Anemia

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KEY POINTS

• Anemia is a blood problem. It can be either not having enough red blood cells (RBCs), or not having enough hemoglobin. Hemoglobin is the part of red blood cells that carries oxygen.
• Treatment depends on the type of anemia and may include medicines, diet changes, or blood transfusions.
• Ask your healthcare provider how to take care of yourself at home, what symptoms or problems you should watch for, and what to do if you have them.

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What is anemia?

Anemia is a blood problem. It can be either not having enough red blood cells (RBCs), or not having enough hemoglobin (the part of red blood cell that carries oxygen).

If you don’t have enough red blood cells, have too little hemoglobin, or your hemoglobin is not working properly, you can’t get enough oxygen to your cells. Your cells need oxygen to work properly.

What is the cause?

There are different causes for different types of anemia. Some common anemias are:

Iron deficiency anemia

This is the most common form of anemia. It happens when there is not enough iron in your blood. Your blood cells need iron to make hemoglobin. Iron deficiency anemia may happen when there is not enough iron in your diet. It may also happen if you lose a lot of blood. For example, women lose blood during their menstrual periods, which can add up over time. Another cause of blood loss may be internal bleeding in the stomach or in the intestine. Pregnant women may have anemia because the baby uses iron to make its own red blood cells and to grow.

Hemolytic anemia

This kind of anemia happens when red blood cells are destroyed or damaged by infection, drugs, or certain problems you are born with.

Vitamin B12 deficiency anemia

This type of anemia most often happens when your intestines have trouble absorbing vitamin B12. Stomach or intestinal illness, some medicines, and some problems you are born with can keep your body from absorbing vitamin B12. Some vegetarians may not get enough B12 from the foods they eat. Your body needs vitamin B12 to make healthy red blood cells.

Folic acid deficiency anemia

Folic acid, also called folate, is another kind of B vitamin. Your body needs folic acid to make healthy red blood cells. Folic acid deficiency anemia can happen when you don’t get enough folic acid in your diet. Not enough folic acid during early pregnancy can cause birth defects, such as spina bifida. This type of anemia is common in:

• Pregnant women
• People who have problems absorbing nutrients from food
• People who use certain medicines every day
• Alcoholics

Anemia caused by problems with red blood cells that you are born with

Sickle cell anemia is caused by abnormal, sickle-shaped red blood cells. The abnormal blood cells are damaged or destroyed as they flow through the bloodstream. The deformed cells may block tiny blood vessels and cause severe pain and other problems. Sickle cell disease is inherited, which means that it is passed from parents to children through their genes. Genes are inside each cell of your body. They contain the information that tells your body how to develop and work. Sickle cell disease is most common among in people whose ancestors came from Africa, Italy, Greece, the Middle East, India, the Caribbean, Central America, or South America.

Thalassemia is an inherited condition in which the red blood cells have less hemoglobin than normal. The cells don’t last as long as normal red blood cells. There are different forms of thalassemia, depending on which genes are affected. Most forms of thalassemia are mild, but some are life threatening for children. Thalassemia is most common in people whose ancestors came from Italy, Greece, Africa, Asia, India, and the South Pacific.

Anemia caused by disease

Some of the long-term (chronic) diseases that may cause anemia are:

• Cancer
• Immune system diseases, such as rheumatoid arthritis and lupus
• Infections such as HIV/AIDS or hepatitis
• Kidney disease

Anemia is more common in the elderly. It is still important to find the cause of the anemia and treat it, if possible.

What are the symptoms?

Mild anemia that has happened over time usually does not cause symptoms. Different types of anemia may cause different symptoms.

For most types of anemia, especially if it’s from bleeding that has happened more quickly, severe symptoms include:

• Feeling unusually weak and tired
• Pale skin and gums, or other skin changes such as bruises, or tiny red spots on the skin
• Lightheadedness or fainting, especially when you stand up
• Fast heartbeat
• Shortness of breath, especially with activity
• Chest pain, especially with activity

How is it diagnosed?

Your healthcare provider will examine you and ask about your symptoms and medical history. You will have blood tests to check how severe your anemia is and to check for possible causes.

Tell your healthcare provider if you have been taking any kind of supplements before the tests.

How is it treated?

Treatment depends on the type of anemia and how severe it is.

• To treat iron deficiency anemia, your healthcare provider may prescribe iron supplements or a diet of foods rich in iron. Depending on your age and health, your provider may need to look for causes of blood loss, such as an ulcer or cancer.
• Vitamin B12 deficiency anemia may be treated with pills or shots of vitamin B12.
• Folic acid deficiency anemia is treated with folic acid or folate tablets.
• Some medicines may be used to try to prevent severe symptoms of sickle cell anemia. Times of severe pain, called sickle cell crises, are treated with IV fluids, rest, and pain medicine. If too many red blood cells are destroyed, you may need a blood transfusion.
• Treatment of thalassemia depends on how severe it is and your age. Sometimes it needs to be treated with a blood transfusion. People who have thalassemia must not take iron tablets.
• Anemia caused by chronic disease may be treated with medicine that helps your body make more red blood cells.

You will have follow-up visits with your provider to check if your treatment is working.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent anemia?

The prevention of anemia depends on the cause. For example:

• If your anemia was caused by your diet, eating more foods rich in the missing nutrient will help keep it from coming back.
• If your anemia is caused by a chronic disease, treating the disease may help prevent anemia.
• If sickle cell anemia or thalassemia run in your family, genetic counseling may help you avoid passing it on to your children.