Anemia

What Is Anemia?

BY National Institutes of Health TIMEAugust 3, 2022 PRINT

Anemia is a condition that develops when your blood produces a lower-than-normal amount of healthy red blood cells. If you have anemia, your body does not get enough oxygen-rich blood. The lack of oxygen can make you feel tired or weak. You may also have shortness of breath, dizziness, headaches, or an irregular heartbeat. According to the Centers for Disease Control and Preventionexternal link, about 3 million people in the United States have anemia.

There are many types of anemia, including:

Mild anemia is a common and treatable condition that can develop in anyone. It may come about suddenly or over time, and may be caused by your diet, medicines you take, or another medical condition. Anemia can also be chronic can also be chronic, meaning it lasts a long time and may never go away completely. Some types of anemia are inherited. The most common type of anemia is iron-deficiency anemia.

Some people are at a higher risk for anemia, including women during their menstrual periods and pregnancy. People who do not get enough iron or certain vitamins and people who take certain medicines or treatments are also at a higher risk.

Anemia may also be a sign of a more serious condition, such as bleeding in your stomach, inflammation from an infection, kidney disease, cancer, or autoimmune diseases. Your doctor will use your medical history, a physical exam, and test results to diagnose anemia.

Treatments for anemia depend on the type you have and how serious it is. For some types of mild to moderate anemia, you may need iron supplements, vitamins, or medicines that make your body produce more red blood cells. To prevent anemia in the future, your doctor may also suggest healthy eating changes.

Symptoms

If you have mild anemia, you may not have any symptoms. Symptoms of anemia may develop quickly or slowly, depending on the cause of your anemia. General symptoms that are the same for many types of anemia include:

  • Weakness
  • Paleness
  • Tiredness
  • Chills
  • Shortness of breath
  • Headache
  • Dizziness and fainting
  • Bleeding
  • jaundice, or yellowing of the skin

Diagnosis

How will your doctor know you have anemia?

To diagnose anemia, your doctor may ask you questions about your risk factors and order blood tests or other diagnostic tests. Your doctor may also ask about your medical history, what you eat, and whether other people in your family have been diagnosed with anemia. Your doctor may also do a physical exam to look for symptoms of anemia, such as a pale tongue or brittle nails. If you have anemia, your doctor may ask you to visit a hematologist (a doctor who specializes in blood diseases).

Blood tests

The complete blood count is one of the most common blood tests. It’s often done as part of a routine checkup. This test measures many different parts of your blood, including red blood cells, white blood cells, and platelets.

  • Red blood cell levels that are higher or lower than normal could be a sign of anemia. Red blood cells carry oxygen from your lungs to the rest of your body.
  • Hemoglobin levels that are higher or lower than normal may be a sign of anemia. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen.
  • Hematocrit levels that are too low may be a sign of anemia. Hematocrit is a measure of how much space red blood cells take up in your blood.
  • Mean corpuscular volume (MCV) levels that are higher or lower than normal may be a sign of anemia. MCV is a measure of the average size of your red blood cells.

Blood test results

The table below shows some normal ranges for adults for different parts of the complete blood count (CBC) test. Some of the normal ranges differ between men and women. Other factors, such as age, high altitude, and race, also may affect normal ranges. Talk to your doctor about your results and whether they are outside an acceptable range based on your individual needs.

Red blood cell (varies with altitude)
Normal Range Results* Adult men: 5 to 6 million cells/mcL

 

Adult women: 4 to 5 million cells/mcL

Hemoglobin (varies with altitude)
Normal Range Results* Adult men: 14 to 17 gm/dL

 

Adult women: 12 to 15 gm/dL

Hematocrit (varies with altitude)
Normal Range Results* Adult men: 41% to 50%

 

Adult women: 36% to 44%

Mean corpuscular volume
Normal Range Results* 80 to 95 femtoliter†

* Cells/mcL = cells per microliter; gm/dL = grams per deciliter. † A femtoliter is a measure of volume.

Bone marrow tests

Bone marrow tests check whether your bone marrow is healthy and making normal amounts of blood cells. The two bone marrow tests are called aspiration and biopsy, and both are often done at the same time.

  • Aspiration is usually done first. During this procedure a small amount of bone marrow fluid is collected through a needle.
  • Biopsy tests involve collecting a small amount of bone marrow tissue through a larger needle.

Biopsy and aspiration tests can help find the cause of low or high blood cell counts. Before getting them, be sure to tell Before getting these tests, be sure to tell your doctor about current medicines you are taking, known allergies to medicines, if you are pregnant.

Bone marrow tests may require you to go to the hospital or a surgery center. Sometimes, however, they can be done in the doctor’s office or clinic. You will be awake for your test and may be given medicine to relax you during the test. You will lie on your side or stomach. Your doctor will clean and numb the top ridge of the back of a hipbone, where the needle will be inserted. You may feel a brief, sharp pain when the needle is inserted and when the bone marrow is aspirated. The bone marrow samples will be studied in a laboratory.

After your test, you will have a small bandage on the site where the needle was inserted. Most people go home the same day. You will need a ride home if you received medicines to relax you during the test. You may have mild discomfort for about a week. Your doctor may have you take an over-the-counter pain medicine. Call your doctor if you are in serious pain or if you develop symptoms including:

  • Fever
  • Redness
  • Swelling
  • Discharge at the needle injection site

Other diagnostic tests

Your doctor may order other tests to learn whether you have any complications from anemia or to rule out other conditions.

  • Colonoscopy looks for bleeding or other problems such as tumors in your colon. For this test, you will be given medicine to help you relax, and a small camera will be put into your colon to view the colon directly. Your doctor may also check your stool for blood.
  • Endoscopy looks for bleeding in the esophagus, stomach, and the first part of the small intestine. This involves inserting a tube with a tiny camera through your mouth down to your stomach and upper small intestine.
  • genetictests look for changes in the genes that control how your body makes red blood cells.
  • Urine tests check whether your kidneys are working properly. They can also tell whether there is any bleeding in your urinary tract, which is the body’s drainage system for removing urine.

Causes and Risk Factors

You may develop anemia if your body doesn’t make enough red blood cells or loses too many red blood cells. Red blood cells contain hemoglobin. Hemoglobin is an iron-rich protein that helps red blood cells carry oxygen from your lungs to the rest of your body. Many conditions can cause anemia. Mild anemia is a common condition that can develop in anyone. Serious anemia may be a sign of another health condition.

What causes anemia?

Some types of anemias are caused by factors you can’t change, like your family history or your age. Other anemias are caused by factors you can manage, like eating habits or other health conditions that control how your body makes red blood cells.

  • Age: As you age, your chances of developing anemia increase.5
  • Blood loss: Any condition that causes you to lose a lot of blood increases your risk of anemia. While this can include blood lost during the menstrual cycle, anemia due to bleeding too much from your menstrual cycle is not normal. See your doctor if your periods are heavy (you need to change your tampon or pad after less than 2 hours or you pass clots the size of quarters or larger). Bleeding can also lead to anemia if you have other risk factors. These include bleeding due to inflammation in the stomach or bowels, or bleeding from surgery, a serious injury, or donating blood often.
  • Family history: If you have a family history of inherited types of anemia, you may have an increased risk.
  • Lifestyle habits: People who do not get nutrients like iron, vitamin B12, and folic acid to make healthy red blood cells have a higher risk of anemia.2 Drinking too much alcohol also raises your risk of anemia.
  • Other health conditions: Chronic (long-term) kidney disease, inflammation from an infection, cancer, or an autoimmune disease can cause your body to make fewer red blood cells. Certain medicines or treatments such as chemotherapy for cancer can also raise your risk of anemia.

Can you prevent anemia?

You can take steps to prevent some types of anemia. Your doctor may recommend eating more foods rich in iron or vitamin B12, such as leafy vegetables, meat, milk, and eggs. Your doctor may also talk to you about iron or vitamin B12 supplements. If you are a strict vegetarian or vegan, talk to your doctor about how to get all the nutrients you need in your diet.

Anemia that is caused by your genes cannot be prevented. If you plan to have children and have an inherited type of anemia, you can talk to a genetic counselor. A genetic counselor can answer questions about the risk and explain what choices are available.

Treatment and Management

Your treatment for anemia will depend on its cause and how serious it is. People who have mild anemia may not need treatment. If your anemia is caused by medicines or another health condition, your doctor may change your treatment to manage or stop your anemia.

Medicines

Your doctor may prescribe medicines to help your bone marrow make more red blood cells. If your anemia is caused by an autoimmune disease, you may need medicines to suppress your immune system. Your immune system is your body’s natural defense against germs and sickness.

Dietary supplements

For some types of mild to moderate anemia, your doctor may recommend prescription supplements:

  • Iron supplements can increase the iron in your body. This may help treat iron-deficiency anemia. Iron supplements are generally not given to people who do not have iron-deficiency anemia because too much iron can damage your organs.
  • Vitamin B12 supplements or shots can help treat vitamin B12–deficiency anemia.

Procedures

Blood transfusion

A blood transfusion is a common, safe medical procedure in which healthy blood is given to you through an intravenous (IV) line that has been inserted in one of your blood vessels. Blood transfusions replace blood that is lost through surgery or injury, or they provide blood it if your body is not making it properly.

Most of the blood used for transfusions comes from whole blood donations given by volunteer blood donors. A person can also have their own blood collected and stored a few weeks before surgery in case it is needed.

After a doctor determines that you need a blood transfusion, he or she will test your blood to make sure that the blood you are given is a good match. Blood transfusions usually take 1 to 4 hours to complete. You will be monitored during and after the procedure.

Blood transfusions are usually very safe because donated blood is carefully tested, handled, and stored. However, there is a small chance that your body may have a mild to severe reaction to the donor blood. Other complications may include:

  • Fever
  • Heart or lung problems
  • Alloimmunization (when the body’s natural defense system attacks donor blood cells)
  • Rare but serious reactions that occur when donated white blood cells attack your body’s healthy tissues

Some people have health problems from getting too much iron from frequent transfusions. There is also a very small chance of getting an infectious disease, such as hepatitis B or C or HIV, through a blood transfusion. For HIV, that chance is less than one in one million. Scientific research and careful medical controls make the supply of donated blood very safe.

Transfusions help people with serious anemia quickly increase the number of red blood cells in their blood. Your doctor may recommend this if you have serious complications of anemia.

Blood and bone marrow transplant

A bone (or blood) marrow transplant, also called a hematopoietic stem cell transplant, replaces faulty blood-forming stem cells with healthy cells.

Blood or bone marrow transplants are usually performed in a hospital. Often, you must stay in the hospital for one to two weeks before the transplant to prepare. You also will receive special medicines and possibly radiation to destroy your abnormal stem cells and to weaken your immune system so that it won’t reject the donor cells after the transplant.

On the day of the transplant, you will be awake and may get medicine to relax you during the procedure. The stem cells will be given to you through an IV (intravenous catheter). The stem cells will travel through your blood to your bone marrow, where they will begin making new healthy blood cells.

When the healthy stem cells come from you, the procedure is called an autologous transplant. When the stem cells come from another person, called a donor, it is an allogeneic transplant. For allogeneic transplants, your doctor will try to find a donor whose blood cells are the best match for you. Your doctor will consider using cells from your close family members, from people who are not related to you and who have registered with the National Marrow Donor Program, or from publicly stored umbilical cord blood.

Your doctor will keep watching your recovery, possibly for up to one year. After the transplant, your doctor will check your blood counts every day to see if new blood cells have started to grow in your bone marrow. The length of your recovery will depend on many factors. Before you leave the hospital, you will get detailed instructions on how to prevent infection and other complications.

Although blood or bone marrow transplant is an effective treatment for some conditions, the procedure can cause complications. The required medicines and radiation can cause side effects, including:

  • Nausea
  • Vomiting
  • Diarrhea
  • Tiredness
  • Mouth sores
  • Skin rashes
  • Hair loss
  • Liver damage

Blood and bone marrow transplants also can weaken your body’s natural defense against germs and sickness and raise your risk of infection. Some people may experience a serious complication called graft-versus-host disease if the donated stem cells attack the body. Other people may reject the donor stem cells after the transplant, which can be an extremely serious complication.

Surgery

Surgery may be needed to stop internal bleeding.

Anemia and healthy eating habits

Healthy eating habits are essential for everyone. It is important to eat healthy to ensure your diet has iron-rich foods, as well as foods that contain vitamin B12.

How anemia may affect your health

If left untreated, anemia can raise your risk of the following health conditions:

Anemia can also make other health conditions worse. In children, anemia can cause developmental delays.

Anemia in Pregnancy

Anemia, especially iron-deficiency anemia, is common during pregnancy. Your body makes more blood to support your baby’s growth during this time. As a result, you need more iron and other nutrients, and to help you get them, you will be asked to take prenatal vitamins. If you don’t get enough of these nutrients while pregnant, you may feel weak or more tired than usual.

Because all women are at risk for anemia during pregnancy, your doctor will do blood tests to check for the condition at different stages in your pregnancy.

Anemia in pregnancy is preventable and treatable. Your doctor may recommend a supplement in addition to your prenatal vitamins. Serious or untreated anemia in pregnancy can cause the following complications:

  • Preterm labor
  • Increased blood loss during delivery
  • Low birthweight
  • Anemia and developmental delays in your baby

If you had significant anemia during your pregnancy, your doctor may screen your newborn for anemia.

Learn how much iron you need during pregnancy and while breastfeeding.

Iron-Deficiency Anemia

What is iron-deficiency anemia?

Iron-deficiency anemia is a type of anemia that develops if you do not have enough iron in your body. It is the most common type of anemia.

What are the symptoms of iron-deficiency anemia?

People with mild or moderate iron-deficiency anemia may not have any symptoms. More serious iron-deficiency anemia may cause common symptoms of anemia, such as tiredness, shortness of breath, or chest pain. Other symptoms include:

  • Fatigue
  • Dizziness or lightheadedness
  • Cold hands and feet
  • Pale skin

What causes iron-deficiency anemia?

Your body needs iron to make healthy red blood cells. Conditions that increase your risk of iron-deficiency anemia include the following:

Blood loss

When you lose blood, you lose iron. Blood loss can happen in many ways:

  • Bleeding in your gastrointestinal tract(GI tract) from an inflammatory bowel disease, ulcer, colon cancer, or a or other GI disorders such as celiac disease.
  • Traumatic injuries or surgery
  • Heavy menstrual periods or bleeding during childbirth
  • Regular use of medicines such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen and naproxen that can lead to GI tract bleeding
  • Urinary tract bleeding

Problems absorbing iron

Certain conditions or medicines can decrease your body’s ability to absorb iron and lead to iron-deficiency anemia. These conditions include:

  • Certain rare genetic conditions that block your intestines from absorbing iron or make it harder to stop bleeding
  • Endurance sports, which can make athletes lose iron through their GI tracts and through the breakdown of red blood cells
  • Intestinal and digestive conditions, such as celiac disease, ulcerative colitis, Crohn’s disease, and Helicobacter pylori infection
  • Surgery on your stomach and intestines, including weight loss surgery

Other medical conditions

Other conditions that may cause iron-deficiency anemia include:

  • Kidney disease: People who have kidney disease do not make enough of a substance called erythropoietin. Your body needs erythropoietin to make red blood cells. Your doctor may prescribe erythropoietin if you have kidney disease.
  • Long-lasting conditions that lead to inflammation: These include congestive heart failure or obesity. They can make it hard for your body to regulate and use your body’s iron.

Sometimes young children can develop iron-deficiency anemia if they do not get enough iron in their diet. This usually occurs between the ages of 9 months and 1 year, as a child transitions to eating whole foods.

How do you prevent iron-deficiency anemia?

Iron-deficiency anemia may be preventable if you are able to treat the causes of blood loss or problems with iron absorption that can lead to the condition.

It is also always a good idea to help the body keep iron levels where they need to be by maintaining a healthy diet that includes good sources of iron and vitamin C.

  • Good sources of iron include beans, dried fruits, eggs, lean red meat, salmon, iron-fortified breads and cereals, peas, tofu, and dark green leafy vegetables.
  • Vitamin C-rich foods such as oranges, strawberries, and tomatoes help your body absorb iron.
  • Ensure that toddlers eat enough solid foods that are rich in iron.

How much iron do I need each day?

The recommended daily amounts of iron depend on your age, your sex, and whether you are pregnant or breastfeeding.

Generally, a diet that includes beans, dried fruits, eggs, lean red meat, salmon, iron-fortified breads and cereals, peas, tofu, and dark green leafy vegetables will provide the iron level that your body needs.

Recommended daily iron intake for children and adults

Recommended daily iron intake for children and adults. The table lists the recommended amounts of iron, in milligrams (mg) at different ages and stages of life. Until the teen years, the recommended amount of iron is the same for boys and girls. From birth to 6 months, babies need 0.27 mg of iron. This number goes up to 11 mg for children ages 7 to 12 months, and down to 7 mg for children ages 1 to 3. From ages 4 to 8, children need 10 mg, and from ages 9 to 13, 8 mg. From ages 14 to 18, boys need 11 mg, while girls need 15 mg. From ages 19 to 50, men need 8 mg and women need 18 mg. After age 51, both men and women need 8 mg. Pregnant women need 27 mg. Breastfeeding girls under age 18 need 10 mg while breastfeeding women older than 18 need 9 mg.

How is iron-deficiency anemia diagnosed?

To help diagnose iron-deficiency anemia, your doctor will order a blood test to check your complete blood count (CBC), hemoglobin levels, blood iron levels, and ferritin levels. Your doctor may tell you that the iron level in your blood is low. Your doctor may also tell you that you have anemia with the iron deficiency.

Different tests help your doctor diagnose iron-deficiency anemia. In iron-deficiency anemia, blood levels of iron will be low, or less than 10 micromoles per liter (mol/L) for both men and women. Normal levels are 10 to 30 mol/L. Levels of ferritin will also be low, or less than 10 micrograms per liter (g/L) for both men and women. Normal levels are 40 to 300 for men and 20 to 200 for women.

How is iron-deficiency anemia treated?

Several treatments can be used to treat anemia.

  • Iron supplements, also called iron pills or oral iron, help increase the iron in your body. This is the most common treatment for iron-deficiency anemia. It often takes three to six months to restore your iron levels. Your doctor may ask you to take iron supplements during pregnancy. Talk to your doctor if you have side effects such as a bad metallic taste, vomiting, diarrhea, constipation, or upset stomach. Your doctor may suggest taking your supplements with food, lowering the dose, or trying a different type of iron supplement.
  • Intravenous or IV iron is sometimes used to put iron into your body through one of your veins. This helps increase iron levels in your blood. It often takes only one or a few sessions to restore your iron levels. People who have serious iron-deficiency anemia or who have long-term conditions are more likely to receive IV iron. Side effects include vomiting or headaches right after the treatment, but these usually go away within a day or two.
  • Medicines such as erythropoiesis stimulating agent (esa) help your bone marrow make more red blood cells, if this is causing your iron deficiency. These medicines are usually used with iron therapy in people who have both iron-deficiency anemia and another chronic (long-term) condition such as kidney disease.
  • Blood transfusions quickly increase the amount of red blood cells and iron in your blood. They may be used to treat serious iron-deficiency anemia.
  • Surgery may be needed to stop internal bleeding.

In addition to the steps above, your doctor may ask you to adopt heart-healthy eating habits and to choose iron-rich foods such as beans, dried fruits, eggs, lean red meat, salmon, iron-fortified breads and cereals, peas, tofu, and dark green leafy vegetables. Foods that are rich in vitamin C can help your body absorb iron. Some foods like black tea can reduce iron absorption.

What happens if iron-deficiency anemia is not treated?

Undiagnosed or untreated iron-deficiency anemia may cause serious complications such as fatigue, headaches, restless legs syndrome, heart problems, pregnancy complications, and developmental delays in children.

Iron-deficiency anemia can also make other chronic conditions worse or cause their treatments to work poorly.

Vitamin B12–Deficiency Anemia

What is vitamin B12–deficiency anemia?

Vitamin B12–deficiency anemia, also known as cobalamin deficiency, is a condition that develops when your body can’t make enough healthy red blood cells because it doesn’t have enough vitamin B12. Your body needs vitamin B12 to make healthy red blood cellswhite blood cells, and platelets. Since your body doesn’t make vitamin B12, you have to get it from the foods you eat or from supplements.

You can get vitamin B12 deficiency if you can’t absorb vitamin B12 due to problems with your gut or if you have pernicious anemia, which makes it difficult to absorb vitamin B12 from your intestines. Without enough vitamin B12, blood cells do not form properly inside your bone marrow, the sponge-like tissue within your bones. These blood cells die sooner than normal, leading to anemia.

What are the symptoms of vitamin B12–deficiency anemia?

If you have vitamin B12–deficiency anemia, you may have the typical symptoms of anemia at first, such as fatigue, paleness, shortness of breath, headaches, or dizziness. If left untreated, you may start to notice brain and nervous system symptoms. This is because vitamin B12 is also needed for your brain and your nerves to work properly.

Your symptoms may include:

  • Tingling feelings or pain
  • Trouble walking
  • Uncontrollable muscle movements
  • Confusion, slower thinking, forgetfulness, and memory loss
  • Mood or mental changes, such as depression or irritability
  • Problems with smell or taste
  • Vision problems
  • Diarrhea and weight loss
  • Glossitis, which is a painful, smooth, red tongue

What causes vitamin B12–deficiency anemia?

You can develop vitamin B12–deficiency anemia if you do not eat enough food with vitamin B12, such as if you follow a strict vegetarian or vegan diet. But this is rare. In the United States, vitamin B12–deficiency anemia is most often due to other risk factors.

You can develop vitamin B12 deficiency for the following reasons:

  • Lack of intrinsic factor: Intrinsic factor is a protein made in the stomach, which helps the body absorb vitamin B12. People who have pernicious anemia do not produce intrinsic factor. Pernicious anemia is more common in people with northern European or African ancestry. You may develop vitamin B12–deficiency anemia if your body is not able to absorb enough vitamin B12 from the foods you eat. Older adults are more likely to have digestive problems that make it harder to absorb vitamin B12.
  • Lifestyle habits: Drinking too much alcohol can make it harder for your body to absorb vitamin B12. For men this is more than two drinks in a day. For women, it’s more than one drink in a day.
  • Medicines: Taking certain medicines can make it harder for your body to absorb vitamin B12 over time. These include some heartburn medicines and metformin to treat diabetes.
  • Medical conditions: Some medical conditions can raise your risk of vitamin B12–deficiency anemia. These include:
  • Stomach surgery: Surgery on your stomach or intestines, such as weight-loss surgery or gastrectomy, can make it harder for your body to absorb vitamin B12.

How do you prevent vitamin B12 deficiency?

If you are otherwise healthy, maintaining a normal diet enriched in vitamin B12 is important.

Foods that are good sources of vitamin B12 include:

  • Lean red meat and chicken
  • Fish, such as catfish and salmon; and seafood, such as clams and oysters
  • Milk, yogurt, cheese, and fortified vegan milk substitutes
  • Fortified cereals
  • Eggs

How much vitamin B12 do you need each day?

The recommended daily amounts of vitamin B12 depend on your age, your sex, and whether you are pregnant or breastfeeding. Your healthcare provider can look at your medical history to help determine how much vitamin B12 you need each day.

Recommended daily vitamin B12 intake for children and adults

Recommended Daily Amounts of Vitamin B12, in micrograms (mcg)
Age Male or Female Pregnancy Breastfeeding
1–3 years 0.9 mcg
4–8 years 1.2 mcg
9–13 years 1.8 mcg
14–18 years 2.4 mcg 2.6 mcg 2.8 mcg
19–50 years 2.4 mcg 2.6 mcg 2.8 mcg
51+ years 2.4 mcg (mostly from fortified foods or a supplement)

How is vitamin B12–deficiency anemia diagnosed?

To screen for vitamin B12–deficiency anemia, your healthcare provider may order blood tests to see whether you have low hemoglobin or vitamin B12 levels.

Healthy and Abnormal Blood Levels in Adults
Hemoglobin, g/dL Normal

 

Men: 13 or higher

Women: 12 or higher

Anemia Men: 12 or lower

Women: 11 or lower

 Vitamin B12, pg/mL Normal 400 or higher
Vitamin B12-deficiency 200 or lower (although levels may be normal in some cases)

Tests to screen for vitamin B12-deficiency anemia. A complete blood count measures hemoglobin. Another blood test measures vitamin B12 levels in the blood. You may still have the condition even if your vitamin B12 levels are normal.

How is vitamin B12–deficiency anemia treated?

If your doctor diagnoses you with vitamin B12–deficiency anemia, your treatment will depend on the cause and seriousness of your condition. Some people need lifelong treatment.

Different therapies can be used to treat anemia.

  • Vitamin B12 medicine can be prescribed by your provider for you to take by mouth or as a nose spray or a shot. These supplements can help increase the levels of vitamin B12 in your body. For serious vitamin B12–deficiency anemia, your doctor may recommend vitamin B12 shots until your levels are healthy.
  • Blood transfusions to treat serious vitamin B12–deficiency anemia in combination with vitamin B12 treatment.

Your care provider may also recommend you make some changes to your eating habits to help increase the amount of vitamin B12 in your diet.

Some symptoms may take months to improve, depending on how serious they are. Some symptoms related to the brain or the nerves, such as numbness and tingling, may not go away even with treatment.

What happens if vitamin B12–deficiency anemia is not treated?

Vitamin B12–deficiency may cause serious complications, such as bleeding, infections, and problems with your brain or nerves that may be permanent. Babies born to mothers who have vitamin B12–deficiency may have developmental delays and birth defects of the brain and spinal cord.

Hemolytic Anemia

What is hemolytic anemia?

Hemolytic anemia is a blood condition that occurs when your red blood cells are destroyed faster than they can be replaced. Hemolytic anemia can develop quickly or slowly, and it can be mild or serious.

What are the symptoms of hemolytic anemia?

Your symptoms may include tiredness, dizziness, weakness, and a spleen or liver that is larger than normal.

How is hemolytic anemia diagnosed?

To diagnose hemolytic anemia, your doctor will do a physical exam and order blood tests. Additional tests may include a urine test, a bone marrow test, or genetic tests.

What causes hemolytic anemia?

Red blood cells develop in the bone marrow, which is the sponge-like tissue inside your bones. Your body normally destroys old or faulty red blood cells in the spleen or other parts of your body through a process called Hemolysis. Hemolytic anemia occurs when you have a low number of red blood cells due to too much hemolysis in the body.

Certain conditions can cause hemolysis to happen too fast or too often, including the following:

How is hemolytic anemia treated?

If you have mild hemolytic anemia, you may not have any symptoms or need treatment. For others, hemolytic anemia can often be treated or managed. Treatments may include the following:

  • Blood transfusions
  • Medicines
  • Surgery to remove your spleen
  • Blood and bone marrow transplants

If your hemolytic anemia is caused by medicines or another health condition, your doctor may change your treatment to manage or stop hemolytic anemia.

What happens if hemolytic anemia is not treated?

People who have mild hemolytic anemia may not need treatment. Serious hemolytic anemia that is not treated or managed can cause irregular heart rhythmsa heart that is larger than normal, and heart failure if anemia gets severe

Aplastic Anemia

What is aplastic anemia?

Despite its name, aplastic anemia, or bone marrow failure, is more than anemia. Aplastic anemia is a rare but serious blood condition that occurs when your bone marrow cannot make enough new blood cells for your body to work normally. It can develop quickly or slowly, and it can be mild or serious. At this time, there is no way to prevent aplastic anemia.

What are the symptoms of aplastic anemia?

Symptoms of aplastic anemia include:

  • Fatigue
  • Infections that last a long time
  • Easy bruising or bleeding

How is aplastic anemia diagnosed?

To diagnose aplastic anemia, your doctor will order tests to find out whether you have low numbers of cells in your bone marrow and blood.

What causes aplastic anemia?

Aplastic anemia is caused by damage to stem cells inside your bone marrow, which is the sponge-like tissue within your bones. Many diseases and conditions can damage the stem cells in bone marrow. As a result, the bone marrow makes fewer red blood cellswhite blood cells, and platelets.

The most common cause of bone marrow damage is from your immune system attacking and destroying the stem cells in your bone marrow. This is a type of autoimmune illness, a disease that makes your body attack itself. Other causes of aplastic anemia include some medicines, such as those used in chemotherapy, and exposure to toxins or chemicals in the environment.

You can also inherit the condition, in rare cases.

How is aplastic anemia treated?

Treatments for aplastic anemia may include the following:

  • Blood and bone marrow transplants, which may cure aplastic anemia in some people
  • Blood transfusions
  • Medicines to stop your immune system from destroying the stem cells in your bone marrow
  • Medicines to help your body make new blood cells
  • Removing or staying away from toxins in your environment

Your doctor will monitor your condition and screen you for blood conditions regularly. If you take medicine that affects your immune system, you will also need to take steps to prevent infection and get annual flu shots.

What happens if aplastic anemia is not treated?

Aplastic anemia can raise your risk of complications such as bleeding, leukemia, or other serious blood conditions. Without treatment, aplastic anemia can lead to serious medical conditions such as an irregular heartbeat and heart failure.

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