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Anemia

Definition

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.

Other types of anemia include:

Causes

Although many parts of the body help make red blood cells, most of the work is done in the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form all blood cells.

Most often, healthy red blood cells last between 90 and 120 days. Parts of your body then remove old blood cells. A hormone called erythropoietin (epo) made in your kidneys signals your bone marrow to make more red blood cells.

Hemoglobin is the oxygen-carrying protein inside red blood cells. It gives red blood cells their red color. People with anemia do not have enough hemoglobin.

The body needs certain vitamins, minerals, and nutrients to make enough red blood cells. Iron, vitamin B12, and folic acid are three of the most important ones. The body may not have enough of these nutrients because:

  • Changes in the lining of the stomach or intestines affect how well nutrients are absorbed (for example, celiac disease)
  • Poor diet
  • Slow blood loss (for example, from heavy menstrual periods or stomach ulcers)
  • Surgery that removes part of the stomach or intestines

Possible causes of anemia include:

  • Certain medications
  • Destruction of red blood cells earlier than normal (which may be caused by immune system problems)
  • Long-term (chronic) diseases such as chronic kidney disease, cancer, ulcerative colitis, or rheumatoid arthritis
  • Some forms of anemia, such as thalassemia or sickle cell anemia, which can be inherited
  • Pregnancy
  • Problems with bone marrow such as lymphoma, leukemia, myelodysplasia, multiple myeloma, or aplastic anemia

Symptoms

You may have no symptoms if the anemia is mild. If the problem develops slowly, symptoms that may occur first include:

  • Feeling grumpy
  • Feeling weak or tired more often than usual, or with exercise
  • Headaches
  • Problems concentrating or thinking

If the anemia gets worse, symptoms may include:

  • Blue color to the whites of the eyes
  • Brittle nails
  • Desire to eat ice or other non-food things (pica)
  • Light-headedness when you stand up
  • Pale skin color
  • Shortness of breath
  • Sore tongue

Some types of anemia may have other symptoms.

Exams and Tests

The doctor will perform a physical examination, and may find:

  • Heart murmur
  • Low blood pressure, especially when you stand up
  • Pale skin
  • Rapid heart rate

Some types of anemia may cause other findings on a physical exam.

Blood tests used to diagnose some common types of anemia may include:

Other tests may be done to find medical problems that can cause anemia.

Treatment

Treatment should be directed at the cause of the anemia, and may include:

  • Blood transfusions
  • Corticosteroids or other medicines that suppress the immune system
  • Erythropoietin, a medicine that helps your bone marrow make more blood cells
  • Supplements of iron, vitamin B12, folic acid, or other vitamins and minerals

Possible Complications

Severe anemia can cause low oxygen levels in vital organs such as the heart, and can lead to a heart attack.

When to Contact a Medical Professional

Call your health care provider if you have any symptoms of anemia, or any unusual bleeding.

References

Marks PW. Approach to anemia in the adult and child. In: Hoffman R, Benz EJ Jr, Silberstein LE, et al., eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 32.


Review Date: 2/24/2014
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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