Anemia: Causes, Symptoms and Treatment Explained

What is Anemia?

Anemia is one of the most common blood disorders worldwide. It occurs when the number of red blood cells (erythrocytes) or the level of hemoglobin in the blood falls below the normal range. Hemoglobin is the protein inside red blood cells that carries oxygen from the lungs to the rest of the body. When hemoglobin levels are too low, the body does not receive enough oxygen, leading to a range of symptoms that can affect daily life.

Causes

Anemia can develop for many different reasons. The most common include:

• Iron deficiency: The most prevalent form globally. Iron is essential for hemoglobin production.
• Vitamin B12 or folate deficiency: Both vitamins are required for the production of healthy red blood cells.
• Chronic diseases: Conditions such as kidney disease, cancer, or chronic inflammation can suppress red blood cell production.
• Blood loss: Caused by heavy menstrual periods, gastrointestinal bleeding (e.g., ulcers), or trauma.
• Inherited conditions: Such as sickle cell disease or thalassemia, which affect the structure or lifespan of red blood cells.
• Hemolysis: Premature destruction of red blood cells by the immune system or other factors.

Symptoms

The symptoms of anemia depend on its severity and how quickly it develops. Common symptoms include:

• Persistent fatigue and weakness
• Pale skin, pale mucous membranes, and pale lips
• Shortness of breath, especially during physical activity
• Rapid or irregular heartbeat (tachycardia)
• Dizziness and headaches
• Difficulty concentrating
• Cold hands and feet

In severe cases, anemia can cause fainting or chest pain and requires immediate medical attention.

Diagnosis

Anemia is typically diagnosed through a complete blood count (CBC). Key values include:

• Hemoglobin (Hb): A value below 12 g/dL in women and below 13 g/dL in men indicates anemia.
• Hematocrit: The proportion of red blood cells in total blood volume.
• MCV (mean corpuscular volume): Helps classify the type of anemia based on the size of red blood cells.
• Reticulocyte count: Measures the production rate of new red blood cells by the bone marrow.

Additional tests may include ferritin (iron stores), vitamin B12, folate levels, or in complex cases, a bone marrow biopsy.

Treatment

Treatment depends on the underlying cause of the anemia:

Iron Deficiency Anemia

Treated with iron supplements, available as tablets or intravenous infusions for severe cases. The underlying cause of iron loss should also be investigated and addressed.

Vitamin Deficiency Anemia

Vitamin B12 or folate deficiencies are corrected through dietary supplements or injections. In cases of pernicious anemia, where absorption of vitamin B12 is impaired, regular intramuscular injections are required long-term.

Anemia of Chronic Disease

The primary focus is on treating the underlying condition. In some cases, erythropoietin injections may be used to stimulate red blood cell production.

Severe Anemia

When hemoglobin levels drop dangerously low, a blood transfusion may be necessary to restore oxygen-carrying capacity quickly.

Prevention

Dietary anemia can often be prevented through a well-balanced diet. Foods rich in iron include red meat, legumes, dark leafy greens, and fortified cereals. Consuming vitamin C alongside iron-rich foods improves iron absorption. Regular health check-ups allow early detection of anemia before symptoms become severe.

References

1. World Health Organization (WHO): Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. WHO/NMH/NHD/MNM/11.1 (2011). Available at: https://www.who.int
2. Camaschella C. - Iron-Deficiency Anemia. New England Journal of Medicine, 372:1832-1843 (2015). Available at: https://www.nejm.org
3. Kasper DL et al. (Eds.): Harrison's Principles of Internal Medicine, 20th Edition. McGraw-Hill Education, 2018.