Anemia: When Your Blood Doesn’t Deliver Enough Oxygen

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One of the most important tasks your blood performs is delivering fresh oxygen to nourish all the cells and tissues of your body. But if you have anemia, your blood does not carry enough oxygen. This can leave you feeling tired or weak and cause other symptoms such as paleness, jaundice, dizziness, or fainting.

Anemia, the most common blood disorder, affects more than 3 million Americans. And it’s highly treatable.

How Anemia Works

The blood’s oxygen-delivery system relies on red blood cells (RBCs), which make up 40 percent of your blood volume. RBCs contain hemoglobin — a protein that gives blood its characteristic red color. Each time you inhale, you draw fresh oxygen molecules into your body. The oxygen passes through your lungs and into your bloodstream, where it attaches to the hemoglobin in your RBCs and heads out through your blood vessels for delivery.

After the hemoglobin distributes its cargo of oxygen, it picks up waste gasses, such as carbon dioxide, and carries them back to your lungs, where they’re expelled in your exhaled breath.

RBCs clearly play a vital role in keeping your cells supplied with oxygen. But if you don’t have enough healthy red blood cells, your body doesn’t get enough oxygen — and you have anemia.

But if you don’t have enough healthy red blood cells, your body doesn’t get enough oxygen — and you have anemia.

What Are the Symptoms of Anemia?

It’s possible to have anemia without obvious signs, but most people show symptoms, from mild to severe, including:  

  • Weakness and fatigue 
  • Paleness 
  • Feeling dizzy or fainting 
  • Having a rapid heartbeat 
  • Shortness of breath 
  • Difficulty doing normal activities 
  • Jaundice (yellowing of your eyes, skin, or mouth, and having dark urine) 

Common Causes and Types of Anemia

You can become anemic if you lose too much blood or your body doesn’t make enough RBCs. Anemia can also occur if your body loses RBCs faster than it can replace them or if your RBCs don’t make a healthy amount of hemoglobin. These conditions can occur for reasons such as:

  • Not having enough iron in your body, which is required for making hemoglobin. This condition, iron-deficiency anemia, is the most common type of anemia and can result from blood loss or poor absorption of iron. Pregnancy and childbirth can result in loss of iron, leading to pregnancy-related anemia. 
  • Being low in certain vitamins, such as folate (folic acid) or vitamin B12, possibly from a poor diet or a condition such as celiac disease or Crohn's disease
  • Aplastic anemia, a rare bone-marrow disorder
  • Being born with a condition such as sickle cell disease or thalassemia
  • Bleeding heavily, as can occur if you’re injured, having surgery, giving birth, or experiencing a heavy menstrual period
  • Having an ulcer
  • Suffering from certain chronic conditions such as diabetes, arthritis, or kidney disease
  • Having a chronic infection such as tuberculosis or HIV
  • Being exposed to certain medicines, such as those used for chemotherapy

Who Is at Risk for Anemia?

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You may be at risk for anemia if:

  • You have a poor diet
  • You are menstruating or pregnant 
  • You suffer from a chronic condition such as rheumatoid arthritis or other autoimmune disease, cancer, kidney disease, liver disease, thyroid disease, or inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

How Is Anemia Diagnosed?

After you are examined and discuss your symptoms with your doctor, he will order blood tests, which may include:  

  • Iron studies, to measure the amount of iron in your blood
  • A complete blood cell count (CBC), to measure different types of blood cells
  • Vitamin B12 and folate studies, to check for components that help build RBCs
  • A blood smear, to check the size and shape of your blood cells
  • Hemoglobin electrophoresis, to look for problems with your hemoglobin
  • A reticulocyte count, to measure new RBCs produced by your bone marrow

How Is Anemia Treated? 

How your anemia will be treated depends on the type of anemia you have, its cause, and how severe it is. Treatments may include:

  • Medication. Some medicines treat the cause of anemia, and others work at relieving symptoms or building new red blood cells. 
  • Changes in your diet. Your health care provider may recommend increasing your intake of certain nutrients, such as iron, vitamin B12, or folate. Supplements may be suggested. 
  • Surgery, which may be advised to treat an underlying cause of anemia 
  • Blood transfusions. Replacing some of your blood can increase the number of healthy RBCs in your body. 

If you think you might have anemia, visit your health care provider for an exam and a discussion about the treatment that’s right for you. While some types of anemia may require lifetime management, others can be treated quickly, leading to a full recovery.