- Not Enough WBC/platelets

Many types of anemia exist, such as iron-deficiency In some types of anemia, such as aplastic anemia, your
anemia, pernicious anemia, aplastic anemia, and hemo- body also doesn’t have enough of other types of blood
lytic anemia. The different types of anemia are linked cells, such as white blood cells (WBCs) and platelets.
to various diseases and conditions. WBCs help your body’s immune system fight infec-
tions. Platelets help your blood clot, which helps stop
Anemia can affect people of all ages, races, and ethnici- bleeding.
ties. Some types of anemia are very common, and some
are very rare. Some are very mild, and others are severe
or even life-threatening if not treated aggressively. The - Pregnancy/ Autoimmune disorders/ External and
good news is that anemia often can be successfully Internal Bleeding
treated and even prevented.
Many diseases, conditions, and other factors can
cause anemia. For example, anemia may occur dur-
What Causes Anemia?
ing pregnancy if the body can’t meet its increased need
for RBCs. Certain autoimmune disorders and other
- Not enough RBC conditions may cause your body to make proteins that
Anemia occurs if your body makes too few red blood destroy your RBCs, which can lead to anemia. Heavy
cells (RBCs), destroys too many RBCs, or loses too internal or external bleeding—from injuries, for
many RBCs. RBCs contain hemoglobin, a protein that example—may cause anemia because your body loses
carries oxygen throughout your body. When you don’t too many RBCs.
have enough RBCs or the amount of hemoglobin in
your blood is low, your body doesn’t get all the oxygen
it needs. As a result, you may feel tired or have other - Genetics
symptoms.
The causes of anemia can be acquired or inherited.
“Acquired” means you aren’t born with the condition,
but you develop it. “Inherited” means your parents
passed the gene for the condition on to you.

Sometimes the cause of anemia is unknown.

Diagnosing Anemia
People find out they have anemia in a variety of ways.
You may have symptoms and go to your doctor, who
discovers the anemia through blood tests. Or, your
doctor might find out you have anemia as a result of
tests done for another reason.

Your doctor will likely ask about your medical and

family histories, do a physical exam, and recommend
tests or procedures to find out whether you have
anemia, what is causing it, and how severe it is. This
 The main goals of treatment are to:

Possible Signs and ■ Raise your RBC count or hemoglobin level to im-
prove your blood’s ability to carry oxygen
Treat condition causing your anemia

Symptoms of Anemia
■
■ Prevent complications of the anemia, such as heart
or nerve damage
■ Relieve symptoms and improve your quality of life
● Tiredness or weakness
● Pale or yellowish skin If you have a mild or moderate anemia with no
● Faintness or dizziness symptoms—or if your anemia isn’t getting worse—you
may not need treatment. Some anemias are treated
● Increased thirst
with dietary changes and nutritional supplements.
● Sweating
Other anemias are treated with medicines, procedures,
● Weak and rapid pulse, rapid breathing surgery, or blood transfusions (for severe anemia).
● Shortness of breath
● Lower leg cramps Preventing or Controlling Anemia
● Heart-related symptoms (abnormal heart rhythms, heart You can take steps to prevent or control anemia. These
murmur, enlarged heart, heart failure) actions can give you greater energy and improve your
health and quality of life. Here are a few simple things
you can do.
information will help your doctor treat the anemia and
its underlying cause. Most anemias are treatable, so an Follow a Healthy Diet
accurate diagnosis is important. Following a healthy diet ensures that you get enough
of the nutrients that your body needs to make healthy
Medical and Family Histories blood cells. These nutrients include iron, vitamin B12,
Your doctor will want to know about your signs and folate, and vitamin C. These nutrients are found in a
symptoms and how long you’ve had them. He or she variety of foods. Healthy eating also is good for your
also may ask whether you’ve had an illness that can overall health.
cause anemia. You also may be asked about your diet,
any medicines or supplements you take, and whether The basics of healthy eating:
you have a family history of anemia or anemia-related
■ Focus on nutrient-dense foods and beverages—
conditions.
vegetables, fruits, whole grains, fat-free or low-fat
Physical Exam dairy products, seafood, lean meats and poultry,
A physical exam can confirm signs and symptoms and eggs, beans and peas, and nuts and seeds.
provide information about what organs or body systems ■ Limit your intake of salt, solid fats, added sugars,
may be involved. As part of a physical exam, your doctor and refined grains.
may check the color of your skin, gums, and nail beds ■ Maintain a healthy weight by bal-
and look for signs of bleeding or infection. He or she ancing the calories you get from
may listen to your heart and lungs, feel your abdomen, foods and beverages with the
or do a pelvic or rectal exam to check for internal calories you use through physi-
bleeding. cal activity.
■ Follow food safety
Tests and Procedures guidelines when preparing
Your doctor will recommend tests to identify the type of and eating foods to reduce
anemia you may have and its severity. Often, the first the risk of foodborne
test is a complete blood count (CBC), which provides illnesses.
useful information about your blood. Depending on the
CBC results, your doctor may recommend further tests Make following a healthy diet a
of your blood or bone marrow (the soft tissue inside family goal. Infants, young
bones that makes blood cells). children, and teens grow
rapidly. A healthy diet
Treating Anemia supports growth and
Anemia often is easily treated. The treatment your development and
doctor chooses will depend on the type of anemia you can help prevent
have, its cause, and how severe it is. anemia. Have
Information About
Specific Types of Anemia
Iron-Deficiency Anemia
Your body needs iron to make hemoglobin, the protein in
6. Beans and Legumes: These are plant-based sources
of iron. Examples include lentils, chickpeas, black beans,
RBCs that carries oxygen. The main way you get iron is
from food. At certain times—such as during pregnancy, and kidney beans.
growth spurts, or blood loss—your body may need to make 7. Tofu and Tempeh: These soy-based products
more RBCs than usual. contain non-heme iron and are suitable for vegetarians
Thus, your body needs more iron than usual. Iron- and vegans.
deficiency anemia occurs if your body can’t keep up with 8. Nuts and Seeds: Some nuts and seeds are good
its need for iron. sources of iron, including pumpkin seeds (pepitas),
Groups at risk sunflower seeds, and almonds.
● Infants and children, adolescents, and women of 9. Fortified Cereals: Many breakfast cereals are
childbearing age fortified with iron, providing a convenient source of this
essential nutrient.
● People who have certain diseases and conditions, such
as Crohn’s disease, celiac disease, or kidney failure 10. Leafy Greens: While non-heme iron in plant-based
foods is less easily absorbed than heme iron, leafy
● People who don’t get enough iron from the foods they
greens like spinach, kale, and Swiss chard are good
eat
sources of iron. Pairing them with vitamin C-rich foods
● People who have internal bleeding can enhance iron absorption.\
Treatment: Iron supplements and dietary changes (eating 11. Dried Fruits: Raisins, apricots, and prunes contain
food rich in iron and vitamin C, which increases iron non-heme iron and can be eaten as snacks or added to
absorption from food). dishes.
12. Iron-Fortified Foods: Some processed foods, such
as iron-fortified bread, pasta, and rice, are designed to
Including iron-rich foods in the diet is essential for boost iron intake.
individuals with anemia, particularly those with iron- 13. Pumpkin and Squash Seeds: These seeds are rich
deficiency anemia. Here is a list of foods that are in iron and can be roasted as a snack or used as a salad
good sources of dietary iron: topping.
14. Quinoa: This whole grain is a good source of non-
1. Red Meat: Lean cuts of beef, pork, and lamb are heme iron and is also high in protein.
rich in heme iron, which is more readily absorbed by 15. Dark Chocolate: Dark chocolate contains some
the body than non-heme iron found in plant-based
iron, but it should be consumed in moderation due to
sources.
its calorie and sugar content.
2. Poultry: Chicken and turkey are good sources of
heme iron, especially in the dark meat
3. Fish: Fish such as salmon, tuna, and sardines
provide heme iron. Canned sardines with bones are
particularly rich in iron and calcium.
4. Organ Meats: Liver, in particular, is a highly
concentrated source of heme iron. However, it should
be consumed in moderation due to its high vitamin A
content.
5. Shellfish: Clams, oysters, mussels, and shrimp are
seafood options rich in heme iron.

Beans and Legumes: These are plant-based sources

of iron. Examples include lentils, chickpeas, black
beans, and kidney beans.
 Pernicious Anemia Aplastic Anemia
Vitamin B12 and folate (another B vitamin) are needed to The term “anemia” usually refers to a condition in which
make healthy RBCs. Your body absorbs these vitamins your blood has a lower than normal number of RBCs.
from foods. Pernicious anemia occurs if your body can’t However, some types of anemia, such as aplastic anemia,
make enough RBCs because it can’t absorb enough vitamin cause lower than normal numbers of other blood cells,
B12 from food. too. Aplastic anemia can occur if your bone marrow is
damaged and can’t make enough RBCs, WBCs, and
Groups at risk platelets. The causes of aplastic anemia can be acquired
● People who have conditions that prevent them from or inherited.
absorbing vitamin B12
Groups at risk
● People who don’t get enough vitamin B12 in their
diets ● People undergoing radiation or chemotherapy,
exposed to toxins, or taking certain medicines
Treatment: Vitamin B12 supplements and dietary
● People who have diseases or conditions that
changes (eating foods rich in vitamin B12, such meat; fish; damage the bone marrow
eggs; dairy products; and breads, cereals, and other foods
fortified with vitamin B12). Treatment: Depends on the cause of the anemia.
Treatments may include blood transfusions, medicines,
blood and marrow stem cell transplants, and lifestyle
changes.

Hemolytic Anemia
Normally, RBCs have a lifespan of about 120 days. Your
body constantly makes new RBCs to replace ones that die.
Sometimes, RBCs are destroyed before their normal
lifespan is up. Hemolytic anemia occurs if your body can’t
make enough RBCs to replace those destroyed. Acquired
hemolytic anemia occurs if your body gets a signal to
destroy RBCs even though they are normal. Inherited
hemolytic anemia is related to problems with the genes
that control RBCs.
Groups at risk
● Risk groups differ depending on the cause and type
of hemolytic anemia.
Treatment: Depends on the cause of the anemia.
Treatments may include blood transfusions, medicines,
surgery and procedures, and lifestyle changes.

healthy foods at home, and show your children how to

Avoid Substances That Can Cause or Trigger
make healthy choices when they’re away from home.
Anemia Contact with chemicals or toxins in the
Also, help your parents or other older relatives enjoy a environment can cause some types of anemia. Others
healthy, nutrient-rich diet. Anemia is common in older types of ane- mia are triggered by certain foods or cold
adults because of chronic (ongoing) diseases, lack of temperatures. If you have one of these types of anemia,
iron, and poor diet. avoid these triggers if you can.
With some types of anemia, you’ll want to reduce your types of anemia are generally straightforward and
chances of getting an infection. To do this, wash your easily treated. As a result, the NHLBI’s clinical research
hands often, avoid people who have colds, and stay on anemia focuses on a few specific, rarer types of the
away from crowds. disorder. Research on these and other blood disorders
continues to be an important priority for the NHLBI.
Work With Your Doctor
Visit your doctor if you have signs or symptoms of The NHLBI’s research efforts often depend on the
anemia. If you’re diagnosed with anemia, follow your willingness of volunteers to take part in clinical trials.
doctor’s advice about diet, supplements, medicines, and Clinical trials test new ways to prevent, diagnose, or
other treatments. treat various diseases and conditions. You can take
part in a clinical trial to gain access to new treatments
Visit your doctor regularly for checkups and ongoing before they’re widely available and help add to scien-
care, and tell him or her about any new or changing tific knowledge.
symptoms.
For more information about clinical trials related to
Older children and teens who have severe anemia may anemia, talk with your doctor. You also can visit the
have an increased risk of injury or infection. Talk with following Web sites to learn more about clinical re-
your doctor about ways to keep them as healthy as pos- search and to search for clinical trials:
sible and whether they need to avoid certain activities.
■ www.clinicaltrials.gov
Girls and women who have heavy menstrual periods
■ clinicalresearch.nih.gov
may need regular screenings and followup with their
■ www.nhlbi.nih.gov/studies/index.htm
doctors to prevent or control iron-deficiency anemia.

Talk To Your Family

To Learn More
Some types of anemia—such as pernicious anemia, The National Heart, Lung, and Blood Institute
Fanconi anemia, or thalassemia—can be inherited. If (NHLBI) provides information about the causes, pre-
you’ve been diagnosed with one of these kinds of ane- vention, diagnosis, and treatment of anemia and other
mia, talk to your family members. Suggest they visit blood diseases. The NHLBI also provides dependable
their doctors for a checkup to see whether they also information about heart and lung diseases and condi-
might have anemia. tions and sleep disorders. Resources include numerous
publications, tools, and the NHLBI Web site.
If you have children or teens who have anemia, talk to
them about how they can take an active role in their NHLBI Health Information Center
own care. Encourage them to learn about their condi- P.O. Box 30105
tion and make decisions with their doctor. This can Bethesda, MD 20824–0105
help young people feel more in control and have a more Phone: 301–592–8573
positive outlook about their health. TTY: 240–629–3255
Fax: 301–592–8563
Clinical Trials Web site: www.nhlbi.nih.gov/health/infoctr/index.htm
The National Heart, Lung, and Blood Institute (NHLBI) NHLBI Web Site
supports research aimed at learning more about blood The NHLBI Web site offers health education materials,
diseases and disorders, including anemia. Common health assessment tools, and resources for patients, the
public, and health professionals.
www.nhlbi.nih.gov

Diseases and Conditions A–Z Index

The NHLBI’s Diseases and Conditions Index (DCI) pro-
vides complete, dependable, plain-language information
about heart, lung, and blood diseases and sleep
disorders. www.nhlbi.nih.gov/health/dci/index.html

USDA ChooseMyPlate.gov
The U.S. Department of Agriculture’s (USDA’s)
ChooseMyPlate.gov Web site has information, tips, and
resources to help you learn more about healthy eating.
www.choosemyplate.gov
NIH Publication No. 11-7629A September
2011