What is anaemia: typical anaemia symptoms

 

What is anaemia? Anaemia is a sign from our body that we have a nutrient or mineral deficiency, such as iron deficiency or vitamin B12 deficiency. Did you know that a hefty one-third of the world's population is affected by anaemia – especially women and children? 

Are you pale, tired and unable to concentrate? Then you may be suffering from anaemia symptoms. When you have anaemia, the red blood cells in your blood are out of balance, in many cases due to a lack of iron – this is also called iron deficiency anaemia – the most common form of anaemia.^[1]

Children, pregnant women and women of childbearing age are often affected by anaemia, but many people do not know that athletes and older people typically often have anaemia too. Experts suspect that dementia in the elderly could be triggered or aggravated by anaemia.^[2] It is therefore worthwhile having your blood values checked regularly.

So, what are considered typical anaemia symptoms and causes and how dangerous can anaemia become? How is anaemia diagnosed and treated? Which nutrients other than iron are crucial for blood formation? Find out in our blog article!

What is anaemia?

Anaemia is when there are too few red blood cells (erythrocytes) present in your blood, or when your red blood cells contain too little red blood pigment (haemoglobin).^[3]

According to the World Health Organization (WHO) definition, anaemia is when the haemoglobin concentration (Hb level) is below the following values:^[4]

• in men: below 13 g/dl (8.07 mmol/l)
• in women: below 12 g/dl (7.45 mmol/l)

Why do we need erythrocytes and haemoglobin?

Our red blood cells transport oxygen from the lungs to the various tissues and organs of our body. Haemoglobin is a component of the erythrocytes and has a particularly important task: with the help of iron, it can bind the oxygen and thus bring it to all the body’s cells. On its way back to the lungs, it supplies the erythrocytes with carbon dioxide, which we later exhale.

If you have too few erythrocytes or too little haemoglobin, the blood can no longer transport enough oxygen. You then feel tired, weak and groggy, for example.^[1]

What are common anaemia causes?

There are various anaemia causes, including:^[5]

• blood loss through excessive bleeding
• insufficient formation of red blood cells
• excessive destruction of red blood cells (rare)
• reduced haemoglobin formation
• nutrient deficiencies through low intake

Did you know that severe blood loss can occur, for example, due to an injury or during an operation. Some women also suffer from heavy menstrual bleeding – this can make anaemia more likely.

If your body does not produce enough haemoglobin for the red blood cells, there may be various reasons for this. These include inflammation or infectious diseases such as malaria, tuberculosis and HIV. Most often, nutrient deficiencies lead to reduced haemoglobin production: if you lack folic acid, or suffer from an iron or vitamin B12 deficiency, you could equally develop anaemia.^[4]

Iron deficiency anaemia vs vitamin B12 anaemia: what’s the difference?

At least half of all anaemia cases are caused by iron deficiency. This type of anaemia is called iron deficiency anaemia. If, for example, you take in too little iron from your diet or have lost a lot of iron through blood loss, your body cannot produce enough haemoglobin. This, in turn, affects the build-up and existence of red blood cells.^[6]

About two billion people worldwide suffer from iron deficiency. Women of childbearing age are particularly affected, as they regularly lose iron through menstruation.^[7] Pregnant women are furthermore considered a risk group for iron deficiency anaemia, as many women do not meet their daily iron requirements, which are significantly higher during pregnancy. Find out more about the ideal diet during pregnancy in our Health Portal.

If you suffer from vitamin B12 anaemia, this is also triggered by a deficiency – by a vitamin B12 deficiency. Some people naturally receive less vitamin B12 through their diets – such as vegans – or some people simply absorb the vitamin less efficiently than other people.

Over time, this lack of vitamin B12 intake can result in a vitamin B12 deficiency. As the effects of this kind of deficiency can be very detrimental to your health if left untreated, it is wise to check your vitamin B12 levels regularly – especially if you are considered someone who is at risk.

Who is affected by anaemia?

Many people of all age groups can experience anaemia at different stages of their life. Those who are most often affected by anaemia are:^{[8, 9]}

• children (during growth phases and puberty)
• women of childbearing age (15 to 49 years)
• pregnant and breastfeeding women
• older people
• athletes
• people with diseases (such as tumours, inflammatory gastrointestinal diseases)

What are common anaemia symptoms?

If you have too few red blood cells in your blood or too little haemoglobin in your red blood cells, you are probably suffering from oxygen deficiency – because the erythrocytes can no longer bind enough oxygen. As a result, your body’s cells are no longer sufficiently supplied with oxygen, meaning your body no longer has enough energy.^[1]

If you have mild anaemia, you might experience the following symptoms:^{[1, 6]}

• paleness
• tiredness and weakness
• dizziness
• difficulty concentrating and headaches
• hair loss, brittle fingernails and torn corners of the mouth

If your anaemia is more severe, you will also experience the following anaemia symptoms:^[6]

• palpitations
• chest pain
• shortness of breath
• increased thirst and sweating

How anaemia affects the body: is anaemia dangerous?

Depending on the cause of anaemia or pre-existing conditions, anaemia can have a strong impact on your body.

For people with cancer or cardiovascular disease (such as heart failure), anaemia can be life-threatening.^{[3, 10]} Even if you are otherwise healthy, you should get seek anaemia treatment. This is because a chronic lack of oxygen can cause lasting damage to various organs, such as the lungs or heart.

If you feel weak, this will reduce your performance. This could severely limit you in everyday tasks and in your professional life. Anaemia can also delay the physical and mental development of children.^[1]

Is there a link between anaemia and dementia?

The results of a Dutch study suggest that anaemia increases your risk of developing dementia. The reason is that there is poorer oxygen supply to the brain. If an older person with anaemia does not seek anaemia treatment, brain cells die. This can lead to permanent damage and the development of dementia.^[2]

How do you test for anaemia?

If you suspect that you are suffering from anaemia symptoms, you should consult your doctor. Share any information about any previous or relevant illnesses you have, whether you are taking medication and how you eat.

How is a test for anaemia carried out?

Your doctor will take a blood sample to have it analysed in the laboratory. The haemoglobin content and the number and size of your red blood cells are particularly looked at in this lab analysis.

You have anaemia if any of the following values are too low:

• Haemoglobin value
• Haematocrit value

The haematocrit value (HKT) indicates the ratio of solid cells (in this case, red blood cells) to the liquid portion of the blood. If you have too few red blood cells, your haematocrit value is low.

Usually, with a blood test like this, ferritin levels and your iron reserves are also determined. This way, you can find out whether your anaemia is caused by an iron deficiency.

How do I clarify any anaemia causes?

If your doctor has diagnosed you with anaemia, you may need to investigate the causes for your anaemia. This may require further tests, such as stool and urine samples, a gynaecological examination, or analysing liver and inflammation values, as well as checking vitamin levels in your blood.^[11]

Anaemia treatment: how is anaemia treated?

Which form of anaemia treatment you opt for depends on the cause and severity of the anaemia.

If your anaemia is caused by a nutrient deficiency – that is, you lack iron, folic acid or vitamin B12, for example – then you can take appropriate supplements after consulting a doctor. You can also make changes to your diet to prevent a deficiency in the future.^[5] Vitamin B12 not only affects blood formation, but it also influences your nerves and vision. If you have a vitamin B12 deficiency, you should discuss with your doctor whether vitamin B12 supplements are advisable.

Sometimes, however, there are other anaemia causes. With metabolic disorders, gastrointestinal diseases, tumours or infectious diseases, your doctor will discuss special anaemia treatment options with you that are recommended for the respective disease.^[5]

Treating anaemia: what should I eat if I have anaemia?

If you struggle with anaemia symptoms, you can support your body with the right nutrition – perfecting your diet means you are giving your body the important nutrients it needs to make blood! To make new blood cells, your body needs iron, folic acid and vitamin B12, among other nutrients.

Did you know that our red blood cells have a limited lifespan, which is why our bodies constantly need to produce new blood cells – in fact, our bodies produce several billion cells per day!^[12]

How can I increase iron in my diet?

Iron is found in meat, for example, but also in grains and pulses. You can find information about more iron-rich foods, as well as tips for vegetarians and vegans, in our article on a vegan diet!

What foods are high in folic acid?

In addition to blood formation, folic acid is also involved in cell division and growth. There is a lot of folic acid in these foods:^[13]

• green vegetables (leafy vegetables such as spinach and lettuce), tomatoes and potatoes
• pulses and wholemeal products
• nuts
• oranges
• sprouts and wheat germ
• eggs

How do you get B12 naturally?

Vitamin B12 is found in milk and dairy products, eggs, fish, seafood and poultry. ^[14] Find out from our article of vitamin B12 deficiency or from your doctor how much vitamin B12 you need daily.

Some nutrients, such as vitamin A and vitamin C, are not directly involved in the formation of vitamin B12, but they boost its absorption and transport in our bodies.

What is anaemia – at a glance

What is anaemia?

Anaemia (anaemia) refers to a lack of red blood cells (erythrocytes) or red blood pigment (haemoglobin). Red blood cells carry oxygen from the lungs to the different tissues of your body..

What are typical anaemia causes?

Anaemia can have several causes. These include blood loss, insufficient red blood cell production or reduced haemoglobin production. Anaemia can additionally be caused by the body destroying red blood cells too quickly – although, this is rare.

Many sufferers have a nutrient or mineral deficiency, such as iron or folic acid. If iron deficiency is the cause of the anaemia, it is also called iron deficiency anaemia.

What are the most common anaemia symptoms?

If you have too few red blood cells in your blood or too little haemoglobin in your red blood cells, you are probably suffering from a lack of oxygen.

Anaemia symptoms include paleness, tiredness, dizziness and difficulty concentrating. If the anaemia is more severe, it can be accompanied by symptoms such as palpitations, shortness of breath and an increased feeling of thirst.

How do you know if you have anaemia?

Anaemia can be diagnosed by a blood test. If the haemoglobin value or the haematocrit value (i.e. the number of red blood cells) in your blood are too low, this is called anaemia.

Is there a form of anaemia treatment?

If your anaemia is caused by a nutrient deficiency, then you can take food supplements. You can also adjust your diet. If the cause of the anaemia is another disease, this will be treated first.

Can your diet help with anaemia?

With anaemia, you can support your body with the right nutrition. In order to form enough new blood cells, your body needs iron, folic acid and vitamin B12, among other things.

Iron is found, for example, in meat, grains and legumes. Leafy vegetables, wholemeal products, nuts and oranges contain a lot of folic acid. Vitamin B12 is found in animal products such as milk, eggs, fish, seafood and poultry.

Sources

^[1]       World Health Organisation (WHO), „Anaemia - Symptoms“, World Health Organization. https://www.who.int/health-topics/anaemia#tab=tab_1, accessed on 21 September 2020.

^[2]       F. J. Wolters u. a., „Hemoglobin and anemia in relation to dementia risk and accompanying changes on brain MRI“, Neurology, Bd. 93, Nr. 9, S. e917–e926, Aug. 2019, doi: 10.1212/WNL.0000000000008003.

^[3]       D. Ä. G. Ärzteblatt, „Anämie- und Blutmanagement: Neubewertung in verschiedenen Indikationen“, Deutsches Ärzteblatt, Dez. 01, 2017. https://www.aerzteblatt.de/archiv/194970/Anaemie-und-Blutmanagement-Neubewertung-in-verschiedenen-Indikationen, accessed on 21 September 2020.

^[4]       World Health Organization (WHO), „Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity“, Vitamin and Mineral Nutrition Information System, 2011. https://www.who.int/vmnis/indicators/haemoglobin.pdf, accessed on 8 September 2020.

^[5]       „Anämie | Universitätsklinikum Ulm“. https://www.uniklinik-ulm.de/innere-medizin-iii/haematologie/anaemie.html, accessed on 22 September 2020.

^[6]       J. Hastka, G. Metzgeroth, und N. Gattermann, „Onkopedia Leitlinien - Eisenmangel und Eisenmangelanämie“. Deutsche Gesellschaft für Hämatologie und Medizinische Onkologie e.V., Dez. 2018, accessed on 8 September 2020. ^[Online]. Verfügbar unter: https://www.onkopedia.com/de/onkopedia/guidelines/eisenmangel-und-eisenmangelanaemie.

^[7]       E. McLean, M. Cogswell, I. Egli, D. Wojdyla, und B. de Benoist, „Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005“, Public Health Nutrition, Bd. 12, Nr. 4, S. 444–454, Apr. 2009, doi: 10.1017/S1368980008002401.

^[8]       World Health Organisation (WHO), „Nutritional anaemias: tools for effective prevention and control“, Nov. 13, 2017. https://www.who.int/publications-detail-redirect/9789241513067, accessed on 8 September 2020.

^[9]       J. P. Schuchardt und A. Hahn, „Die Bedeutung von Eisen, Zink und Selen in der Ernährung des Menschen“. Ernährungs Umschau, Okt. 2010, accessed on 28 September 2020 ^[Online]. Verfügbar unter: https://www.ernaehrungs-umschau.de/fileadmin/Ernaehrungs-Umschau/pdfs/pdf_2010/10_10/EU10_538_549.qxd.pdf.

^[10]     Deutsche Apotheker Zeitung, „Häufige Begleiterscheinung bei Krebs und Diabetes“, DAZ.online, Juni 05, 2005. https://www.deutsche-apotheker-zeitung.de/daz-az/2005/daz-23-2005/uid-14065, accessed on 23 September 2020.

^[11]     A. M. Krause S. W., „Anämie - Diagnostische Schritte für die Hausarztpraxis • allgemeinarzt-online“, Allgemeinarzt-online. Fortbildung und Praxis für den Hausarzt, Feb. 25, 2013. http://www.allgemeinarzt-online.de/cme/a/diagnostische-schritte-fuer-die-hausarztpraxis-1574734, accessed on 24 September 2020.

^[12]     Kompetenznetz akute und chronische Leukämien, „Blut und Blutbildung“, Kompetenznetz Leukämien, März 31, 2015. https://www.kompetenznetz-leukaemie.de/content/patienten/leukaemien/blut_und_blutbildung/, accessed on 28 September 2020.

^[13]     Deutsche Gesellschaft für Ernährung e. V., „Referenzwerte für die Zufuhr von Folat aktualisiert“, Referenzwerte für die Zufuhr von Folat aktualisiert, Feb. 06, 2019. https://www.dge.de/nachrichten/detail/referenzwerte-fuer-die-zufuhr-von-folat-aktualisiert/, accessed on 28 September 2020.

^[14]     Deutsche Gesellschaft für Ernährung e.V., „Neuer Referenzwert für die Vitamin-B-12-Zufuhr“, Jan. 22, 2019. https://www.dge.de/presse/pm/neuer-referenzwert-fuer-die-vitamin-b12-zufuhr/, accessed on 8 September 2020.