Anemia is a condition characterized by a deficiency of red blood cells or hemoglobin in the blood, resulting in reduced oxygen delivery to the body's tissues.
What is anemia?
Anemia is a condition in which you don't have enough healthy red blood cells to carry adequate oxygen to your body's tissues. Having anemia can make you feel tired and weak.
There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe. In many cases, anemia has more than one cause. Anemia is a fairly common condition, but its prevalence varies depending on factors like age, sex, ethnicity, and geographic location. It is more common in women than men, and it is more prevalent in certain populations, such as pregnant women and individuals with chronic diseases. Some things to look out for if you think you may have anemia are fatigue, weakness, pale skin, shortness of breath, and dizziness.
See a doctor if you suspect you have anemia. It can be a warning sign of a serious illness.
Nonmalignant Blood Disorders Program
Benign disorders of the blood are non-cancerous conditions that affect the components of your blood, such as red blood cells, white blood cells, and platelets. These disorders can impact the blood's ability to function correctly, but they are not life-threatening in the same way as blood cancers. Our benign blood disorder specialists at Nonmalignant Blood Disorders Program can help.
Why choose AHN for anemia treatment?
At AHN, we see you. Our focus is on providing each patient with the individualized care they require. We offer several advantages for anemia treatment:
- Expert hematologists: Our team of experienced hematologists specialize in blood disorders, including anemia. They can accurately diagnose the type and cause of anemia.
- Comprehensive diagnostic services: We provide a full range of diagnostic tests to identify the underlying cause of anemia.
- Personalized treatment plans: Our team creates individualized treatment plans based on the specific type and cause of anemia, as well as your overall health.
- Advanced treatment options: We offer access to the latest treatment options, including iron infusions, blood transfusions, and medications to stimulate red blood cell production.
- Multidisciplinary approach: Our multidisciplinary approach, involving hematologists, primary care physicians, and other specialists as needed, ensures comprehensive and coordinated care.
- Convenient locations: We have multiple locations throughout the region and telehealth options for those outside of the region, making it easy for you to access care where and when you need it.
Anemia symptoms and signs
The symptoms of anemia often develop gradually, and a person may not realize they are anemic until the condition becomes more advanced. This is because the body can often compensate for mild to moderate anemia without causing noticeable symptoms. However, as the anemia worsens, symptoms become more apparent and can significantly impact a person's quality of life. Common symptoms and signs of anemia include:
- Fatigue: Feeling tired or weak is one of the most common symptoms.
- Weakness: A general feeling of being physically weak or lacking energy.
- Pale skin: Reduced blood flow can make the skin appear paler than usual.
- Shortness of breath: The body tries to compensate for the lack of oxygen by breathing faster.
- Dizziness: Reduced oxygen to the brain can cause dizziness or lightheadedness.
- Headaches: Can be caused by reduced oxygen flow to the brain.
- Cold hands and feet: Reduced circulation can lead to cold extremities.
- Irregular heartbeat: The heart may beat faster or irregularly to try to compensate for the lack of oxygen.
- Chest pain: In severe cases, anemia can cause chest pain, especially if you have underlying heart conditions.
- Cognitive problems: Difficulty concentrating, memory problems, and impaired cognitive function.
Causes and risk factors
Anemia can be caused by a variety of factors and are, most often, categorized into three categories:
- Blood loss: Acute blood loss that is caused by a sudden loss of large volumes of blood whether that is from trauma, surgery, childbirth, or gastrointestinal bleeding can cause anemia. Chronic blood loss, like that from losing blood over time from heavy menstrual periods, frequent nosebleeds, or gastrointestinal bleeding caused by conditions like ulcers, polyps, or certain medical conditions can also cause anemia.
- Decreased red blood cell production: Anemia can be caused from decreased red blood cell productions. This can stem from the following conditions:
- Iron and vitamin deficiencies.
- Chronic diseases such as kidney disease, cancer, HIV/AIDS, rheumatoid arthritis, and inflammatory bowel disease.
- Bone marrow disorders such as aplastic anemia, myelodysplastic syndromes, leukemia, and lymphoma can impair the production of red blood cells.
- Certain genetic disorders, such as thalassemia and sickle cell anemia, can cause abnormal red blood cell production or destruction.
- Destruction of red blood cells: This is called hemolytic anemia, which is premature destruction of red blood cells in the bloodstream caused by autoimmune disorders, infections, inherited abnormalities, medications, and exposure to certain toxins.
The risk factors for developing anemia include:
- Dietary factors: This includes iron deficiency from a diet low in iron-rich foods (e.g., red meat, poultry, fish, beans, leafy green vegetables) can increase the risk of iron-deficiency anemia. Also, a diet lacking in vitamin B12 (found in animal products) or folate (found in fruits, vegetables, and fortified grains) can increase the risk of vitamin-deficiency anemia.
- Medical conditions: Individuals with chronic diseases such as kidney disease, liver disease, autoimmune disorders, cancer, and inflammatory bowel disease are at higher risk of developing anemia. Those with gastrointestinal disorders such as celiac disease, Crohn's disease, and gastric bypass surgery, can increase the risk of anemia. Those who experience heavy menstrual periods are at higher risk of iron-deficiency anemia due to blood loss. Additionally, being pregnant can an increased demand for iron and folate to support fetal development, which can increase the risk of anemia.
- Genetic factors: Having a family history of inherited anemias, such as sickle cell anemia or thalassemia, increases the risk of developing these conditions.
- Other factors can also impact the risk of developing anemia:
- Age: Infants, children, and older adults are at higher risk of anemia due to factors such as rapid growth, inadequate dietary intake, and age-related changes in bone marrow function.
- Medications: Certain medications, such as NSAIDs, aspirin, and some antibiotics, can increase the risk of anemia by causing gastrointestinal bleeding or interfering with red blood cell production.
- Exposure to toxins: Exposure to certain toxins, such as lead, can damage red blood cells and increase the risk of anemia.
- Alcohol abuse: Excessive alcohol consumption can interfere with red blood cell production and increase the risk of anemia.
- Vegetarian or vegan diet: People who follow a vegetarian or vegan diet may be at higher risk of vitamin B12 deficiency if they do not consume fortified foods or take supplements.
Understanding the causes and risk factors for anemia can help you stay on top of your health and know what to look for if you fall into a higher risk category.
Anemia screening and diagnosis
AHN uses several methods for anemia screening and diagnosis.
Our initial assessment is a physical exam and gathering information about your symptoms, medical history, family history, medications, and lifestyle factors that could contribute to anemia.
Blood tests
Blood tests are essential for detecting anemia. There are different types of blood tests that will help your care team get the information necessary to determine if you have anemia and, if so, what type it is and how to best treat it. Your doctor may order any of the following blood tests for anemia:
- Complete blood count (CBC): This is the primary blood test used to diagnose anemia. It measures:
- Hemoglobin (Hgb): The amount of oxygen-carrying protein in red blood cells.
- Hematocrit (Hct): The percentage of blood volume made up of red blood cells.
- Red blood cell (RBC) Count: The number of red blood cells.
- Mean corpuscular volume (MCV): The average size of red blood cells (helps determine the type of anemia).
- Mean corpuscular hemoglobin (MCH): The average amount of hemoglobin in each red blood cell.
- Mean corpuscular hemoglobin concentration (MCHC): The average concentration of hemoglobin in each red blood cell.
- Red cell distribution width (RDW): Measures the variation in the size of red blood cells.
- Peripheral blood smear: A blood sample is examined under a microscope to assess the size, shape, and color of red blood cells. This can help identify certain types of anemia.
- Reticulocyte count: Measures the number of young red blood cells (reticulocytes) in the blood, indicating the bone marrow's ability to produce new red blood cells.
Further diagnostic tests (if necessary)
Based on the initial blood tests, additional tests may be ordered to determine the underlying cause of the anemia. These may include:
- Iron studies:
- Serum iron: Measures the amount of iron in the blood.
- Serum ferritin: Measures the amount of iron stored in the body.
- Total iron binding capacity (TIBC): Measures the blood's capacity to bind iron.
- Transferrin saturation: Measures the percentage of transferrin (a protein that carries iron in the blood) that is saturated with iron.
- Vitamin B12 and folate levels: To check for deficiencies in these essential vitamins.
- Bone marrow aspiration and biopsy: In some cases, a sample of bone marrow may be needed to evaluate the production of blood cells.
- Hemoglobin electrophoresis: To identify abnormal hemoglobins, which can cause certain types of anemia (e.g., sickle cell anemia, thalassemia).
- Other blood tests: Depending on the suspected cause, tests for kidney function, liver function, or autoimmune disorders may be performed.
Types and stages of anemia
Anemia is a condition characterized by a deficiency of red blood cells or hemoglobin in the blood, resulting in reduced oxygen delivery to the body's tissues. There are different types of anemia that can affect the body in different ways. They include:
- Iron deficiency anemia: The most common type, caused by a lack of iron, which is needed to produce hemoglobin.
- Vitamin deficiency anemia: Caused by a deficiency of vitamin B12 or folate, which are needed to produce healthy red blood cells.
- Aplastic anemia: A rare condition in which the bone marrow stops producing enough blood cells.
- Hemolytic anemia: Occurs when red blood cells are destroyed faster than they can be replaced.
- Sickle cell anemia: A genetic disorder that causes red blood cells to be misshapen (sickle-shaped), leading to chronic anemia.
- Thalassemia: Another inherited blood disorder that causes the body to produce less hemoglobin than normal.
- Anemia of chronic disease: Associated with long-term inflammatory conditions, infections, or chronic kidney disease.
Bone marrow and kidney cancer, as well as common cancer treatments like chemotherapy and radiation therapy, can also disrupt normal blood production and cause anemia.
Anemia, in general, progresses through stages based on severity and how it affects your body. These stages are primarily defined by hemoglobin levels (Hgb), as that's the key measure of anemia. Here's a general overview of anemia stages:
- Normal: Hemoglobin levels are within the normal range for your age and sex.
- Mild anemia: Hemoglobin levels are slightly below the normal range. You might experience mild fatigue or weakness, but many people have no noticeable symptoms at this stage.
- Moderate anemia: Hemoglobin levels are moderately reduced. Symptoms become more noticeable and may include fatigue, weakness, shortness of breath, and dizziness.
- Severe anemia: Hemoglobin levels are significantly below the normal range. Symptoms are pronounced and can be debilitating. Severe anemia can lead to serious complications, such as heart problems.
It's important to note that these stages are general guidelines, and the specific hemoglobin levels that define each stage may vary slightly depending on the laboratory and the individual's specific circumstances. Additionally, the severity of symptoms can vary depending on the individual's overall health and other medical conditions.
Anemia treatment
AHN offers a comprehensive range of treatment options for anemia, tailored to the specific type and severity of the condition. Here are some of the common treatment options available:
- Iron supplements: Often the first line of treatment for iron-deficiency anemia. These can be administered orally or intravenously, depending on the individual's needs.
- Vitamin B12 injections or supplements: Used to treat Vitamin B12 deficiency, common treatments include intramuscular injections or high-dose oral supplements.
- Folic acid supplements: Prescribed for folic acid deficiency anemia.
- Erythropoiesis-stimulating agents (ESAs): Medications that stimulate the bone marrow to produce more red blood cells. Often used in cases of anemia related to chronic kidney disease or cancer treatment.
- Blood transfusions: Used in severe cases of anemia to quickly increase red blood cell levels.
- Bone marrow transplantation: In rare cases of severe anemia due to bone marrow disorders, a bone marrow transplant may be considered.
- Treatment of underlying conditions: Addressing the root cause of the anemia, such as kidney disease, heavy menstrual bleeding, or gastrointestinal disorders.
- Dietary changes: Recommending iron-rich, vitamin B12-rich, and folate-rich foods to support red blood cell production.
Anemia FAQs
Having anemia or being at higher risk for developing anemia can bring about questions and maybe even concerns. Your AHN care team is available to provide answers and resources so you can feel confident in your treatment. If you need a place to start, we have answers to frequently asked questions that you can take to get more information on from your care team.
What does it mean to be anemic?
Anemia means you don't have enough healthy red blood cells to carry adequate oxygen to your body's tissues. This can lead to fatigue, weakness, and other symptoms.
What is the main cause of anemia?
The most common cause of anemia is iron deficiency. Iron is essential for producing hemoglobin, the protein in red blood cells that carries oxygen.
Can anemia be cured?
Yes, many types of anemia can be cured, especially when the underlying cause is addressed. For example, iron deficiency anemia can often be cured with iron supplements or dietary changes. Anemia caused by vitamin deficiencies can be treated with vitamin supplements. However, some types of anemia, such as sickle cell anemia or thalassemia, are chronic conditions that require ongoing management.
How to test for anemia?
Anemia is primarily tested for through a blood test called a complete blood count (CBC). This test measures:
- Hemoglobin level
- Hematocrit (percentage of blood volume made up of red blood cells)
- Red blood cell count
- Red blood cell indices (MCV, MCH, MCHC, RDW)
How to help anemia?
The best way to help anemia depends on the type and underlying cause:
- Iron deficiency anemia: Iron supplements, dietary changes (iron-rich foods), and addressing any underlying causes of iron loss.
- Vitamin deficiency anemia: Vitamin B12 or folate supplements, dietary changes.
- Anemia of chronic disease: Managing the underlying chronic condition, possibly with medications to stimulate red blood cell production.
- Severe anemia: Blood transfusions in some cases.
- Consult a health care provider: It's essential to see a doctor to determine the specific cause of the anemia and receive appropriate treatment.
Contact us
Call the Division of Hematology and Cellular Therapy at 412-578-4484. We have anemia specialists available at AHN West Penn Hospital, Mellon Pavilion and AHN Allegheny General Hospital. Once scheduled, our staff will instruct you on what is needed so that our doctors get access to your medical records.
We also provide telehealth services if you live far from our offices and would like to work with one of our hematologists.