Anemia

Anemia is a blood cell condition in which there is a drop in the percentage of oxygen-transporting red blood cells. A low level of hemoglobin, the iron-rich protein that carries the oxygen in red blood cells, is an indicator of the condition. Anemia can be chronic or it can be a temporary condition caused by other health issues, including bleeding, cancer or treatments for cancer, kidney disease, infections, autoimmune diseases, and vitamin or mineral deficiency. Anemia itself is usually not frequently undiagnosed, however, an underlying cause of anemia may be missed if it is attributed to another health condition. The most common type of anemia results from iron deficiency from blood loss. There are other, less common types of anemia. For example, aplastic anemia is a bone marrow condition in which the body does not produce enough red and white blood cells and platelets. Sickle cell anemia and thalassemia are inherited blood disorders affecting red blood cells that can also lead to anemia.

At-risk groups include people with the following conditions or patient groups:

• Heart disease 
• Rheumatoid arthritis
• Cancer 
• Chronic kidney disease
• Inflammatory bowel disease 
• Intestinal disorders
• A low-iron diet
• Old age
• Autoimmune disease
• Liver or thyroid disease
• Chronic health conditions
• Infections 
• Women with heavy menses
• Pregnant women
• Infants and young children with inadequate amounts of iron in the diet

Statistics

• At initial cancer diagnosis, 22.7 to 63 percent of patients have anemia. This rises 89 percent for those receiving chemotherapy during treatment.
• Twelve percent of pregnant women in the United States were anemic in 2019 (latest available data).
• About 5,633 deaths in the U.S. occurred due to anemia in 2020 (latest available data).
• Approximately 890,000 emergency department visits in the U.S. were due to anemia in 2018 (latest data available).
• About six percent of U.S. children under five years old had anemia in 2019 (latest available data).
• Between 600 and 900 U.S. adults are diagnosed with aplastic anemia each year.

Risk Factors

• Menstruation in women
• Loss of blood from disease, injuries, or surgery
• Infections
• Family history, including sickle cell anemia and thalassemia
• Low iron and folic acid during pregnancy
• Low production or increased destruction of red blood cells
• Deficiency of certain vitamins and minerals in diet
• Serious illnesses, including cancer, heart failure, lung disease, inflammatory bowel disease, kidney disease, liver disease, rheumatoid arthritis, thyroid disease, and autoimmune disease
• Low amounts of iron caused by an iron-deficient diet
• Treatment for cancer, including radiation and chemotherapy
• Von Willebrand disease
• Carriers of hemophilia gene

Symptoms

• Fatigue is the main symptom of most types of anemia
• Swelling of hands or feet
• Weakness or dizziness
• Rapid or irregular heartbeat
• Chest pain
• Shortness of breath
• Trouble breathing with exertion
• Pounding or whooshing sound in ears
• Headache
• Cold hands or feet
• Paleness of the skin, nails, mouth, and gums

Treatments

Anemia treatment can reduce blood loss or increase the survival or production of red blood cells, and increase the amount of oxygen in the blood. The exact treatment depends on the severity, cause, and type of the disorder, but can include:

• Dietary and nutritional changes or supplements, including intake of B12, folic acid, iron, and vitamin C. Iron can be replenished through foods including fish, meat, poultry, beans, green-leafy vegetables, tofu, dried fruits, and enriched bread, cereal, and pasta. B12 can be replenished through foods like eggs, fish, meat, poultry, and dairy products.
• Medication, such as vitamin B12 injections, folic acid pills, intravenous iron or oral iron pills, antibiotics, or hormones.
• Procedures such as blood transfusions or surgery.