People with anemia may experience shortness of breath when there aren’t enough red blood cells to transport oxygen. Untreated, it can cause other complications.

Anemia is a blood disorder that can be short term or chronic. From vitamin deficiencies caused by eating a diet limited in key nutrients to other temporary life moments like pregnancy or having recently given birth, multiple causes can lead to a lower red blood cell count.

Formally, this is what anemia is — when a person has an abnormally, low red blood cell count. Although most people associate the condition with having low iron levels, multiple forms of anemia exist.

One common symptom that can manifest from it is shortness of breath (dyspnea). Understanding why this unique symptom occurs, as well as how to manage it in everyday life can help people with anemia better manage their condition.

Anemia is a condition that exists on a spectrum. As with many other disorders, no one single type exists. There are roughly five different types of anemia. While all of these versions affect the red blood cell count, the causes and symptoms associated with each version can vary.

Both the acute and chronic forms of anemia can lead to shortness of breath because there are not enough red blood cells to transport oxygen throughout the body.

The body relies on a precise ecosystem that consistently exchanges carbon dioxide (CO2) for oxygen (O) — and for this to occur efficiently, you need enough red blood cells circulating.

Consistent research into anemia as the sole cause for shortness of breath is thin. However, many studies have focused on the development of anemia in people with chronic obstructive pulmonary disease (COPD) and if there is a link between decreased physical function and oxygenation recovery.

The results of these studies are somewhat inconclusive. One study involving COPD patients found that although anemia is not linked as a sole cause of shortness of breath in COPD patients, it did have a slight influence on oxygen recovery rates after exercise.

Why does it get worse at night?

Similar to many other breathing conditions like asthma or COPD, just simply lying down can make it harder to breathe. This is because your supine (lying down) position puts additional pressure on your diaphragm, making it feel like you have to work harder for each breath.

Likewise, other contributing factors like mucus buildup or even a postnasal drip can all make nighttime breathing more difficult.

Did you know?

The most commonly known type is iron deficiency anemia, with estimates that roughly 50% of people with anemia have this form. This is where low iron levels — usually linked to eating a low-nutrient diet or experiencing blood loss — cause a reduction in the red blood cell count.

Note that this type of anemia features shortness of breath as one of the hallmark symptoms in more severe or chronic cases. So if you have anemia and experience shortness of breath, know that it can commonly occur.

Was this helpful?

If your anemia is not well managed, your symptoms are more likely to worsen and become severe. They could escalate in a variety of ways. Here are some examples:

  • Frequently being short of breath can cause your heart rate to increase or even cause you to routinely experience hyperventilation.
  • Left untreated, anemia can encourage the development of other conditions like heart problems or restless leg syndrome.
  • In pregnant people with untreated iron deficiency anemia, pregnancy complications. Untreated iron deficiency anemia in pregnant people can also lead to their children experiencing developmental delays.
  • If a chronic condition triggered your anemia and it’s not treated, it can interfere with how well your underlying health concerns respond to medication therapy. This means that those chronic conditions can worsen.

Anemia is a condition that occurs because of other health concerns that are not addressed or not managed well.

While short-term fixes like oxygen supplementation, rescue inhalers, and breathing treatments can help manage shortness of breath, prioritizing long-term anemia management is the most important step.

When anemia is properly managed long term, it helps the red blood cell count return to an acceptable level within the recommended range.

Depending on the type of anemia that you have, your long-term treatment options may vary.

For example, selecting nutrient-rich foods and possibly supplementing can be effective in treating iron and vitamin deficiency anemia.

More serious forms of anemia may require:

When to seek emergency care

Shortness of breath can be a difficult experience, but it’s usually a temporary symptom. Your breathing typically returns to normal within a short period of time.

However, if shortness of breath is persistent or is frequently accompanied by dizziness or fainting, getting emergency care is critical.

Likewise, if shortness of breath has become so commonplace that you also experience a faster heart rate, it’s important that you get immediate medical care as your anemia is not well managed.

Was this helpful?

Some people may not fully understand what anemia is and may think it isn’t a serious condition.

Anemia is a medical condition that usually develops due to other underlying conditions that have not been addressed or have not been managed well.

Left untreated, it can affect your health in various ways — including creating shortness of breath.

It’s important to work with a healthcare professional to properly manage your anemia and treat any other conditions that may be triggering the condition. Doing this can help prevent any current symptoms from getting worse and help prevent new and possibly harsher symptoms from developing.