Symptoms of Anemia

There are many types and causes of anemia but all lead to a drop in red blood cells or the hemoglobin protein in those cells that's needed to carry oxygen throughout your body.

Many people with mild anemia do not have any signs or symptoms or may attribute common symptoms, such as exhaustion, to other causes.

As anemia worsens or becomes severe, it can lead to a range of serious symptoms, such as dizziness or shortness of breath, and complications, such as heart problems, that can become life-threatening.

This article will explore causes and types of anemia, signs and symptoms, and possible complications.

Woman with high fever at home.
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Causes and Types

Anemia is the most common blood condition in the United States.

It has three main causes:

  • Reduced production of oxygen-carrying red blood cells (RBCs)
  • Blood loss
  • Increased destruction of red blood cells that's called hemolysis

Reduced Production of Red Blood Cells

Types of anemia caused by a reduction in RBC production include:

  • Iron deficiency anemia, which is the most common type, is when your body lacks enough iron to make the protein hemoglobin that's needed to transport oxygen to your organs.
  • Vitamin deficiency anemia is when the body can't make enough healthy red blood cells due to low levels of certain vitamins, such as folate, B12, or vitamin C.
  • Aplastic anemia is when your blood-forming organs, such as bone marrow, stop producing enough red blood cells.
  • Anemia of chronic inflammation or chronic disease is when conditions such as infections, kidney disease, cancer, autoimmune disease cause the body to make fewer red blood cells.

A rare form of vitamin deficiency anemia called pernicious anemia is the result of an inability to absorb vitamin B12. This is often due to an autoimmune condition in which the immune system mistakenly attacks cells that line the stomach and make a protein needed to move and absorb B12.

The treatment for anemia depends on how severe it is and the type and cause.

For example, treatment for mild iron deficiency anemia may involve iron supplements and dietary changes. Severe iron deficiency anemia may require intravenous (IV) iron given through a vein or a blood transfusion to restore red blood cells and iron-rich hemoglobin.

Blood Loss

If you have a sudden loss of blood, such as during to an injury or surgery, it can lead to anemia.

It can also be due to a chronic blood loss that happens over time, such as heavy menstrual bleeding or bleeding in the digestive system.

Destruction of Red Blood Cells

When red blood cells are destroyed faster than they are made it's called hemolytic anemia.

This rare form of anemia can be caused by an inherited blood conditions, such as sickle cell anemia, or an immune reaction that leads to your immune system mistakenly attacking your red blood cells or healthy tissues.

Recap

Anemia is the most common blood disorder in the United States. It can be caused by a reduced production of red blood cells, blood loss, or an increased destruction of red blood cells.

Iron deficiency anemia, or when your body lacks iron, is the most common type.

Common Symptoms

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

Common symptoms of anemia include:

  • Tiredness or lack of energy
  • Weakness
  • Pale skin
  • Yellowish skin

These symptoms can occur regardless of the severity of the anemia, but they tend to occur more intensely with severe anemia.

As anemia progresses, you may experience other symptoms like:

  • Dizziness
  • Headaches
  • Increased thirst
  • Irritability
  • Easily bruising
  • Sore tongue
  • Cramps in the lower leg when exercising
  • Reduced tolerance of exercise

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 such as:

Since anemia leads to a lack of adequate oxygen around the body, the brain may get deprived as well and this can sometimes lead to brain damage.

Type-Specific Symptoms

There are additional symptoms that can also occur in iron deficiency anemia. There are also type-specific symptoms for many of the rare types of anemia.

Iron-Deficiency Anemia

Some symptoms that usually only occur in iron deficiency anemia are:

  • Pica, or the desire to eat non-food substances like ice, paper, clay, and paint chips
  • Brittle nails
  • Cold hands and feet

Pernicious Anemia

Symptoms of pernicious anemia include:

  • Tingling, prickling feelings (also called pins and needles or paresthesia)
  • Muscle weakness
  • Ataxia, or an 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 may also include:

  • Confusion
  • Depression
  • Memory problems or dementia.

Hemolytic Anemia

Symptoms of hemolytic anemia include:

  • An enlarged spleen, an organ that helps create and filter blood cells
  • Upper abdomen pain
  • Brown or reddish looking urine
  • Chills

Aplastic Anemia

Aplastic anemia also 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 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

Recap

Symptoms of anemia depend on the type and severity. Common symptoms, such as fatigue and weakness, tend to gradually increase as the anemia gets worse.

Complications

Red blood cells serve an important role of supplying oxygen throughout your body so when their levels drop, it can lead to a range of complications, especially if the anemia becomes severe.

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

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, cardiac hypertrophy (increase in the size of the heart's muscle), and heart failure.

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.

Depression

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

Restless leg syndrome, also called Willis-Ekbom disease, is a complication of iron deficiency anemia in particular.

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.

Impaired Development

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

Recap

Anemia, especially if it's severe, can strain your heart, weaken your immune system, and lead to other complications. It can cause pregnancy complications or developmental problems in infancy and childhood.

When to See a Healthcare Provider

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 problems or 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 healthcare provider once you notice any of the signs or symptoms of anemia.

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

Generally, anemia can be a sign of a more serious or chronic conditions like cancer or chronic internal bleeding. So if you find yourself experiencing a number of its symptoms, it’s worth a visit to the healthcare provider for evaluation.

Summary

Anemia means there is a drop in red blood cells or the hemoglobin protein in those cells that's needed to carry oxygen throughout your body. It can lead to a range of signs and symptoms depending on the type, cause, and severity.

Symptoms may include tiredness, weakness, pale or yellowish skin, feeling cold, or dizziness.

If you have signs or symptoms of anemia, seek medical attention, especially with any serious symptoms, such as difficulty breathing or fainting.

A Word From Verywell

Anemia can be a serious condition and it is important that you follow your healthcare provider's instructions and recommendations on diet, medication, exercise, and other lifestyle choices to prevent its complications from occurring.

If you've been diagnosed with anemia, inform your healthcare provider 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 healthcare provider's instructions to prevent yourself from becoming anemic.

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