What Is Anemia: Symptoms, Causes & Treatment

Friderike Gerlinger

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What is anemia? Anemia is a sign from our body that we have a nutrient or mineral deficiency, such as iron deficiency or vitamin B12 deficiency. Did you know that a hefty one-third of the world's population is affected by anemia – especially women and children? 

Are you pale, tired, and unable to concentrate? Then you may be suffering from anemia symptoms. When you have anemia, the red blood cells in your blood are out of balance, in many cases due to a lack of iron – this is also called iron deficiency anemia – the most common form of anemia.[1]

Children, pregnant women, and women of childbearing age are often affected by anemia, but many people do not know that athletes and older people typically often have anemia too. Experts suspect that dementia in the elderly could be triggered or aggravated by anemia.[2] It is therefore worthwhile having your blood values checked regularly.

So, what are considered typical anemia symptoms and causes and how dangerous can anemia become? How is anemia diagnosed and treated? Which nutrients other than iron are crucial for blood formation? Find out in our blog article!

What Is Anemia?

red blood cells

Anemia is when there are too few red blood cells (erythrocytes) present in your blood, or when your red blood cells contain too little red blood pigment (hemoglobin).[3]

According to the World Health Organization (WHO) definition, anemia is when the hemoglobin concentration (Hb level) is below the following values:[4]

  • in men: below 13 g/dl (8.07 mmol/l)
  • in women: below 12 g/dl (7.45 mmol/l)

    Why Do We Need Erythrocytes and Hemoglobin?

    Our red blood cells transport oxygen from the lungs to the various tissues and organs of our body. Hemoglobin is a component of the erythrocytes and has a particularly important task: With the help of iron, it can bind the oxygen and thus bring it to all the body’s cells. On its way back to the lungs, it supplies the erythrocytes with carbon dioxide, which we later exhale.

    If you have too few erythrocytes or too little hemoglobin, the blood can no longer transport enough oxygen. You then feel tired, weak, and groggy, for example.[1]

    What Are Common Anemia Causes?

    There are various anemia causes, including:[5]

    • blood loss through excessive bleeding
    • insufficient formation of red blood cells
    • excessive destruction of red blood cells (rare)
    • reduced hemoglobin formation
    • nutrient deficiencies through low intake
    Did you know that severe blood loss can occur, for example, due to an injury or during an operation? Some women also suffer from heavy menstrual bleeding – this can make anemia more likely.

    If your body does not produce enough hemoglobin for the red blood cells, there may be various reasons for this. These include inflammation or infectious diseases such as malaria, tuberculosis, and HIV. Most often, nutrient deficiencies lead to reduced hemoglobin production: If you lack folic acid, or suffer from an iron or vitamin B12 deficiency, you could equally develop anemia.[4]

    Iron Deficiency Anemia vs Vitamin B12 Anemia: What’s the Difference?

    At least half of all anemia cases are caused by iron deficiency. This type of anemia is called iron deficiency anemia. If, for example, you take in too little iron from your diet or have lost a lot of iron through blood loss, your body cannot produce enough hemoglobin. This, in turn, affects the buildup and existence of red blood cells.[6]

    About two billion people worldwide suffer from iron deficiency. Women of childbearing age are particularly affected, as they regularly lose iron through menstruation.[7] Pregnant women are furthermore considered a risk group for iron deficiency anemia, as many women do not meet their daily iron requirements, which are significantly higher during pregnancy. Gain more insights into the ideal diet during pregnancy in our Health Portal.

    If you suffer from vitamin B12 anemia, this is also triggered by a deficiency – by a vitamin B12 deficiency. Some people naturally receive less vitamin B12 through their diets – such as vegans – or some people simply absorb the vitamin less efficiently than other people.

    Over time, this lack of vitamin B12 intake can result in a vitamin B12 deficiency. As the effects of this kind of deficiency can be very detrimental to your health if left untreated, it is wise to check your vitamin B12 levels regularly – especially if you are considered someone who is at risk.

    Who Is Affected by Anemia?

    Many people of all age groups can experience anemia at different stages of their life. Those who are most often affected by anemia are:[8, 9]

    • children (during growth phases and puberty)
    • women of childbearing age (15 to 49 years)
    • pregnant and breastfeeding women
    • older people
    • athletes
    • people with diseases (such as tumors, inflammatory gastrointestinal diseases)

      What Are Common Anemia Symptoms?

      Man with fatigue sitting at his laptop

      If you have too few red blood cells in your blood or too little hemoglobin in your red blood cells, you are probably suffering from oxygen deficiency – because the erythrocytes can no longer bind enough oxygen. As a result, your body’s cells are no longer sufficiently supplied with oxygen, meaning your body no longer has enough energy.[1]

      If you have mild anemia, you might experience the following symptoms:[1, 6]

      • paleness
      • tiredness and weakness
      • dizziness
      • difficulty concentrating and headaches
      • hair loss, brittle fingernails, and torn corners of the mouth

        If your anemia is more severe, you will also experience the following anemia symptoms:[6]

        • palpitations
        • chest pain
        • shortness of breath
        • increased thirst and sweating

        banner to ferritin test

        How Anemia Affects the Body: Is Anemia Dangerous?

        Depending on the cause of anemia or pre-existing conditions, anemia can have a significant impact on your body.

        For people with cancer or cardiovascular disease (such as heart failure), anemia can be life-threatening.[3, 10] Even if you are otherwise healthy, you should get seek anemia treatment. This is because a chronic lack of oxygen can cause lasting damage to various organs, such as the lungs or heart.

        If you feel weak, this will reduce your performance. This could severely limit you in everyday tasks and in your professional life. Anemia can also delay the physical and mental development of children.[1]

        Is There a Link between Anemia and Dementia?

        The results of a Dutch study suggest that anemia increases your risk of developing dementia. The reason is that there is poorer oxygen supply to the brain. If an older person with anemia does not seek anemia treatment, brain cells die. This can lead to permanent damage and the development of dementia.[2]

        How Do You Test for Anemia?

        If you suspect that you are suffering from anemia symptoms, you should consult your doctor. Share any information about any previous or relevant illnesses you have, whether you are taking medication, and how you eat.

        How Is a Test for Anemia Carried Out?

        Your doctor will take a blood sample to have it analyzed in the laboratory. The hemoglobin content and the number and size of your red blood cells are particularly looked at in this lab analysis.

        You have anemia if any of the following values are too low:

        • Hemoglobin value
        • Hematocrit value

        The hematocrit value (HKT) indicates the ratio of solid cells (in this case, red blood cells) to the liquid portion of the blood. If you have too few red blood cells, your hematocrit value is low.

        Usually, with a blood test like this, ferritin levels and your iron reserves are also determined. This way, you can find out whether your anemia is caused by an iron deficiency.

        How Do I Clarify Any Anemia Causes?

        If your doctor has diagnosed you with anemia, you may need to investigate the causes for your anemia. This may require further tests, such as stool and urine samples, a gynecological examination, or analyzing liver and inflammation values, as well as checking vitamin levels in your blood.[11]

        Anemia Treatment: How Is Anemia Treated?

        Which form of anemia treatment you opt for depends on the cause and severity of the anemia.

        If your anemia is caused by a nutrient deficiency – that is, you lack iron, folic acid, or vitamin B12, for example – then you can take appropriate supplements after consulting a doctor. You can also make changes to your diet to prevent a deficiency in the future.[5] Vitamin B12 not only affects blood formation, but it also influences your nerves and vision. If you have a vitamin B12 deficiency, you should discuss with your doctor whether vitamin B12 supplements are advisable.

        Sometimes, however, there are other anemia causes. With metabolic disorders, gastrointestinal diseases, tumors, or infectious diseases, your doctor will discuss special anemia treatment options with you that are recommended for the respective disease.[5]

        Treating Anemia: What Should I Eat if I Have Anemia?

        If you struggle with anemia symptoms, you can support your body with the right nutrition – perfecting your diet means you are giving your body the important nutrients it needs to make blood! To make new blood cells, your body needs iron, folic acid, and vitamin B12, among other nutrients.

        Did you know that our red blood cells have a limited lifespan, which is why our bodies constantly need to produce new blood cells – in fact, our bodies produce several billion cells per day![12]

        How Can I Increase Iron in My Diet?

        Iron is found in meat, for example, but also in grains and pulses. You can find information about more iron-rich foods, as well as tips for vegetarians and vegans, in our article on a vegan diet!

        What Foods Are High in Folic Acid?

        Spinach is rich in folate

        In addition to blood formation, folic acid is also involved in cell division and growth. There is a lot of folic acid in these foods:[13]

        • green vegetables (leafy vegetables such as spinach and lettuce), tomatoes and potatoes
        • pulses and wholemeal products
        • nuts
        • oranges
        • sprouts and wheat germ
        • eggs

          How Do You Get B12 Naturally?

          Vitamin B12 is found in milk and dairy products, eggs, fish, seafood, and poultry. [14] Find out from our article of vitamin B12 deficiency or from your doctor how much vitamin B12 you need daily.

          Some nutrients, such as vitamin A and vitamin C, are not directly involved in the formation of vitamin B12, but they boost its absorption and transport in our bodies.

          What Is Anemia – at a Glance

          What Is Anemia?

          Anemia (anemia) refers to a lack of red blood cells (erythrocytes) or red blood pigment (hemoglobin). Red blood cells carry oxygen from the lungs to the different tissues of your body.

          What Are Typical Anemia Causes?

          Anemia can have several causes. These include blood loss, insufficient red blood cell production, or reduced hemoglobin production. Anemia can additionally be caused by the body destroying red blood cells too quickly – although, this is rare.

          Many sufferers have a nutrient or mineral deficiency, such as iron or folic acid. If iron deficiency is the cause of the anemia, it is also called iron deficiency anemia.

          What Are the Most Common Anemia Symptoms?

          If you have too few red blood cells in your blood or too little hemoglobin in your red blood cells, you are probably suffering from a lack of oxygen.

          Anemia symptoms include paleness, tiredness, dizziness, and difficulty concentrating. If the anemia is more severe, it can be accompanied by symptoms such as palpitations, shortness of breath, and an increased feeling of thirst.

          How Do You Know If You Have Anemia?

          Anemia can be diagnosed by a blood test. If the hemoglobin value or the hematocrit value (i.e. the number of red blood cells) in your blood are too low, this is called anemia.

          Is There a Form of Anemia Treatment?

          If your anemia is caused by a nutrient deficiency, then you can take food supplements. You can also adjust your diet. If the cause of the anemia is another disease, this will be treated first.

          Can Your Diet Help with Anemia?

          With anemia, you can support your body with the right nutrition. In order to form enough new blood cells, your body needs iron, folic acid, and vitamin B12, among other things.

          Iron is found, for example, in meat, grains, and legumes. Leafy vegetables, wholemeal products, nuts, and oranges contain a lot of folic acid. Vitamin B12 is found in animal products such as milk, eggs, fish, seafood, and poultry.

          Sources

          [1]       World Health Organisation (WHO), „Anaemia - Symptoms“, World Health Organization. https://www.who.int/health-topics/anaemia#tab=tab_1, accessed on September 21, 2020.

          [2]       F. J. Wolters u. a., „Hemoglobin and anemia in relation to dementia risk and accompanying changes on brain MRI“, Neurology, Bd. 93, Nr. 9, S. e917–e926, Aug. 2019, doi: 10.1212/WNL.0000000000008003.

          [3]       D. Ä. G. Ärzteblatt, „Anämie- und Blutmanagement: Neubewertung in verschiedenen Indikationen“, Deutsches Ärzteblatt, Dez. 01, 2017. https://www.aerzteblatt.de/archiv/194970/Anaemie-und-Blutmanagement-Neubewertung-in-verschiedenen-Indikationen, accessed on September 21, 2020.

          [4]       World Health Organization (WHO), „Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity“, Vitamin and Mineral Nutrition Information System, 2011. https://www.who.int/vmnis/indicators/haemoglobin.pdf, accessed on September 8, 2020.

          [5]       „Anämie | Universitätsklinikum Ulm“. https://www.uniklinik-ulm.de/innere-medizin-iii/haematologie/anaemie.html, accessed on September 22, 2020.

          [6]       J. Hastka, G. Metzgeroth, und N. Gattermann, „Onkopedia Leitlinien - Eisenmangel und Eisenmangelanämie“. Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie e.V., Dez. 2018, accessed on September 8, 2020. [Online] available at https://www.onkopedia.com/de/onkopedia/guidelines/eisenmangel-und-eisenmangelanaemie.

          [7]       E. McLean, M. Cogswell, I. Egli, D. Wojdyla, und B. de Benoist, „Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005“, Public Health Nutrition, Bd. 12, Nr. 4, S. 444–454, Apr. 2009, doi: 10.1017/S1368980008002401.

          [8]       World Health Organisation (WHO), „Nutritional anaemias: tools for effective prevention and control“, Nov. 13, 2017. https://www.who.int/publications-detail-redirect/9789241513067, accessed on September 8, 2020.

          [9]       J. P. Schuchardt und A. Hahn, „Die Bedeutung von Eisen, Zink und Selen in der Ernährung des Menschen“. Ernährungs Umschau, October 2010, accessed on 28 September 2020 [Online] available at https://www.ernaehrungs-umschau.de/fileadmin/Ernaehrungs-Umschau/pdfs/pdf_2010/10_10/EU10_538_549.qxd.pdf.

          [10]     Deutsche Apotheker Zeitung, „Häufige Begleiterscheinung bei Krebs und Diabetes“, DAZ.online, June 5, 2005. https://www.deutsche-apotheker-zeitung.de/daz-az/2005/daz-23-2005/uid-14065, accessed on September 23, 2020.

          [11]     A. M. Krause S. W., „Anämie - Diagnostische Schritte für die Hausarztpraxis • allgemeinarzt-online“, Allgemeinarzt-online. Fortbildung und Praxis für den Hausarzt, February 25, 2013. http://www.allgemeinarzt-online.de/cme/a/diagnostische-schritte-fuer-die-hausarztpraxis-1574734, accessed on September 24, 2020.

          [12]     Kompetenznetz akute und chronische Leukämien, „Blut und Blutbildung“, Kompetenznetz Leukämien, March 31, 2015. https://www.kompetenznetz-leukaemie.de/content/patienten/leukaemien/blut_und_blutbildung/, accessed on September 28, 2020.

          [13]     Deutsche Gesellschaft für Ernährung e. V., „Referenzwerte für die Zufuhr von Folat aktualisiert“, Referenzwerte für die Zufuhr von Folat aktualisiert, February 6, 2019. https://www.dge.de/nachrichten/detail/referenzwerte-fuer-die-zufuhr-von-folat-aktualisiert/, accessed on September 28, 2020.

          [14]     Deutsche Gesellschaft für Ernährung e.V., „Neuer Referenzwert für die Vitamin-B-12-Zufuhr“, Jan. 22, 2019. https://www.dge.de/presse/pm/neuer-referenzwert-fuer-die-vitamin-b12-zufuhr/, accessed on September 8, 2020.

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