Anaemia

What Is Anaemia?

Anaemia is a blood disorder. It happens when the number of red blood cells in your body falls below normal, or when the red blood cells you do have cannot carry oxygen properly. Red blood cells contain a protein called haemoglobin. Haemoglobin picks up oxygen in the lungs and carries it to every part of the body. Without enough of it, your organs and tissues do not get what they need. 

A haemoglobin value below 13.5 grams per decilitre in men, or below 12.0 in women, meets the criteria for anaemia. Values vary for children depending on age. The condition ranges from mild to severe. Some people recover quickly with simple treatment and never have it again. Others manage chronic forms for years. In rare cases, severe anaemia can become life-threatening, especially when an underlying condition goes undiagnosed for too long.

Types of Anaemia

There are more than 400 types of anaemia, and they are grouped based on what causes them. Some develop over time due to nutritional deficiencies or chronic illness. Others are present from birth. 

Iron-deficiency anaemia is the most common, accounting for around 50% of all cases. The body needs iron to produce haemoglobin. When iron stores are low, the bone marrow cannot make enough working red blood cells. 

Vitamin-deficiency anaemia develops when the body runs short of vitamin B12 or folate. A specific form called pernicious anaemia occurs when the body cannot absorb B12 from the digestive tract, usually because a protein called intrinsic factor is missing. 

Haemolytic anaemia is a type of anaemia in which red blood cells are destroyed faster than the bone marrow can replace them. Causes include autoimmune disorders, infections, inherited conditions, and certain medications. 

Aplastic anaemia is rare and serious. It happens when the bone marrow stops making enough new blood cells altogether.

Anaemia of chronic disease develops when a long-standing illness like cancer, kidney disease, or rheumatoid arthritis stops the body from using iron properly.

Sickle cell anaemia and thalassaemia are inherited forms passed down through families. In sickle cell anaemia, an abnormal haemoglobin causes red blood cells to form a rigid sickle shape that blocks blood flow and breaks down too soon. In thalassaemia, the body produces less haemoglobin than it should, leading to small, fragile red blood cells. 

Causes of Anaemia

Red blood cells are produced in the bone marrow and live for around 120 days before they are removed from circulation. The bone marrow continuously replaces them, producing roughly 2 million cells per second. Anaemia develops when the body stops making enough red blood cells, starts destroying them too fast, or loses them through bleeding. 

• The most common nutritional cause is too little iron in the diet, particularly among infants, young children, pregnant women, and people with heavy periods. 
• Deficiencies in vitamin B12 and folate also prevent the bone marrow from producing healthy red blood cells. 
• Blood loss is another major cause, whether from injury, surgery, or slow ongoing bleeding from conditions like stomach ulcers, gut lesions, or haemorrhoids. 
• Infections, including malaria, tuberculosis, HIV, and parasitic infections, can interfere with red blood cell production or cause their early destruction. 
• Long-term inflammation from chronic diseases suppresses the bone marrow's ability to make new cells. 
• Kidney disease reduces the production of erythropoietin, the hormone that signals the bone marrow to produce red blood cells. 
• Some causes are inherited, including sickle cell disease, thalassaemia, and glucose-6-phosphate dehydrogenase deficiency, all of which affect the structure or function of red blood cells.

Risk Factors for Anaemia

Certain factors increase the likelihood of developing anaemia. Understanding them helps identify people who may need earlier screening or closer monitoring.

A diet low in iron, B12, or folate is one of the most common risk factors. This matters most for people on strict vegetarian or vegan diets who do not supplement. Poor absorption from conditions like Crohn's disease or coeliac disease raises the risk even further, regardless of what a person eats. Heavy or prolonged periods mean monthly blood loss that adds up. Pregnancy increases iron and folate demands sharply, and anaemia is common when diet or supplements do not keep up.

Roughly 10 to 20 percent of people over 65 have anaemia, often tied to kidney disease, cancer, or other chronic conditions. Long-term illnesses, including diabetes, autoimmune diseases, liver disease, and inflammatory bowel disease, all interfere with red blood cell production or iron use. A family history of sickle cell disease or thalassaemia is also a significant risk factor.

Symptoms of Anaemia

Mild anaemia often causes no noticeable symptoms at first and is discovered unexpectedly during routine blood tests. As the condition worsens, the body struggles to compensate for low oxygen levels, and symptoms become more obvious. 

• Fatigue or unusual tiredness
• Weakness
• Shortness of breath
• Dizziness or lightheadedness
• Cold hands and feet
• Fast or irregular heartbeat
• Headaches
• Pale skin, or pale gums, nails, or inner eyelids in people with darker skin tones
• Chest pain in more severe cases

Some types bring their own additional symptoms. Iron deficiency can cause unusual cravings for things like ice or clay, a condition called pica, along with brittle nails. B12 deficiency can cause numbness and tingling in the hands and feet, trouble concentrating, depression, and memory problems. Haemolytic anaemia may cause yellowing of the skin or eyes and an enlarged spleen.

How Is Anaemia Diagnosed?

Diagnosis starts with a complete blood count, or CBC. It measures red blood cell numbers, haemoglobin levels, and haematocrit, giving a clear picture of whether anaemia is present and how severe it is. A peripheral blood smear looks at red blood cells under a microscope to check their size and shape, which can point to the specific type. A reticulocyte count measures immature red blood cells to show whether the bone marrow is producing new cells at a normal rate.

Additional tests may be needed to find the underlying cause, including iron studies, ferritin levels, vitamin B12 and folate tests, kidney function tests, and tests for autoimmune activity. A bone marrow biopsy may be performed if bone marrow disease is suspected. 

Treatment for Anaemia

Treatment depends entirely on the underlying cause. For nutritional deficiencies, iron supplements in tablet or liquid form are prescribed for iron-deficiency anaemia and are best absorbed on an empty stomach, away from milk, caffeine, or calcium. Folic acid tablets address folate deficiency. Vitamin B12 is replaced through oral supplements or injections, with injections used when absorption from the gut is the problem. 

Erythropoietin injections are used in people with chronic kidney disease to stimulate red blood cell production. Immunosuppressants are prescribed when the immune system is attacking red blood cells or bone marrow stem cells. Blood transfusions restore red blood cell levels quickly when haemoglobin has dropped critically low or blood loss has been severe. A bone marrow transplant may be an option for serious forms like aplastic anaemia. Surgery may be needed to stop internal bleeding that is keeping anaemia going.

Complications of Anaemia

Untreated anaemia forces the heart to work harder to compensate for low oxygen in the blood. Over time, this can lead to arrhythmia, an enlarged heart, or heart failure. Severe acute blood loss can cause a heart attack. 

Anaemia during pregnancy is associated with a higher risk of premature birth, low birth weight, and risk to the mother’s life during labour. In children, untreated anaemia can interfere with cognitive development and behaviour. In older adults, even mild anaemia has been linked to falls, fractures, and faster cognitive decline. Other complications include peripheral nerve damage, depression, memory problems, and a weakened immune system. 

When to See a Doctor

If fatigue, dizziness, or shortness of breath persist for more than two weeks despite rest, a blood test is worth getting. Chest pain, fainting, a very rapid heartbeat at rest, or difficulty breathing without exertion require prompt attention. People with a family history of inherited anaemias, women with heavy periods, those with chronic conditions such as kidney disease or inflammatory bowel disease, and adults over 65 should ask about regular blood monitoring. If you are told your haemoglobin is too low when donating blood, book a medical appointment rather than waiting for symptoms to develop. 

Prevention

Many types of anaemia cannot be prevented, particularly inherited forms. Iron-deficiency and vitamin-deficiency anaemias can often be avoided through a balanced diet that includes lean red meats, lentils, beans, dark leafy vegetables, and iron-fortified cereals for iron; meat, dairy, and fortified foods for vitamin B12; and fruits, kidney beans, and enriched grains for folate. Vitamin C consumed alongside iron-rich foods improves absorption. Tea, coffee, and calcium-rich foods reduce absorption and are best avoided around the time iron supplements are taken. 

Pregnant women need significantly more iron and folate and should take prenatal supplements throughout pregnancy. Spacing pregnancies by at least 24 months helps the body recover iron stores between births. People with absorption conditions like Crohn's disease or coeliac disease may need supplements regardless of dietary intake and should have blood levels checked regularly. 

At-Home Anaemia Care With First Response Healthcare (FRH)

Managing anaemia well requires regular blood monitoring, clear guidance on diet and medication, and a healthcare provider who understands your full medical picture. For many patients, getting to a clinic repeatedly is one of the biggest barriers to staying on top of the condition.

First Response Healthcare (FRH) provides professional at-home medical care that removes this barrier. FRH offers home blood collection for full blood counts and iron studies, making it far more practical to track progress without travelling or waiting. Qualified nurses and doctors can visit at home to assess symptoms, review medications, and administer IV iron or B12 injections where clinically needed. For elderly patients, pregnant women, or those recovering from illness, this removes the disruption of repeated clinic visits entirely. FRH also provides tailored guidance on diet, supplementation, and lifestyle based on each patient's specific type of anaemia and overall health.

If you or a family member is experiencing persistent fatigue, breathlessness, or dizziness, or if blood tests have shown low haemoglobin, reaching out to FRH is a practical first step toward getting the right care in place quickly.

Frequently Asked Questions

Can anaemia go away on its own?
Some mild anaemias improve when the cause is addressed, such as changing diet or treating an infection. Anaemia caused by ongoing blood loss, chronic disease, or inherited conditions will not resolve without treatment. 

How long does recovery take?
Haemoglobin levels often begin to rise within a few weeks of starting iron supplements, but fully restoring iron stores can take three to six months. Some types require longer or ongoing treatment. 

Is anaemia serious?
Most forms are treatable. However, severe or long-untreated anaemia can cause heart problems, pregnancy complications, and, in extreme cases, organ failure. Earlier diagnosis generally means simpler treatment. 

Can children have anaemia?
Yes. Children under five years of age and adolescent girls are among the most vulnerable groups. Iron-deficiency anaemia in children can affect cognitive development and behaviour if left untreated. 

Is anaemia more common in women?
Yes. Women of reproductive age have a higher risk due to monthly blood loss and the increased iron demands of pregnancy.