10 Signs That You Might Have Anemia

More than 3 million people in the U.S. are living with anemia, a common blood disorder that develops when a person’s red blood cell count is low or when red blood cells do not have enough hemoglobin. This is something we see here at Westchester Health but if diagnosed properly and treated promptly, anemia in most cases can be successfully reversed.

What causes anemia?

Margaret Andersen, MD

Since organs and tissues all need oxygen to function correctly, being anemic can cause widespread health problems. According to the U.S. Department of Health and Human Services, women and people with chronic diseases are at the greatest risk for anemia, but it can affect anyone.

The most common cause, especially in women, is iron deficiency. Iron is an important component of hemoglobin and if you don’t have enough iron, your body cannot make enough healthy oxygen-carrying red blood cells. You can also become iron deficient from not eating enough iron—this is very common in pregnant women because they have to eat enough iron for two. In addition, some people may eat enough iron but have problems absorbing it, due to gastrointestinal disorders such as Crohn’s disease.

Other causes of anemia include:

  • severe injury
  • surgery
  • ulcers
  • poor diet
  • inadequate intake of vitamins and minerals
  • very heavy menstrual periods
  • childbirth
  • extreme blood loss
  • sickle cell disease
  • gastritis
  • hemorrhoids
  • colorectal cancer
  • inherited conditions such as the blood disorder thalassemia
  • environmental exposure to lead

10 symptoms of anemia to watch out for

You may have no symptoms at first, or very mild ones. However, as anemia gets worse some telltale signs become apparent. Here are the most common ones.

  1. You’re exhausted and weak

The most common symptom of iron-deficiency anemia is fatigue. Without enough oxygen being delivered to your cells you aren’t able to break down nutrients and make energy. Without energy, you continually feel tired and weak throughout the day and it can be difficult to complete your daily tasks.

  1. You have strange cravings for things that aren’t food

People who are anemic may develop a syndrome called pica, which causes strange cravings for non-food items such as dirt, ice or clay. There are some theories as to why iron deficiency leads to pica, but the true cause is unclear. Research shows that the cravings seem to go away when patients receive iron supplements.

  1. You get headaches or feel dizzy

Headaches, dizziness and lightheadedness can all be symptoms of anemia caused by a lack of oxygen to the brain. For some people, this may even lead to fainting.

  1. Your heartbeat is irregular

Heart palpitations, an irregular heartbeat or an increased heart rate can be signs that your body is attempting to compensate for its lack of energy. By circulating blood faster your body is trying to spread around the small amounts of available hemoglobin in order to deliver more oxygen.

  1. You’re short of breath

When your organs do not get enough oxygen your lungs may start to overcompensate and work harder to bring in more oxygen. For example, if walking up stairs leaves you winded or you can barely catch your breath during a workout (and these are new occurrences) your iron levels may be far too low.

  1. You have chest pain

Your heart needs oxygen to function. Without enough hemoglobin and oxygen, the heart tissue will behave as though you have impaired blood flow. In very severe anemia this can lead to a myocardial infarction or what is more commonly known as a heart attack.

  1. Your legs tingle

Low iron stores are associated with restless leg syndrome. This is a strong, unpleasant urge to move your legs. This can also make it hard to fall asleep at night. Fortunately, iron supplements have been shown to help make this condition go away in people who are deficient.

  1. Your skin is pale

When your heart and brain, your two most vital organs, are not getting enough oxygen your body sends more blood there, depriving other parts of your body in the process. When less blood flows to your skin you’re likely to lose some of your color or skin tone. With severe anemia, the skin can look grey or ashen.

  1. Your nails are brittle

Nails like every other living cell in your body need oxygen to breathe and grow. Without it, the nail beds stop making healthy new cells leading to weak and brittle nails over time.

  1. Your hands and feet are always cold

Although it may sound harsh, your extremities are treated by your body as non-essential body parts, and consequently, blood flow to those areas may become limited when you are anemic. Limited circulation in your hands and feet can cause them to feel cold and often numb.

How to treat anemia caused by iron deficiency

I typically recommend to my patients iron supplements that contain the ferrous form of iron, which your body can absorb easily. If you are seriously anemic you may need to continue taking iron supplements for up to a year. In this case, you should heed the following precautions:

  • Excess iron intake can be harmful. Symptoms of iron overload include fatigue, vomiting, diarrhea, headache, irritability, heart disease and joint problems.
  • Iron supplements (and all supplements and medications) should be kept out of the reach of children. Iron poisoning is one of the most common causes of accidental poisoning in young children and can prove fatal in a matter of hours. Symptoms of iron poisoning in a child include dizziness, confusion, nausea, vomiting and diarrhea. Seek medical help immediately.
  • Watch for side effects. Taking iron supplements with food can help prevent common side effects which may include nausea, diarrhea, constipation, and stomach pain. Let your doctor know if you continue to have side effects. Different formulations are available.
  • Watch for drug interactions. Tell your doctor if you are being treated for another condition. For example, calcium supplements interfere with iron absorption, so it is best to take them at different times of the day.
  • The body absorbs iron best when taken in a mildly acidic medium. For this reason, your doctor may suggest taking iron with a half-glass of orange juice or with vitamin C. Your doctor may also recommend that you increase the amount of iron in your diet. Good dietary sources of iron include red meat, beans, egg yolk, whole-grain products, nuts and seafood. Many processed foods, as well as milk, are also reinforced with iron.

Your doctor will monitor your red blood cell counts during treatment. If your anemia doesn’t improve with iron supplements, he/she will look for some other underlying cause. In rare cases, your doctor may prescribe iron injections or give you iron intravenously. In extremely rare cases of life-threatening iron-deficiency anemia, treatment may involve a blood transfusion.

Worried that you may be anemic? Come see us.

If you think you may have anemia, or would like to learn more about how to prevent it, please call (914) 232-1919 to make an appointment with one of our Westchester Health Internal Medicine specialists. We will perform tests to determine if you are in fact anemic or are at risk of developing it. If you are anemic, we will work closely with you to determine the best treatment plan to reverse this potentially serious health condition. We also may prescribe medication, if appropriate. Whenever, wherever you need us, we’re here for you.

By Margaret Andersen, MD, an Internist with Women Caring For Women, an internal medicine practice focused solely on women, part of Westchester Health, member of Westchester Health Physician Partners