Anemia is a low level of healthy red blood cells (RBCs). 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.
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
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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The main causes of anemia are:
Blood loss, such as that caused by:
Heavy menstrual periodsBleeding in the digestive tractBleeding in the urinary tractSurgeryTraumaCancer
Abnormally low RBC production, due to:
Kidney diseaseCancerInfectionMedicationRadiationPregnancyLead intoxication
Abnormally high RBC destruction, caused by inherited disorders such as:
Sickle cell anemiaThalassemia—difficulty in manufacturing hemoglobin
Anemia is more common in: Women of childbearing ageWomen who are pregnantOlder adults with other medical conditionsInfants younger than 2 years of age
Factors that may increase your chances of anemia include: Poor diet low in iron, vitamins, and mineralsBlood loss such as that due to surgery or injuryChronic or serious illnessChronic infectionsFamily history of inherited anemia such as sickle cell anemia and thalassemia
Symptoms of anemia may include: TirednessPalenessShortness of breathLightheadednessHeadacheColdness in the hands and feetPale skinChest painRapid or irregular heartbeat
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids, waste products and tissues may be tested. This can be done with: Blood testsStool testsBone marrow aspiration or biopsy
Talk with your doctor about the best plan for you. Options include:
You may be told to make changes to your diet. The diet may include foods rich in iron, vitamin C, vitamin B12, and folate. Vitamins or iron supplements may be added.
To help treat your anemia or your symptoms, your doctor may prescribe: AntibioticsHormone treatmentEpoetin for anemia due to chronic kidney disease or cancer chemotherapyMedications that act on the immune systemChelation therapy for lead poisoning
This procedure places healthy
or stem cells in the body. The goal is for the new tissue to produce healthy blood cells. This procedure carries risk. It is only done in severe cases of anemia.
Critical bleeding may be treated with surgery. In cases of very high RBC destruction, your
may need to be surgically removed.
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 advised by your doctor.Treat underlying causes of anemia.Report signs and symptoms, especially chronic fatigue, to your doctor.
Anemia—differential diagnosis. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated September 23, 2015. Accessed September 23, 2015.
Guralnik JM, Eisenstaedt RS, et al. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia.
Nissenson AR, Goodnough LT, et al. Anemia: not just an innocent bystander?
Arch Intern Med. 2003;163:1400-1404.
What is anemia? National Heart, Lung, and Blood Institute website. Available at:
Updated May 18, 2012. Accessed September 23, 2015.
Last reviewed September 2015 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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