Anemia: What is it and what are its symptoms?
Published: 25 February, 2020 - Updated: 30 July, 2020 | 6'
Do you feel constantly tired and without energy? Maybe you’re going through a process of anemia. This condition occurs when our body is not able to generate enough red blood cells to carry an adequate level of oxygen to the cells that make up our body tissues.
Anemia can be temporary or prolonged, mild or severe and of many different types, and is a much more common public health problem than is often thought. According to the World Health Organization, 1.62 billion people worldwide suffer from anemia, of which iron deficiency anemia (low iron in the body) is the most common, accounting for 50 per cent of cases.
Here are the most common symptoms, types and causes of anemia and the best tips for avoiding and coping with it.
Main symptoms of anemia
The most common symptoms of anemia are:
- Fatigue and weakness
- Pale skin
- Irregular heartbeat
- Difficulty in breathing
- Cold hands and feet
- Poor appetite, especially in infants and children with iron deficiency anemia
- Brittle nails and hair
The severity of the anemia, the physical condition of the affected person, or age explain that, in some cases, anemia has hardly any symptoms. In other cases, the symptoms are so noticeable that they require immediate medical attention.
Causes of anemia
To understand why anemia occurs, it is necessary to first clarify some concepts.
The body produces three types of blood cells: white cells to fight infection; platelets to help the blood clot; and red cells to carry oxygen throughout the body. All of these are produced in the bone marrow which is located in the bones, mainly the long bones.
Red blood cells contain hemoglobin, a protein that allows them to carry oxygen from the lungs to all parts of the body. Hemoglobin is rich in iron, so its production depends on the amount of iron in the body, vitamin B12, folate, and other nutrients in the foods we eat.
When the amount of hemoglobin inside red blood cells is below 13 g/dl in adult men and 12 g/dl in adult non-pregnant women, the person is said to be anemic.
The most common causes that determine whether or not you have anemia are:
- Blood loss (heavy bleeding) that may be sudden, such as from an injury or during surgery, or may be chronic due to disorders of the digestive or urinary tract or due to heavy menstruation.
- Insufficient production of red blood cells due to imbalances in key nutrients for red blood cell formation, such as iron, vitamin B12, folic acid, zinc or copper, among others, as well as an insufficient hormonal balance, especially erythropoietin (a hormone that stimulates red blood cell production). These imbalances can lead to the formation of red blood cells that are deficient or whose shape is not optimal for transporting oxygen.
- Excessive destruction of red blood cells. In general in a normal process, red blood cells have a lifespan of approximately 120 days after which they are eliminated by organs such as the bone marrow, liver and spleen. If by some extraordinary situation the rate of destruction of red blood cells is greater than the rate of production, the result is a hemolytic anemia, which, however, is rare.
Types of anemia
There are several types of anemia: iron deficiency anemia, pernicious anemia, sickle cell anemia, and aplastic anemia, among others. Let’s look at the two most frequent and important ones:
Iron deficiency anemia
Iron deficiency anemia is the most common and occurs when our body does not have the amount of iron needed to generate healthy red blood cells to carry oxygen to the cells in the body. This type of anemia can occur when our body’s iron requirements exceed reserves, such as during pregnancy, as well as from blood loss such as heavy menstrual bleeding, ulcers, injury to the gastrointestinal tract, etc.
Pernicious anemia occurs when the decrease in red blood cells is caused by a deficiency in vitamin B12 and folate. It usually occurs in extreme situations of malnutrition or in people who, due to certain situations, are not able to absorb vitamin B12 or folate within the gastrointestinal tract.
How do I know if I have anemia?
If you have some of the symptoms described above and you feel tired or fatigued for no apparent reason, you may be facing an episode of anemia.
Don’t be alarmed. These episodes are usually not serious and can be easily resolved. Always consult your doctor first for a diagnosis. To do this, you only need to go to your health centre as a simple blood test will clear up any doubts. You may also have other tests to determine the origin of the anemia and to determine possible treatments.
Can I tell if I’m anemic by looking at my eyes?
If you suspect you have anemia, a quick and simple test is to examine the inside of your eyelid. You will only need to stand in front of a mirror, lower your eyelid with your index finger and look at the color. If the tone is too muted, you may be anemic.
This observation – and this is important – is never a substitute for a medical diagnosis. If you suspect that you are anemic, visit your health center to confirm or rule out this possibility.
Risk factors for anemia
Several factors can increase the risk of anemia. According to the Mayo Clinic, the most common are the following:
- An unbalanced diet. If you eat a diet low in iron, vitamin B12 and folate, your risk of disease increases.
- Age. People over 65 are at greater risk of anemia.
- Menstruation. Women of childbearing age are at greater risk of anemia from loss of blood -and red blood cells- during their periods.
- Pregnancy. Pregnant women who have imbalances in iron and vitamins such as folic acid are also at greater risk.
- Stomach ulcers. Slow, chronic blood loss also increases the risks.
- Intestinal disorders such as Crohn’s disease, ulcerative colitis or celiac disease make it difficult for the intestine to absorb nutrients.
- Genetics. If you have family members who have had hereditary anemia, you should seek medical advice.
- Other factors such as chronic diseases (cancer, kidney failure), blood and autoimmune disorders, alcoholism, exposure to toxic substances or the intake of certain medications. All of these can affect the proper formation of red blood cells.
Anemia in pregnancy
Iron needs are higher during pregnancy to facilitate the proper development of the fetus and placenta. When the iron supply is insufficient, the pregnant woman becomes anemic. This is a fairly common, but easily reversible, process and it occurs in up to a third of pregnant women, especially during the third trimester.
A good diet can prevent iron deficiency anemia during pregnancy. Prenatal supplements with iron and vitamins (folic acid and vitamin B12) can help prevent and treat iron deficiency anemia during pregnancy.
If there is a risk or suspicion of anemia, the pregnant woman should always contact her healthcare provider. They will determine the amount of iron needed to ensure your health and the proper development of the fetus.
How to fight and prevent anemia?
Maintaining a healthy lifestyle is the best way to rule out anemia. A good diet, physical exercise and avoiding the use of toxins such as tobacco or alcohol can become the best ally against anemia. In extraordinary situations, food supplements can help. Here are the best nutrients for anemia.
What is the best diet for anemia? Vitamins and recommended foods
This mineral enters our body through the food we eat. The following foods are rich in iron:
- Egg yolk
- Beef and pork
- Seafood and sardines.
- Nuts (almonds, walnuts)
- Wholemeal bread
- Enriched cereals
As with iron, folates are also ingested through the diet. These are rich in folates:
- Cow’s liver
- Spinach and green vegetables
- Dried fruits (peanuts, nuts)
- Beans and peas
- Red cabbage
Diets rich in vitamin B12 or cobalamin
The following are foods rich in vitamin B12:
- Beef and liver
- Poultry meat.
- Milk, eggs and derivatives
- Enriched cereals
Evan M. Braunstein, MD, PhD, Johns Hopkins School of Medicine. Introducción a la anemia. Sept, 2017.
Mayo Clinic. Anemia. Dic, 2019.
National Library of Medicine. Medline Plus. Anemia. Nov, 2019.
Organización Mundial de la Salud. Prevalencia mundial de la anemia y número de personas afectadas. Jul, 2013.