Definition

Anemia is a low level of healthy red blood cells (RBC). RBCs carry oxygen from the lungs to the rest of the body. When red blood cells are low the body does not get enough oxygen. This can cause symptoms such as fatigue, pale skin, or irregular heartbeat.

There are several specific types of anemia, including:

• Anemia of chronic disease —chronic diseases can slow the production of RBCs
• Aplastic anemia —bone marrow is not able to produce enough RBCs
• Iron-deficiency anemia —iron is a building block of hemoglobin
• Macrocytic B12 deficient anemia and pernicious anemia —B12 is a building block of RBCs
• Sickle cell anemia —RBCs have an abnormal shape that causes destruction of RBCs and low levels of hemoglobin

Red Blood Cells

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Causes

The main causes of anemia are:

• Blood loss, such as that caused by:
  • Heavy menstrual periods
  • Bleeding in the digestive tract
  • Bleeding in the urinary tract
  • Surgery
  • Trauma
  • Cancer
• Abnormally low RBC production, due to:
  • Kidney disease
  • Cancer
  • Infection
  • Medication
  • Radiation
  • Pregnancy
  • Lead intoxication
• Abnormally high RBC destruction, caused by inherited disorders such as:
  • Sickle cell anemia
  • Thalassemia —difficulty in manufacturing hemoglobin
  • Enzyme deficiencies

Risk Factors

Risk factors that may increase your chances of anemia include:

• Women of childbearing age
• Pregnancy
• Older adults with other medical condition
• Infants younger than two years
• Poor diet low in iron, vitamins, and minerals
• Blood loss (eg, due to surgery or injury)
• Chronic or serious illness
• Chronic infections
• Family history of inherited anemia (eg, sickle cell anemia, thalassemia)

Symptoms

Symptoms of anemia may include:

• Tiredness
• Feeling faint
• Paleness
• Shortness of breath
• Dizziness
• Headache
• Coldness in the hands and feet
• Pale skin
• Chest pain
• Rapid or irregular heartbeat

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Other tests may include:

• Tests of your blood:
  • Complete Blood Count (CBC)
  • Other blood tests
  • Blood smear
• Stool sample
• Bone marrow aspiration or biopsy

Treatment

Talk with your doctor about the best plan for you. Options include:

Prevention

Most inherited forms of anemia cannot be prevented. But the following steps may be taken to prevent certain types of anemia:

• Eat a diet rich in iron and vitamins
• Take iron or vitamin supplements, as recommended by your doctor
• Treat underlying causes of anemia
• Report signs and symptoms, especially chronic fatigue, to your doctor