Anemia symptoms may include persistent fatigue, dizziness, shortness of breath, and pale skin. These symptoms may vary depending on the type and severity of anemia.

Anemia occurs when the body doesn’t have enough healthy red blood cells to carry the oxygen your organs and tissues need. It may result from blood loss, dietary restrictions, or chronic conditions.

Anemia symptoms can be mild, moderate, or severe, and the condition can be short-term or chronic.

The most common type of anemia is iron deficiency anemia, often related to blood loss on low iron intake.

There are many other types of anemia. Some of them are:

  • vitamin-deficiency anemia, from low levels of folate or B12
  • hemolytic anemia, from blood cells being destroyed faster than new ones can be produced
  • aplastic anemia, a rare condition related to the body not producing new blood cells
  • Sickle cell anemia, a genetic type of anemia that causes abnormal red blood cell size
  • pernicious anemia, from the body not absorbing enough vitamin B12 in the small bowel

If you have anemia, you may feel:

  • Fatigued or weak: Persistent low energy or tiredness is a hallmark symptom of most types of anemia. It results from reduced oxygen delivery.
  • Short of breath: As your body has difficulty meeting oxygen needs, you may become breathless even with minimum physical effort.
  • Dizzy and lightheaded: Because of low oxygen flow to the brain, you may have dizzy spells or persistent dizziness.
  • In pain: Headaches and chest pain may be symptoms of severe anemia. These anemia symptoms may be more likely to appear if you already live with a heart condition.
  • Cold: Because circulation may be impaired with anemia, you may feel cold at times when others don’t. Your feet and hands may constantly feel cold and clammy.

In addition to how you may feel if you have anemia, there may be visible signs of the condition:

  • Pale or sallow skin: Your face, eyelids, gums, and nail beds may be paler than usual.
  • Brittle nails and hair loss: If you have chronic iron-deficiency anemia, you may start shedding hair and your nails may be weaker and more brittle than before.
  • Tongue or mouth sores: If you have a vitamin B12 or folate deficiency, you may develop small, painful sores around your mouth. These may resolve within days but reappear soon after.
  • Yellowing of the skin or eyes: This symptom is associated with hemolytic anemia, but could also signal other health challenges related to the liver.
  • Unusual cravings: Feeling the need to chew on ice or eat non-food items (pica) is a common sign of iron-deficiency anemia.

Anemia diagnosis often begins with a complete blood count (CBC test) to measure levels of hemoglobin and red blood cells. A low hemoglobin count will point to anemia, but further testing is often needed to determine the severity and causes.

CBC tests may also include differential markers, which indicate the differences in size and other characteristics of blood cells. Small red blood cells often point to low iron, while large red blood cells are linked to folate or B12 vitamin deficiencies. If the blood cells are normal in size, the anemia may be due to your body not making enough blood cells, which may merit other tests.

Other tests a doctor may recommend to confirm or rule out anemia include:

  • iron panel, including serum iron, ferritin, and transferrin saturation
  • vitamin B12 and folate levels
  • reticulocyte count to measure the number of newly formed blood cells
  • peripheral blood smear to look at your blood under a microscope and check the size, shape, and appearance of red blood cells

In some cases, bone marrow testing or genetic tests may be required, especially for rarer types of anemia like aplastic or sickle cell.

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Once anemia is diagnosed, the next step is to determine the type of anemia and the underlying cause.

Depending on he cause, a range of healthcare professionals may be involved in care:

  • primary care physician (PCP)
  • hematologist (blood specialist)
  • gastroenterologist (if bleeding in the digestive tract is suspected)
  • gynecologist (for heavy menstrual bleeding)

Treatment options for anemia may include:

  • iron infusions or supplements
  • dietary changes
  • vitamin B12 shots
  • folate supplements
  • treatment of other underlying causes (for example, ulcers or digestive tract bleeding)
  • blood transfusions or anemia medication (for severe cases)
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Anemia is a condition with a wide range of symptoms that can affect how you feel and look. Symptoms like fatigue, dizziness, pale skin, and shortness of breath may signal anemia. Diagnosis usually starts with a blood test, and treatment depends on the cause.

What’s next?

If you think you have anemia, this checklist may help you determine what steps you may start taking today:

  • Identify and log in a journal or app persistent symptoms, like fatigue or shortness of breath.
  • Check for visual signs, like pale skin or brittle nails.
  • Schedule an appointment with a primary care physician, if possible for you.
  • Ask the doctor for a complete blood count. You can search online for companies that sell lab orders directly.
  • Check test results and determine if you need a follow-up with a doctor.
  • Ask the healthcare professional if you should see a specialist, like a hematologist.
  • Ask about treatment options and adhere to the plan as best as you can.
  • Monitor symptoms over time, and connect with a healthcare professional if new symptoms develop or resolved ones reappear.

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