Understanding Anemia -- Diagnosis and Treatment - WebMD

What Is Anemia?

Anemia is a condition that develops when your blood lacks enough healthy red blood cells or
hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too
few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your
body will not get enough oxygen. Symptoms of anemia -- like fatigue -- occur because organs
aren't getting what they need to function properly.

Anemia is the most common blood condition in the U.S. It affects about 5.6% of the people
in the U.S. Women, young children, and people with chronic diseases are at increased risk of
anemia. Important factors to remember are:

 Certain forms of anemia are hereditary and infants may be affected from the time of
birth.
 Women in the childbearing years are particularly susceptible to iron-deficiency
anemia because of the blood loss from menstruation and the increased blood supply
demands during pregnancy.
 Older adults also may have a greater risk of developing anemia because of poor diet
and other medical conditions.

There are many types of anemia. All are very different in their causes and treatments. Iron-
deficiency anemia, the most common type, is very treatable with diet changes and iron
supplements. Some forms of anemia -- like the mild anemia that develops during pregnancy -
- are even considered normal. However, some types of anemia may present lifelong health
problems.

What Causes Anemia?

There are more than 400 types of anemia, which are divided into three groups:

 Anemia caused by blood loss

 Anemia caused by decreased or faulty red blood cell production
 Anemia caused by destruction of red blood cells

Anemia Caused by Blood Loss

Red blood cells can be lost through bleeding, which often can occur slowly over a long
period of time, and can go undetected. This kind of chronic bleeding commonly results from
the following:

 Gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of

the stomach), and cancer
 Use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen,
which can cause ulcers and gastritis
 Menstruation, especially if menstrual bleeding is excessive
What Are the Symptoms of Anemia?
The symptoms of anemia vary according to the type of anemia, the underlying cause, the
severity and any underlying health problems, such as hemorrhaging, ulcers, menstrual
problems, or cancer. Specific symptoms of those problems may be noticed first.

The body also has a remarkable ability to compensate for early anemia. If your anemia is
mild or has developed over a long period of time, you may not notice any symptoms.

Symptoms common to many types of anemia include the following:

 Easy fatigue and loss of energy

 Unusually rapid heart beat, particularly with exercise
 Shortness of breath and headache, particularly with exercise
 Difficulty concentrating
 Dizziness
 Pale skin
 Leg cramps
 Insomnia

Other symptoms are associated with specific forms of anemia.

Anemia Caused by Iron Deficiency

People with an iron deficiency may experience these symptoms:

 A hunger for strange substances such as paper, ice, or dirt (a condition called pica)
 Upward curvature of the nails, referred to as koilonychias
 Soreness of the mouth with cracks at the corners

Anemia Caused by Vitamin B12 Deficiency

People whose anemia is caused by a deficiency of Vitamin B12 may have these symptoms:
  A tingling, "pins and needles" sensation in the hands or feet
 Lost sense of touch
 A wobbly gait and difficulty walking
 Clumsiness and stiffness of the arms and legs
 Dementia

Anemia Caused by Chronic Lead Poisoning

Chronic lead poisoning may lead to these symptoms:

 A blue-black line on the gums referred to as a lead line

 Abdominal pain
 Constipation
 Vomiting

Anemia Caused by Chronic Red Blood Cell Destruction

Anemia caused by chronic red blood cell destruction may include these symptoms:

 Jaundice (yellow skin and eyes)

 Brown or red urine
 Leg ulcers
 Failure to thrive in infancy
 Symptoms of gallstones

Sickle Cell Anemia

Symptoms of sickle cell anemia may include:

 Fatigue
 Susceptibility to infection
 Delayed growth and development in children
  Episodes of severe pain, especially in the joints, abdomen, and limbs

Anemia Caused by Sudden Red Blood Cell Destruction

Symptoms of anemia caused by sudden red blood cell destruction may include:

 Abdominal pain
 Brown or red urine
 Jaundice (yellow skin)
 Small bruises under the skin
 Seizures
 Symptoms of kidney failure

How Do I Know if I Have Anemia?

To diagnose anemia, your doctor will likely ask you about your medical history, perform a
physical exam, and order blood tests.

You can help by providing detailed answers about your symptoms, family medical history,
diet, medications you take, alcohol intake, and ethnic background. Your doctor will look for
symptoms of anemia and other physical clues that might point to a cause.

There are basically three different causes of anemia: blood loss, decreased or faulty red blood
cell production, or destruction of red blood cells.

Blood tests will not only confirm the diagnosis of anemia, but also help point to the
underlying condition. Tests might include:

 Complete blood count (CBC), which determines the number, size, volume, and
hemoglobin content of red blood cells
 Blood iron level and your serum ferritin level, the best indicators of your body's total
iron stores
 Levels of vitamin B12 and folate, vitamins necessary for red blood cell production
 Special blood tests to detect rare causes of anemia, such as an immune attack on your
red blood cells, red blood cell fragility, and defects of enzymes, hemoglobin, and
clotting
 Reticulocyte count, bilirubin, and other blood and urine tests to determine how
quickly your blood cells are being made or if you have a hemolytic anemia, where
your red blood cells have a shortened life span

Only in rare cases will a doctor need to remove a sample of bone marrow to determine the
cause of your anemia.
What Are the Treatments for Anemia?
Your doctor may not treat your anemia until the underlying cause has been established. The
treatment for one type of anemia may be both inappropriate and dangerous for another type
of anemia.

Anemia Caused by Blood Loss

If you suddenly lose a large volume of blood, you may be treated with fluids, a blood
transfusion, oxygen, and possibly iron to help your body build new red blood cells. Chronic
blood loss is treated by identifying the source of bleeding, stopping the bleeding, and, if
necessary, providing treatment for iron-deficiency anemia.

Anemia Caused by Decreased Red Blood Cell Production

The type of treatment you receive depends on the cause of decreased red blood cell
production.