Fatigue is blamed on work and lack of sleep. And then a blood test shows low hemoglobin. Let's break down what this means and which examinations reveal the cause.
What anemia is and how iron deficiency differs from other types
Anemia is a condition in which the blood lacks healthy red blood cells. These cells carry oxygen to tissues. There are many types of anemia, and their causes differ.
Iron deficiency is the most common form. Iron is needed for hemoglobin synthesis; without it, the blood carries oxygen less well. A blood test will also show other forms, such as vitamin B12 or folate deficiency.
To understand which type you have, the doctor looks at test results, not at how you feel.
Why iron deficiency anemia develops
Iron stores become depleted when losses exceed intake. There are usually three causes: blood loss, poor absorption, and too little iron in food.
In adults, the cause is most often blood loss. In women, this means heavy and prolonged menstruation. In men, it means hidden bleeding from the stomach and intestines: ulcers, inflammation, hemorrhoids, taking ibuprofen or aspirin.
Tumors of the stomach and intestines are also possible, although they occur less often. Even small chronic blood loss can gradually deplete iron stores.
Pregnancy and breastfeeding increase the need for iron. Absorption is impaired by celiac disease, Crohn's disease, and stomach surgery. Latent deficiency is found in 20–30% of women of reproductive age, and anemia in 8–10%.
Which symptoms indicate anemia
With mild anemia, there may be no complaints. Symptoms increase slowly, so they are easy to attribute to fatigue.
- fatigue and lack of energy;
- shortness of breath with usual exertion;
- a feeling that the heart is beating more noticeably;
- pale skin;
- headaches and difficulty concentrating.
There are also rare signs: ringing in the ears, a strange taste of food, itching, a sore tongue, hair loss, a craving to eat ice or paper, spoon-shaped nails, restless legs.
Which tests are needed and how hemoglobin and anemia are related
It all starts with a complete blood count. It shows the number of red blood cells and the hemoglobin level. Hemoglobin is the protein inside red blood cells that carries oxygen; its number is used to judge the degree of anemia.
Degrees by hemoglobin: mild — above 90 g/L, moderate — 90–70 g/L, severe — below 70 g/L.
Next, iron stores are clarified: serum iron, total iron-binding capacity, ferritin. Sometimes a reticulocyte count is added and, if the picture is unclear, a bone marrow biopsy.
The second question is why iron is insufficient. Here the source of blood loss is sought: a fecal occult blood test or FIT, gastroscopy, colonoscopy, examination of the urinary tract and uterus.
No preparation is needed for a complete blood count.
Why anemia is dangerous when undiagnosed
Without treatment, iron deficiency affects various systems. Immunity suffers, so infections occur more often.
The risk of heart and lung complications may increase, such as a rapid heartbeat (tachycardia) or heart failure.
In pregnant women, the risk of complications before and after childbirth is higher.
Low hemoglobin may be a consequence of hidden blood loss, for example from an ulcer. That is why anemia is not left to wait for months.
When to see a doctor
A reason for consultation is constant fatigue without a cause and low hemoglobin on a test. Another reason is blood in the stool or black tarry stool.
Anemia by itself is not a reason to call an ambulance; 103/112 — for a life-threatening condition: loss of consciousness, severe chest pain, severe difficulty breathing, or severe bleeding.
The doctor will ask about lifestyle, menstruation, and medications, and will review the test results. If the cause is unclear, they will refer you to a specialist. If it is difficult to get iron from food — to a dietitian.
The text is for reference. It does not replace a doctor's consultation: your numbers should be reviewed by a doctor.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer