What is anemia?

Anemia is a medical condition where the red blood cell count or hemoglobin is less than normal. This medical condition is associated with iron deficiency. Therefore the oxygen-carrying capacity of the blood is decreased. Hemoglobin is an iron-rich protein that enables red blood cells to take oxygen from your lungs and deliver it to the body’s vital tissues and organs.

It is a sign, not a diagnosis. There are many kinds of anemia, each with its cause. It is characterized by insufficient erythrocytes or hemoglobin. Loss of blood is the most common cause of anemia. It can be temporary or long-term, and it can range from mild to severe. This condition leads to fatigue, weakness, paleness and intolerance to cold, which is related to lack of oxygen needed for energy and heat production.

Types of anemia

There are many types of anemia and each type has specific symptoms. Some common types of anemia are:

Iron Deficiency (Microcytic) Anemia:  This is the most common type of anemia worldwide. This type of anemia is mostly caused by an iron deficiency. Iron is important for hemoglobin production and without it the body cannot produce enough hemoglobin to make healthy red blood cells. This deficiency occurs either because the body is not getting enough iron or it is not absorbing it properly.

Vitamin Deficiency (Megaloblastic) Anemia:  In addition to iron, the body also needs folate and vitamin B-12 to produce enough healthy red blood cells. A lack of nutritious diet can result in lack of folate, vitamin B-12 and other key nutrients, and this can cause decreased red blood cell production. In some cases, people consume enough vitamin B-12, but their bodies aren’t able to process the vitamin B-12. This medical condition is known as pernicious anemia.

Anemia of Chronic Disease:  Diseases such as Cancer, HIV/AIDS, Kidney disease, Rheumatoid Arthritis, Crohn’s disease and other chronic inflammatory diseases can affect the red blood cells production.

Aplastic Anemia:  This rare and life-threatening anemia occurs when your immune system starts attacking stem cells that produce blood. Your body stops producing enough new red blood cells, white blood cells and platelets. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases, and exposure to toxic chemicals.

Anemias Associated With Bone Marrow Disease:  Diseases such as Leukemia and Myelofibrosis can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders can be life-threatening sometimes.

Hemolytic Anemias:  This medical condition is either acquired or genetic. This type of anemia develops when red blood cells are destroyed faster than bone marrow can replace them with new one. Certain blood diseases increase red blood cell destruction. This is typically the result of an autoimmune issue where a person’s immune system attacks their own red blood cell producing tissues.

Sickle Cell Anemia:  This medical condition is inherited and sometimes life-threatening. It’s caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die early, resulting in a chronic shortage of red blood cells.

Thalassemia:  This is an inherited blood disorder. In this medical condition, the body makes less healthy red blood cells and less hemoglobin. Hemoglobin is a protein that carries oxygen to the whole body. That leads to anemia. Thalassemias occur most often among people of Italian, Greek, Middle Eastern, Southern Asian, and African descent.

Causes of anemia

The following are the most common causes of Anemia:

  Inherited blood disorder

  Decreased red blood cell production

  Increased red blood cell destruction

  Iron deficiency occurs either because the body is not getting enough iron or it is not absorbing it properly.

  B12 deficiency

  Folate deficiency

  Having an intestinal disorder that affects the absorption of nutrients in small intestines such as Crohn’s disease and celiac disease

  Poor diet or lack of food containing iron

  Chronic diseases can affect the red blood cells production

  Frequent nose bleeding or excessive bleeding during heavy injuries or heavy menstrual bleeding


Symptoms of anemia

Anemia symptoms vary depending on the cause of anemia. Initially, mild anemia can be unnoticed but symptoms increase as anemia worsens.





  Chest pain

  Rapid or irregular heartbeat (Arrhythmia)

  Shortness of breath

  Pale skin

  Low body temperature

  Cold hands and feet

How is anemia diagnosed?

By performing various diagnosis procedures, doctors will be able to clearly understand the general situation, determine the type of anemia and find out the reasons for its appearance. Various tests are required for a detailed examination. This is the only way to stop the course of the disease. These tests include:

Complete Blood Count (CBC):  This is the most common test involving a blood test called a complete blood count (CBC). This test measures a number of components, including:

   Hematocrit Levels:   It involves comparing the volume of RBCs with the total volume of blood. A normal range in male is 40% to 52% where in female it is 35% to 47%.

   Red Blood Cell (RBC) Count:   A normal range in male is 4.35 to 5.65 million red blood cells per microliter (mcL) of blood where in female it is 3.92 to 5.13 million red blood cells per mcL of blood.

A CBC can give an indication of a person’s overall health. It can also help a doctor decide whether to check for underlying conditions such as leukemia or kidney disease.

If RBC, Hemoglobin and Hematocrit levels fall below the typical range, a person likely has some form of anemia.

Physical Test and Family History:   In addition to a CBC, the doctor will take a complete personal and family health history and perform an exam to determine the status of a patient. The doctor will listen to your heart and lungs to assess heart rate and breathing. The doctor may check the size of the liver and spleen and assess for any tenderness.

Red blood cells size and shape determination test:   Some red blood cells may also be examined for unusual size, shape and color. It can help to pinpoint a diagnosis.

   Iron deficiency anemia:   Here red blood cells are smaller and paler in color than normal.

   Vitamin deficiency anemia:   Here red blood cells are enlarged and fewer in number.

Other Blood Tests:   There are other tests that may be performed by your doctor for further investigation.

   Serum Ferritin:   This is a blood cell protein that contains iron. It indicates total iron status in the body.

   Serum Iron:   It indicates the amount of iron in the blood that is bound to transferrin and is not an accurate representation of total iron present in the body. Ferritin is a better indicator of iron deficiency.

   Total Iron Binding Capacity (TIBC):   This measures a red blood cell’s capacity to bind to transferrin.

   Hemoglobin Electrophoresis:   It detects the different types of hemoglobin that are present.

   A Reticulocyte Count:   It assesses how well and how quickly RBCs are manufactured.

   MCH:   MCH stands for Mean Corpuscular Hemoglobin. This is the average mass of hemoglobin per red blood cell.

   MCHC:   MCHC stands for Mean Corpuscular Hemoglobin Concentration. This is the average concentration of hemoglobin in red blood cells.

   MCV:   MCV stands for the Mean Corpuscular Volume and is the average volume of a red blood cell.

Bone Marrow Tests:   A doctor uses a needle to get a small sample of bone marrow from a large bone (usually hip) in your body. The sample is examined in the lab to rule out other blood-related diseases. In aplastic anemia, bone marrow contains fewer blood cells than normal.

Treatment of anemia

There are various treatments available for anemia based on their causes and types. Treatment for various types of anemia may include:


Iron Deficiency (Microcytic) Anemia:   This type of anemia is treated with changes in diet and iron supplements. For some people, this might involve receiving iron through a vein. If the underlying cause of iron deficiency is loss of blood, other than from menstruation, the source of the bleeding must be located and stopped. This may involve surgery. Some available medications are:

  Ferrous Sulfate



Vitamin Deficiency (Megaloblastic) Anemia:   This type of anemia is treated with changes in diet and folate and vitamin B-12 supplements. If the digestive system has trouble absorbing vitamin B12 from the food the person should take vitamin B-12 injections or tablets. Some available medications are:


  Cyanocobalamin Injections


  Vitamin B-12




  Folic Acid



Anemia of Chronic Disease:   This type of anemia has no specific treatment. In severe cases, blood is given to one of the patient's blood vessels by blood transfusion or injections.

Aplastic Anemia:   This type of anemia is treated by blood transfusions to boost levels of red blood cells. A bone marrow transplant is needed if the bone marrow can’t make healthy blood cells.

Hemolytic Anemia:   This type of anemia is treated by treating related infections and taking drugs that suppress the immune system, which may be attacking red blood cells. Depending on the severity of anemia, a blood transfusion or plasmapheresis (blood-filtering procedure) may be necessary. Some available medications are:




  Dexamethasone Intensol



Sickle Cell Anemia:   This type of anemia is treated with oxygen therapy, pain relief drugs, oral and intravenous fluids to reduce pain and prevent complications. Treatment may also include antibiotics medications, folic acid supplements, blood transfusions and cancer drugs called hydroxyurea. In certain cases, a bone marrow transplant treatment may be effective. Some available medications are:








Thalassemia:   This type of anemia is treated with folic acid supplements, blood transfusions, removal of the spleen (splenectomy) and a bone marrow transplant. Some available medications are:







For iron deficiency anemia, eating iron-rich foods will be helpful. Some iron-rich foods are:

  Vegetables: Spinach, Kale, Swiss Chard, Collard, Beetroot

  Beans and Peas: Lentils, Kidney beans, White beans, Black beans

  Nuts: Almonds, Cashews, Pine, Hazelnut, Pistachios

  Dried Fruits: Apricots, Raisins, Prunes, Dates

  Seeds: Squash and Pumpkin Seeds


  Brown rice

  Iron-fortified cereal and bread

  Meats: Beef, Chicken Liver, Lamb


  Seafoods: Tuna, Haddock, Mackerel, Sardines, Shrimp, Clams, Oysters

For vitamins deficiency anemia, eating folate and vitamin B-12 rich foods will be helpful. Some folate and vitamin B-12 rich foods are:

  Vegetables and Fruits: Avocados, Spinach, Broccoli, Brussel Sprouts, Beetroot, Cabbage, tomatoes, kiwis, strawberries

  Beans and Peas: Lentils

  Nuts: Almonds

  Dairy Products: Raw Milk, Raw Cheese, Yogurt

  Meats: Beef, Chicken Liver


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