Anemia (blood deficiency)

According to the World Health Organization (WHO) definition, it is a condition in which the hemoglobin level in the blood is lower than what is normal for a person’s age and sex. Hemoglobin is an important component of red blood cells and ensures the transport of oxygen to tissues. If the body does not have enough of it, oxygenation of tissues and organs is impaired. 

The red blood cell count may be reduced in anemia, but in some types of anemia it may remain normal or even be elevated. Therefore, a comprehensive laboratory workup is essential for accurately determining the type and cause of anemia and for subsequent treatment. 

What are the possible causes of anemia? 

The causes of anemia are generally divided into two main groups: 

• anemia caused by a disorder in red blood cell production, 
• anemia caused by their premature destruction. 

A disorder in red blood cell production can arise, for example, due to a deficiency of:

• iron, 
• vitamin B12, 
• folic acid (folate), 
• erythropoietin. 

It can also be caused by bone marrow disorders, in which insufficient red blood cells are produced or the red blood cells are of poor quality. 

Premature loss of red blood cells can be caused by increased breakdown of red blood cells (hemolysis) or by acute or chronic blood loss. Hemolysis can occur, for example, in certain diseases, following exposure to toxic substances, or as a side effect of certain medications. 

One of the most common forms of anemia is iron deficiency anemia (sideropenic anemia). Anemias associated with chronic diseases or those resulting from a deficiency of vitamin B12 and folic acid—known as megaloblastic anemias—are also common. 

What are the symptoms of anemia? 

Anemia causes what is known as the anemic syndrome—a set of symptoms resulting from insufficient oxygenation of tissues. Specific symptoms may vary from person to person depending on the severity of the anemia, how quickly it developed, age, or the presence of other medical conditions. 

The most common symptoms include: 

• fatigue, 
• weakness, 
• malaise, 
• sensitivity to cold, 
• ringing in the ears, 
• dizziness, 
• fainting, 
• shortness of breath on exertion, 
• difficulty concentrating, 
• confusion. 

Some people may also experience chest pain (angina pectoris) or pain and cramps in the legs while walking. 

At the same time, the body tries to compensate for the lack of oxygen, which can lead to: 

• rapid heartbeat (tachycardia), 
• heart palpitations, 
• pallor of the skin and mucous membranes. 

Typical symptoms of certain types of anemia 

Iron-deficiency anemia (sideropenic anemia)

It may manifest as increased brittleness of the nails, so-called spoon-shaped nails (koilonychia), poor hair quality, or pica—a craving to consume non-food substances such as dirt, chalk, sand, or paper. 

Megaloblastic Anemia

It is often associated with neurological symptoms, such as tingling and numbness in the extremities, muscle weakness, memory problems, confusion, or irritability. Mild jaundice or a burning sensation and redness of the tongue (Hunter’s glossitis) may also occur. 

Hemolytic Anemias

Typical symptoms may include jaundice or an enlarged spleen.