Anemia Symptoms & Warning Signs

By Tom Iarocci, MD. May 7th 2016

Sometimes anemia is it’s own disease. For instance, if you care for someone with sickle cell anemia, you know that this disease can lead to many other conditions and concerns.

In other cases, and especially when there are no symptoms, anemia can be more like the “check engine” light on the dash panel, signaling a need to figure out when something might be wrong. Sometimes it’s nothing major to worry about; sometimes there’s a need for a simple fix; and sometimes, unfortunately, it can be very serious.

What is Anemia?

Anemia is a lower than normal number of red blood cells (RBCs) in circulation. There are several different laboratory RBC measurements that can reveal anemia. Decreased RBC production, increased RBC destruction, and blood loss are the three major categories or causes of anemia.

Signs and Symptoms of Anemia

The most common type of anemia, iron deficiency anemia, is most often caused by blood loss. Women are particularly at risk if they have heavy menstrual bleeding, and also during pregnancy due to increased iron demand.

But the body has ways to compensate for anemia, and many people with iron deficiency anemia have no symptoms at all. When symptoms do arise, one can often trace them back to a lack of oxygen.

Low oxygen can be felt in the brain and muscles as dizziness, fatigue and weakness. The body senses the need for oxygen, and sends a message to the heart to work harder, work faster, and pump more blood. For people who do get symptoms from iron deficiency anemia, one or more of the following are most common:

  • Weakness
  • Shortness of breath or chest pain with activity
  • Dizziness
  • Fast heartbeat
  • Headache
  • Cold hands or feet
  • Pale or yellow skin

Some intriguing but less common symptoms of iron deficiency anemia include cravings for ice, grass, clay, paper, and hair for nutrition, sore or smooth tongue, and brittle nails or hair loss.

The Type of Anemia Can Predict Symptoms and Severity

Some types of anemia are more serious than others. The most common type, iron deficiency anemia, can be due to blood loss, increased demand for iron (as in pregnancy), or occasionally, poor absorption. Vitamin B12 deficiency can also result in anemia. Anemia due to a nutritional deficiency can often be prevented an/or corrected with vitamins and adequate nutrition.

Other types of anemia tend to happen more suddenly than is the case with iron deficiency; aplastic anemia occurs when the body stops making enough red blood cells, such as after exposure to toxic chemicals; hemolytic anemia means red blood cells are destroyed by processes that include autoimmunity, infection, and inherited diseases. Sickle cell anemia is one such inherited anemia that can result in abnormal red blood cells (sickle cells) that can get stuck, blocking blood flow to vital organs. Still other forms of anemia are due to other chronic diseases, such as rheumatoid arthritis.

Some Concerns in Adults

Anemia can be concerning in and of itself, or anemia may be just as concerning for what it signifies, or what it may lead to. Anemia places a greater demand on the heart and can contribute to arrhythmias and heart failure. Anemia may also be a sign of an underlying medical condition such as one of the following:

  • Cancer
  • Gastrointestinal bleeding
  • Autoimmune disease
  • Kidney disease
  • Other chronic diseases

In some ways, anemia is similar to a fever in that it may or may not be a warning sign – and the doctor needs to know what else is going on to be able to determine if it is serious.

Some Concerns in Children

Individual children can experience symptoms of anemia differently. Some of the most common symptoms, when present, include:

  • Paleness, especially lips, hands, or under eyelids
  • Faster heart rate
  • Having a hard time catching a breath
  • Lack of energy, dizziness
  • Headache

Infants can also develop anemia, and in addition to pale skin and other common symptoms, babies with anemia may not want to feed. Preterm infants may have “anemia of prematurity” a condition due in part to a lack of enough erythropoietin – a hormone that increases the production of red blood cells.

Iron deficiency is a common cause of anemia in infants and toddlers, but as in adults, blood tests are necessary for a conclusive diagnosis. Infants and children with iron deficiency should be monitored closely since the condition has the potential to impair neurological development.

Take the Next Steps

Since iron deficiency is such a common cause of anemia, make sure you and your loved ones get enough iron in your diet, and pay attention to any warning signs that you might be losing blood. For example, dark stool color might be an indicator of gastrointestinal bleeding. If you are a woman with heavy menstrual bleeding and fatigue, be sure your doctor is aware of your condition and work together to find an answer.

Giving Care

If someone you care for is being evaluated for anemia, it may help to know that anemia is the most common hematologic (blood-related) condition in the universe. A vast number of conditions ranging from relatively harmless to very serious can cause anemia, so it’s important not to entertain needless worry until you have more facts, and it’s equally important to work with your doctor to sort out the possibilities, and to receive any appropriate treatment.

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