What organs can anemia damage?

Anemia Overview

Anemia is a common blood disorder. It occurs when you have fewer red blood cells than normal or not enough hemoglobin in your blood. Hemoglobin is the iron-rich protein in red blood cells. It carries oxygen from your lungs to all parts of your body.

When you have anemia, your blood can’t carry enough oxygen to your body. Without enough oxygen, your body can’t work as well as it should.

There are several different types of anemia. Each has its own cause and treatment. They include:

• Iron-deficiency anemia
• Vitamin B-12 deficiency anemia
• Anemia of folate deficiency
• Hemolytic anemia
• Sickle cell anemia
• Cooley’s anemia (beta thalassemia)
• Aplastic anemia
• Chronic anemia
• Kidney failure associated anemia

What causes anemia?

Anemia is often a symptom of another disease. Anemia often occurs when you have:

• Too much blood loss
• Not enough red blood cells being made
• Too many red blood cells being destroyed
• More than one of these problems at the same time

Anemia may often be caused by several problems, including:

• Certain infections
• Certain diseases
• Certain medicines
• Poor nutrition
• Blood loss

Who is at risk for anemia?

Anyone can get anemia. But it’s more common in women of childbearing age. It’s also more common during pregnancy, infancy, and in older adults. Risk factors include:

• A diet low in iron-rich foods
• Heavy menstrual periods
• Lifelong (chronic) diseases such as kidney disease, rheumatoid arthritis, HIV, Crohn’s disease, and heart, liver, or thyroid disease

What are the symptoms of anemia?

Most anemia symptoms occur because of less oxygen getting to the body’s cells and tissues (hypoxia). The hemoglobin in red blood cells carries oxygen. So having fewer red blood cells leads to hypoxia. If you have mild anemia, you may not have many symptoms.

Each person’s symptoms will vary. Symptoms may include:

• Being very pale
• Faster heart rate
• Having trouble catching your breath
• Lack of energy or tiring easily (fatigue)
• Feeling dizzy or faint, especially when standing
• Headache
• Being irritable
• Irregular menstruation cycles
• Delayed menstruation, or not having a period
• Sore or swollen tongue
• Yellowing of skin, eyes, and mouth (jaundice)
• Enlarged spleen or liver
• Not easy for wounds or tissue to heal

Anemia symptoms may look like other blood disorders or health problems. Anemia is often a symptom linked to another disease. So be sure your healthcare provider knows about symptoms you may have. Always see your provider for a diagnosis.

How is anemia diagnosed?

Your healthcare provider may think you have anemia based on your symptoms, health history, and a physical exam. Anemia is often confirmed using blood tests. These tests check your hemoglobin level and your red blood cell count.

You may have additional tests such as:

• Other blood tests
• Bone marrow aspiration or biopsy. A small amount of bone marrow fluid (aspiration) or solid bone marrow tissue (called a core biopsy) is taken. The sample is often taken from the hipbones. It’s checked for the number, size, and maturity of blood cells or abnormal cells.

How is anemia treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment may include:

• Treating any underlying cause
• Vitamin and mineral supplements
• Change in diet
• Medicine
• Blood transfusion
• Bone marrow transplant
• Surgery to remove the spleen, if it’s linked to hemolytic anemia
• Antibiotics if an infection is the cause

What are possible complications of anemia?

Mild anemia may cause no problems. But if your body’s organs don’t get enough oxygen, you may have organ damage. The heart can be damaged by the increased stress of pumping faster. It can also be damaged by working too hard to carry oxygen to the body. In some cases, the underlying cause of the anemia may be deadly.

Can anemia be prevented?

Preventing anemia includes eating a well-balanced diet with iron-rich foods. It also includes managing any lifelong (chronic) or underlying conditions that may be causing the anemia. For young women and women with heavy menstrual periods, using birth control medicines may help manage anemia.

Living with anemia

Some types of anemia can’t be cured, such as sickle cell anemia. Work with your healthcare provider to make a treatment plan that can reduce the effects of these diseases.

Key points about anemia

• Anemia is a common blood disorder. It happens when you have fewer red blood cells than normal.
• When you have anemia, your blood can’t carry enough oxygen to your body. Without enough oxygen, your body can’t work as well as it should.
• Anyone can get anemia. But it’s more common in women of childbearing age.
• Preventing anemia includes eating a well-balanced diet with iron-rich foods.
• Some types of anemia can’t be cured, such as sickle cell anemia.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Medical Reviewer: Todd Gersten MD
Medical Reviewer: Raymond Turley Jr PA-C
Medical Reviewer: L Renee Watson MSN RN

© 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

What Are the Symptoms of Anemia?

Tolu Ajiboye is a health writer who works with medical, wellness, biotech, and other healthcare technology companies.

Updated on March 30, 2022

Jennifer Pollard Ruiz, MD, is a board-certified family physician and diplomate of the American Board of Integrative Holistic Medicine. She has over 20 years of experience as a primary care physician in the public, private, and government sectors and is based in Texas.

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Having anemia—a condition defined by not having enough healthy red blood cells—means that your organs and other tissues are not getting a normal amount of oxygen. This sounds significant, and it certainly can be. But symptoms of anemia vary depending on the extent of the condition, as well as the type of anemia you have.

Many people with mild anemia actually do not have any signs or symptoms at all. Or if they do, they may attribute some of them to other causes. Fatigue is an anemia symptom that’s commonly overlooked.

But as anemia worsens or becomes severe, it can lead to a range of serious symptoms, such as dizziness or shortness of breath. Complications, such as heart problems, can become life-threatening.

This article explores the many signs and symptoms of anemia, including those that tend to only occur with certain types, and possible complications.

Common Symptoms

Anemia means there is a drop in red blood cells or the hemoglobin protein in those cells that’s needed to carry oxygen throughout your body. The signs and symptoms of anemia tend to gradually increase as the anemia gets worse.

Common symptoms of any type of anemia include:

• Tiredness or lack of energy
• Weakness
• Pale skin
• Yellowish skin

These symptoms can occur regardless of the severity of the anemia, but they tend to occur more intensely with severe anemia.

As anemia progresses, you may experience other symptoms like:

• Dizziness
• Headaches
• Increased thirst
• Irritability
• Easily bruising
• Sore tongue
• Cramps in the lower leg when exercising
• Reduced tolerance of exercise

Since the symptoms of anemia are gradual and similar to the symptoms of other illnesses, they are often overlooked.

If you have severe anemia, you may also experience more serious symptoms such as:

• Shortness of breath ( dyspnea )
• Fainting or near fainting
• Fast breathing ( tachypnea )
• Fast heartbeat ( tachycardia )
• Irregular heartbeat ( arrhythmia )

Since anemia leads to a lack of adequate oxygen around the body, the brain may get deprived as well and this can sometimes lead to brain damage.

Recap

Common general symptoms, such as fatigue and weakness, tend to gradually increase as the anemia gets worse and can occur with any type.

Type-Specific Symptoms

There are also type-specific symptoms for iron deficiency anemia, or anemia due to a lack of iron, and many of the rarer types of anemia.

Iron Deficiency Anemia

Iron deficiency anemia is the most common form of anemia. Your body needs iron to make healthy red blood cells and a deficiency can occur due to blood loss, not eating enough iron-rich foods, or from conditions that affect iron absorption from foods.

Some additional symptoms that usually only occur in iron deficiency anemia are:

• Cold hands and feet
• Brittle nails
• Pica, or the desire to eat non-food substances like paper, clay, and paint chips

Pernicious Anemia

Vitamin-deficiency anemia occurs when the body can’t make enough healthy red blood cells due to low levels of certain vitamins. A rare form of vitamin-deficiency anemia called pernicious anemia is the result of an inability to absorb vitamin B12.

Pernicious anemia is often due to an autoimmune condition in which the immune system mistakenly attacks cells that line the stomach and make a protein needed to move and absorb B12.

Symptoms of pernicious anemia include:

• Tingling, prickling feelings (also called «pins and needles» or paresthesia )
• Muscle weakness
• Ataxia : An inability to voluntarily coordinate and control your muscle movements, which can affect eye movement, speech, and swallowing
• Digestive tract issues like bloating, nausea, and loss of appetite
• An enlarged liver

• Confusion
• Depression
• Memory problems or dementia

Hemolytic Anemia

Hemolytic anemia is when red blood cells are destroyed faster than they are made.

This rare form of anemia can be caused by inherited blood conditions, such as sickle cell anemia, or an immune reaction that leads to your immune system mistakenly attacking your red blood cells or healthy tissues.

Symptoms of hemolytic anemia include:

• Upper abdomen pain
• Brown or reddish looking urine
• Chills

Aplastic Anemia

Aplastic anemia is when your blood-forming organs, such as bone marrow, stop producing enough red blood cells.

Aplastic anemia also has its own distinctive and uncommon signs and symptoms. These can range from mild to very serious. They include:

• Frequent infections
• Easily bleeding
• Fevers
• Tiny, circular red spots on the skin caused by bleeding from small blood vessels ( petechiae )
• Nosebleeds
• Blood in stool
• Heavy bleeding during menstrual periods
• Nausea
• Skin rashes
• Abnormally formed kidneys, heart, lungs, digestive tract, arms, and hands (specific to Fanconi anemia, a form of aplastic anemia)

Recap

Signs and symptoms vary widely based on the type and severity of the anemia. A desire to eat non-food substances and brittle nails can be signs of iron deficiency anemia. Muscle weakness or tingling can happen with pernicious anemia.

Complications

Red blood cells serve an important role of supplying oxygen throughout your body so when their levels drop, it can lead to a range of complications, especially if the anemia becomes severe.

Anemia can also worsen other underlying medical conditions and lessen the efficacy of treatments for them.

Heart Problems

In anemia, the heart has to work harder than normal to compensate for the lack of hemoglobin-rich red blood cells.

It pumps harder in order to make sure oxygen-filled blood is moved around the body.

This extra work can put a strain on your heart and lead to complications like heart murmurs, cardiac hypertrophy (increase in the size of the heart’s muscle), and heart failure.

Issues With Pregnancy

In addition, anemia during pregnancy is not uncommon especially in the second and third trimesters.

However, if it is severe and not managed well it can lead to having a low-birth-weight baby or a preterm birth.

It can also increase your baby’s risk of having anemia during their infancy. Further, anemia can put you at risk of experiencing blood loss during labor.

Depression

The nerve damage in some form of anemias like pernicious anemia can lead to depression.

Women who have iron deficiency anemia during pregnancy also have an increased risk of developing postpartum depression, or depression that occurs within a year after giving birth.

Weakened Immune System

Iron deficiency anemia can cause your immune system to be compromised, leaving you more open to infections and reducing your body’s ability to fight them.

Restless Legs Syndrome

Restless legs syndrome, also called Willis-Ekbom disease, is a complication of iron deficiency anemia in particular.

This is a nervous system condition which produces the irresistible urge to move your legs. This is usually felt in the evening and nighttime.

Impaired Development

Many studies show that iron is needed for the brain to develop properly. Having severe iron deficiency anemia in infancy and childhood can lead to mental, cognitive, and motor developmental delays.

Recap

Anemia, especially if it’s severe, can strain your heart, weaken your immune system, and lead to other complications. It can cause pregnancy complications or developmental problems in infancy and childhood.

When to See a Healthcare Provider

If you’ve been diagnosed with anemia and you experience a worsening of symptoms like chest pain, trouble breathing, fast or irregular heartbeat, head to the hospital immediately. If possible, get someone else to drive you. You may be experiencing heart problems, including heart failure.

Beyond that, the following warrant making an appointment to see your healthcare provider:

• You’ve already been diagnosed with an underlying condition that can lead to anemia (e.g., kidney disease, HIV/AIDS, cancer, or Crohn’s disease) and you notice signs or symptoms of anemia
• You have a family history of inherited anemia (consider undergoing genetic testing and counseling for it)
• You’re experiencing a number of anemia symptoms; this could be a sign of a more serious or chronic condition like cancer or chronic internal bleeding

Summary

Anemia can lead to a range of signs and symptoms depending on the type, cause, and severity.

Symptoms may include tiredness, weakness, pale or yellowish skin, feeling cold, or dizziness.

If you have signs or symptoms of anemia, seek medical attention, especially with any serious symptoms, such as difficulty breathing or fainting.

A Word From Verywell

Anemia can be a serious condition and it is important that you follow your healthcare provider’s instructions and recommendations on diet, medication, exercise, and other lifestyle choices to prevent its complications from occurring.

If you’ve been diagnosed with anemia, inform your healthcare provider if you have any new symptoms, or are experiencing a significant increase in your existing ones.

14 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. American Society of Hematology. Anemia.
2. Rabel A, Leitman SF, Miller JL. Ask about ice, then consider iron. J Am Assoc Nurse Pract. 2016;28(2):116-20. doi:10.1002/2327-6924.12268
3. Robinson KJ, Sanchack KE. Palpitations. StatPearls Publishing.
4. Berliner D, Schneider N, Welte T, Bauersachs J. The differential diagnosis of dyspnea. Dtsch Arztebl Int. 2016;113(49):834-845. doi:10.3238/arztebl.2016.0834
5. National Library of Medicine MedlinePlus. Iron deficiency anemia.
6. Rodriguez NM, Shackelford KS. Pernicious anemia. StatPearls Publishing.
7. Park MY, Kim JA, Yi SY, Chang SH, Um TH, Lee HR. Splenic infarction in a patient with autoimmune hemolytic anemia and protein C deficiency. Korean J Hematol. 2011;46(4):274-8. doi:10.5045/kjh.2011.46.4.274
8. Moore CA, Krishnan K. Aplastic anemia. StatPearls Publishing.
9. Alder L, Tambe A. Acute anemia. StatPearls Publishing.
10. American Society of Hematology. Anemia and pregnancy.
11. Kumar KJ, Asha N, Murthy DS, Sujatha M, Manjunath V. Maternal anemia in various trimesters and its effect on newborn weight and maturity: an observational study. Int J Prev Med; 4(2):193-9.
12. Andres E, Serraj K. Optimal management of pernicious anemia. J Blood Med. 2012;3:97-103. doi:10.2147/JBM.S25620
13. Wassef A, Nguyen QD, St-andré M. Anaemia and depletion of iron stores as risk factors for postpartum depression: a literature review. J Psychosom Obstet Gynaecol. 2019;40(1):19-28. doi:10.1080/0167482X.2018.1427725
14. Georgieff MK. Iron assessment to protect the developing brain. Am J Clin Nutr. 2017;106(Supplement 6):1588S-1593S. doi:10.3945/ajcn.117.155846

Additional Reading

• National Heart, Lung, and Blood Institute. Your guide to anemia.
• National Heart, Lung, and Blood Institute. Iron-deficiency anemia.
• Sutherland S, OʼSullivan D, Mullins J. An association between anemia and postpartum depression [35C]. Obstetrics & Gynecology. 2018;131:39S. doi:10.1097/01.aog.0000532975.79181.b6

By Tolu Ajiboye
Tolu Ajiboye is a health writer who works with medical, wellness, biotech, and other healthcare technology companies.

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Anemia

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Anemia means a decreased number of red blood cells in circulation. Packed Cell Volume (PCV, also often called hematocrit) is the most common way to measure anemia and refers to the percentage of blood volume that is taken up by red blood cells. The normal PCV for a cat is 25-45%, and any PCV below 25% is considered anemic.

Red blood cells carry oxygen and nutrients to the body’s tissues. These cells circulate for about 70-80 days before being removed from circulation and replaced with new red blood cells from the bone marrow. Without enough red blood cells in circulation, cells will not receive enough oxygen or nutrients to survive, so anemia can become a critical or even fatal situation very quickly.

Clinical Signs

Because anemia starves the body of oxygen (the body’s fuel), the first sign is often lethargy. An anemic cat may have little energy to play or may sleep more than usual. The cat’s gums may appear almost white or even yellow (a condition called jaundice) due to red blood cell destruction. In extreme cases, the cat may have trouble breathing, and respiratory and heart rates can increase as the body tries to compensate for the lowered oxygen delivery by the red blood cells.

Depending on the cause of anemia, fever and loss of appetite may occur due to an infection or inflammatory response. Black stools can be seen if blood loss occurs in the stomach or intestinal tract, and discolored urine can be a sign of red blood cell destruction. The signs of anemia can be very vague, however, and if a cat has been anemic for a long time, their body has likely had time to compensate and the cat may show no signs at home.

Causes of Anemia

There are many causes of anemia in the cat, but they can be broken down into three major categories: loss of red blood cells, destruction of red blood cells, and failure to produce new red blood cells. A discussion of some, but not all of the common causes of anemia from each of those categories is provided below. Feline anemia is common and can be secondary to many health conditions.

Loss of red blood cells

Loss of red blood cells (hemorrhage) can be due to an obvious source such as a wound or trauma, or from more insidious causes. Flea and tick infestations are a major cause of anemia, especially in kittens, as the parasites suck blood from the body faster than it can be replaced. The hookworm parasite (Ancylostoma tubaeforme), which feeds on blood in the intestines, can cause anemia in cases of severe infestation.

Hemorrhage can also occur in the stomach or intestines due to ulcers or inflammation in the gastrointestinal tract. Cats with blood loss in these areas may have chronic vomiting, diarrhea, or black stools.

Reticulocytes are a specific type of red blood cell made and released by the bone marrow when it senses anemia in an attempt to compensate for the low red blood cell numbers. With chronic blood loss through the intestinal tract or from parasites, cats would be expected to show an elevated reticulocyte count. When a cat has a low red blood cell count and high reticulocyte count, this is called a “regenerative” anemia, as the body is reacting appropriately to blood loss. As long as red blood cells are being lost faster than reticulocytes can be released from the bone marrow, however, the cat will remain anemic.

Destruction of red blood cells

Red blood cells that have reached the end of their lifespan (about 70-80 days) are routinely removed from circulation by a cat’s body and replaced by new red blood cells made in the bone marrow. However, certain diseases can cause red blood cells to be broken down or destroyed more quickly than normal, leading to anemia as they are removed more quickly than they can be replaced.

Certain infectious diseases can lead to damage and destruction of red blood cells. These include Mycoplasma haemofelis, Candidatus, Mycoplasma haemominutum, Cytauxzoon felis, and Babesia species infections. These diseases are spread to cats by fleas and ticks, and they then attach to red blood cells, leading to their destruction.

Red blood cells can also be damaged by certain toxins. Oxidative injury to red blood cells secondary to the ingestion of acetaminophen (Tylenol ®), zinc, copper, onions, and some other toxins or medications can lead to anemia in cats.

Occasionally, a cat’s body tags its own red blood cells as foreign, causing them to be destroyed by the cat’s own immune system. This is called Immune-mediated hemolytic anemia (often abbreviated to IMHA). In some cases, there is a trigger causing the immune system to incorrectly destroy too many red blood cells. This trigger can include a reaction to a drug, cancer, or infectious diseases such as Feline Leukemia Virus (FeLV) or feline infectious peritonitis (FIP). If there no underlying cause for the inappropriate activation of the immune system is identified, this disease is called primary IMHA. There is no evidence that this is a hereditary disease in cats.

Anemias caused by loss or destruction of red blood cells are typically regenerative, so an elevated reticulocyte count would be expected as the body tries to compensate for the destruction of red blood cells.

Failure to produce red blood cells

New red blood cells are produced in the bone marrow to replace those that are regularly removed from circulation. A hormone produced in the kidney, called erythropoietin, is the primary signal that tells the bone marrow that more red blood cells are needed in the body. If the bone marrow is not able to produce enough red blood cells to replace those that normally outlive their lifespan, a cat will develop a non-regenerative anemia, with a low reticulocyte count.

One common cause of non-regenerative anemia in cats is chronic kidney disease. Chronic kidney disease is a very common, affecting approximately 15-30% of geriatric cats. When the cells in the kidney degenerate, they release less erythropoietin, leading to lowered red blood cell production by the bone marrow. As chronic kidney disease advances, 30-65% of affected cats will develop some degree of anemia.

Problems within the bone marrow itself can also lead to decreased production of red blood cells. Cancer, immune-mediated disease, or inflammation in the bone marrow can reduce its ability to replace red blood cells. Chronic inflammation elsewhere in the body can also impair the ability of the bone marrow to effectively produce red blood cells. This is often referred to as “anemia of chronic disease”, and can be seen with many other illnesses in cats, including FeLV infections and various cancers.

Diagnosis

The first step in diagnosing anemia is to determine the packed cell volume, or PCV. This test involves spinning down a small blood sample in a centrifuge to determine what percentage of the overall blood volume is made up of red blood cells. Further blood testing can look for evidence of regeneration in the red blood cells, abnormalities in other blood cell types such as white blood cells and platelets, evidence of organ damage such as chronic kidney disease, or the presence of infectious diseases.

Other tests, such as radiographs (x-rays) or an ultrasound to look for causes of bleeding or a bone marrow biopsy, may be recommended by a veterinarian,

Treatment

Treatment for anemia will vary depending on the underlying cause. In some cases, treatment for parasites or infectious diseases will be most important to stop the loss or destruction of red blood cells. Medications can be used to help stop bleeding from the gastrointestinal tract, and steroids and other immune-modulating drugs are essential in the treatment of immune-mediated diseases.

In cases of severe anemia, a blood transfusion may be necessary to replace red blood cells that have been lost or destroyed while the underlying condition is being treated. Cats have two major blood types, so it is important that both the donor and recipient blood be tested to reduce the risk of any reactions to the blood transfusion.

In the case of chronic kidney disease, a medication called darbepoetin is available to help stimulate the production of new red blood cells in the bone marrow by replacing erythropoietin normally made in the kidneys. This medication requires weekly injections and close monitoring for side effects, but can result in resolution of anemia in 60-65% of cats with chronic kidney disease.

Last updated 2021