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Learn about anemia

Anemia occurs when you don't have enough healthy red blood cells to carry oxygen to all your organs. It can result from having too few red blood cells or from having red blood cells that are damaged or misshapen. Anemia can be either acquired (you developed it from something) or congenital (you were born with a genetic reason for it). According to the National Heart, Lung and Blood Institute, anemia affects more than 3 million Americans.

Anemia causes

In general, anemia occurs when your body:

Makes inadequate red blood cells (RBCs)
Destroys too many RBCs in a short period of time
Loses too many RBCs (often through blood loss)

Many types of anemia exist, each with its own cause. Some common forms of anemia including iron-deficiency anemia, pernicious anemia, aplastic anemia, and hemolytic anemia.

Iron deficiency anemia

This is the most common type of anemia. Iron deficiency anemia occurs when the body lacks enough iron to produce hemoglobin, the molecule that carries oxygen in red blood cells. Causes of iron deficiency can include blood loss from menstrual or gastrointestinal bleeding, increased iron demands during pregnancy, or poor iron absorption from food or due to stomach problems.

Vitamin deficiency anemia

This type of anemia results from low levels of vitamin B12, folic acid/folate, or thiamine, usually due to poor dietary intake. People with restrictive diets, a history of bariatric or gastric bypass surgery, alcohol or other substance use disorders, and autoimmune conditions are at particular risk of vitamin deficiencies which can cause anemia. Pernicious anemia is due to an autoimmune condition that causes poor absorption of vitamin B12 in the gastrointestinal tract.

Aplastic anemia

Aplastic anemia occurs when the blood-forming stem cells in the bone marrow are not producing enough red blood cells. The destruction or deficiency of blood-forming stem cells in your bone marrow can be due to the following causes:

Autoimmune disorders (where the immune system attacks stem cells)
Exposure to toxic chemicals, drugs, or radiation
Viral infections
Certain types of cancer

Hemolytic anemia

Hemolytic anemia occurs when the red blood cells are broken down ("lysed") by the body faster than bone marrow can replace them. Several factors can contribute to the accelerated red blood cell destruction, including:

Infections
Abnormalities in the red blood cell structure, such as those caused by sickle cell disease or thalassemias
Autoimmune disorders

Anemia symptoms

Because anemia causes decreased red blood cells and lower oxygen levels throughout the body, common symptoms of all types of anemia can include:

Feeling cold, particularly in the hands or feet
Feeling tired/fatigued
Shortness of breath
Feeling weak or dizzy
Irregular or fast heartbeat
Pale skin, eyes or lips

How to treat anemia

Treatments for anemia, which depend on the cause, range from taking iron or other vitamin supplements to having medical procedures. Some severe anemias require blood transfusions to increase red blood cell levels, or may even require a bone marrow transplant.

Genetic disorders, such as sickle cell anemia, can be treated with targeted medications, or sometimes by bone marrow transplant. Hemolytic anemia due to mechanical factors such as a leaky heart valve may require a heart or vascular specialist and surgery. Iron deficiency anemia due to blood loss will require treating the underlying issue that is causing blood loss.

Anemia medication

Iron supplements

For iron deficiency anemia due to poor diet or inability to properly absorb iron, iron supplements, diet changes, or intravenous (IV) iron are often recommended.

Vitamin B-12 or folic acid (folate) supplements

Similar to iron deficiency, for vitamin deficiency anemia, vitamin B12 or folic acid supplements and dietary changes may be recommended. Some people require B12 injections if they are unable to absorb B12 from the stomach.

Chemotherapeutics and immunologic medications

For some anemias caused by genetic factors, such as sickle cell anemia or thalassemia major, medications that alter the immune system, like hydroxyurea, are often prescribed under the direction of blood and cancer specialists (hematologists).

Erythropoiesis-stimulating agents

In cases in which the body is not making enough red blood cells or they are being destroyed too quickly, erythropoietin-stimulating agents can sometimes be given to stimulate the production of red blood cells by the bone marrow.

How to prevent anemia

You might be able to prevent some types of anemia by eating a healthy, varied diet. Specifically, anemia due to nutritional deficiency may be prevented by increasing your intake of the following foods:

Food with high levels of iron (dark green leafy vegetables, oatmeal, egg yolks and some meats)
Food with vitamin B12 (animal products and supplemented vegetarian foods)
Food with folic acid (dark leafy vegetables, legumes)

Daily multivitamins may help prevent nutritional anemias but always check with your doctor before taking them.

In addition, for conditions that cause chronic blood loss anemia, such as heavy menstrual periods, extended cycling of birth control pills, or insertion of progestin-containing IUDs that decrease periods can help prevent anemia.

Anemia treatment FAQs

What is the best treatment for anemia?

The best treatment for anemia depends on the cause and can range from taking supplements to having medical procedures. If the anemia is related to nutrient deficiency, nutrient supplementation, diet changes, and sometimes injections are the best treatment. For treatment of aplastic anemia and hemolytic anemia, your doctor may recommend blood transfusions or medications to increase red blood cell levels or a bone marrow transplant.

What is the fastest way to cure anemia?

For iron deficiency anemia, the fastest way to raise iron levels is through a blood transfusion, iron infusion, or regular iron supplementation. In addition, you can also increase your dietary intake of iron-rich foods such as red meat, dark green leafy vegetables, and iron-fortified cereals.

Is anemia curable?

This depends on the type of anemia. Some types of anemia are mild and resolve with proper treatment, such as iron/vitamin deficiency anemia. However some types of anemia, such as sickle cell anemia, are life-long conditions requiring ongoing management.

How serious is being anemic?

Being anemic means the organs in your body are not getting enough oxygen. As a result, you can become weak and immunocompromised. Some forms of anemia are serious and can become life-threatening. Others are more of a nuisance. Acute anemia due to sudden loss of blood, such as due to a serious injury, can be fatal. Sickle cell anemia can lead to complications in many different organ systems.

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Related conditions to anemia

HIV & AIDS

An HIV infection can disrupt the immune system's proper functioning, increase red blood cell lysis (hemolysis), or cause ineffective red blood cell production. As such, anemia is a common complication of HIV infection.

Crohn's disease

For people with Crohn's disease, the blood vessels in the digestive tract can rupture leading to blood loss. As a result of this blood loss, people with Crohn's disease have a high risk of developing iron deficiency anemia.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease that cause pain and inflammation of the joints of your fingers, wrists, knees, feet and toes. As a result, patients typically take non-steroidal anti-inflammatory drugs (NSAIDs) for pain management and to reduce inflammation. However, NSAIDS can also cause bleeding in the gastrointestinal tract, leading to blood loss. As a result, people with RA also can develop iron deficiency anemia.

Kidney disease

People with chronic kidney disease (CKD) are at greater risk of developing anemia. This is because the kidneys are not producing adequate erythropoietin that stimulate the production of red blood cells by the bone marrow.

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