What are the symptoms of anemia?

Some people with anemia have no symptoms. But most people have symptoms that range from mild to severe. These can include:

• Extreme tiredness (fatigue)

• Weakness

• Pale skin

• Shortness of breath

• Feeling dizzy or fainting

• Rapid or irregular heartbeat

• Trouble doing normal amounts of activity

• Yellowing of your eyes, skin, or mouth and dark urine (jaundice)

• Headache

• Cold hands or feet

• Chest pain

• Pounding or whooshing sound in your ears

What causes anemia?

Anemia can occur when your body:

• Loses too much blood

• Doesn't make enough RBCs

• Destroys your RBCs at a faster rate than it can replace them

• Doesn't make a normal amount of hemoglobin in your RBCs

These problems can occur for many reasons, including:

• A condition that you're born with (congenital or inherited), such as sickle cell disease or thalassemia

• Heavy bleeding for any reason, including injury, surgery, childbirth, or even heavy menstrual periods

• Being low in certain nutrients, such as iron, folate, or vitamin B-12

• Certain long-term (chronic) conditions such as diabetes, arthritis, or kidney disease

• Certain chronic infections such as tuberculosis or HIV

• Exposure to certain medicines, such as those used for chemotherapy

There are different types of anemia. Your healthcare provider can tell you more about the type of anemia you have and what may have caused it.

How is anemia diagnosed?

To diagnose anemia, your healthcare provider orders blood tests. These can include:

• Complete blood cell count (CBC). This test measures the amounts of the different types of blood cells.

• Blood smear. This test checks the size and shape of your blood cells. To do the test, a drop of your blood is looked at under a microscope. A stain is used to make the blood cells easier to see.

• Iron studies. These tests measure the amount of iron in your blood. Your body needs iron to make hemoglobin in your RBCs.

• Vitamin B-12 and folate studies. These tests check for some of the components that help give RBCs a normal size and shape.

• Reticulocyte count. This test measures the amount of new RBCs that your bone marrow makes.

• Hemoglobin electrophoresis. This test checks for problems with your hemoglobin in RBCs.

• Lactate dehydrogenase (LDH) and haptoglobin levels. These tests check the amount of substances in your blood called LDH and haptoglobin. Both LDH and haptoglobin levels can be abnormal with a type of anemia that destroys red blood cells (hemolytic anemia).

• Bone marrow biopsy. This test evaluates the bone marrow where RBCs are made.

How is anemia treated?

Treatment for anemia is based on the type of anemia, its cause, and the severity of your symptoms. Treatments may include:

• Diet changes. This includes increasing the amount of certain nutrients in your diet, such as iron, vitamin B-12, or folate. Your healthcare provider may also prescribe nutrient supplements.

• Medicines. Certain medicines treat the cause of your anemia. Others help build new RBCs or ease symptoms. If a medicine is the cause of your anemia, you may need to stop or change it.

• Blood transfusions. Replacing some of your blood can increase the number of healthy RBCs in your body.

• Surgery. In some cases, your healthcare provider may do surgery to treat the underlying cause of anemia. If you need surgery, your healthcare provider will explain the procedure and outline the risks and benefits for you.

What are the long-term concerns?

If you have a certain type of anemia, you can expect a full recovery after treatment. If you have other types of anemia (especially a type you're born with), you'll need to manage it for life. Your healthcare provider can tell you more.