Red blood cells carry oxygen in the blood. When a person has anemia, they are low in red blood cells and the body may not be getting the oxygen it needs.
Treatment to fix anemia depends on the type of anemia.
For anemia caused by iron deficiency, the cause of the low iron must first be determined. If low iron is due to blood loss, such as from stomach ulcers or bowel problems, those issues need to be treated.
People with iron deficiency anemia need additional iron. Eating foods high in iron is not enough. Iron supplementation may be given:
- Orally as pills or liquid
- Ferrous fumarate
- Ferrous gluconate
- Ferrous sulfate
- Ferrous sulfate liquid
- Polysaccharide iron complex
- Intravenously
- For people unable to absorb an adequate amount of iron orally
If iron deficiency anemia is severe, a blood transfusion may be needed.
For some cases of anemia of inflammation, erythropoietin or erythropoiesis-stimulating agents (ESAs) that help the body produce more red blood cells may be used.
Autoimmune hemolytic anemia is treated with:
- Treating the underlying condition such as lupus or chronic lymphocytic leukemia (CLL)
- Medications
- Prednisone
- Cyclophosphamide (Cytoxan) or rituximab (Rituxan) if prednisone does not work
- Blood transfusions
- Spleen removal (splenectomy)
Treatment for aplastic anemia depends on the cause and may include:
- Stopping medicines that caused the problem
- Don’t stop taking a prescribed medication without talking to your doctor first
- Medications
- Antibiotics
- Antivirals
- Immunosuppressive medicines
- Avoiding toxic chemicals
- Transfusion of red blood cells or platelets
- Bone marrow transplant (stem cell transplant)
What Are Symptoms of Anemia?
Anemia doesn’t always cause symptoms. When symptoms occur, they may include:
- Irritability
- Headache
- Weakness
- Fatigue
- Difficulty exercising (due to shortness of breath, rapid heartbeat)
- Chest pain or trouble breathing
- Sore tongue
- Brittle nails
- Restless legs syndrome
- Muscle pain
- Abnormal craving to eat ice (pagophagia)
- Abnormal cravings for non-food items, such as clay or dirt, paper products, or cornstarch (pica)
- Pale skin or a pale color in the tissue that lines the inside of the eyelids
- Reddish or brown urine (autoimmune hemolytic anemia)
- More frequent infections (aplastic anemia)
- More bruising or bleeding than normal (aplastic anemia)
What Causes Anemia?
Causes of anemia include:
- Iron deficiency anemia
- Decreased iron absorption from food
- Inadequate dietary iron intake
- Pregnancy and the postpartum period
- Loss of large amounts of blood
- Anemia of inflammation or anemia of chronic disease
- Autoimmune hemolytic anemia
- Occurs due to problems with the body's immune system in which the immune system mistakenly attacks and destroys red blood cells
- The cause is often unknown but may be related to:
- Infections such as pneumonia and mononucleosis (“mono”)
- Autoimmune diseases such as lupus
- Some types of cancer, including chronic lymphocytic leukemia (CLL), multiple myeloma, and lymphoma
- Certain medicines, including some antibiotics
- Aplastic anemia
- Caused by damage to bone marrow
- The cause is often unknown but may include:
- People may be born with damaged bone marrow
- Certain medicines
- Some chemicals
- Infections from certain viruses
- Problems with the body’s immune system
How Is Anemia Diagnosed?
Anemia is diagnosed with a medical history, physical examination, and blood tests.
Blood tests used to diagnose anemia include:
- Complete blood count (CBC)
- Serum iron
- Total iron binding capacity (TIBC or transferrin)
- Transferrin saturation (TSAT)
- Ferritin
For aplastic anemia, tests may also include a bone marrow biopsy.
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