Symptoms of Anemia

Many people with anemia have a mild case and are asymptomatic, which means they don't experience any symptoms at all. In these cases, they may only require treatment with iron supplements or dietary changes.

However, in some cases, the symptoms are present, identifiable, and signify a need for proper treatment.

Woman with high fever at home.
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Frequent Symptoms

Common symptoms of mild anemia include tiredness or a lack of energy, weakness, pale skin and yellowish skin. If you have severe anemia, you may also experience these symptoms, albeit more intensely.

Some common symptoms that usually only occur in iron deficiency anemia are pica (the desire to eat non-food substances like ice, paper, clay, and paint chips), brittle nails, and cold hands and feet.

As anemia progresses, you may experience other symptoms like:

  • Dizziness
  • Irregular heartbeat (arrhythmia)
  • Increased thirstiness
  • Chest pain
  • Irritability

The signs and symptoms of anemia gradually increase as the anemia gets worse.

Since the symptoms of anemia are gradual and similar to the symptoms of other illnesses, they are often overlooked.

If you have severe anemia, you may also experience more serious symptoms like shortness of breath (dyspnea), fast breathing (tachypnea), jaundice, cramps in the lower leg when exercising, fast heartbeat (tachycardia), irregular heartbeat (arrhythmia), chest pain, reduction of tolerance for exercise, and fainting or near fainting.

Type-Specific Symptoms

Some symptoms are specific to hemolytic anemia only, and they include:

  • An enlarged spleen
  • Upper abdomen pain
  • Brown or reddish looking urine
  • Chills

Some symptoms are specific to pernicious anemia and some of them are:

  • Tingling, prickling feelings (also called pins and needles or paresthesia)
  • Muscle weakness
  • Ataxia (inability to voluntarily coordinate and control your muscle movements.—it can affect eye movement, speech, and swallowing)
  • Digestive tract issues like bloating, nausea, and loss of appetite
  • An enlarged liver

Symptoms of severe pernicious anemia are confusion, memory problems, depression, and dementia.

Rare Symptoms

Since anemia leads to a lack of adequate oxygen around the body, the brain may get deprived as well, leading to brain damage.

Aside from the common symptoms of anemia, aplastic anemia (a rare form of anemia) has its own distinctive and uncommon symptoms. In terms of severity, These symptoms can range from mild to very serious. They include:

  • Frequent infections
  • Easily bruising
  • Easily bleeding
  • Fevers
  • Tiny, circular red spots on the skin caused by bleeding from small blood vessels (they are also called petechiae)
  • Abnormally formed kidneys, heart, lungs, digestive tract, arms, and hands (specific to Fanconi anemia, a form of aplastic anemia)
  • Nosebleeds
  • Blood in stool
  • Heavy bleeding during menstrual periods
  • Nausea
  • Skin rashes

Complications/Sub-Group Indications

Heart Problems

In anemia, the heart has to work harder than normal to compensate for the lack of hemoglobin-rich red blood cells. It pumps harder in order to make sure oxygen-filled blood is moved around the body. This extra work can put a strain on your heart and lead to complications like heart murmurs, heart failure and cardiac hypertrophy (increase in the size of the heart's muscle).

Issues With Pregnancy

In addition, anemia during pregnancy is not uncommon especially in the second and third trimester. However, if it is severe and not managed well it can lead to having a low birth weight baby or a having a preterm birth. It can also increase your baby’s risk of having anemia during his/her infancy. Further, anemia can put you at risk of experiencing blood loss during labor.


The nerve damage in some form of anemias like pernicious anemia can lead to depression. Women who have iron deficiency anemia during pregnancy also have an increased risk of developing postpartum depression.

Weakened Immune System

Iron deficiency anemia can cause your immune system to be compromised, leaving you more open to infections and reducing your body's ability to fight them.

Restless Leg Syndrome

This is a nervous system condition which produces the irresistible urge to move your legs. This urge is usually felt in the evening and nighttime. It is also called Willis-Ekbom Disease and is a complication of iron deficiency anemia in particular.

Impaired Development

Having severe iron deficiency anemia in infancy and childhood can lead to mental, cognitive, and motor developmental delays. Many studies support that finding that iron is needed for the brain to develop properly.

Anemia can also worsen other underlying medical conditions and lessen the efficacy of treatments for them.

When to See a Doctor/Go to the Hospital

If you’ve been diagnosed with anemia and you experience a worsening of symptoms like chest pain, trouble breathing, fast or irregular heartbeat, you should head to the hospital immediately (or if possible, get someone else to drive you to the hospital). This is because those symptoms, in particular, may be signs of heart failure.

If you’ve already been diagnosed with an underlying condition like kidney disease, HIV/AIDS, cancer, or Crohn's disease which can lead to anemia, you should see your doctor once you notice any of the signs or symptoms of anemia.

If you have a family history of inherited anemia, you should see a doctor and consider undergoing genetic testing and counseling for it.

Generally, anemia is often a sign of a more serious and chronic condition like cancer or chronic internal bleeding, So If you find yourself experiencing a number of its symptoms, it’s worth a visit to the doctor for evaluation.

A Word From Verywell

Anemia can be a serious condition and it is important that you follow your doctor's instructions and recommendations on diet, medication, exercise, and other lifestyle choices to prevent its complications from occurring. You should also inform your doctor if you have any new symptoms, or are experiencing a significant increase in your existing ones as this can also avert the occurrence of complications.

Finally, because some conditions lead to anemia, you should be sure to manage those conditions well according to your doctor's instructions to prevent yourself from becoming anemic.

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