Anemia occurs when there is a decrease in circulating red blood cells. When this happens, the blood cannot provide enough oxygen to the body. A person with anemia may feel tired or weak.

Around 3 million people in the United States have some type of anemia.

Other health conditions, such as those that interfere with the body’s production of healthy red blood cells (RBCs) or increase the rate of the breakdown or loss of these cells, can cause anemia. Anemia can lead to symptoms including fatigue, shortness of breath, and lightheadedness.

In this article, we explain the types, symptoms, and causes of anemia, as well as the treatments available.

Symptoms

The most common symptom of anemia is fatigue. Other common symptoms include:

• pallid complexion
• a fast or irregular heartbeat
• shortness of breath
• chest pain
• headache
• lightheadedness

However, symptoms vary from person to person. Some people with mild anemia may experience few or no symptoms.

Types

There are many forms of anemia, and each type has telltale symptoms. Some common types of anemia include:

• iron deficiency anemia
• vitamin B12 deficiency anemia
• aplastic anemia
• hemolytic anemia

Causes

The body needs RBCs to survive. They transport hemoglobin, a complex protein that attaches to iron molecules. These molecules carry oxygen from the lungs to the rest of the body.

Various health conditions can result in low levels of RBCs and cause anemia.

There are many types of anemia and no single cause. In some people, it can be difficult to identify what is causing a low RBC count.

The three main causes of anemia are:

Blood loss

Iron deficiency anemia is the most common form of anemia, and blood loss is often the cause. Blood loss can lead to low levels of iron in the blood, causing anemia.

When the body loses blood, it draws water from tissues beyond the bloodstream to help keep the blood vessels full. This additional water dilutes the blood, reducing the RBC count.

Blood loss can be acute (short term) or chronic (long term).

Some causes of acute blood loss include surgery, childbirth, and trauma. However, chronic blood loss is more often responsible for anemia. Chronic blood loss may result from conditions such as a stomach ulcer, endometriosis, cancer, or another type of tumor.

Other causes of anemia due to blood loss include:

• gastrointestinal conditions, such as hemorrhoids, cancer, or gastritis
• the use of nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen
• heavy menstrual bleeding

Treatment

There is a range of treatments for anemia. Each aims to increase a person’s RBC count, which increases the amount of oxygen in the blood.

The required treatment depends on the type of anemia a person has. Treatments for common forms of anemia include the following:

• Iron-deficiency anemia: Iron supplements and dietary changes can help, and a doctor will identify and address the cause of any excessive bleeding if present.
• Vitamin deficiency anemia: Treatments can include dietary supplements and vitamin B12 injections.
• Anemia due to chronic disease: The doctor will focus on managing the underlying condition.
• Aplastic anemia: Treatment for aplastic anemia involves blood transfusions or bone marrow transplants.

Diet

If nutritional deficiencies are responsible for anemia, eating more iron-rich foods can help.

Some foods that are high in iron include:

• iron-fortified cereal and bread
• leafy green vegetables, such as kale, spinach, and watercress
• pulses and beans
• brown rice
• white or red meats
• nuts and seeds
• fish
• tofu
• eggs
• dried fruits, including apricots, raisins, and prunes

Diagnosis

There are various ways to diagnose anemia, but the most common method involves a blood test called a complete blood count (CBC). This test measures a number of components, including:

• hematocrit levels, which involves comparing the volume of RBCs with the total volume of blood
• hemoglobin levels
• RBC count

A CBC can give an indication of a person’s overall health. It can also help a doctor decide whether to check for underlying conditions such as leukemia or kidney disease.

If RBC, hemoglobin, and hematocrit levels fall below the typical range, a person likely has some form of anemia.

However, it is possible for a healthy person’s levels to fall outside this range. A CBC is not conclusive, but it is a helpful starting point for a doctor to make an accurate diagnosis.

Summary

Anemia occurs when a low number of RBCs are circulating in the body. This reduces the person’s oxygen levels and can lead to symptoms such as fatigue, pale skin, chest pain, and breathlessness.

Common causes are blood loss, reduced or impaired RBC production, and the destruction of RBCs.

A doctor can use a CBC test to help detect anemia. Treatment varies depending on the type, but it may include dietary changes, supplements, medications, blood transfusions, and bone marrow transplants.

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