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Anemia

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Condition Detail

Definition

Anemia is a low level of healthy red blood cells (RBC). RBCs carry oxygen from the lungs to the rest of the body. When red blood cells are low the body does not get enough oxygen. This can cause symptoms such as fatigue, pale skin, or irregular heartbeat.

There are several specific types of anemia, including:

Anemia of chronic disease —chronic diseases can slow the production of RBCs
Aplastic anemia —bone marrow is not able to produce enough RBCs
Iron-deficiency anemia —iron is a building block of hemoglobin
Macrocytic B12 deficient anemia and pernicious anemia —B12 is a building block of RBCs
Sickle cell anemia —RBCs have an abnormal shape that causes destruction of RBCs and low levels of hemoglobin

Red Blood Cells

Causes

The main causes of anemia are:

Blood loss, such as that caused by:
- Heavy menstrual periods
- Bleeding in the digestive tract
- Bleeding in the urinary tract
- Surgery
- Trauma
- Cancer
Abnormally low RBC production, due to:
- Kidney disease
- Cancer
- Infection
- Medication
- Radiation
- Pregnancy
- Lead intoxication
Abnormally high RBC destruction, caused by inherited disorders such as:
- Sickle cell anemia
- Thalassemia —difficulty in manufacturing hemoglobin
- Enzyme deficiencies

Risk Factors

Risk factors that may increase your chances of anemia include:

Women of childbearing age
Pregnancy
Older adults with other medical condition
Infants younger than two years
Poor diet low in iron, vitamins, and minerals
Blood loss (eg, due to surgery or injury)
Chronic or serious illness
Chronic infections
Family history of inherited anemia (eg, sickle cell anemia, thalassemia)

Symptoms

Symptoms of anemia may include:

Tiredness
Feeling faint
Paleness
Shortness of breath
Dizziness
Headache
Coldness in the hands and feet
Pale skin
Chest pain
Rapid or irregular heartbeat

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Other tests may include:

Tests of your blood:
- Complete Blood Count (CBC)
- Other blood tests
- Blood smear
Stool sample
Bone marrow aspiration or biopsy

Treatment

Talk with your doctor about the best plan for you. Options include:

Nutrition

Your doctor may suggest changes to your diet. The diet may include foods rich in iron, vitamin C, vitamin B12, and folate. Vitamins or iron supplements may be added.

Medications

To help treat your anemia or your symptoms, your doctor may prescribe:

Antibiotics
Hormone treatment
Epoetin
Medications that act on the immune system
Chelation therapy (for lead poisoning)

Blood Transfusions

A blood transfusion delivers blood cells from healthy donor blood.

Bone Marrow or Stem Cell Transplant

This procedure places healthy bone marrow or stem cells in the body. The goal is for the new tissue to produce healthy blood cells. This procedure carries risk. It is only done in severe cases of anemia.

Surgery

Critical bleeding may be treated with surgery. In cases of very high RBC destruction, your spleen may need to be surgically removed.

Prevention

Most inherited forms of anemia cannot be prevented. But the following steps may be taken to prevent certain types of anemia:

Eat a diet rich in iron and vitamins
Take iron or vitamin supplements, as recommended by your doctor
Treat underlying causes of anemia
Report signs and symptoms, especially chronic fatigue, to your doctor

RESOURCES

Iron Disorders Institute http://www.irondisorders.org

National Anemia Action Council http://www.anemia.org

CANADIAN RESOURCES

Anemia Institute http://www.anemiainstitute.org

Government of British Columbia Ministry of Health http://www.gov.bc.ca/health/

References

Anemia—differential diagnosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 8, 2011. Accessed November 2, 2012.

Anemia. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/anemia/anemia%5Fwhatis.html . Accessed November 1, 2012.

Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood . 2004;104:2263-2268.

Nissenson AR, Goodnough LT, Dubois RW. Anemia: not just an innocent bystander? Arch Intern Med . 2003;163:1400-1404.

Revision Information

Reviewer: Kari Kassir, MD
Review Date: 11/2012 -
Update Date: 03/28/2013 -

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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