Anemia Symptoms, Causes, Tests, Treatment & Urgent Care

Anemia means blood has too few healthy red cells or too little hemoglobin. Hemoglobin is a protein that carries oxygen from the lungs through the body^2,3.

This condition may be mild, severe, short-term, or long-term. It can also signal blood loss or another health problem.

This guide covers common signs, causes, anemia blood tests, and treatment. It also explains when to see a doctor and why iron requires a confirmed diagnosis.

Red blood cells carry oxygen to the body’s tissues and organs^2,3. Bone marrow, the soft tissue inside bones, makes most blood cells³.

The kidneys make a hormone called erythropoietin, or EPO³. EPO tells bone marrow to make more red blood cells³.

The body needs iron, vitamin B12, and folate to make healthy blood cells^3,9. Folate is a B vitamin that occurs in food and supplements.

Anemia can develop through three main processes:

Iron deficiency is the most common type of anemia^3,5. Yet many other problems can cause this condition^2,9.

A blood test can show low red cell or hemoglobin levels^1,4. Symptoms alone cannot confirm anemia because they can occur with other health problems.

Hemoglobin limits differ based on age, sex, and physical state⁷. Pregnancy is one physical state relevant to anemia in women⁷.

Mild anemia may cause no symptoms, especially when it develops slowly^3,9. Signs often become clearer as the condition gets worse.

Early signs of anemia may affect energy, comfort, and focus:

These symptoms do not prove that anemia is present. A complete blood count can check red cell and hemoglobin levels¹.

Some physical changes become clearer as anemia gets worse^3,4. Certain signs can also occur with iron deficiency.

Possible changes may include the following signs:

A fast pulse or abnormal heart rhythm can occur as anemia worsens^3,4. Severe anemia can lower oxygen levels in vital organs, including the heart³.

Untreated anemia can raise the risk of heart problems⁶. These may include an abnormal rhythm, an enlarged heart, or heart failure⁶.

Blood contains iron inside its red blood cells^5,10. Losing blood also means losing iron^5,10.

Ongoing blood loss can drain iron stores and cause iron-deficiency anemia. Blood loss and problems with iron absorption can lead to iron-deficiency anemia^5,10.

Possible sources of blood loss include these problems:

Low iron intake can also cause a deficiency⁷. This risk rises when meals do not provide enough iron-rich foods^5,10.

Pregnancy raises iron needs because the body makes more blood. The developing baby also needs iron for hemoglobin.

The body needs iron, vitamin B12, folate, and other nutrients to make blood cells^3,9. A limited diet may not supply enough of these nutrients^2,9.

Poor absorption can cause a deficiency despite food intake^3,5. Celiac disease, Crohn’s disease, and ulcerative colitis may increase the risk of iron-deficiency anemia^5,10.

Stomach or bowel surgery can also affect nutrient absorption^3,10. This includes surgery on the stomach or intestines, such as weight-loss surgery^5,10.

Several health problems can reduce blood cell production:

Some anemias involve early destruction of red blood cells^3,9. As red blood cells are removed, bone marrow makes replacements^3,9.

Immune problems can cause early red cell destruction³. Certain medicines may also play a role^3,8.

Sickle cell disease and thalassemia are inherited blood disorders^2,7. Both conditions involve changes affecting hemoglobin⁷.

The following groups may have a higher anemia risk:

A clinician may ask about symptoms, food choices, and past health problems^1,8. Questions may also cover family history and recent blood donations^1,8.

Expect questions about anemia risk factors^1,8. The clinician may also ask about your medical history^1,8.

Bring a list of all medicines, vitamins, and supplements. Include each dose when possible.

During the examination, the clinician may check for pale skin or a pale tongue^1,3. Brittle nails may also be present^1,3.

The examination may find a fast pulse or low blood pressure³. Some people may also have a heart murmur, which is an unusual heart sound³.

A complete blood count, or CBC, can identify anemia¹. It measures red cells, white cells, and platelets¹.

The CBC provides several useful measurements for anemia:

An MCV result above or below normal may be a sign of anemia¹. More tests may be needed to find the cause^1,8.

A reticulocyte count may be part of the blood testing^2,3. A blood smear is also listed among anemia-related tests².

Tests may measure blood iron and ferritin levels⁵. These results can help diagnose iron deficiency with anemia⁵.

Vitamin B12 and folate tests may find a lack of these nutrients^2,3. Read more about vitamin B12 deficiency.

A clinician may also order tests to rule out other conditions^1,2. Genetic tests can find some changes that affect red blood cell production¹.

Finding anemia is often only the first step. The next step is finding why it developed.

Further testing may include the following options:

Bone marrow tests can help explain abnormal blood cell counts¹. They can also show whether marrow is making normal amounts of blood cells¹.

Anemia treatment depends on its cause and how serious it is⁶. Some mild cases may not need treatment⁶.

Do not start iron only because fatigue is present. Iron is not advised for people without iron-deficiency anemia⁶.

Too much iron can build up and damage organs^6,10. A clinician should confirm iron deficiency and check its cause^5,10.

Oral iron is a common iron-deficiency anemia treatment⁵. It raises the body’s iron supply and supports hemoglobin production⁵.

Iron pills may cause these unwanted effects:

Iron-rich foods can support a treatment plan. Food choices may include these options:

Foods rich in vitamin C can help the body absorb iron⁵. Black tea can reduce iron absorption⁵.

Intravenous iron, or IV iron, sends iron through a vein⁵. It may be used for serious deficiency or long-term health problems⁵.

Vitamin B12 pills or shots can treat anemia from B12 deficiency^6,8. Folate supplements can treat anemia caused by low folate^3,8.

Replacing iron does not stop ongoing blood loss. The source of bleeding also needs care.

Treatment may address heavy periods or bleeding in the digestive tract^7,8. Surgery may be needed to stop internal bleeding^5,6.

A clinician may review medicines that contribute to anemia⁶. Changes may help when a medicine causes the condition⁶.

Treatment for chronic disease anemia focuses on the underlying illness. Kidney disease, inflammation, and cancer may require different plans^5,7.

Serious anemia may need treatment tailored to its cause and severity^1,6. A hematologist is a doctor who treats blood disorders^1,8.

Specialist-led care may include the following treatments:

Transfusions may treat serious anemia or related complications^5,6. Clinicians match donated blood and watch the patient during and after treatment⁶.

A marrow transplant replaces faulty blood-forming cells with healthy cells⁶. This treatment can cause serious problems and needs close monitoring⁶.

Follow-up blood tests can show how blood counts respond after a transplant⁶. Other follow-up plans depend on the cause and treatment.

Make an appointment if fatigue lasts or other symptoms cause concern. Testing should come before self-treatment with iron.

Contact a clinician for possible anemia symptoms or unusual bleeding³. This includes ongoing heavy periods, weakness, dizziness, or pica^3,7.

If breathlessness has no clear cause, make a medical appointment. Explain when it started and whether activity makes it worse.

Schedule an evaluation after a blood center reports low hemoglobin. Testing may show whether iron deficiency or another problem caused the result.

Pregnancy raises the risk of iron-deficiency anemia. Anemia can also cause pregnancy problems when left untreated⁵.

Serious iron deficiency can delay growth and development in children^5,10. A child with possible symptoms should see a health professional.

Tell the clinic how quickly the symptoms began. Also explain whether they are getting worse.

You can prepare for the visit with these simple steps:

Anemia may be mild or may signal a serious illness. It can result from blood loss, low production, or early cell breakdown^2,9.

Blood tests can find anemia, but more tests may reveal its cause^1,8. Treatment should target that cause rather than fatigue alone^6,8.

Confirm iron deficiency before taking iron supplements^6,10. Excess iron can collect in the body and harm organs^6,10.