Struggling with brain fog? Feeling sluggish and tired all the time? It might be worth getting a complete blood count (CBC) test to check for anemia.
Anemia is one of the most common blood disorders that can occur due to reduced levels of hemoglobin, an iron-rich protein found in red blood cells that carries oxygen in the body.
There are different causes of anemia, but iron deficiency anemia is the most common. It can be caused by blood loss such as menstrual bleeding or conditions that can cause gastrointestinal bleeding such as Crohn’s disease , decreased dietary intake, poor absorption of iron which can happen after bariatric surgery, antacid medications or Celiac disease, and pregnancy.
Anemia can also be the result of other underlying medical conditions including autoimmune disorders such as lupus or chronic kidney disease. Inherited forms of anemia can be found in people with sickle cell disease, a blood disorder that impacts hemoglobin.
“If people have a more sustained anemia, that can put stress on the heart and lead to a more rapid or irregular heartbeat,” said Kelsey Martin, MD, a hematologist and oncologist who cares for patients at Smilow Cancer Care Center. “It’s our heart’s job to pump blood and deliver oxygen to the body so with anemia, our heart has to work a bit harder to accomplish that.”
In kids, anemia can impact growth, development and behavior.
Anemia symptoms
Anemia can be easy to overlook because sometimes patients don’t have any signs. Others may experience symptoms including:
- Headaches
- Shortness of breath
- Palpitations or fluttering in the chest
- Pica: Craving non-food items such as ice chips, chalk or sand
- Looking jaundiced
- Restless legs
- Cracking in the corners of the mouth
- Feeling fatigued
“Brian fog and a mental sluggishness can lead to challenges of wellbeing,” said Dr. Martin. “There is a culture of people feeling tired, but when you’re tired and you’re not getting enough oxygen to your brain and body, that really impacts people’s quality of life.”
Anemia treatments
Dr. Martin says anemia treatments depend on the cause. For example, those with anemia stemming from other chronic medical conditions need to have those conditions addressed first.
Low iron levels require iron supplements, which can come in a pill or IV form. Additional diet changes, such as cutting back on dairy and pairing vitamin c with iron rich foods can aid absorption. However, iron supplements can take several months to be effective, which is why in some cases iron infusions or even a blood transfusion is necessary.
Depending on the patient’s condition, routine monitoring will be needed to ensure improved hemoglobin levels are sustained long term.
“I can give somebody iron and that will improve things but if every month they’re bleeding and losing blood it becomes a revolving door. That’s why it’s important we work closely with our gynecology and gastroenterology colleagues if that’s something that needs to be addressed,” said Dr. Martin.
Women, older adults and those who had gastric bypass surgery are at increased risk of anemia. But not everyone with risk factors should start taking supplements, unless directed by their healthcare provider.
“We have to have a blood test in order to diagnose it, so it’s not something a doctor can see on an examination,” said Dr. Martin. “I would love for patients who are higher risk to advocate for themselves to say, ‘I would like to have my iron checked’ because it’s not always routinely done.”
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