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Overview of Anemia

What is anemia?

Anemia is a common blood disorder that occurs when there are fewer red blood cells than normal, or there is a low concentration of hemoglobin in the blood.

  • Hemoglobin. The  iron-containing protein inside the red blood cell that carries oxygen from the lungs to tissues in the body.

  • Hematocrit. The percentage of a volume of blood that is made up by the red blood cells.

Anemia is often a symptom of a disease rather than a disease itself. Anemia usually develops due to the presence of one of the following:

  • Excessive blood loss or hemorrhaging

  • Deficient production of red cells

  • Excessive red cell destruction

  • Both decreased production and excessive destruction of red blood cells

What are the symptoms of anemia?

Most symptoms of anemia are a result of the decrease of oxygen getting to the cells and tissues of the body, or hypoxia. Because the hemoglobin in red blood cells carries oxygen, a decreased production or number of these cells result in hypoxia. Many of the symptoms will not be present with mild anemia, as the body can often compensate for gradual changes in hemoglobin.

The following are the most common symptoms of anemia. However, each individual may experience symptoms differently. The symptoms may include, but are not limited to, the following:

  • Abnormal paleness or lack of color of the skin

  • Increased heart rate (tachycardia)

  • Breathlessness, or difficulty catching a breath (dyspnea)

  • Lack of energy, or tiring easily (fatigue)

  • Dizziness, or faintness, especially when standing

  • Headache

  • Irritability

  • Irregular menstruation cycles

  • Absent or delayed menstruation (amenorrhea)

  • Sore or swollen tongue (glossitis)

  • Jaundice, or yellowing of skin, eyes, and mouth

  • Enlarged spleen or liver (splenomegaly, hepatomegaly)

  • Impaired wound and tissue healing

The symptoms of anemia may resemble other blood disorders or medical problems. Because anemia is often a symptom associated with another disease, it is important for your doctor to be aware of symptoms you may be experiencing. Always consult your doctor for a diagnosis.

What causes anemia?

Generally, anemia may be caused by several problems, including the following:

  • Certain infections

  • Certain diseases

  • Certain medications

  • Poor nutrition

  • Blood loss

What are the different types of anemia?

There are several different types of anemia, each with a specific cause and treatment, including the following:

  • Iron-deficiency anemia

  • Megaloblastic (pernicious or vitamin B12 deficiency) anemia

  • Anemia of folate deficiency

  • Hemolytic anemia

  • Sickle cell anemia

  • Cooley's anemia (beta thalassemia)

  • Aplastic anemia

  • Chronic anemia

  • Kidney failure associated anemia 

How is anemia diagnosed?

Anemia may be suspected from general findings on a complete medical history and physical examination, such as complaints of tiring easily, pale skin and lips, or a fast heartbeat (tachycardia). Anemia is usually discovered during a medical examination through blood tests that measure the concentration of hemoglobin and the number of red blood cells.

In addition to a complete medical history and physical examination, diagnostic procedures for anemia may include:

  • Additional blood tests

  • Bone marrow aspiration and/or biopsy. A procedure that involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.

Treatment for anemia

Specific treatment for anemia will be determined by your doctor based on:

  • Your age, overall health, and medical history

  • Extent of the disease

  • Your tolerance for specific medications, procedures, or therapies

  • Expectations for the course of the disease

  • Your opinion or preference

Treatment may include:

  • Treatment of the causative disease

  • Vitamin and mineral supplements

  • Change in diet

  • Medication

  • Blood transfusion

  • Bone marrow transplant

  • Surgery (to remove the spleen, if related to hemolytic anemia)

  • Antibiotics (if an infection is the causative agent)