Symptoms of Anemia

Symptoms of Anemia

Anemia is one of the most common conditions family physicians see in the office. Anemia is defined as a lower than normal hemoglobin level in the blood stream. Hemoglobin is the oxygen carrying protein in our red blood cells, and is measured directly by most automated lab testing equipment and has replaced hematocrit as the gold standard measurement for assessing anemia. The hematocrit is the percentage of whole blood that is red blood cells, the rest being plasma, and is a calculated value by most modern labs. A normal hemoglobin level is from 12-16 mg/dl in women, and from 13-17 mg/dl in men.

Since hemoglobin carries oxygen from the lungs to the tissues of the body some symptoms of anemia are directly related to the body’s attempts to increase oxygen delivery. These symptoms often include:

Tachycardia: This is an abnormally fast heart rate. In an attempt to increase cardiac output and deliver more oxygen rich blood from the lungs anemic patients often have both resting and exertional tachycardia. Patients may describe this as a pounding or fast heartbeat.

Dyspnea on exertion: The lack of oxygen being delivered to the tissues due to low hemoglobin levels frequently leads to a feeling of shortness of breath, called dyspnea, with exertion.

Dizziness on standing upright: This is called orthopnea in medical circles, and is related to a drop in blood pressure.

Other symptoms that are common with anemia include fatigue, insomnia, paleness of the skin and eyes, trouble thinking or concentrating, and cramping of the legs.

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Specific causes of anemia can be associated with other symptoms more specific to that type of anemia. Iron deficiency, which can lead to a microcytic anemia, is sometimes associated with ingestion of things not usually eaten, especially ice. This is called pica. Iron deficiency can also cause cracking of the corners of the mouth. Vitamin B12 deficiency is often associated with symptoms of a peripheral neuropathy. This is often pain or burning in the feet or legs. B12 deficiency can also cause more serious neurologic symptoms.

Hemolytic anemia is a type of anemia caused by the rapid destruction of red blood cells, usually due to an autoimmune process where the body develops antibodies against the red blood cells. In this type of anemia patients may develop jaundice due to metabolize and get rid of the bilirubin that is a metabolic byproduct of hemoglobin. It can also be associated with enlargement of the liver and spleen or dark-colored urine.