What Causes a Person to Become Anemic?

Iron deficiency is a common anemia Iron deficiency is a common anemia

Anemia is a medical condition in which the person has less red blood cells (RBCs) than what is considered normal for their age and gender. Routine blood investigations may report anemia as low hemoglobin or hematocrit.  

Depending on the reason for anemia, the causes may be categorized as:

  • Nutritional anemia: When the body cannot make enough hemoglobin due to poor stores of nutrients: eg iron-deficiency anemia, B12 deficiency anemia (due to low B12 in the diet or the inability of the body to absorb B12 as seen in pernicious anemia), or folic acid deficiency.
  • Faulty hemoglobin production: When the body makes hemoglobin, but the hemoglobin does not function correctly: eg, sickle cell anemia, thalassemia
  • Anemia when the body does not make enough red blood cells: eg. anemia due to long term or chronic kidney disease (CKD), hyperthyroidism, hypothyroidism, lupus and other chronic diseases, viral infections, radiation injury
  • Hemolytic anemia: due to increased RBC breakdown by the body eg. anemia due to certain medications, mechanical factors (a leaky heart valve or aneurysm), infection or an autoimmune disease. 
  • Anemia of increased blood loss is seen in conditions such as ulcers, piles (hemorrhoids) and gastritis
  • The most common type of anemia is due to deficiency of iron in the body, called iron-deficiency anemia.

What are the symptoms of anemia?

Pallor or weakness is the main sign of anemia. A person may look pale or feels weak, more tired or cold. This is because their organs do not receive adequate oxygen (Iron in hemoglobin is the oxygen carrier). The symptoms of anemia are:

How do you fix anemia?

Anemia treatment depends upon the cause:

  • Iron-deficiency anemia: Your doctor will investigate the cause of iron-deficiency anemia through various tests. Nutritional deficiencies (low iron, B12, folic acid) are fixed through changes in diet or by taking supplements. If there is a problem with the absorption of vitamin B12, your doctor may prescribe B12 injections.
  • Anemia due to chronic disease: If the anemia is due to a chronic condition such as chronic kidney disease, hypothyroidism or chronic infections, treatment of the underlying medical condition will often improve the anemia. In certain conditions, such as chronic kidney diseases, the doctor may prescribe other medications such as erythropoietin injections. These medications stimulate the bone marrow to make more red blood cells.
  • Aplastic anemia: This type of anemia occurs when the bone marrow stops producing red blood cells. Certain medications and viral infections may cause this. Treatment for aplastic anemia may include blood transfusions or a bone marrow transplant besides other therapy depending upon the root cause and severity of aplastic anemia.
  • Hemolytic anemia: The cause for hemolysis can often be determined by special blood tests and by examining the red blood cells under a microscope. The treatment will depend upon the cause of anemia and may include removing the culprit medication, referral to a heart or vascular specialist, antibiotics or drugs that suppress the immune system.

You must consult with your doctor if you think you may have anemia or you are at risk for anemia. They will determine and prescribe the best treatment options for you.

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