Anemia: Causes, Symptoms, Types & Treatment Options

Anemia is mainly found in Low- and lower-middle-income countries especially in population residing in the rural areas with low -income and no formal education.

• Mainly young children, menstruating adolescent girls and women, pregnant and postpartum women, are majorly affected by Anemia.

• According to WHO, 40% of all children aged 6–59 months, 37% of pregnant women and 30% of women 15–49 years of age are affected by anaemia around the world.

• In the year 2019, 50 million lives were lost due to Anemia.

• The dietary iron deficiency, thalassaemia and sickle cell trait, and malaria being the largest cause.

What is the normal range of hemoglobin?

The Normal ranges of Hemoglobin will vary based on age, sex, and health issues:

Men: 13.8-17.2 g/dL

Women: 12.1-15.1 g/dL

Children: 11-16 g/dL

Pathophysiology of Anemia:

• The pathophysiology of anemia varies based on the underlying etiology or the cause.

• It involves one or more mechanisms such as:

• Acute or chronic bleeding causing blood loss.

• Nutritional deficiencies, bone marrow disorders, or chronic disorder may lead to decreased production of red blood cells.

• Blood cells destruction increases for example in hemolytic anemia

• This imbalance reduces the amount of oxygen delivered to body’s tissues, inturn activating the compensatory responses such as increased heart rate and respiratory rate.

What are the Types of Anemias?

• Depending upon the cause, Anemia is classified into several types which are as follows:

• Iron deficiency anemia: As name the name indicates this is caused due to insufficient iron. This is the most common type anemia. Iron is required by the bone marrow to prepare healthy hemoglobin but in deficiency the bone marrow produces smaller and paler Hb, leading to a condition where not enough oxygen is carried to the body’s tissues.

• Vitamin B12 or folate deficiency anemia: Due to a deficiency in Vitamin B12 the bone marrow produces large and abnormal Hb. This condition might be due to poor dietary intake or absorption.

• Anemia of chronic disease: This is the second most common type of anemia after Iron deficiency anemia. It’s a condition where with long term (chronic) illnesses may lead to chronic inflammation which prevents the body from effectively using the iron stored in the body to make RBCs.

• Hemolytic anemia: resulting from the premature destruction of red blood cells. Normally, the RBCs life span in the body is 120 days before they are naturally removed from circulation. But due to premature hemolysis, the body removes RBCs faster than they can be produced leading to in reduced oxygen supply to the body’s tissues.

• Aplastic anemia: The hemopoietic cells in the bone marrow are responsible for the production of all blood cell types like RBCs, WBCs, platelets etc. This spongy bone marrow becomes empty or aplastic in the bones leading to not enough production of RBCs.

• Sickle cell anemia: A genetic mutation causes the production of abnormal hemoglobin called the HbS instead of normal HbA. This genetic condition where in the presence of HbS the red blood cells are abnormally shaped or sickle-shaped.

• Thalassemia: inherited blood disorder affecting hemoglobin production. When there is not enough functional Hb, the RBCs become fragile and get destroyed prematurely leading to anemia.

What are the Causes of Anemia:

• There are many causes for anemia to name a few:

• Nutritional deficiencies: lack of iron, vitamin B12, or folic acid are a few reasons. Other nutritional deficiencies like severe Vitamin A deficiency, copper deficiency, Vitamin C deficiency and protein-energy malnutrition leads to anemia too.

• Chronic disease: Chronic kidney disorder (CKD), cancer, autoimmune disorders, Chronic liver disorders, Severe trauma or burns may lead to Anemia.

• Blood loss: menstruation, ulcers, trauma, gastrointestinal bleeding, surgery, obstetric emergencies (postpartum bleeding after childbirth), Ruptured aneurysm etc may lead to Anemia.

• Genetic disorders: sickle cell disease, thalassemia

• Medications & toxins: Certain drugs or chemical exposure can impair red blood cell production

What are the Symptoms of anemia?

Symptoms of anemia include:

• Fatigue and tiredness

• Pale or yellowish skin

• Shortness of breath

• Bruising more easily

• Pale mucous membranes

• Cold hands and feet

• Dizziness and lightheadedness

• Irregular or rapid heartbeat

• Chest pain

• Headache

• Brittle nails

How to Diagnosis

To diagnose anemia, there are several ways which healthcare professionals may recommend to find out the condition:

• Complete blood count (CBC): To measure hemoglobin, hematocrit, and red blood cell count

• Peripheral blood smear: to examine the shape and size of blood cells

• Hemolytic anemia: Bilirubin, Haptoglobin, Lactase Dehydrogenase (LDH) levels

• Reticulocyte count: Measures the number of immature cells in the body

• For iron deficiency anemia: Serum iron, ferritin, Total Iron Binding Capacity (TIBC)

• vitamin B12, and folate levels

• Bone marrow biopsy (if required)

• Stool test : to detect gastrointestinal bleeding

What are the Treatment Options

The underlying cause determines the treatment:

• Iron supplement: for iron deficiency anemia

• Vitamin B12 or folate therapy: Oral or injectable supplements

• Aplastic Anemia: Supportive care like blood transfusion, antibiotics/Antifungals, bone marrow transplant, Immunosuppressive therapy or IST.

• Treating underlying conditions: managing chronic disease

• Blood transfusions: for severe anemia or rapid blood loss

• Sickle cell anemia: drugs for pain management, Hydroxyurea, Blood transfusions, folic acid supplements, Bone marrow transplant, gene therapies.

• Erythropoiesis-stimulating agents (ESAs)-for anemia of chronic disease, like chronic kidney disease or certain cancers

• Bone marrow transplant: in several aplastic anemia or certain genetic types

• Dietary changes: iron-rich food, vitamin C to enhance iron absorption

What are the Prevention tips:

Maintaining good health and preventing anemia involves:

• Eat balanced diet: include iron-rich foods (red meat, poultry, fish, beans, lentils, leafy greens) vitamin C (Citrus fruits), B vitamins, dry fruits, nuts, seeds etc.,

• Avoid overuse of antacids: they can reduce iron absorption

• Be mindful of iron inhibitors like: calcium supplements and calcium rich foods, limit Phytates and tannins

• Limit tea and coffee: they may interfere with iron absorption when consumed with meals

• Regular checkups: especially for women, older adults, and those with chronic illness

• Manage chronic disease: good control of diabetes, kidney disease, and other long-term conditions

• Genetic counseling or screening

• Prenatal care: Iron and folic acid supplement during pregnancy

Conclusion:

Anemia as discussed is a condition where the blood lacks sufficient healthy RBCs or Hb leading to impaired ability to transport oxygen to the body’s tissues. Anemia is a diverse condition where the causes of the disease are many. If left untreated, anemia can impact quality of life. Therefore, early recognition, accurate diagnosis, and proper treatment are crucial. While certain conditions of anemia may be unavoidable as they are genetic the other conditions can be avoided and managed with healthy lifestyle choices, regular screenings, and appropriate medical care.

This blog is for informational purposes only and reflects the views and interpretations of Elite Expertise regarding health-related topics such as anemia. While we strive to provide accurate and up-to-date information, medical guidelines, treatment protocols, and healthcare policies may vary by region and are subject to change. This content is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized medical guidance. Elite Expertise does not accept responsibility for any decisions made based on the information provided in this article.

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About the Author

Sahana Rao

Sahana Chinthapatla is renowned for her expertise in scientific and medical writing, backed by an MPharm in Pharmacology and years of experience in research analysis and scientific writing.

As the Head Business Writer at Elite Expertise, she provides insightful and well-researched content on KAPS, OPRA, PEBC, PSI and global pharmacy pathways, guiding aspiring pharmacists in their professional journeys.

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Head Business Writer | Elite Expertise