Anemia

Anemia is the most common blood disorder, and according to the National Heart, Lung, and Blood
Institute, it affects more than 3 million Americans.

The Role of Red Blood Cells in Anemia

Red blood cells carry hemoglobin, an iron-rich protein that attaches to oxygen in the lungs and carries
it to tissues throughout the body. Anemia occurs when you do not have enough red blood cells or when
your red blood cells do not function properly. It is diagnosed when ablood test shows a hemoglobin
value of less than 13.5 gm/dl in a man or less than 12.0 gm/dl in a woman. Normal values for children
vary with age.
When you have anemia, your body lacks oxygen, so you may experience one or more of the following
symptoms:

Weakness

Shortness of breath

Dizziness

Fast or irregular heartbeat

Pounding or "whooshing" in your ears

Headache

Cold hands or feet

Pale or yellow skin

Chest pain

Common Types of Anemia

Iron-deficiency anemia is the most common type of anemia. It happens when you do not have
enough iron in your body. Iron deficiency is usually due to blood loss but may occasionally be due to
poor absorption of iron. Pregnancy and childbirth consume a great deal of iron and thus can result
in pregnancy-related anemia. People who have had gastric bypass surgery for weight loss or other
reasons may also be iron deficient due to poor absorption.
Vitamin-deficiency anemia may result from low levels of vitamin B12 or folate (folic acid), usually
due to poor dietary intake. Pernicious anemia is a condition in which vitamin B12 cannot be absorbed
in the gastrointestinal tract.

Anemia and Pregnancy - Learn about the risk factors and symptoms of anemia during pregnancy.
Aplastic anemia

is a rare form of anemia that occurs when the body stops making enough red blood

cells. Common causes include viral infections, exposure to toxic chemicals, drugs, and autoimmune
diseases. Idiopathic aplastic anemia is the term used when the reason for low red blood cell production
is not known.
Hemolytic anemia

occurs when red blood cells are broken up in the bloodstream or in the spleen.

Hemolytic anemia may be due to mechanical causes (leaky heart valves or aneurysms), infections,
autoimmune disorders, or congenital abnormalities in the red blood cell. Inherited abnormalities may
affect the hemoglobin or the red blood cell structure or function. Examples of inherited hemolytic
anemias include some types of thalassemia and low levels of enzymes such as glucose-6 phosphate
dehydrogenase deficiency. The treatment will depend on the cause.
Sickle cell anemia is an inherited hemolytic anemia in which the hemoglobin protein is abnormal,
causing the red blood cells to be rigid and clog the circulation because they are unable to flow through
small blood vessels.
Anemia caused by other diseases

- Some diseases can affect the body's ability to make red blood

cells. For example, some patients with kidney disease develop anemia because the kidneys are not
making enough of the hormone erythropoietin to signal the bone marrow to make new or more red
blood cells. Chemotherapy used to treat various cancers often impairs the body's ability to make new
red blood cells, and anemia often results from this treatment.

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How is Anemia Treated?

The treatment for anemia depends on what causes it.
Iron-deficiency anemia is almost always due to blood loss. If you have iron-deficiency anemia, your
doctor may order tests to determine if you are losing blood from your stomach or bowels. Other
nutritional anemias, such as folate or B-12 deficiency, may result from poor diet or from an inability to
absorb vitamins in the gastrointestinal tract. Treatment varies from changing your diet to taking
dietary supplements.
If your anemia is due to a chronic disease, treatment of the underlying disease will often improve the
anemia. Under some circumstances, such as chronic kidney disease, your doctor may prescribe

medication such as erythropoietin injections to stimulate your bone marrow to produce more red blood
cells.
Aplastic anemia occurs if your bone marrow stops producing red blood cells. Aplastic anemia may be
due to primary bone marrow failure, myelodysplasia (a condition in which the bone marrow produces
abnormal red blood cells that do not mature properly), or occasionally as a side effect of some
medications. If you appear to have a form of aplastic anemia, your doctor may refer you to a
hematologist for a bone marrow biopsy to determien the cause of the anemia. Meedications and blood
transfusions may be used to treat aplastic anemia.
Hemolytic anemia occurs when red blood cells are destroyed in the blood stream. This may be due to
mechanical factors (a leaky heart valve or aneurysm), infection, or an autoimmune disease. The cause
can often be identified by special blood tests and by looking at the red blood cells under a microscope.
The treatment will depend upon the cause and may include referral to a heart or vascular specialist,
antibiotics, or drugs that suppress the immune system.
Talk with your doctor if you believe you may be at risk for anemia. Your doctor will determine your best
course of treatment and, depending on your condition, may refer you to a hematologist, a doctor who
specializes in blood disorders.

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Is Anemia Preventable?
While many types of anemia cannot be prevented, eating healthy foods can help you avoid both ironand vitamin-deficiency anemia. Foods to include in your diet include those with high levels of iron
(beef, dark green leafy vegetables, dried fruits, andnuts),vitamin B-12 (meat and dairy), and folic acid
(citrus juices, dark green leafy vegetables, legumes, and fortified cereals). A daily multivitamin will also
help prevent nutritional anemias; however, older adults should not take iron supplementsfor irondeficiencyanemia unless instructed by their physicians.

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Hereditary Spherocytosis: A Patient's Journey

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Where Can I Find More Information?

If you find that you are interested in learning more about blood diseases and disorders, here are a few
other resources that may be of some help:

Results of Clinical Studies Published in Blood

Search Blood, the official journal of ASH, for the results of the latest blood research. While recent
articles generally require a subscriber login, patients interested in viewing an access-controlled article
in Blood may obtain a copy by e-mailing a request to the Blood Publishing Office.
Patient Groups
A list of Web links to patient groups and other organizations that provide information.

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Anemia and Older Adults

There are approximately 35 million people in the United States over the age of 65, and it is estimated
that within 25 years that number will double. Almost 10 percent of the older population is currently
anemic. If you are over the age of 65, it is important to learn about the risks of anemia and what to do
if you are experiencing symptoms.
There are different types of anemia, including iron-deficiency anemia (when you do not have enough
iron), vitamin-deficiency anemia (when you do not have enough of a vitamin like folic acid), aplastic
anemia (when your body stops producing red blood cells), anemia associated with a chronic disease
(when anemia results from a condition like kidney disease) and hemolytic anemia (when your body
destroys red blood cells).

Where Can I Find More Information?

If you find that you are interested in learning more about blood diseases and disorders, here are a few
other resources that may be of some help:
Results of Clinical Studies Published in Blood
Search Blood, the official journal of ASH, for the results of the latest blood research. While recent
articles generally require a subscriber login, patients interested in viewing an access-controlled article
in Blood may obtain a copy by e-mailing a request to the Blood Publishing Office.
Patient Groups
A list of Web links to patient groups and other organizations that provide information.

Anemia and Pregnancy

Your body goes through significant changes when you become pregnant. The amount of blood in your
body increases by about 20-30 percent, which increases the supply of iron and vitamins that the body
needs to make hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen to other
cells in your body.
Many women lack the sufficient amount of iron needed for the second and third trimesters. When your
body needs more iron than it has available, you can become anemic.
Mild anemia is normal during pregnancy due to an increase in blood volume. More severe anemia,
however, can put your baby at higher risk for anemia later in infancy. In addition, if you are
significantly anemic during your first two trimesters, you are at greater risk for having a pre-term
delivery or low-birth-weight baby. Being anemic also burdens the mother by increasing the risk of
blood loss during labor and making it more difficult to fight infections.
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Am I at Risk?
You are at higher risk for becoming anemic during your pregnancy if you:

Have two pregnancies close together

Are pregnant with more than one child

Are vomiting frequently due to morning sickness

Do not consume enough iron

Have a heavy pre-pregnancy menstrual flow

Many of the symptoms of anemia during pregnancy are also symptoms you may experience even if
you are not anemic; these include:

Feeling tired or weak

Progressive paleness of the skin

Rapid heartbeat

Shortness of breath

Trouble concentrating

Doctors typically perform several tests to check the percentage of red blood cells in your plasma and
the amount of hemoglobin in your blood. These are indicators of whether you are at risk for becoming
anemic.

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Is Pregnancy-Related Anemia Preventable?

Good nutrition is the best way to prevent anemia if you are pregnant or trying to become pregnant.
Eating foods high in iron content (such as dark green leafy vegetables, red meat, fortified cereals,
eggs, and peanuts) can help ensure that you maintain the supply of iron your body needs to function
properly. Your obstetrician will also prescribe vitamins to ensure that you have enough iron and folic
acid. Make sure you get at least 27 mg of iron each day. If you do become anemic during your
pregnancy, it can usually be treated by taking iron supplements.
Ask your doctor about your risk for anemia and make sure you are tested at your first prenatal visit.
You also may want to get tested four to six weeks after delivery. Depending on your condition, your
doctor may refer you to a hematologist, a doctor who specializes in blood conditions.

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Where Can I Find More Information?

If you find that you are interested in learning more about blood diseases and disorders, here are a few
other resources that may be of some help:
Results of Clinical Studies Published in Blood
Search Blood, the official journal of ASH, for the results of the latest blood research. While recent
articles generally require a subscriber login, patients interested in viewing an access-controlled article
in Blood may obtain a copy by e-mailing a request to the Blood Publishing Office.
Patient Groups
A list of Web links to patient groups and other organizations that provide information.

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Sickle Cell Anemia

Approximately 70,000-100,000 Americans have sickle cell anemia, the most common form of an
inherited blood disorder that causes the production of abnormal hemoglobin, a protein that attaches to
oxygen in the lungs and carries it to all parts of the body. Healthy red blood cells are flexible so that
they can move through the smallest blood vessels. In sickle cell anemia, the hemoglobin is abnormal,
causing the red blood cells to be rigid and shaped like a "C" or sickle, the shape from which the disease
takes its name. Sickle cells can get stuck and block blood flow, causing pain and infections.
Complications of sickle cell anemia are a result of sickle cells blocking blood flow to specific organs,
and include stroke, acute chest syndrome (a condition that lowers the level of oxygen in the blood),
organ damage, other disabilities, and in some cases premature death.
In order for you or your child to inherit sickle cell anemia, both parents must have either sickle cell
anemia (two sickle cell genes) or sickle cell trait (one sickle cell gene); read more about sickle cell
trait here. There are variations of sickle cell disease called sickle C or sickle thalassemia, which are
serious conditions but are sometimes less severe. If you have sickle cell disease, you will pass one
sickle cell gene to your children.
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Sickle Cell Trait

Sickle cell trait is an inherited blood disorder that affects approximately 8 percent of AfricanAmericans. Unlike sickle cell disease, in which patients have two genes that cause the production of
abnormal hemoglobin, individuals with sickle cell trait carry only one defective gene and typically live
normal lives without health problems related to sickle cell. Rarely, extreme conditions such as severe
dehydration and high-intensity physical activity can lead to serious health issues, including sudden
death, in individuals with sickle cell trait.
Learn More about Sickle Cell Trait

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The Problem With Sickled Cells

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Risk Factors
Sickle cell anemia is more common in certain ethnic groups, including:

People of African descent, including African-Americans (among whom 1 in 12 carries a sickle

cell gene)

Hispanic-Americans from Central and South America

People of Middle Eastern, Asian, Indian, and Mediterranean descent

Because sickle cell anemia symptoms can begin by four months of age, early diagnosis is critical. All
newborns in the United States are now tested for the disease. Sickle cell anemia can be identified
before birth by testing a sample of amniotic fluid or tissue from the placenta. People who carry the
sickle cell gene can seek genetic counseling before pregnancy to discuss options.

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Signs and Symptoms

Signs and symptoms of sickle cell anemia can be mild or severe enough to require frequent
hospitalizations. They may include:

Anemia (looking pale)

Dark urine

Yellow eyes

Painful swelling of hands and feet

Frequent pain episodes

Stunted growth

Stroke

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Treatment
There are no standard treatments that cure sickle cell anemia. However, there are treatments that help
people manage and live with the disease. Treatment relieves pain, prevents infections, minimizes
organ damage, and controls complications and can include medications, such as pain relievers and
hydroxyurea (Hydrea), at times blood transfusions, and other options as needed.
Clinical trials provide access to experimental therapies for treating sickle cell anemia. ASH provides
information on clinical trials for which you may be eligible. Researchers are looking at new drugs and
also exploring the use of bone marrow transplants to treat sickle cell disease. Stem cell transplants are
associated with significant risks and are appropriate only for some patients with severe forms of sickle
cell disease and closely matched donors such as a family member.
It is important for you to talk with your doctor if you believe you may have sickle cell anemia. If you
carry the sickle cell trait, make sure you tell your doctor before getting pregnant as well. Depending on
your condition, your doctor may refer you to a hematologist, a doctor who specializes in blood
conditions.

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Sickle Cell Anemia: A Patient's Journey

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Advances in Sickle Cell Anemia

Since researchers first identified sickle cell disease more than 100 years ago, numerous advances have
been made in the treatment and care of sickle cell patients.

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More Information
Read the latest clinical sickle cell disease research published in Blood, the official journal of ASH. While
recent article generally require a subscriber login, patients interested in viewing an subscriber-only
article in Blood may obtain a copy by emailing a request to the Blood Publishing office.

Patient Groups
A list of Web links to patient groups and other organizations that provide information.

Sickle Cell Trait

Sickle cell trait is an inherited blood disorder that affects 1 million to 3 million Americans and 8 to 10
percent of African Americans. Sickle cell trait can also affect Hispanics, South Asians, Caucasians from
southern Europe, and people from Middle Eastern countries. More than 100 million people worldwide
have sickle cell trait.
Unlike sickle cell disease, a serious illness in which patients have two genes that cause the production
of abnormal hemoglobin (the substance in red blood cells that helps carry oxygen), individuals with
sickle cell trait carry only one defective gene and typically live normal lives. Rarely, extreme conditions
such as severe dehydration and high-intensity physical activity can lead to serious health issues,
including sudden death, for individuals with sickle cell trait.
If an individual has sickle cell trait, it means that he or she carries or has inherited a single copy of the
gene that causes sickle cell disease. It is not a disease. In general, people with sickle cell trait enjoy
normal life spans with no medical problems related to sickle cell trait.
Sickle cell trait can never become sickle cell disease. It is possible, however, for individuals with sickle
cell trait to pass the gene to their children.
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Signs and Symptoms

Most people with sickle cell trait have no symptoms and will not have any health complications.
Occasionally people with sickle cell trait can have blood in their urine. Under extreme conditions such
as high altitude, severe dehydration, or very high intensity physical activity, red cells can become
deformed or sickled. Complications include muscle breakdown (rhabdomyolysis), reduced blood supply
to the spleen (ischemia/infarction), or increased pressure in the eye (glaucoma) following eye injuries.
Finally, a very rare form of kidney cancer (renal medullary carcinoma) has been associated with sickle
cell trait.

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Risk Factors
Sickle cell trait is more common in certain ethnic groups, including:

African Americans (8 to 10 percent of African Americans have sickle cell trait)

Hispanics

South Asians

Caucasians from southern Europe

People from Middle Eastern countries

All newborns in the United States are now tested for sickle cell disease and sickle cell trait. Sickle cell
disease can be identified before birth by testing a sample of amniotic fluid or tissue from the placenta.
People who carry the sickle cell gene can seek genetic counseling before pregnancy to discuss options.

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Sickle Cell Trait and Athletic Participation

Individuals can and do lead active lifestyles. In fact, several professional athletes are carriers of the
trait. In recent years, however, there has been heightened attention on cases of athletes with sickle
cell trait who have experienced exertion-related illness and, in some cases, sudden death, during or
after strenuous athletic training sessions. These cases caused some organizations to mandate that
athletes be tested for sickle cell trait as a prerequisite to participation and has led to some confusion
about whether or not it is safe for individuals with sickle cell trait to play sports.
In January 2012, ASH released a Policy Statement on Screening for Sickle Cell Trait and Athletic
Participation, opposing mandatory sickle cell trait screening as a prerequisite to athletic participation
and urging athletics programs to adopt universal preventive interventions in their training programs to
protect all athletes from exertion-related illness and death. These preventative interventions include
drinking adequate amounts of fluid and taking rest breaks as needed, as well as having staff present at
organized sport practices or games who can recognize when a participant may be experiencing
exertion related complications and may need medical attention. The policy statement also states that
screening for sickle cell trait should be voluntary and should take place in a setting that ensures
privacy and is performed by a knowledgeable provider who is able to offer comprehensive counseling.

Access a list of Frequently Asked Questions about sickle cell trait

Iron-Deficiency Anemia
Iron is very important in maintaining many body functions, including the production of hemoglobin, the
molecule in your blood that carries oxygen. Iron is also necessary to maintain healthy cells, skin, hair,
and nails.
Iron from the food you eat is absorbed into the body by the cells that line the gastrointestinal tract; the
body only absorbs a small fraction of the iron you ingest. The iron is then released into the blood
stream, where a protein called transferrin attaches to it and delivers the iron to the liver. Iron is stored
in the liver as ferritin and released as needed to make new red blood cells in the bone marrow. When
red blood cells are no longer able to function (after about 120 days in circulation), they are re-absorbed
by the spleen. Iron from these old cells can also be recycled by the body.
Jump To:

Am I at Risk?
Iron deficiency is very common, especially among women and in people who have a diet that is low in
iron. The following groups of people are at highest risk for iron-deficiency anemia:

Women who menstruate, particularly if menstrual periods are heavy

Women who are pregnant or breastfeeding or those who have recently given birth

People who have undergone major surgery or physical trauma

People with gastrointestinal diseases such as celiac disease (sprue), inflammatory bowel
diseases such as ulcerative colitis, or Crohn disease

People with peptic ulcer disease

People who have undergone bariatric procedures, especially gastric bypass operations

Vegetarians, vegans, and other people whose diets do not include iron-rich foods (Iron from
vegetables, even those that are iron-rich, is not absorbed as well as iron from meat, poultry,
and fish.)

Children who drink more than 16 to 24 ounces a day of cow's milk (Cow's milk not only
contains little iron, but it can also decrease absorption of iron and irritate the intestinal lining
causing chronic blood loss.)

Other less common causes of iron deficiency include:

Blood loss from the gastrointestinal tract due to gastritis (inflammation of the stomach),
esophagitis (inflammation of the esophagus), ulcers in the stomach or bowel, hemorrhoids,
angiodysplasia (leaky blood vessels similar to varicose veins in the gastrointestinal tract),
infections such as diverticulitis, or tumors in the esophagus, stomach, small bowel, or colon

Blood loss from chronic nosebleeds

Blood loss from the kidneys or bladder

Frequent blood donations

Intravascular hemolysis, a condition in which red blood cells break down in the blood stream,
releasing iron that is then lost in the urine. This sometimes occurs in people who engage in
vigorous exercise, particularly jogging. This can cause trauma to small blood vessels in the
feet, so called "march hematuria." Intravascular hemolysis can also be seen in other conditions
including damaged heart valves or rare disorders such as thrombotic thrombocytopenia
purpura (TTP) or diffuse intravascular hemolysis (DIC).

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What Are the Signs and Symptoms of Iron-Deficiency Anemia?

Symptoms of iron-deficiency anemia are related to decreased oxygen delivery to the entire body and
may include:

Being pale or having yellow "sallow" skin

Unexplained fatigue or lack of energy

Shortness of breath or chest pain, especially with activity

Unexplained generalized weakness

Rapid heartbeat

Pounding or "whooshing" in the ears

Headache, especially with activity

Craving for ice or clay - "picophagia"

Sore or smooth tongue

Brittle nails or hair loss

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How Is Iron-Deficiency Anemia Diagnosed?

Iron-deficiency anemia is diagnosed by blood tests that should include a complete blood count (CBC).
Additional tests may be ordered to evaluate the levels of serum ferritin, iron, total iron-binding
capacity, and/or transferrin. In an individual who is anemic from iron deficiency, these tests usually
show the following results:

Low hemoglobin (Hg) and hematocrit (Hct)

Low mean cellular volume (MCV)

Low ferritin

Low serum iron (FE)

High transferrin or total iron-binding capacity (TIBC)

Low iron saturation

The peripheral smear or blood slide may show small, oval-shaped cells with pale centers. In severe iron
deficiency, the white blood count (WBC) may be low and the platelet count may be high or low.

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What Other Tests Will Be Done If Iron Deficiency Is Diagnosed?

Your doctor will decide if other tests are necessary. Iron deficiency is common in menstruating and
pregnant women, children, and others with a diet history of excessive cow's milk or low iron-containing
foods. By talking with your doctor about your diet and medical history, your doctor may gain enough
information to determine whether additional testing is needed. In patients such as men,
postmenopausal women, or younger women with severe anemia, the doctor may recommend
additional testing. These tests may include the following:

Testing for blood in the stool (fecal occult blood test)

Looking for abnormalities in the gastrointestinal tract - upper and lower endoscopy (looking
into the stomach, esophagus, or colon with a tube), capsule enteroscopy (swallowing a tiny
camera that takes images of the gastrointestinal tract), barium enema, barium swallow, or
small bowel biopsy

Testing the urine for blood or hemoglobin

In women with abnormal or increased menstrual blood losses, a gynecologic evaluation that
may include a pelvic ultrasound or uterine biopsy

Sometimes it is difficult to diagnose the cause of iron deficiency, or your doctor may be concerned that
there is a problem other than iron deficiency causing the anemia. These may include inherited blood

disorders called thalassemiasin which red blood cells also appear small and pale, hemoglobinopathies
such as sickle cell disease (but not sickle cell trait alone), or other blood disorders. People with chronic
infections or conditions such as kidney failure, autoimmune diseases, and inflammatory disorders may
also have small red blood cells. When the cause of the anemia is not clear, your doctor may refer you
to a hematologist, a medical specialist in blood disorders,for consultation and further evaluation.

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How Is Iron Deficiency Treated?

Even if the cause of the iron deficiency can be identified and treated, it is still usually necessary to take
medicinal iron (more iron than a multivitamin can provide) until the deficiency is corrected and the
body's iron stores are replenished. In some cases, if the cause cannot be identified or corrected, the
patient may have to receive supplemental iron on an ongoing basis.
There are several ways to increase iron intake:
Diet

Meat: beef, pork, or lamb, especially organ meats such as liver

Poultry: chicken, turkey, and duck, especially liver and dark meat

Fish, especially shellfish, sardines, and anchovies

Leafy green members of the cabbage family including broccoli, kale, turnip greens, and collard
greens

Legumes, including lima beans, peas, pinto beans, and black-eyed peas

Iron-enriched pastas, grains, rice, and cereals

Medicinal Iron
The amount of iron needed to treat patients with iron deficiency is higher than the amount found in
most daily multivitamin supplements. The amount of iron prescribed by your doctor will be in
milligrams (mg) of elemental iron. Most people with iron deficiency need 150-200 mg per day of
elemental iron (2 to 5 mg of iron per kilogram of body weight per day). Ask your doctor how many
milligrams of iron you should be taking per day. If you take vitamins, bring them to your doctor's visit
to be sure.

There is no evidence that any one type of iron salt, liquid, or pill is better than the others, and the
amount of elemental iron varies with different preparations. To be sure of the amount of iron in a
product, check the packaging. In addition to elemental iron, the iron salt content (ferrous sulfate,
fumarate, or gluconate) may also be listed on the package, which can make it confusing for consumers
to know how many tablets or how much liquid to take to get the proper dosage of iron.
Iron is absorbed in the small intestine (duodenum and first part of the jejunum). This means that
enteric-coated iron tablets may not work as well. If you take antacids, you should take iron tablets two
hours before or four hours after the antacid. Vitamin C (ascorbic acid) improves iron absorption, and
some doctors recommend that you take 250 mg of vitamin C with iron tablets.
Possible side effects of iron tablets include abdominal discomfort, nausea, vomiting, diarrhea,
constipation, and dark stools.
Intravenous Iron
In some cases your doctor may recommend intravenous (IV) iron. IV iron may be necessary to treat
iron deficiency in patients who do not absorb iron well in the gastrointestinal tract, patients with severe
iron deficiency or chronic blood loss, patients who are receiving supplemental erythropoietin, a
hormone that stimulates blood production, or patients who cannot tolerate oral iron. If you need IV
iron, your doctor may refer you to a hematologist to supervise the iron infusions. IV iron comes in
different preparations:

Iron dextran

Iron sucrose

Ferric gluconate

Large doses of iron can be given at one time when using iron dextran. Iron sucrose and ferric gluconate
require more frequent doses spread over several weeks. Some patients may have an allergic reaction
to IV iron, so a test dose may be administered before the first infusion. Allergic reactions are more
common with iron dextran and may necessitate switching to a different preparation. Severe side
effects other than allergic reactions are rare and include urticaria (hives), pruritus (itching), and muscle
and joint pain.
Blood Transfusions
Red blood cell transfusions may be given to patients with severe iron-deficiency anemia who are
actively bleeding or have significant symptoms such as chest pain, shortness of breath, or weakness.
Transfusions are given to replace deficient red blood cells and will not completely correct the iron

deficiency. Red blood cell transfusions will only provide temporary improvement. It is important to find
out why you are anemic and treat the cause as well as the symptoms.

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Where Can I Find More Information?

If you find that you are interested in learning more about blood diseases and disorders, here are a few
other resources that may be of some help:
Results of Clinical Studies Published in Blood
Search Blood, the official journal of ASH, for the results of the latest blood research. While recent
articles generally require a subscriber login, patients interested in viewing an access-controlled article
in Blood may obtain a copy by e-mailing a request to the Blood Publishing Office.
Patient Groups
A list of Web links to patient groups and other organizations that provide information.

Am I at Risk?
Many people are at risk for anemia because of poor diet, intestinal disorders, chronic diseases,
infections, and other conditions. Women who are menstruating or pregnant and people with chronic
medical conditions are most at risk for this disease. The risk of anemia increases as people grow older.
People who engage in vigorous athletic activities, such as jogging or basketball, may develop anemia
as a result of red blood cells breaking down in the bloodstream.
If you have any of the following chronic conditions, you might be at greater risk for developing anemia:

Rheumatoid arthritis or other autoimmune disease

Kidney disease

Cancer

Liver disease

Thyroid disease

Inflammatory bowel disease (Crohn disease or ulcerative colitis)

The signs and symptoms of anemia can easily be overlooked. In fact, many people do not even realize
that they have anemia until it is identified in a blood test.