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What is anemia?

Anemia happens when the number of healthy red blood cells in your body is too low. Red blood cells carry oxygen to all of the body’s tissues, so a low red blood cell count indicates that the amount of oxygen in your blood is lower than it should be.

Many of the symptoms of anemia are caused by decreased oxygen delivery to the body’s vital tissues and organs.

Anemia is measured according to the amount of hemoglobin — the protein within red blood cells that carries oxygen from the lungs to the body’s tissues.

Anemia affects more than 1.6 billion people around the world. Women and people with chronic diseases such as cancer have the highest risk of developing anemia.

Dietary iron, vitamin B-12, and folate are essential for red blood cells to mature in the body. Normally, 0.8 to 1 percent of the body’s red blood cells are replaced every day, and the average lifespan for red cells is 100 to 120 days. Any process that has a negative effect on this balance between red blood cell production and destruction can cause anemia.

Causes of anemia are generally divided into those that decrease red blood cell production and those that increase red blood cell destruction.

Factors that decrease red blood cell production

The things that typically decrease red blood cell production, causing anemia, include:

Factors the increase red blood cell destruction

On the other hand, any disorder that destroys red blood cells at a rate faster than they’re made can cause anemia. This typically occurs due to hemorrhaging, which can happen because of:

Overall, however, iron deficiency is the most common cause of anemia. It accounts for nearly half of all anemia cases, and is a major nutritional disorder worldwide.

Daily requirements for vitamins and iron vary according to sex and age.

Women need more iron and folate than men because of iron losses during their menstrual cycle and fetal development during pregnancy and breastfeeding.

Iron

According to the National Institutes of Health, the recommended daily iron intake for adults ages 19 to 50 are as follows:

For men8 mg
For women18 mg
During pregnancy27 mg
While breastfeeding9 mg

Men and women over age 50 require only 8 milligrams (mg) of iron daily. A supplement may be needed if adequate iron levels can’t be acquired through diet alone.

Good sources of dietary iron include:

  • chicken and beef liver
  • dark turkey meat
  • red meats, such as beef
  • seafood
  • fortified cereals
  • oatmeal
  • lentils
  • beans
  • spinach

Folate

Folate is the form of folic acid that occurs naturally in the body.

Males and females over the age of 14 require 400 micrograms of dietary folate equivalents (mcg/DFE) per day.

For women who are pregnant or breastfeeding, the recommended intake increases to 600 mcg/DFE and 500 mcg/DFE per day, respectively.

Examples of foods rich in folate are:

  • beef liver
  • lentils
  • spinach
  • great northern beans
  • asparagus
  • eggs

You can also add folic acid to your diet with fortified cereals and breads.

Vitamin B-12

The daily adult recommendation for vitamin B-12 is 2.4 mcg. Women and teens who are pregnant need 2.6 mcg per day, and those who are breastfeeding require 2.8 mcg daily.

Beef liver and clams are two of the best sources of vitamin B-12. Other good sources include:

  • fish
  • meat
  • poultry
  • eggs
  • other dairy products

Vitamin B-12 is also available as a supplement for those who don’t get enough from their diet alone.

Need a supplement?

If you know you have anemia, or aren’t getting enough of the above nutrients, get your boost by shopping below:

People with anemia appear pale and may often complain of being cold.

They may also experience:

Some types of anemia can cause inflammation of the tongue, resulting in a smooth, glossy, red, and often painful tongue.

If anemia is severe, fainting may occur. Other symptoms include:

  • brittle nails
  • shortness of breath
  • chest pains

Blood oxygen levels can be so low that a person with severe anemia can have a heart attack.

If you get a physical exam and you have anemia, your results may show:

People with signs or symptoms of anemia should seek medical attention, especially if fainting or chest pains occur.

A diagnosis of anemia begins with both your health history and your family health history, along with a physical exam.

A family history of certain types of anemia such as sickle cell anemia can be helpful. A history of exposure to toxic agents in the home or workplace might point to an environmental cause.

Laboratory tests are often what’s used to help doctors find out the cause of the anemia.

Tests to diagnose anemia include:

  • Complete blood count (CBC). The CBC blood test shows the number and size of the red blood cells. It also shows if levels of other blood cells like white blood cells and platelets are normal.
  • Serum iron levels. This blood test shows if iron deficiency is the cause of anemia.
  • Ferritin test. This blood test analyzes iron stores.
  • Vitamin B-12 test. This blood test shows vitamin B-12 levels and helps your doctor determine if they’re too low.
  • Folic acid test. This blood test reveals if serum folate levels are low.
  • Stool test for occult blood. This test applies a chemical to a stool specimen to see if blood is present. If the test is positive, it means that blood is being lost somewhere in the gastrointestinal tract, from the mouth to the rectum. Problems like stomach ulcers, ulcerative colitis, and colon cancer can cause blood in stool.

Additional tests

Based on the results of these tests, doctors may order additional tests such as:

Treating anemia depends on what’s causing it.

Anemia caused by inadequate amounts of dietary iron, vitamin B-12, and folate is treated with nutritional supplements. In some cases, injections of B-12 are needed as it isn’t absorbed properly from the digestive tract.

Your doctor and nutritionist can prescribe a diet that contains the proper amounts of vitamins, minerals, and other nutrients. A proper diet can help prevent this kind of anemia from recurring.

In some cases, if the anemia is severe, doctors use erythropoietin injections to increase red blood cell production in the bone marrow. If bleeding occurs or the hemoglobin level is very low, a blood transfusion may be necessary.

The long-term outlook for anemia depends on the cause and the response to treatment. Anemia is very treatable, but it can be dangerous if it’s left untreated.

Pay attention to food labels and invest in a multivitamin to ensure that you’re getting the recommended daily amount of iron.

Talk to your doctor if you’re experiencing any symptoms of anemia, especially if you have a family history of it. Your doctor will most likely get you started on a diet or supplement regimen to increase your iron intake.

An iron deficiency may also be a sign of more serious medical conditions, so it’s important to pay attention to your body. In most cases, just tweaking your diet or taking an iron supplement can solve your anemia.