Anemia

Anemia is a common blood disorder that affects millions of people. At Banner Health, we understand the challenges of anemia and are committed to providing expert care and support. Your health is our priority and we’re here to help you every step of the way.

What is anemia?

Anemia is when your body does not have enough red blood cells. These cells are important because they carry oxygen from your lungs to the rest of your body. Anemia can be caused by acute blood loss or ineffective red blood cell production.

When you don’t have enough red blood cells, your organs and tissues may not get the oxygen they need to work correctly. This can lead to several symptoms of anemia, including tiredness and weakness, which can impact your daily life.

What causes anemia?

Anemia can have several causes. Understanding these can help you find the proper treatment. Here are some common reasons for anemia:

• Iron deficiency anemia: Low iron levels, often due to poor diet, blood loss (from heavy periods or internal bleeding, for example) or trouble absorbing iron (gastric bypass surgery, for example) can cause iron deficiency anemia or microcytic anemia. 
• Vitamin deficiency: Lack of vitamin B12 and/or B9 (folate) can lead to megaloblastic anemia. These vitamins help produce healthy red blood cells.
• Chronic disease: Conditions like kidney disease, cancer and autoimmune disorders can affect red blood cell production, leading to anemia of chronic disease. 
• Aplastic anemia: Aplastic anemia is a rare but serious condition where the bone marrow fails to make enough red blood cells, white blood cells and platelets (a type of blood cell that helps with clotting). 
• Hemolytic anemia: This type of anemia occurs when red blood cells are destroyed faster than the bone marrow can make them. It can be caused by autoimmune disorders, certain medications, infections and other factors. Some hemolytic anemias run in families, like hereditary spherocytosis or pyruvate kinase deficiency.
• Sickle cell anemia: Sickle cell anemia is a hereditary condition associated with sickle cell disease, a disease that causes red blood cells to become sickle-shaped or crescent-shaped. These misshapen cells are destroyed prematurely leading to anemia and can block blood flow, leading to pain and other more serious complications.
• Thalassemia: Thalassemia is a genetic condition where the body makes less hemoglobin (a protein in red blood cells). This can cause mild or severe anemia and may be associated with more serious complications. 
• Pernicious anemia: A type of anemia you could have if you can't absorb enough vitamin B12.

Risk factors for anemia

Several factors can increase your chances of developing anemia. These risk factors include:

• Poor diet: A diet low in iron, vitamin B12 and folate increases your risk of anemia. Vegetarians, vegans or people with limited access to varied foods may have a higher risk due to the lack of iron-rich animal products. Sometimes, food allergies can also prevent proper absorption of the nutrients needed to make red blood cells.
• Gastric bypass procedures: These procedures may reduce the normal absorption of nutrients necessary to produce red blood cells.
• Pregnancy: Pregnant people are at higher risk for iron-deficiency anemia. The body needs extra iron during pregnancy to support a growing baby. 
• Genetics: Your risk is higher if someone in your family has hereditary (inherited) anemia, such as hereditary spherocytosis, G6PD deficiency or pyruvate kinase deficiency. In these disorders, the red blood cells don’t often live as long as they should, leading to increased stress on the bone marrow.
• Chronic conditions: Conditions such as kidney disease, autoimmune disorders and autoimmune disease such as rheumatoid arthritis can increase your risk of anemia.
• Blood loss: Heavy blood loss from surgery, trauma or menstrual periods can lead to anemia. Chronic blood loss from conditions like ulcers may also contribute to anemia over time.  This type of anemia may be acute or chronic and often results in iron deficiency anemia.
• Gender: Women and people assigned female at birth (AFAB) are more likely to develop iron-deficiency anemia due to chronic blood loss from menstrual periods
• Age: Older adults are more likely to develop anemia.
• Certain medications: Some drugs, like blood thinners can increase the risk of bleeding (blood loss) resulting in anemia.  Certain types of cancer treatment can affect red blood cell production, increasing your risk of anemia.

Signs and symptoms of anemia

Anemia can cause a variety of symptoms that can vary in severity. Some common signs include:

• Feeling tired or weak: One of the most common symptoms of anemia is increased  tiredness or fatigue. You may feel weak and find it hard to carry out daily tasks.
• Pale skin: The lack of red blood cells can make your skin look pale or slightly yellow. 
• Dizzy or lightheaded: You may feel dizzy or lightheaded, especially when standing up quickly. 
• Shortness of breath: You may notice that you get out of breath more easily, even during mild activity. This occurs because your body is not getting enough oxygen.
• Fast heartbeat: Your heart may beat faster to compensate for the lack of oxygen in your blood. This can feel like your heart is racing, especially during exercise. 

How is anemia diagnosed?

If you notice these symptoms, talk to your health care provider. Early diagnosis and treatment can help reduce the severity of your anemia and prevent complications.

Your provider will perform blood tests to diagnose anemia based on your history. Blood tests may include:   

• Complete blood count (CBC): This test provides detailed information about your blood, including red and white blood cells and platelets. This test will measure the size, shape and number of red blood cells and the amount of hemoglobin in your blood.
• Iron studies: These tests measure iron levels in your blood, how much iron your body stores and how well your body uses iron.
• Nutrition stores: These tests are often ordered to measure B12 and folate levels and detect deficiencies in these nutrients.  Copper levels may also be ordered.

In some cases, further testing may be indicated, such as: 

• Blood tests for hemolysis (red blood cell destruction): These tests check for red blood cell destruction.
• Hereditary anemias test: Tests for hereditary anemias such as sickle cell disease or thalassemia may be ordered if a family history is suspected.
• Bone marrow test: In rare cases, your provider may recommend a bone marrow biopsy to determine how well your bone marrow produces red blood cells or to detect underlying bone marrow diseases 

Treatment options

Treatment for anemia depends on the cause. Here are some common treatment options:

• Iron supplements: Your provider may recommend iron supplements and dietary changes. In some cases, intravenous (IV) iron may be required.  Eating iron-rich foods like red meat, beans and spinach can help improve your iron levels.
• Vitamin supplements: Your provider may recommend vitamin B12 or folate supplements or injections. Eating foods rich in vitamin B12 and folate can also help.   
• Treating underlying conditions: Your provider will focus on managing the condition to help improve your anemia.   
• Blood transfusions: A blood transfusion may be necessary in severe cases to quickly increase red blood cell levels. This is usually for serious situations where immediate action is required.
• Erythropoiesis-stimulating agents (ESAs): These medications may help the bone marrow produce red blood cells. ESAs are often used in people with chronic kidney disease or certain forms of cancer. 
• Bone marrow or stem cell transplant: A bone marrow or stem cell transplant may be an option for certain severe types of anemia, like aplastic or sickle cell anemia. This treatment replaces damaged or diseased bone marrow with healthy stem cells that can produce new blood cells. 

Preventing anemia

While not all cases of anemia can be prevented, there are several steps you can take to lower your risk:

• Eat iron-rich foods: To get enough iron, include red meat, beans, spinach and lentils in your diet. Add foods rich in vitamin B12 (meat, dairy, eggs) and folate (dark green leafy vegetables, citrus, beans). The exception is for patients with hemochromatosis who need to avoid iron rich foods or supplements.
• Take supplements: If you’re not getting enough iron, B12 or folate from food, ask your provider about supplements or injections. 
• Manage health conditions: Keep chronic illnesses under control to help prevent anemia.
• Get regular checkups: If you’re at risk, regular blood tests can help catch anemia early.
• Control blood loss: If you have heavy periods or conditions like ulcers, work with your provider to reduce your blood loss.
• Stay hydrated: Drink plenty of water to support healthy blood flow and help your body function properly.
• Limit alcohol: Excessive drinking can affect your body’s ability to produce healthy red blood cells. 
• Pregnancy precautions: Prenatal vitamins that include iron are recommended during pregnancy.  Check with your obstetrician for recommendations if you become pregnant. 

How Banner Health Can Help

If you think you may be anemic or want to learn more about your risk, Banner Health is here for you. Our experts will help diagnose, treat and manage your condition, providing personalized care every step of the way. Schedule an appointment and take the first step toward better health.