is
rare.

1.Your body destroys

red blood cells early
and faster that they
can be replaced.
Treatments, such as chemotherapy, can
damage your red blood cells and/or bone
marrow. Infection caused by a weakened
immune system can lead to anemia. You
may be born with a condition that
destroys or remove red blood cells.
Examples include sickle cell disease,
thalassemia , and a lack of certain enzymes.
Having an enlarged or diseased spleen
can cause anemia, too.

1.You have blood loss

that creates a
shortage of red blood
cells.
Heavy periods may cause low iron levels
in women. Internal bleeding, such as in
your digestive or urinary tract, can cause
blood loss. This can be caused by
conditions such as a stomach ulcer or
ulcerative colitis. Other reasons for blood
loss include:

Cancer
Surgery
 Trauma
Taking aspirin or a similar medicine for a
long time

How is anemia
diagnosed?
Talk to your doctor if you think you or your
child might have anemia. They will do a
physical exam and review your health
history and symptoms. To diagnose
anemia, your doctor will test your blood.
This test is called a complete blood count
(CBC). Based on the results, they may
need to do other tests, such as testing
your bone marrow. This can help confirm
the cause of anemia or another health
condition.
Can anemia be
prevented or
avoided?
You cannot avoid anemia caused by a
genetic disease. You often cannot avoid it
due to blood loss. If your blood loss is
from heavy periods, receiving treatment
can help prevent anemia. If your body
can’t absorb certain nutrients, such as
iron or vitamin B12, talk to your doctor
about taking a supplement. This can help
manage your levels and prevent anemia.

A balanced diet can help prevent some

types of anemia. Eat foods high in iron to
prevent a deficiency.
Foods high in iron include:

Red meat
Seafood
Organ meats (such as liver)
Whole grains
Dried fruits
Nuts
Beans (especially lima beans)
Dark green leafy vegetables (such as
spinach and broccoli)
Iron-fortified foods like breads and
cereals (check the label)
Vitamin C can help your body absorb iron.
Try eating foods rich in vitamin C, such as
citrus fruits or juice, peppers, and
broccoli. Some foods can make it harder
for your body to absorb iron. These include
coffee, tea, milk, egg whites, fiber, and soy
protein. Try to avoid these foods if you
have iron deficiency anemia.

Foods high in vitamin B12 include:

Meat and poultry

Organ meats (such as liver)
Fish and shellfish
Eggs, milk, and dairy products
Some fortified cereals, grains, and yeasts
(check the label)
Foods high in folic acid (folate) include:

Dark green leafy vegetables (such as

spinach and broccoli)
Asparagus
Beans
Peas
Lentils
Bananas, oranges, and orange juice
Pregnant people may be tested for anemia
or take an iron supplement to help prevent
it. However, the American Academy of
Family Physicians (AAFP) has insufficient
evidence to assess the benefits and risks
of screening all pregnant people for iron
deficiency anemia or having them take an
iron supplement.

Evidence also is lacking to measure the

benefits and risks of screening children
ages 6 to 24 months. To help prevent your
child from getting iron deficiency anemia,
you can:

Use iron-fortified formula

Use iron-fortified cereal starting around 4
months of age
Limit your child to less than 24 oz. (3
cups) of cow’s milk per day (after 12
months of age)
 Introduce foods high in iron starting
around 12 months of age
Warning: Keep all products with iron
stored out of reach of your child. Iron can
be toxic if taken in large amounts.

Anemia treatment
There are many treatment options for
anemia. They vary based on the type,
cause, and severity, as well as your overall
health. The first goal of treatment is to
create more healthy red blood cells that
can carry enough oxygen to your body.
Often this is achieved by increasing your
red blood cell count and/or hemoglobin.
The other goal is to treat the cause, if
possible. For example, if anemia results
from losing too much blood, your doctor
will need to treat the cause of your blood
loss.

If you have a type of anemia caused by a

deficiency, make changes to your diet.
This can increase your nutrient levels or
help your body absorb nutrients.

In some cases, your doctor can prescribe

medicine to help your body produce more
red blood cells. Examples include:

Erythropoietin shots to treat normocytic

anemia (these can help your bone
marrow produce more red blood cells)
Hormone medicines to treat heavy
periods
Antibiotic medicines to treat infections
Medicines to help prevent your body from
damaging or destroying red blood cells
Other forms of anemia require intense
treatment. You may need surgery to stop
blood loss or have your spleen removed.
Other treatments include a blood
transfusion or a blood and bone marrow
stem cell transplant.

Talk to your doctor about how to manage a

chronic disease or other health problem
that causes anemia.

Living with anemia

Following treatment, most people go on to
live normal, healthy lives. However,
anemia can have lasting, or life-
threatening, effects. These are more
common if the condition is chronic,
severe, or left untreated. They include:
 Arrhythmia. This is an issue with your
heartbeat. It can be too fast, too slow,
or uneven. Over time, this can lead to
heart disease or heart failure .
Organ damage. This can occur if an
organ doesn’t get enough oxygen.
Weakened immune system. This can be
fatal if your immune system already is
weak from cancer, disease (such as
/
HIV AIDS ), or an infection.
Children who have iron deficiency anemia
have a higher risk of lead poisoning . They also can
develop mental, motor, or behavioral
problems over a long time.

Pregnant women who have iron deficiency

anemia may have their baby premature or
at a low birth weight. There also is a risk
of needing a blood transfusion if you lose
a lot of blood during delivery. Anemia may
be associated with postpartum depression .

Questions to ask
your doctor
If I have anemia once, will I always have
it, or will it come back again?
If I have anemia during pregnancy, is
there a risk of passing it to my
children?
If I have anemia during pregnancy, am I
more at risk of having it after?
If I have a health condition that causes
anemia, what is the risk of passing it to
my children?

Resources
National Heart, Lung, and Blood Institute: Anemia

National Institutes of Health, MedlinePlus: Anemia