Anemia

• Causes, incidence, and risk factors

  The cause depends on the type of anemia. Possible causes include:

  • Certain medications
  • Diseases such as cancer or rheumatoid arthritis
  • Genes -- some forms of anemia can be inherited
  • Kidney failure
  • Blood loss (for example, from heavy menstrual periods)
  • Poor diet
  • Pregnancy
  • Problems with bone marrow (where blood cells are made)
  • Problems with the immune system that cause the destruction of blood cells
  • Surgery to the stomach or intestines that reduces the absorption of iron, vitamin B12, or folic acid
• Symptoms

  Possible symptoms include:

  • Chest pain
  • Dizziness or light-headedness (especially when standing up or with exertion)
  • Fatigue or lack of energy
  • Headaches
  • Problems concentrating
  • Shortness of breath (especially during exercise)

  Some types of anemia may have other symptoms, such as:

  • Constipation
  • Problems thinking
  • Tingling
• Signs and tests

  The doctor will perform a physical examination, and may find:

  • Pale skin
  • Rapid heart rate

  Some types of anemia may cause other findings on a physical exam.

  The following blood tests are used to diagnose anemia:

  • Blood levels of vitamin B12, folic acid, and other vitamins and minerals
  • Bone marrow examination
  • Red blood count and hemoglobin level

  Other tests may be done to identify medical problems that can cause anemia.

• Treatment

  Treatment should be directed at the cause of the anemia, and may include:

  • Blood transfusions
  • Corticosteroids or other medicines that suppress the immune system
  • Erythropoietin, a medicine that helps your bone marrow make more blood cells
  • Supplements of iron, vitamin B12, folic acid, or other vitamins and minerals
• Expectations (prognosis)

  The outlook depends on the cause.

• Complications

  Severe anemia can cause low oxygen levels in vital organs such as the heart, and can lead to a heart attack.

• Calling your health care provider

  Call your health provider if you have any symptoms of anemia, or any unusual bleeding.

• References

  Antony AC. Megaloblastic anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 170.

  Zuckerman KS. Approach to the anemias. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 162.

Review Date: 4/5/2009

Reviewed By: Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc