Anemia - What it is, Causes, Symptoms & Effective Treatments

Nearly 1 in 4 people worldwide suffer from anemia, according to statistics from the Institute of Health Metrics and Evaluation (IHME). That means about 2 billion people worldwide have a condition that, over time, can increase the risk of heart attack, cardiovascular disease, dementia, and other chronic diseases.

Read the article and discover what factors lead to anemia, what are the common symptoms of anemic people, and what treatment options exist.

What is anemia?

Anemia is a blood disorder characterized by a decrease in hemoglobin, when there are not enough red blood cells in the blood or they no longer function optimally.

What is hemoglobin?

Hemoglobin, found in red blood cells, is an iron-rich protein that carries oxygen from the lungs to all other organs and tissues. Without enough hemoglobin, the body doesn't get enough oxygen from the blood and can't function properly. This is exactly what happens when you have anemia.

Why is it important to recognize the signs of anemia in time?

In mild or long-term anemia, symptoms can often go unnoticed. It's easy to chalk up headaches, fatigue, or dizziness to stress and lack of rest and ignore them. Other symptoms, like unusual food cravings, are hard to recognize because you don't think they could be signs of anemia.

Because of the way it manifests itself and the fact that it reduces the amount of oxygen reaching the organs, anemia can seriously affect the lives of patients. Severe anemia, for example, can cause serious health problems throughout life and can even lead to death.

That is why it is important that the signs are not ignored, so that anemia is detected and treated in its early stages.

Types of anemia and their causes

Although in everyday conversation we simply use the term "anemia," in reality there are over 400 types of this condition, classified into several categories. The cause and appropriate treatment differ for each. Here are the categories:

Iron deficiency anemia

Iron deficiency anemia is anemia caused by iron deficiency. It occurs when the body does not have enough iron to produce hemoglobin. The causes are numerous, ranging from dietary habits and lifestyle to menstrual disorders and other health problems.

Specific causes:

• Poor diet, with low iron intake
• Frequent blood donation
• Heavy or prolonged menstruation
• Intermenstrual bleeding
• Chronic, slow bleeding, especially in the digestive system (e.g. gastric ulcer)
• Overly intense resistance training
• Certain treatments, foods, and beverages that contain caffeine
• Crohn's disease and other digestive disorders or autoimmune diseases of the gastric mucosa
• Helicobacter Pylori infection
• Pregnancy and breastfeeding
• Different types of cancer

Megaloblastic anemia

Vitamin deficiency anemia, or megaloblastic anemia, is characterized by a deficiency of vitamins B12 and B9 (folic acid), which are necessary for the production of red blood cells. It occurs especially in people who do not consume vitamin B12 through their diet (do not consume enough meat, eggs, dairy products) or who suffer from certain conditions.

Specific causes:

• Nutritional deficiencies (especially vitamin B12)
• Certain medications
• Excessive alcohol consumption
• Intestinal diseases
• Hematological pathologies

Hemolytic anemia

Specific causes:

• Autoimmune diseases such as lupus, which trigger an attack by the immune system
• Hereditary diseases such as thalassemia
• Splenomegaly (enlarged spleen), which can rarely cause red blood cell destruction
• Infections in the body
• Certain medications
• Inflammation caused by snake venom, spider venom, or certain foods
• Toxins that come from advanced kidney disease or liver disease
• High blood pressure
• Coagulation disorders
• Severe burns
• Tumors
• Hematological disorders or cancers that can lead to hemolysis

Aplastic anemia

Specific causes:

• Damage to stem cells in the bone marrow, often as a result of an immune system attack
• Exposure to certain toxins
• Certain medications
• Chemotherapy or radiation treatments

Chronic anemia

Chronic anemia is anemia that has not been diagnosed and treated, or that does not respond to treatment and persists for a long time. At this stage, it can cause serious medical problems, including heart attack, heart failure, and organ dysfunction.

There is also a type of anemia associated with other chronic conditions. This occurs when there is long-term inflammation in the body, because inflammatory proteins affect the production of red blood cells in the bone marrow.

Thalassemia is a type of hemolytic anemia caused by the inheritance of a genetic defect. In mild forms, it does not require treatment, but in severe cases, blood transfusions are required at regular intervals.

Thalassemia cannot be prevented, because it is genetically transmitted, which is why it is important to collaborate with a geneticist for people who suffer from thalassemia and plan to have a child.

Anemia - Symptoms

Symptoms of the condition differ depending on the type, cause, severity of anemia, and associated diseases.

Some anemias are asymptomatic, others are caused by chronic diseases and the symptoms go unnoticed, masked by the disease. In such cases, anemia is discovered incidentally during investigations for other conditions.

In the early stages, people with anemia may not experience any symptoms. As the condition persists and worsens, symptoms can become increasingly severe.

Among the most common symptoms of anemia are:

• Fatigue and weakness
• Lack of energy
• Pale or yellowish skin
• Palpitations (arrhythmia), especially during physical exertion
• Difficulty breathing, especially during physical exertion
• Feeling dizzy or confused
• Chest pain
• Cold hands and feet
• Tingling sensation in the limbs
• Leg cramps
• Headaches
• Difficulty concentrating
• Insomnia
• Craving for inedible substances such as ice, lime, dirt, or paper

Risk factors for anemia

There are many factors that can increase the predisposition to anemia. Some of these can be controlled, such as diet and lifestyle, others cannot be controlled because they are not related to what the patient does or does not do, but to age or family history.

Among the main factors that influence how the body produces red blood cells and increase the risk of anemia are:

• Nutrition deficient in vitamins and minerals
• Intestinal disorders
• Menstruation
• Task
• Chronic diseases
• Family history
• Age

Anemia in pregnant women

Pregnant women are more prone to anemia, especially iron deficiency anemia. A mother-to-be's body needs to produce about 20-30% more blood to support the developing fetus, so the body's need for iron and vitamins increases proportionally. The risk of anemia is even higher in pregnant women who do not take a multivitamin with folic acid .

Although mild anemia can be normal during pregnancy, severe anemia can have consequences for both the mother's and the baby's health.

In the mother, anemia can lead to extreme fatigue, preeclampsia, premature birth, or postpartum hemorrhage.

In children, anemia can cause low birth weight, poor growth, or death in the first month after birth. Also, if the mother suffers from anemia during pregnancy, the baby is also at increased risk of anemia in childhood.

Anemia in children

The most common cause of anemia in children and infants is iron deficiency. Children are born with a reserve of iron accumulated in the last trimester of pregnancy, from which large amounts are absorbed every day to support their rapid growth and development. As a result, this reserve is quickly depleted, and infants need to absorb iron directly from their diet starting at 4-6 months of age.

In the case of breastfed babies, the iron in breast milk is absorbed better and the risk of deficiency is reduced. The same applies to babies raised on formula milk. The greatest predisposition is found in babies up to 12 months who are fed cow's milk.

In rarer situations, anemia in children can also be caused by certain infections or diseases.

Depending on the severity of the anemia, symptoms may include fatigue, pale skin, a swollen or painful tongue, feelings of agitation and irritability, or a rapid heartbeat.

The link between menstruation and anemia

Any condition that causes large amounts of blood loss increases the risk of anemia. This includes menstruation, or more precisely menstrual disorders, which can promote a deficiency of red blood cells.

Menstrual bleeding is a risk factor for developing iron deficiency anemia when it occurs frequently, continues for more than 7 days, or comes with a very heavy flow ( menorrhagia ) that requires changing menstrual products hourly or more often.

Anemia - How is it diagnosed?

The first step in diagnosing anemia is consulting and discussing with your doctor to identify and evaluate symptoms.

To confirm the deficiency of red blood cells specific to anemia, a series of blood tests will be performed, starting with a complete blood count to check the levels of vitamins B9 and B12. After interpreting the blood count, the doctor may also recommend other useful tests:

• Hemoglobin , to measure hemoglobin in red blood cells
• Hematocrit testing , to measure the percentage of red blood cells in the blood
• Peripheral blood smear , which consists of examining red blood cells under a microscope to determine the shape and size of the blood cells
• Reticulocyte count , to check if the bone marrow is producing enough healthy red blood cells
• The level of iron in the body , measured by ferritin (shows the amount of iron in the body), sideremia (the amount of iron in the blood), but also total iron binding capacity and transferrin saturation (reflects the body's iron needs)
• Dosage of vitamin B12 and folic acid
• ESR (erythrocyte sedimentation rate), to detect the presence of inflammation or other conditions
• Bone marrow sample, to determine the cause of anemia when there are no deficiencies of iron, folic acid, or vitamin B12.

Treatment for anemia

Following the diagnosis, the doctor will recommend treatment depending on the type of anemia, severity, as well as symptoms, age, and general health.

Recommended vitamins and supplements: iron, B12, folic acid

When anemia is caused by iron deficiency, treatment consists of taking iron supplements in the form of tablets or capsules, and increasing the consumption of iron-rich foods.

Similarly, in the case of anemia caused by vitamin and mineral deficiencies, such as folic acid and vitamin B12, appropriate supplements and increased consumption of foods rich in vitamins and nutrients are recommended. The role of this treatment is to support the body in the production of healthy red blood cells.

Diet rich in essential nutrients

Optimizing your diet by adopting a diet rich in essential nutrients is among the first medical recommendations for anemic patients. This involves a high consumption of iron sources and foods containing vitamin C, folic acid, copper, vitamin A, and vitamin B.

Advanced medical treatments (transfusions, hormone therapies)

Depending on the cause and severity, the doctor may recommend drug treatment for anemia and, in rare cases, certain advanced procedures:

• Erythropoietin: a drug that stimulates increased production of stem cells in the spinal cord.
• Immunosuppressants: in the case of anemia caused by autoimmune diseases, there are medications that prevent the immune system from attacking red blood cells.
• Hormone therapy: in the case of anemia developed as a result of excessive menstrual bleeding, caused by menstrual disorders based on a hormonal imbalance.
• Blood transfusions: to replace red blood cells.
• Stem cell (bone marrow) transplant: to replace unhealthy red blood cells with healthy cells.
• Surgery: to treat internal bleeding, when this is the cause of anemia.

Nutrition in case of anemia

A diet for treating and preventing anemia should contain all the macronutrients and a variety of vitamins and minerals. Foods rich in iron, folate, vitamin C, and vitamin B12 are especially recommended.

Foods rich in iron

High amounts of iron are found primarily in dark green leafy vegetables such as spinach, kale, Swiss chard, broccoli, cauliflower, Brussels sprouts, and kohlrabi. Beans, soybeans, chickpeas, and peas can also provide significant amounts.

Other important sources of iron are red meat, poultry, fish, nuts, seeds, dried fruits, and fortified cereals.

How to improve iron absorption

It is important to eat foods rich in iron along with foods containing vitamin C, as it supports the absorption of iron in the body. Oranges, bell peppers, tomatoes, and strawberries are excellent sources of vitamin C.

Avoid consuming calcium-rich foods, coffee, or tea at the same time as iron sources, as they can slow absorption.

Foods to avoid in anemia

Eggs, tofu, edamame beans, soy milk, and tempeh, as well as calcium sources, should be consumed in moderation in anemia. They can inhibit iron absorption, especially if consumed at the same time as an iron-rich meal.

Especially avoid excessive alcohol consumption, as it can hinder the absorption of vitamins.

Anemia - Possible complications

Generally, mild anemias do not cause serious symptoms or complications. But without diagnosis and treatment, they persist, symptoms worsen, and can lead to chronic anemia.

Chronic anemia can cause serious problems such as heart attack and heart failure. Other complications of anemia can include:

• Chronic fatigue
• Cardiovascular complications
• Weakening of the immune system
• Pregnancy complications (preeclampsia, premature birth)
• Impairment of cognitive function
• Kidney damage and kidney failure

How to prevent anemia?

The most common type of anemia, iron deficiency anemia, can be prevented by daily consumption of iron-rich foods and by:

• Diet rich in vitamins and minerals , which supports optimal body functioning and the production of healthy red blood cells.
• Periodic medical checkups , to detect anemia or other conditions that may increase the risk of anemia early
• Preventive supplementation , but only with the recommendation of a doctor, following specific tests.

Unfortunately, there are no methods of prevention for inherited anemias.

Frequently asked questions about anemia

Anemia is a common disorder that affects nearly a quarter of the global population and can significantly reduce quality of life if left untreated. However, the signs can be easily ignored in the early stages.

In this section we will answer the most common questions about the causes, evolution and implications of this disorder, so that you can better understand how anemia works and recognize it from the first symptoms.

What does low hemoglobin level mean?

Hemoglobin is a protein in red blood cells that carries oxygen around the body. A low hemoglobin level is called anemia and often indicates an insufficient number of red blood cells in the blood, which can lead to fatigue, weakness, or difficulty concentrating.

Can anemia recur after treatment?

Yes, anemia can return if the underlying cause (such as chronic bleeding, a diet lacking essential nutrients, or certain health problems) is not treated. Regular monitoring, attention to lifestyle, and avoidance of risk factors are essential to prevent recurrence.

How does anemia influence physical exertion capacity?

Anemia reduces the blood's ability to carry oxygen, leading to decreased physical endurance, rapid fatigue, shortness of breath, and rapid heartbeat during strenuous activities.

Is anemia dangerous during pregnancy?

Mild anemia is normal during pregnancy, as a result of the increased need for iron and increased blood production to support fetal development.

But without careful monitoring and multivitamin supplements with folic acid, anemia can worsen. This can increase the risk of complications for both mother and fetus, including premature birth and low birth weight.

Can I donate blood if I have had or have anemia?

Blood donation is not allowed for people who are currently anemic. If you have had anemia in the past, you can donate blood only if your current hemoglobin values are within normal limits and you feel well.

How long does it take to treat anemia?

The duration of treatment depends on the type and severity of anemia. In general, it can take between a few weeks and a few months for normal hemoglobin and iron levels to be restored in the body.

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