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Common Symptoms of Anemia: Are You Anemic?

5 min read

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Medically Reviewed by Dr. Gerald Morris

Are you anemic? The signs and symptoms of this common blood disorder vary widely depending on the root cause of your anemia, but there are several warning signs that, when treated early enough, can drastically speed up the treatment process.

The symptoms listed below have been broken down into 4 categories: common anemia symptoms, symptoms caused by iron deficiency, symptoms caused by vitamin B12 deficiency and symptoms caused by chronic lead poisoning.

Eight common symptoms of anemia are…

1. Fatigue 

Fatigue is a very common symptom of anemia. In fact, it’s often one of the very first signs of a health problem, with folks experiencing an unexplained loss of energy and booking an appointment with their doctor for that very reason.

According to the Mayo Clinic, some anemias, such as iron deficiency anemia or vitamin B12 deficiency, will cause extreme fatigue due to low hemoglobin. However, fatigue can often be the result of many other health issues (i.e., internal bleeding). Taking a multivitamin with iron or eating high-iron foods (i.e., red meat) may increase iron levels, helping to resolve anemia.

2. Significant Increase in Heart Rate, Particularly with Exercise

According to research from the National Heart Lung and Blood Institute (NHLBI), anemia is taxing on the cardiovascular system (and heart) because the body requires iron to produce hemoglobin, an essential substance that transports oxygen from the lungs to the various tissues and organs. This means that if iron is low oxygen delivery suffers and organ function as well.

Decreased oxygen delivery to the tissues and organs will dramatically affect the cardiovascular system and its related tissues. Patients with anemia produce a drastically decreased number of red blood cells, which don’t contain adequate hemoglobin for blood oxygen transport. Lack of oxygenated blood will result in extreme fatigue because of inadequate oxygen delivery by the cardiovascular system and, over the long term, eventual damage to the body’s organs (i.e., brain and heart).

3. Headache and Shortness of Breath, Specifically with Exercising 

In addition to feelings of extreme fatigue and muscle weakness due to lack of oxygen rich blood, anemia is also likely to cause headache, lightheadedness, and shortness of breath, particularly if you stand up suddenly or following physical exertion. For those with severe anemia, the body’s tissues and organs lack the adequate blood and oxygen to function efficiently. Over the long term, the body’s cells will start to die off, a condition known as ischemia.

Those with severe anemia or sickle cell anemia may experience severe ischemia due to blocked blood flow, particularly in the extremities (i.e., feet) and may eventually require foot amputation. For anemic patients, the most common symptoms are usually fatigue and shortness of breath. This makes it difficult to keep up usual energy levels and activities and can have very negative effects on daily life.

4. Dizziness

Dizziness, or a feeling of sudden lightheadedness is often related to early stage anemia and is often a symptom that prompts that first doctor’s visit. Dizziness can be related to disturbances of the brain, vision issues, disorders of the inner ear (vertigo), and even the gastrointestinal system. However, for those with anemia, which is characterized by low red blood cell count or hemoglobin, dizziness is also fairly common.

Anemia results in the lowered or blocked production of red blood cells and/or hemoglobin, which is responsible for blood oxygen transport to essential tissues and organ. When oxygen blood levels decrease, the body will show signs of unexplained fatigue, muscle weakness, increased heart rate, pale skin, shortness of breath, and dizziness or lightheadedness. Seizures and convulsions may even occur.

5. Pale Skin

Pale skin is another common sign of anemia. This pale complexion, or pallor, will often indicate decreased blood flow or a lower production of red blood cells. A sudden pale complexion should be brought to the attention of your doctor immediately, particularly if its an indication of anemia, a blood condition characterized by reduced production of red blood cells (and hemoglobin).

Pale skin is less common in patients with acute anemia, which often occurs with blood loss (i.e., injury, surgery, or internal bleeding). Chronic (or gradual) anemia is much more common and results when the body doesn’t produce (or the body destroys) adequate red blood cell. Chronic anemia can develop due to a series of health conditions, such as hypothyroidism (underactive thyroid), chronic kidney failure, and bone cancer.

6. Leg Cramps 

Leg cramps, often during physical exertion, are another common symptom of anemia. However, leg cramps are often a symptom that is easily excused, as some with anemia experiencing leg cramping and others experiencing hardly any symptoms at all. As mentioned, leg cramps in mildly anemic patients often only occur with physical exertion. Whereas, patients with severe anemia may experience painful leg cramps, even while at rest.

Mildly anemic patients may experience innocent seeming leg cramps following walking, running, or standing for long periods. However, if the leg cramping is accompanied by other symptoms, such as shortness of breath, dizziness, extreme and unexplained fatigue, muscle weakness, and pale complexion, anemia may be present.

7. Insomnia 

If you have trouble sleeping at night (insomnia), you may suffer from anemia. According to a 2008 Irish study entitled “Restless Legs Syndrome and Periodic Limb Movement Disorder in Children and Adolescents” published in the journal Seminars in Pediatric Nursing, insomnia and other sleep difficulties (i.e., restless leg syndrome) are prevalent in children and teens, as well as adults and seniors due to iron deficiency (or low iron stores).

The study monitored a group of elderly patients at an Irish hospital and found that iron deficiency (many with cases of anemia) caused restless leg syndrome. When the patients were prescribed iron supplements, the symptoms of restless leg syndrome and insomnia were significantly reduced. A 2002 study from Nepal also found that restless leg syndrome had strong ties with personal iron status, with abnormal iron stores often causing restless leg syndrome and insomnia in a group of 6 to 18 month-old infants. The same study showed remarkable improvement in restless sleep disorders after iron therapy was prescribed.

8. Difficulty Concentrating 

Hemoglobin is the oxygen-carrying protein inside red blood cells. A lack of hemoglobin affects not only red blood cell production and blood oxygen delivery to the organs, muscles, and bodily tissues but also inadequate hemoglobin affects our mood, energy level, and ability to make decisions and concentrate if the essential vitamins, minerals, and nutrients (i.e., folate, iron, and vitamin B12) needed to make red blood cells are limited.

When the body lacks these vital nutrients, anemia can occur. Even if the blood disorder is mild inadequate nutrients can cause the body to basically power down slowly. Mood may deteriorate, with patients feeling extreme irritability or moodiness. Energy levels will wane unexpectedly, causing extreme and unexplained fatigue. And the ability to focus, make decisions, and concentrate may completely decline.

Looking for related information? Check out these articles:

MD, Family Medicine, Internal Medicine

Gerald Morris, MD is a family medicine/internal medicine physician with over 20 years expertise in the medical arena. Dr. Morris has spent time as a clinician, clinical research coordinator/manager, medical writer, and instructor. He is a proponent of patient education as a tool in the diagnosis and treatment of acute and chronic medical conditions.

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