Anemia: symptoms, causes, treatment and prevention

Anemia symptoms include paleness of the skin (face, lips, under the nails) and mucous membranes (eyes, inside of the mouth), frequent tiredness and dizziness (blackening in front of the eyes) when standing up quickly and shortness of breath on exertion. Anemia is the condition in which the number of red blood cells in the blood is too low or the red blood cells contain too little hemoglobin (Hb). Hemoglobin is an iron-containing red pigment in red blood cells that binds oxygen and carbon dioxide and therefore ensures the transport of these substances. If the Hb level in the blood is lower than normal (= anemia), the blood cannot transport sufficient oxygen. Anemia is not a standalone disease but rather a symptom or warning sign that something is wrong. Anemia can be detected by blood tests. The value of Hb in the blood is examined. The treatment of anemia depends on the cause.

  • Anemia in a nutshell
  • What is anemia?
  • Hemoglobin
  • Hb content schedule
  • Symptoms of anemia
  • Sometimes no complaints
  • Phenomena
  • Anemia in children
  • Causes of anemia
  • Iron deficiency
  • Vitamin B12 deficiency
  • Heavy blood loss
  • Chronic disease, infection or inflammation
  • Hereditary defect
  • Examination and diagnosis
  • Blood tests
  • Test to determine whether your child has anemia
  • Treatment of anemia
  • Naturopathy for anemia
  • Complications of anemia
  • Prognosis
  • Prevention
  • Anemia significantly increases the risk of death after stroke

Anemia in a nutshell

  • Anemia = too few red blood cells and/or the blood cells contain too little hemoglobin (Hb)
  • Red blood cells = oxygen transporters.
  • Symptoms: fatigue, paleness, shortness of breath.
  • Causes: iron or vitamin deficiency, diseases.
  • Diagnosis via blood test.
  • Treatment varies by cause.
  • Iron or vitamin supplements often needed.
  • Attention to underlying conditions.
  • Regular check-up required by a doctor.
  • Anemia can lead to all kinds of health problems.

Figure shows normal red blood cells flowing freely in a blood vessel. The inset shows a cross-section of a normal red blood cell with normal hemoglobin. / Source: NHLBI, Wikimedia Commons (Public domain)

What is anemia?


Anemia or anemia is the condition in which the number of red blood cells or erythrocytes in the blood is low, or in which the red blood cells contain too little hemoglobin (Hb), or in which there is a combination of both. Red blood cells are made in the bone marrow and are responsible for transporting oxygen and carbon dioxide between the lungs and other tissues in the body. Hemoglobin is an iron-containing red pigment in red blood cells that binds oxygen and carbon dioxide and therefore ensures the transport of these substances. The number of red blood cells in a man is approximately 5,200,000 per mm3 of blood and in women it is approximately 4,700,000. The average lifespan of a red blood cell ranges from 90 to 120 days. If the Hb level is too low, not enough oxygen can be transported through the red blood cells.

Hb content schedule

The chart below shows the normal Hb levels of men and women and also when anemia is considered.

man Woman

normal Hb level

anemia: lower than


7.8 – 10.8 mmol/ml

7.8 mmol/ml


7.3 – 10 mmol/ml

7.3 mmol/ml

Anemia is not a standalone disease but rather a symptom or warning sign that something is wrong.

Symptoms of anemia

Sometimes no complaints

Because insufficient oxygen is delivered to all tissues in the body, anemia can cause many symptoms. It can also worsen almost any other underlying medical condition. With mild anemia there may be no symptoms. With chronic anemia, the body can adapt, so there may be no symptoms until the anemia gets worse. Anemia can therefore go unnoticed and be discovered by chance, for example through a blood test.

Fatigue due to anemia / Source:


The following symptoms may occur with anemia:

  • abnormal fatigue;
  • general weakness and listlessness;
  • reduced resistance;
  • shortness of breath, especially during physical exertion, due to less possibility of oxygen transport;
  • light-headedness, dizziness, the feeling that you are going to faint, especially when standing up quickly you may experience dizziness (blackening before the eyes);
  • in compensation for the reduced amount of blood, a faster heart rate with palpitations and a faster heart rate at rest;
  • perspiration (sweating);
  • headache;
  • due to the lack of red cells you will look pale, with paleness of the skin (including under the fingernails and pale lips), and the mucous membranes (eyes, inside of the mouth);

The hand of a person with severe anemia (left) compared to a person without (right) / Source: James Heilman, MD, Wikimedia Commons (CC BY-SA-3.0)

  • white spots on the nail (leukonychia);
  • cold hands and feet;
  • blurred vision;
  • tingling in the feet;
  • cracked corners of the mouth, or cracks in the lips;
  • in men, impotence (not being able to get an erection) or less desire for sex;
  • tinnitus or ringing in the ears;
  • sleep problems;
  • concentration problems;
  • confusion; and
  • stomach and intestinal disorders.

Anemia in children

In children, anemia can slow physical growth and mental development.

Causes of anemia

Anemia can arise from a number of causes:

Iron deficiency

Iron deficiency (ferriprieve anemia): Iron deficiency or iron deficiency is the most common form of anemia. If iron intake is limited or insufficient due to, for example, poor diet, anemia can occur. But iron deficiency can also occur, for example, due to heavy blood loss during menstruation

Vitamin B12 deficiency

A deficiency of vitamin B12 or folic acid if no animal products have been included in the diet for a long time. This can occur in strict vegetarians and alcoholics. Or due to absorption disorder for vitamin B12.

Heavy blood loss

Heavy blood loss due to heavy menstrual bleeding or a wound. When someone loses small amounts of blood (unnoticed) for a long period of time, anemia can also occur. This includes gastrointestinal ulcers (ulcers in the stomach and intestines) or certain forms of cancer such as cancer of the colon.

Chronic disease, infection or inflammation

A chronic disease, infection or inflammation: many chronic diseases such as rheumatism, (repeated) infections or cancer can disrupt the production of hemoglobin.

Hereditary defect

A hereditary disorder such as celiac disease (gluten enteropathy or native thrush), a chronic intestinal disorder characterized by a congenital gluten intolerance that leads to damage to the intestinal mucosa without a special diet.

Blood collection / Source:

Examination and diagnosis

Blood tests

Doctors can easily detect anemia through blood tests. Since anemia is only a symptom of a disease, doctors will want to determine what caused the anemia. Additional tests may be required for this. When a person has severe anemia, the cause must be identified as soon as possible so that it can be treated appropriately.

Test to determine whether your child has anemia

There is a simple test to determine whether your child has anemia. Pull down your child’s lower eyelid and examine the inside, which should normally be pinkish red. If, on the other hand, the color is pale, there is a good chance that your child has anemia. Further medical research will have to confirm this.

Treatment of anemia

The treatment depends on the cause. For example, blood loss due to heavy periods can be prevented by using the contraceptive pill. A deficiency of folic acid or vitamin B12 can be remedied by taking tablets and sometimes vitamin B12 must be administered by injection. In case of very severe anemia, it may be necessary to give someone extra red blood cells with a blood transfusion.

Urtica dioica (large nettle) from Thomé, Flora von Deutschland, Österreich und der Schweiz 1885 / Source: Public domain, Wikimedia Commons (PD)

Naturopathy for anemia

For anemia, use herbs that build up the blood, such as dong quai root or nettle. In addition, use herbs that stimulate the digestive system, such as gentian root and artichoke leaf. A herbal formula that you can use daily: Add 1 tsp curly dock root, 1 tsp nettle leaf, ½ tsp dandelion root and ½ tsp dong quai root to 1 liter of water. Bring to the boil and let the mixture simmer for 20 minutes. Drink half a liter of this brew per day during meals.

It is not recommended to use the fresh root of curly dock; only use the dried curly dock root. A fresh carrot can have diarrhea and vomiting as side effects. Curled dock can increase the effect of laxative herbs. Furthermore, curly dock should not be administered if you suffer from kidney stones.

Complications of anemia

Hemoglobin ensures that oxygen (an important fuel in your body) and carbon dioxide (a waste product) can be absorbed into the red blood cell. This allows oxygen to be delivered to all parts of the body and returns carbon dioxide to the lung where it can be exhaled. If hemoglobin levels are too low, this process can be disrupted, resulting in low oxygen levels in the body (hypoxia). Depending on the severity of the anemia and the duration of the disease, complications may occur. Complications can occur if the anemia becomes severe and is left untreated, for example:

  • brittle nails and nails that break easily (split nails)
  • hair loss
  • heart failure
  • are more susceptible to infections


Anemia generally has a very good prognosis and can be cured in many cases. The overall prognosis depends on the underlying cause of anemia, its severity, and your overall health.

Lentils contain a lot of iron / Source: Gayvoronskaya_Yana/


Some types of anemia can be prevented by taking the following measures:

  • Eat plenty of iron-rich foods, such as tofu, green leafy vegetables, lean red meat, lentils, beans, and iron-fortified cereals and breads.
  • Eat and drink vitamin C-rich foods and drinks.
  • Do not drink tea or coffee with meals as these may affect iron absorption.
  • Make sure you get enough vitamin B12 and folic acid in your diet.

Anemia significantly increases the risk of death after stroke

People with anemia or anemia have a three times greater risk of dying within a year after a stroke, also called CVA (Cerebro Vascular Accident). This is what researchers stated at the 2012 International Stroke Conference .

Stroke / Source: Alila Medical media/

“Among stroke patients, severe anemia is a powerful predictor of death during the first year after stroke,” said Jason Sico, lead researcher and assistant professor of neurology at Yale University School of Medicine in New Haven, Connecticut , United States. Previous research has already shown that anemia entails a greater risk of death within a year in people who have suffered a heart attack, heart failure or kidney disease.

The researchers studied and assessed the medical records of 3,750 men who had been treated for a cerebral infarction and came to the following findings:

  • Patients with severe anemia died 3.5 times more often in hospital and the risk of death within a year after the stroke was 2.5 times greater than in patients who did not suffer from anemia.
  • Patients with average anemia were twice as likely to die within 12 months after the stroke,
  • In patients with mild anemia, this rate was 1.5 times.

Anemia is measured by measuring the hematocrit value (Ht). This is the amount of red blood cells per liter of blood (in liters per liter = l/l). According to the researchers, a healthy hematocrit is between 38 and 42 percent. Mild anemia corresponded to 33 to 37 percent, moderate anemia 28 to 32 and severe anemia 27 percent or lower.

Factors that could cause distortion, such as age, severity of the stroke and the health status of the patients before the stroke, were corrected. Nevertheless, the connection found remained intact. According to the researchers, both patients and GPs should keep a close eye on the increased risk due to anemia. (02-02-2012,

read more

  • Anemia: dizziness headache fatigue shortness of breath
  • Treat anemia with iron-rich foods
  • Iron deficiency: symptoms, cause, consequences and iron supplementation
  • Vitamin B12 deficiency: symptoms, RDA and supplement deficiency
  • Supplementing iron deficiency, iron in food: table & quantity