Anemia is not a separate diagnosis but a syndrome: a decrease in hemoglobin and red blood cells in the blood disrupts oxygen transport and causes tissue hypoxia. It is estimated to affect about one third of the world's population and is more common in women, children, and older adults. Let us look at how it manifests and where symptoms end and laboratory testing begins.
What anemia is
The term "anemia" describes not the volume of blood but the content of hemoglobin and red blood cells in it. Hemoglobin is an iron-containing protein that carries oxygen from the lungs to the tissues; iron deficiency is the most common cause of its deficiency. Separately, hydremia, or pseudoanemia, is distinguished, for example in pregnant women: the number of formed elements and hemoglobin remains the same, but the volume of the liquid part of the blood increases. Anemia is classified by the color index (normal 0.86–1.1 in men and women), by the bone marrow's capacity for regeneration (normal reticulocyte count 0.5–2%), and by the mechanism of development.
Main signs and symptoms of anemia
The classic picture is weakness, rapid fatigue, and reduced concentration. With more pronounced anemia, shortness of breath on slight exertion, a feeling of palpitations and irregular heartbeat, headache, tinnitus, and disturbances of sleep and appetite appear. A diagnostically significant sign of moderate or pronounced anemia is pallor of the skin, visible mucous membranes, and nail beds. Less common are a strange taste for food, itching, a painful tongue, hair loss, pica (eating paper or ice), difficulty swallowing, cracks at the corners of the mouth, and spoon-shaped nails.
- Fatigue and lack of energy
- Shortness of breath and noticeable palpitations
- Pallor of the skin and mucous membranes
- Headache and tinnitus
- Changes in the nails, hair, and tongue
Features of manifestations in women
Anemia is more common in women than in men, in particular during pregnancy. Heavy menstruation and pregnancy are the most common causes of iron deficiency anemia: during pregnancy, the deficiency is more often associated with insufficient iron in the diet. The symptoms are the same — weakness, shortness of breath, pallor. Untreated anemia in pregnant women increases the risk of complications before and after childbirth.
Features of manifestations in men
Bleeding in the stomach and intestines is one of the common causes of iron deficiency anemia regardless of sex; it is caused by the use of nonsteroidal anti-inflammatory drugs (ibuprofen, aspirin), stomach ulcers, inflammation of the intestines or esophagus, hemorrhoids, and less often cancer of the stomach or intestines. The symptoms in men are the same as in women: weakness, shortness of breath, pallor. If the cause of anemia is unclear, the doctor may order additional tests and refer the patient to a specialist.
Why anemia occurs
Three main mechanisms: blood loss, insufficient production of red blood cells, and accelerated destruction of them. Among the conditions are heavy menstruation, pregnancy, ulcers, polyps or cancer of the colon, hereditary diseases, deficiency of iron, folic acid, or vitamin B12 in the diet, blood diseases, aplastic anemia, and G6PD deficiency. The normal lifespan of a red blood cell is about 120 days; in hemolysis it is destroyed faster.
How it is confirmed and when to see a doctor
The diagnosis is made by a doctor based on examination and blood tests: a complete blood count shows the number of red blood cells and other cells, and ferritin, vitamin B12, and folate are assessed separately. If the cause is unclear, additional tests are possible, including a fecal immunochemical test for occult blood, and referral to a specialist. The examination requires no preparation. You should seek medical attention for persistent weakness, shortness of breath, and pallor without a clear cause.
Anemia by itself is not a reason to call an ambulance; 103 or 112 — in case of sudden deterioration: severe shortness of breath at rest, chest pain, loss of consciousness, heavy bleeding.
This material is for reference: it helps to navigate the symptoms but does not replace a doctor's consultation and is not a treatment recommendation.
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This content is for reference and does not replace a doctor's consultation. Medical disclaimer