Definition

Anemia is a low level of red blood cells (RBC). RBCs carry oxygen from the lungs to the rest of the body. Lower RBC counts mean the body is not getting enough oxygen.

Red Blood Cells Iron makes a critical component of red blood cells. Copyright © Nucleus Medical Media, Inc.

Causes

There are different types of anemia. This type is caused by low levels of iron in the body. Iron is needed to build healthy RBCs. Low iron levels may be caused by one or more of the following:

• Iron that is poorly absorbed in the digestive tract—may occur due to intestinal diseases or surgery
• Chronic bleeding , such as heavy menstrual bleeding or bleeding in the gastrointestinal (GI) tract
• Not enough iron in the diet—common cause in infants, children, and pregnant women

Risk Factors

These factors may increase your chance of developing this condition:

• Rapid growth cycles—may occur with infancy or adolescence
• Heavy menstrual bleeding or chronic blood loss from the GI tract
• Pregnancy
• Breastfed infants who have not started on solid food after 6 months of age
• Babies who are given cow’s milk prior to age 12 months
• Alcohol use disorder
• Diets that contain insufficient iron—rare in the US

Symptoms

There may be no symptoms with mild anemia. In those who do have them, anemia may cause:

• Fatigue
• Pale skin
• Fingernail changes
• Weakness
• Headache
• Decreased work capacity
• Heart palpitations
• Infection
• Craving to eat things that are not food (called pica) such as ice or clay
• Hair loss
• Shortness of breath during or after physical activity
• Restless legs at night

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done.

Tests to diagnose iron-deficiency anemia may include:

• Blood test—to look at RBC and iron levels
• Urine tests—to look for abnormal bleeding
• Stool tests—to look for abnormal bleeding

Treatment

Iron levels will need to be brought back to normal. The body will be able to increase RBCs as iron levels improves. This will relieve the anemia.

Prevention

To help reduce your chance of having anemia:

• Eat a diet rich in iron. Include iron-rich foods such as oysters, meat, poultry, or fish.
• Avoid foods that interfere with iron absorption. Black tea is one common iron blocker.

Talk to your doctor about your baby’s diet. General guidelines include:

• Starting at 4 months, breastfed infants need an iron supplement. Once they are older they can get iron from other sources, like cereal or fortified formula.
• Bottle-fed infants should get a formula that is fortified with iron.
• Premature infants may need extra iron by 1 month of age.