Anemia symptoms and causes

Anemia definition

Anemia literally means lack of blood. In medical terms, anemia specifically means lack of oxygen carrying red component of your blood. The actual substance that carries oxygen in your blood is hemoglobin. This hemoglobin is contained inside the red blood cells. Therefore, anemia means a lack of hemoglobin or lack of red blood cells.

Anemia symptoms

Lack of hemoglobin affects many different organ systems in your body. We will look at anemia symptoms based on the organ affected by anemia.

Anemia symptoms that affect your whole body

Some anemia symptoms affect your whole body. When you have insufficient hemoglobin in your blood, you have less oxygen circulating in your blood. Due to insufficient oxygen, your whole body suffers.

Here are some of the anemia symptoms that affect your whole body:

  1. Feeling tired all the time: Anemia makes you feel tired all the time. You may feel like you have no energy at all. You may be asking yourself, “Why am so tired all the time?”
  2. Extreme fatigue: As your anemia worsens, your symptoms progress from feeling tired all the time to extreme fatigue. You struggle with your daily routine. You get exhausted after minimal activity.
  3. Malaise: As anemia symptoms worsen, you not only have fatigue but also start to have malaise. You do not feel well. You are uncomfortable and restless. Your whole body struggles to find a sense of well being.
  4. Dizziness when standing up: Dizziness and lightheadedness when standing up results from a shift in your blood circulation when you stand up. Even under normal condition, more blood flows to your legs when you go from sitting position to standing. This leads to less blood being available to your brain. When you have anemia, your blood is already carrying less oxygen than normal. When you divert some of this anemic blood away from your brain, your brain does not get enough oxygen and you feel lightheaded and dizzy.
  5. Muscle weakness: In addition to feeling tired, fatigued and having low energy, anemia may actually make you feel like you have muscle weakness. For example, even when you overcome your extreme tiredness, fatigue and low energy, and try to get out of your bed, you will feel like you have muscle weakness in legs. This muscle weakness associated with anemia is a generalized muscle weakness. It means that all your muscles are weak, not just a group of specific muscles.

Anemia symptoms that affect your heart

  1. Heart palpitations: Heart palpitations symptoms are very common with anemia. People with anemia do not have enough oxygen circulating in their bodies. The heart tries to compensate for the lack of oxygen by pumping more blood. The heart beats faster and harder. People with anemia feel their hearts pounding in their chests. In some people, heart palpitations symptoms may sometimes be the only symptoms of being anemic.
  2. Anemia chest pain: Chest pain from anemia does not usually happen in people with anemia who have normal healthy hearts. However people with underlying coronary artery disease may have chest pain due to anemia. In those people, the lack of oxygen related to anemia acts as a “stress test” to unmask the symptoms of coronary artery narrowing.
  3. Shortness of breath with activity: People with anemia my feel like they are out of breath with little exertion.
  4. Anemia heart murmur: Heart mummer is one of the important signs of anemia that doctors can discover when examining people with anemia. Heart murmur in anemia may be present even without any structural abnormality of the heart. This type of heart murmur is sometimes called a functional heart mummer to distinguish it from other types of heart murmur that indicate leaky heart valves or other structural problems with one or more of the heart valves.
  5. Syncope and collapse( Fainting) : People with anemia may experience fainting or passing out as the anemia worsens. As stated earlier, the heart tries to compensate the lack of oxygen in people with anemia by beating harder and faster. Sometimes this compensation is not enough to sustain normal brain function and leads to syncope and collapse from the severe anemia.

Anemia symptoms that affect your brain and nervous system:

  1. Mental slowing and confusion: People with anemia may have some cognitive dysfunction related to low levels of oxygen in their brains. Mental slowing and confusion from anemia is usually the result of untreated anemia for a long time.
    Irritability: People with untreated anemia may become very irritable over time as their brain function gets affected by lack of enough oxygen.
  2. Depression and mood swings: It is important to check for anemia in anyone being evaluated for depression and other mood disorders because people with anemia may develop these mental abnormalities from brain dysfunction related to lack of oxygen.
  3. Memory loss: In addition to general mental slowing and confusion, one specific type of anemia can cause disproportionate amount of memory loss. Memory loss from anemia is specially prominent in vitamin B12 deficiency anemia.

Signs of anemia in fingernails

  1. Spoon shaped nails: People with anemia may develop spoon shaped nails. Spoon shaped nails (medically known as Koilonychia) is specially prominent in people with long standing iron deficiency anemia.
  2. Brittle nails: In addition to spoon shaped nails, brittle nails are also important signs of possible iron deficiency anemia.

Signs of anemia in your skin

  1. Pale skin: Pale skin is an important sign of anemia. There are two main reasons why people with anemia develop pale skin. First, lack of the red pigment hemoglobin makes the skin appear pale. Second, their bodies try to adapt to the lack of oxygen by decreasing the supply of blood to the skin. The blood vessels in the skin of people with anemia constrict to divert blood away from the skin. This allows other vital organs get more oxygen. Due to the decreased blood supply, the skin of people with anemia appear paler than they would from just the lack of hemoglobin.
  2. Jaundice: Jaundice or yellow discoloration of the skin happens in people with anemia of a very specific type. It is called hemolytic anemia or anemia related to the destruction of red blood cells.

Signs of anemia in your hair

  1. Hair loss and thinning of hair: Iron deficiency anemia is an important cause of iron deficiency hair loss. In fact, iron deficiency even without anemia has been found to an important cause of thinning hair in women.

Signs of anemia in the eyes

  1. Pale eyes
  2. Puffy eyes

Anemia symptoms in women

It is important to look out for anemia symptoms in women because women are more susceptible to iron deficiency anemia because of menstrual blood loss. Heavy menstrual bleeding anemia may go undetected for years. Thinning of hair may be an early sign of iron deficiency in women. It may appear before the other signs of anemia in women become discernible. Overall, anemia symptoms in women are similar to anemia symptoms in men. Women may have worsening of their anemia symptoms during pregnancy. In addition to all the signs and symptoms of anemia described above, some women with anemia may have decreased sexual desire. Sexual dysfunction could be one of the important anemia symptoms in women.

Anemia diagnosis

It is easy to make the diagnosis of anemia. All you need to do is check your hemoglobin. Anemia can be diagnosed with routine blood test. You do not need any specialized test to diagnose anemia. Hemoglobin level is included in a simple blood test called CBC or complete blood count. A hemoglobin level of less than 13 grams per deciliter is generally considered diagnostic for anemia in men whereas a hemoglobin level of less than 12 grams per deciliter is generally considered diagnostic for anemia in women.

Although it is easy to establish the diagnosis of anemia with a simple blood test, it may take specialized tests and careful evaluation by specialists to find out the exact type and cause of anemia in any individual patient. If you are diagnosed to have anemia, you need to ask your doctor about what type of anemia you have. You also need to ask what might have caused your anemia because the treatment depends on the exact type, severity and cause of anemia.

Types of anemia based on severity

Anemia can be divided into three different types based on severity

  1. Mild anemia: People with anemia whose hemoglobin concentration is 11g/dl or higher have mild anemia. Most people with mild anemia do not notice any symptoms.
  2. Moderate anemia: People with anemia whose hemoglobin concentration is less than 11g/dl but greater than 8g/dl have moderate anemia. Some people with moderate anemia do not notice any symptoms while others may have moderate to severe symptoms. It depends on the timeline of anemia. Moderate anemia with rapidly dropping hemoglobin may cause severe symptoms. A slowly developing anemia may not only cause mild symptoms.
  3. Severe anemia: People with anemia whose hemoglobin concentration is less than 8g/dl have severe anemia. Most people with severe anemia have severe symptoms. The symptoms are worse if the anemia develops rapidly.

Types of anemia based on timeline

Anemia can be divided into two different types based on the timeline of symptoms

  1. Acute Anemia: The type of anemia that develops rapidly is called acute anemia. For example anemia caused by internal bleeding can develop very rapidly. People with acute anemia have worse symptoms than people with chronic anemia because people with acute anemia do not get time to adjust to the low hemoglobin levels.
  2. Chronic anemia: The type of anemia that develops slowly over time is called chronic anemia. For example anemia caused by nutritional deficiency develops slowly over a long period of time. People with chronic anemia have less severe symptoms because their bodies get time to slowly adjust to the low hemoglobin levels.

Types of anemia based on causes:

There are many causes of anemia. There are several different types of anemia based on those causes of anemia.

Iron deficiency anemia

Iron deficiency anemia is the most common type of anemia. The severity of iron deficiency anemia symptoms depends on how fast the anemia developed. There are many different causes of iron deficiency. We will look into two of these important iron deficiency causes.

Iron deficiency causes:

  1. Iron deficiency caused by bleeding: Iron deficiency may be caused by slow bleeding over a long period of time. Iron deficiency may also be caused by rapid bleeding. Iron deficiency anemia caused by bleeding is also called hemorrhagic anemia which literally means anemia from bleeding. When people have excessive blood loss, they lose significant amount of iron that is present in the hemoglobin. This depletes the storage of iron in those people. Iron deficiency anemia symptoms in women may be related to heavy menstrual bleeding. Anemia due to iron deficiency in men may be related to slow bleeding from their colon or other parts of the gut. Internal bleeding anemia, nose bleeds anemia, bleeding ulcers anemia and heavy menstrual bleeding anemia eventually all lead to depletion of bodily iron store.
  2. Iron deficiency caused by nutritional problems: Iron deficiency caused by lack of iron rich foods is more common in developing countries than in the United States. However, it can still happen here in people who are on a restrictive diet. People on vegan or vegetarian diet may develop iron deficiency if they do not look at list of iron rich foods they can eat and routinely include those foods in their meals. Nutritional iron deficiency anemia develop slowly over a long period of time.

Cancer related anemia

Cancer patients frequently develop anemia. Cancer can cause anemia in many different ways. People may develop severe nutritional deficiencies as a result of the cancer. Anemia in cancer patient may be related to this nutritional problem. Cancer can also cause bleeding and that can lead to iron deficiency anemia. Cancer or its treatment can also damage the bone marrow and it can lead to anemia. Certain cancers also induce the destruction of red blood cells and cause severe anemia.

Anemia related to kidney failure

Kidney failure is another important cause of anemia. Kidney failure leads to anemia by impairment of an important step in the production of red blood cells. Your kidneys produce an important substance call Erythropoietin or EPO. When your kidneys start to fail, they don’t produce enough EPO and you develop anemia related to kidney failure.

Vitamin b12 deficiency anemia:

Vitamin B12 deficiency anemia may be caused by insufficient vitamin B12 in your diet or it may also be caused by problems with vitamin B12 absorption in your stomach. In addition to the common anemia symptoms described in this article, people with severe vitamin B12 deficiency anemia may have symptoms of nerve damage.

Here are some of the potential nerve damage symptoms from vitamin B12 deficiency:

  1. Memory loss
  2. Depression
  3. Problems with balance
  4. Numbness and tingling of hand and feet

Folic acid anemia

Anemia caused by deficiency of folic acid in the diet is similar to vitamin B12 deficiency anemia except, unlike B12 deficiency, folate deficiency does not usually cause nerve damage symptoms.

Sickle cell disease

Sickle cell disease is an important cause of anemia in African Americans. Sickle cell anemia results from a defective gene that makes abnormal hemoglobin in people with sickle cell disease. Anemia in sickle cell disease is accompanied by other symptoms of sickle cell disease such as extremely painful sickle cell crisis.

Hemolytic anemia (the destruction of red blood cells)

Anemia may also be caused by the destruction of red blood cells. It happens in a number of different diseases and conditions. In addition to the common symptoms of anemia described in this article, hemolytic anemia may also cause jaundice or yellow discoloration of the skin.

Severe anemia symptoms: Can you die from anemia?

It is very unusual to die from chronic anemia but severe acute anemia resulting from internal bleeding can be fatal. People with severe anemia from loss of significant amount of blood in a short period of time can die from anemia if left untreated.

Treatment of anemia

It is important to know the exact type and severity of anemia before you seek treatment. Treatment for anemia should not be attempted at home without proper diagnosis. A list of iron rich foods will not help you unless you know the exact type of anemia you have. In fact, some types of anemia will get worse by taking iron supplements.

If you have severe anemia from excessive bleeding, you may need hospitalization and blood transfusion. Anemia treatment diet will only work if your anemia is related to dietary deficiency. For example, If you are found to have problems with absorption of vitamin b12, your vitamin b12 deficiency anemia will not improve by simply starting anemia treatment diet.

If you are already diagnosed with anemia, I suggest you ask your doctor what type of anemia you have before seeking any treatment.