Anemia
When oxygen delivery falls short. Anemia occurs when you have too few red blood cells or not enough hemoglobin to carry oxygen to your tissues. The result: fatigue, weakness, pale skin, shortness of breath. While iron deficiency is most common, anemia has many causes—finding the right one is key to treatment.
Types of Anemia
Iron Deficiency
Most common worldwide. Small, pale RBCs (microcytic). From blood loss, poor absorption, or inadequate intake.
B12 Deficiency
Large RBCs (megaloblastic). Can cause neurological damage. Often from poor absorption or vegan diet.
Folate Deficiency
Also megaloblastic. Common in pregnancy. MTHFR variants can contribute.
Anemia of Chronic Disease
Inflammation blocks iron use. Body has iron but can't access it. Treat underlying condition.
Hemolytic Anemia
RBCs destroyed too fast. Autoimmune, infections, or genetic causes.
Aplastic Anemia
Bone marrow doesn't make enough cells. Rare but serious. Autoimmune or toxic causes.
Common Symptoms
General
- Fatigue: Most common symptom
- Weakness: Muscles don't get enough O2
- Pale skin: Less hemoglobin color
- Shortness of breath: Especially with exertion
- Dizziness: Brain O2 reduction
Iron-Specific
- Pica: Craving ice, dirt, starch
- Restless legs: Common with low ferritin
- Brittle nails: Spoon-shaped (koilonychia)
- Cold hands/feet: Poor circulation
- Headaches: Especially with activity
Key Tests
CBC
Complete blood count. Hemoglobin, hematocrit, RBC count, MCV (cell size).
Ferritin
Iron stores. Best early marker. Optimal is 50-150, not just "normal."
Iron Panel
Serum iron, TIBC, transferrin saturation. Helps distinguish anemia types.
B12 and Folate
Rule out megaloblastic anemia. Check MMA for B12 tissue status.
Reticulocytes
Young RBCs. Shows if bone marrow is responding appropriately.
Inflammatory Markers
CRP, ESR. High inflammation can cause anemia of chronic disease.
Treatment Approaches
Iron Supplementation
For iron deficiency. Take with vitamin C. Every other day may absorb better. Address cause.
B12 Injections
If absorption is the issue (pernicious anemia). High-dose sublingual may also work.
Address Root Cause
GI bleeding, heavy periods, celiac, H. pylori. Supplementing without fixing cause won't work.
Reduce Inflammation
For anemia of chronic disease. Anti-inflammatory diet, treat underlying condition.