Anemia is a common medical condition characterized by a lower-than-normal amount of healthy red blood cells or hemoglobin in the blood. Hemoglobin, an iron-rich protein within red blood cells, is responsible for carrying oxygen from the lungs to the body’s tissues. When there are too few healthy red blood cells or insufficient hemoglobin, the body’s tissues and organs do not receive enough oxygen. This can lead to various symptoms and impact overall well-being.
Visible Signs and Symptoms of Anemia
One of the most frequently reported symptoms of anemia is fatigue, manifesting as an unexplained lack of energy or feeling tired even after rest. This occurs because the body’s cells do not receive enough oxygen. Many individuals also experience generalized weakness, making daily activities challenging.
Insufficient oxygen-carrying red blood cells often lead to changes in appearance. Pale skin, or pallor, is a common visual cue, noticeable in the face, lower eyelids, and nail beds. This paleness results from reduced blood flow and oxygen to the skin.
Beyond fatigue and pallor, individuals with anemia might experience shortness of breath, dizziness, or lightheadedness. The heart may beat faster or irregularly, compensating for reduced oxygen delivery. Headaches, cold hands and feet, and brittle nails are also observed.
Less common signs of iron deficiency anemia include a sore or smooth tongue, and unusual cravings for non-food items like ice or clay (pica). In severe cases, blue discoloration in the whites of the eyes or mouth ulcers may appear. Symptoms and their severity vary depending on the underlying cause and how advanced the anemia is.
Common Causes of Anemia
Anemia arises from issues with red blood cell production, increased destruction, or blood loss. The most prevalent cause globally is iron deficiency, where the body lacks sufficient iron to produce hemoglobin. This deficiency often stems from insufficient dietary intake, poor absorption, or chronic blood loss, such as heavy menstrual periods or gastrointestinal bleeding.
Other nutritional deficiencies also contribute to anemia. A lack of vitamin B12 or folate (vitamin B9) can lead to the production of unusually large, improperly functioning red blood cells. These vitamins are crucial for healthy red blood cell formation, and deficiency can result from inadequate diet or absorption problems.
Chronic diseases are another cause of anemia. Conditions like kidney disease, cancer, inflammatory bowel disease (Crohn’s disease or ulcerative colitis), liver disease, and autoimmune disorders can interfere with the body’s ability to produce red blood cells or utilize iron. For example, chronic inflammation can make it difficult for the body to use iron.
Inherited conditions directly impact red blood cell structure or production. Sickle cell anemia involves an abnormality in hemoglobin that causes red blood cells to become stiff, sticky, and sickle-shaped, leading to premature destruction. Thalassemia is another inherited disorder where the body produces less hemoglobin, resulting in smaller red blood cells. Aplastic anemia, a rarer condition, occurs when the bone marrow does not produce enough new blood cells.
How Anemia is Diagnosed
Diagnosing anemia begins with a healthcare provider reviewing a patient’s medical history, including diet and family history, and performing a physical examination. The physical exam may involve checking for visible signs like pale skin or brittle nails, and listening to the heart for a rapid or irregular heartbeat.
The primary diagnostic tool for anemia is a complete blood count (CBC). This common blood test measures various blood components, providing detailed information about red blood cells. The CBC assesses hemoglobin levels, measuring the oxygen-carrying protein, and hematocrit, indicating the percentage of red blood cells in blood volume.
A low hemoglobin level (generally less than 13.5 gm/dL for men and 12.0 gm/dL for women) or a low hematocrit percentage (typically below 40% for men and 35% for women) often indicates anemia. The CBC also includes the mean corpuscular volume (MCV), which measures the average size of red blood cells. An abnormal MCV can provide clues about the specific type of anemia, such as small red blood cells in iron deficiency or large ones in vitamin B12 deficiency.
If anemia is identified through the CBC, further specialized blood tests determine the underlying cause. These may include tests to measure iron levels (serum ferritin, serum iron, and total iron-binding capacity) or levels of vitamin B12 and folate. In some cases, a bone marrow examination may be necessary to assess the bone marrow’s ability to produce blood cells.
When to Seek Medical Attention
If you notice persistent or worsening symptoms suggesting anemia, such as unexplained fatigue, significant paleness, or shortness of breath, consult a healthcare professional. These symptoms can be subtle initially but intensify as anemia progresses.
Seeking prompt medical evaluation is important if symptoms are severe, including extreme dizziness, chest pain, or fainting. Anemia can be a sign of a more serious underlying health condition requiring specific medical intervention.
Self-diagnosis and self-treatment of anemia are not recommended. Taking iron supplements without a confirmed diagnosis can be harmful, as excessive iron accumulation can damage organs like the liver. A healthcare provider can accurately diagnose the type and cause of anemia and recommend an appropriate treatment plan.