Anemia
On this page:
Anemia happens when your blood doesn't have enough hemoglobin (he-mo-GLOBE-in).
Hemoglobin helps red blood cells carry oxygen from your lungs to all parts
of your body.
Return to top 
There are many types of anemia, all with different causes:
-
Iron deficiency anemia (IDA). IDA is the most
common type of anemia. IDA happens when you don't have enough iron in your
body. You need iron to make hemoglobin. This can happen when you lose blood
from problems like heavy periods, ulcers, colon polyps, or colon cancer. A
diet that doesn't have enough iron in it can also cause IDA. Pregnancy can
also cause IDA if there's not enough iron for the mother and fetus. You can
get iron from foods like ground beef, clams, spinach, lentils, baked potato
with skin, sunflower seeds, and cashews.
-
Megaloblastic (or vitamin deficiency) anemia.
This most often happens when your body doesn't get enough folic acid or
vitamin B-12. These vitamins help your body keep healthy blood and a healthy
nervous system. With this type of anemia, your body makes red blood cells that
can't deliver oxygen right. Folic acid supplements (pills) can treat this type
of anemia. You can also get folic acid in beans and legumes; citrus fruits and
juices; wheat bran and other whole grains; dark green leafy vegetables; and
poultry, pork, shellfish, and liver. Sometimes, with this disease, your health
care provider may not realize you're not getting enough B-12. This usually
happens to someone with pernicious anemia, a type of autoimmune disease. B-12
deficiency may also be more common in people with other autoimmune diseases,
like Crohn's disease. Not getting enough B-12 can cause numbness in your legs
and feet, problems walking, memory loss, and problems seeing. The treatment
depends on the cause. But you may need to get B-12 shots or take special B-12
pills.
-
Underlying diseases. Certain diseases can hurt
the body's ability to make red blood cells. For example, people with kidney
disease, especially those getting dialysis (takes out wastes from your blood
if your kidneys can't), are at higher risk for developing anemia. Their
kidneys can't create enough hormones to make blood cells, and iron is lost in
dialysis.
-
Inherited blood disease. If you have a blood
disease in your family, there is a higher risk that you will also have this
disease. One type of inherited blood disease is sickle cell anemia. Instead of
having normal red blood cells that move through blood vessels easily, sickle
cells are hard and have a curved edge. These cells cannot squeeze through
small blood vessels and block the organs from getting blood. Your body
destroys sickle red cells quickly, but it can't make new red blood cells fast
enough. This causes anemia. Another inherited blood disease is thalassemia. It
happens when the body is missing certain genes or when variant (different from
normal) genes are passed down from parents that affect how the body makes
hemoglobin.
-
Aplastic anemia. This rare problem happens when
your body doesn't make enough red blood cells. Since this affects the white
blood cells too, there is a higher risk for infections and bleeding that can't
be stopped. This can be caused by many things:
- cancer treatments (radiation or chemotherapy)
- exposure to toxic chemicals (like those used in some insecticides,
paint, and household cleaners)
- some drugs (like those that treat rheumatoid arthritis)
- autoimmune diseases (like lupus)
- viral infection that affects bone marrow o bone marrow diseases
The treatment depends on how serious the anemia is. It can be
treated with blood transfusions, medicines, or a bone marrow transplant.
Return to top
Anemia takes some time to develop. In the beginning, you may not have any
signs or they may be mild. But as it gets worse, you may have these symptoms:
- fatigue
- weakness
- not doing well in work or school
- low body temperature
- pale skin
- rapid heartbeat
- shortness of breath
- chest pain
- dizziness
- irritability
- numbness or coldness in your hands and feet
- headache
Return to top
Anemia is diagnosed by a blood test. If you have anemia, your health care
provider (HCP) may want to do other tests to find out what's causing it, like
ulcers (sore on the lining of the stomach or duodenum [beginning of the small
intestine]) or polyps (growths).
Return to top
It depends on the cause of the anemia. For example, treatment for sickle cell
anemia is different than treatment for a diet low in iron or folic acid. Talk to
your HCP about the best treatment for the cause of your anemia.
Return to top
Take these steps to help prevent some types of anemia:
- Eat foods high in iron:
- red meat
- fish
- chicken
- liver o eggs
- dried fruits, like apricots, prunes, and raisins
- lentils and beans
- green, leafy vegetables, like spinach and broccoli o tofu o cereal
with iron in it (iron-fortified)
- Eat/drink foods that help your body absorb iron, like orange juice,
strawberries, broccoli, or other fruits and vegetables with vitamin C.
- Don't drink coffee or tea with meals. These drinks make it harder for your
body to absorb iron.
- Calcium can hurt your absorption of iron. If you have a hard time getting
enough iron, talk to your health care provider about the best way to get
enough calcium too.
- Make sure you get enough folic acid and vitamin B-12 in your diet.
- Talk to your HCP about taking iron pills (supplements). Do NOT take these
pills without talking to your health care provider first. These pills come in
two forms: ferrous and ferric. The ferrous form is better absorbed by your
body. But taking iron pills can cause side effects, like nausea, vomiting,
constipation, and diarrhea. Reduce these side effects by taking these steps:
- Start with half of the recommended dose. Gradually increase to the full
dose.
- Take the pill in divided doses.
- Take the pill with food.
- If one type of iron pill is causing problems, ask your HCP for another
brand.
- If you are a non-pregnant woman of childbearing age, get tested for anemia
every 5 to 10 years. This can be done during a regular health exam. Testing
should start in adolescence.
- If you are a non-pregnant woman of childbearing age with these risk
factors for iron deficiency, get tested every year:
- heavy periods
- low iron intake
- previous diagnosis of anemia
Return to top
Most people get enough iron through a regular healthy diet that has iron-rich
foods. But some groups of people don't get enough iron:
- teenage girls/women of childbearing age (who have heavy menstrual losses,
who have had more than one child, or use an intrauterine device [IUD])
- older infants and toddlers
- pregnant women
These groups of people should be screened periodically for iron deficiency.
If the tests show that the body isn't getting enough iron, iron supplements may
be prescribed. Many health care providers prescribe iron supplements during
pregnancy because many pregnant women don't get enough. They can help when diet
alone can't restore the iron level back to normal. Talk with your HCP to find
out if you are getting enough iron through your diet or if you or your child
needs to be taking iron supplements. Please see to the chart below to see how
many milligrams (mg) of iron you should take every day
|
Age |
Infants & Children |
Women |
Pregnant |
Breastfeeding |
| 7 to 12 months |
11 mg |
|
|
|
| 1 to 3 years |
7 mg |
|
|
|
| 4 to 8 years |
10 mg |
|
|
|
| 9 to13 years |
|
8 mg |
27 mg |
10 mg |
| 14 to18 years |
|
15 mg |
27 mg |
10 mg |
| 19 to 50 years |
|
18 mg |
27 mg |
9 mg |
| 51+ years |
|
8 mg |
|
|
Return to top
Many pregnant women have a hard time getting enough iron. During pregnancy,
your body demands more iron because of the growing needs from the fetus, the
higher volume of blood, and blood loss during delivery. Not getting enough iron
can cause preterm labor and delivering a low-birthweight baby. If you're
pregnant, follow these tips:
- Make sure you get 27mg of iron every day. Take an iron supplement (pill).
It may be part of your prenatal vitamin. Start taking it at your first
prenatal visit.
- Get tested for anemia at your first prenatal visit.
Return to top
It might. If you are still getting your period while taking HT, you may need
more iron than women who are postmenopausal and not taking HT. Talk to your
health care provider.
Return to top
It could. Some women who take birth control pills have less bleeding during
their periods. This would lower their risk for anemia. But women who use an
intrauterine device (IUD) may have more bleeding and increase their chances of
getting anemia. Talk to your health care provider.
Return to top
It depends on your diet. Since it's easier to get iron from meat than from
plant-derived foods, some vegetarians may need to take a higher amount of iron
each day than what is recommended for other people. Follow the tips above to
prevent anemia, and try to take vitamin C with other iron-rich foods.
Return to top
Iron overload happens when the body absorbs too much iron over many years.
Excess iron builds up in organs, like the heart and liver. Many problems can
cause iron overload. It can happen from years of taking too much iron or from
repeated blood transfusions. But the most common form of iron overload in the
United States is an inherited condition (runs in families) called hereditary
hemochromatosis (he-mo-kro-ma-toe-sis).
Signs of early hemochromatosis may include:
- fatigue
- weakness
- weight loss
- abdominal pain
- joint pain
As iron accumulation progresses, patients may have these symptoms:
- arthritis
- amenorrhea
- early menopause
- loss of sex drive
- impotence (repeated inability to get or keep an erection firm enough for
sexual intercourse)
- shortness of breath
Signs of advanced stages of hemochromatosis include:
- arthritis
- liver disease, including an enlarged liver, cirrhosis, cancer, and liver
failure
- damage to the pancreas, possibly causing diabetes
- chronic (ongoing) abdominal pain
- severe fatigue
- weakening of the heart muscle
- problems with your heart rate or rhythms
- heart failure
- abnormal skin color, making it look gray or bronze
Treatment depends on how severe the iron overload is. The first step is to
get rid of the extra iron in the body. The process is called phlebotomy
(fle-bot-o-me), which means removing blood. It is simple and safe. A pint of
blood will be taken once or twice a week for several months to a year, and
sometimes longer. Once iron levels go back to normal, you will give a pint of
blood every 2 to 4 months for life. Although treatment cannot cure the problems
caused by hemochromatosis, it will help most of them. Arthritis is the only
problem that does not improve after excess iron is removed.
Return to top
There is a lot you can do to make your life as healthy as possible:
-
Get check ups. Have the amount of iron in your
blood tested regularly.
-
Get your blood removed. Make sure to get
phlebotomies when you need them.
-
Watch the food you eat. Don't eat raw fish or
raw shellfish.
-
Limit your alcohol intake. If you choose to
drink alcohol, drink very little. Women should have no more than one drink a
day. Men should have no more than two a day. But if you have liver damage, do
NOT drink any alcohol.
-
Don't take iron pills. Don't take iron pills,
supplements, or multivitamin supplements that have iron in them. But eating
foods that contain iron is fine.
-
Watch your vitamin C intake. Vitamin C
increases the amount of iron your body absorbs. So don't take pills with more
than 500mg of vitamin C per day. Eating foods with vitamin C is fine.
-
Exercise. You can exercise as much as you want.
Try to get 30 minutes of exercise every day to stay fit and healthy.
Return to top
Division of Nutrition
and Physical Activity, NCCDPHP, CDC, HHS
National
Heart, Lung, and Blood Institute Information Center, NHLBI, NIH, HHS
American Dietetic Association
Aplastic Anemia & MDS
International Foundation, Inc.
Iron Disorders Institute
Return to top
Abnormal Vaginal Bleeding
