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Home , Anemia, Aplastic anemia, Fanconi anemia, Hemolytic anemia

IN BRIEF: Your Guide to

Anemia is a disorder. Blood is a vital liquid that In some types of anemia, such as , your your constantly pumps through your veins and body also doesn’t have enough of other types of blood arteries and all throughout your body. When some- cells, such as white blood cells (WBCs) and . thing goes wrong in your blood, it can affect your WBCs help your body’s fight infec- health and quality of life. tions. Platelets help your blood clot, which helps stop . Many types of anemia exist, such as -deficiency anemia, pernicious anemia, aplastic anemia, and hemo- Many , conditions, and other factors can lytic anemia. The different types of anemia are linked cause anemia. For example, anemia may occur dur- to various diseases and conditions. ing if the body can’t meet its increased need for RBCs. Certain autoimmune disorders and other Anemia can affect people of all ages, races, and ethnici- conditions may cause your body to make proteins that ties. Some types of anemia are very common, and some destroy your RBCs, which can to anemia. Heavy are very rare. Some are very mild, and others are severe internal or external bleeding—from , for or even life-threatening if not treated aggressively. The example—may cause anemia because your body loses good news is that anemia often can be successfully too many RBCs. treated and even prevented. The causes of anemia can be acquired or inherited. What Causes Anemia? “Acquired” means you aren’t born with the condition, Anemia occurs if your body makes too few red blood but you develop it. “Inherited” means your parents cells (RBCs), destroys too many RBCs, or loses too passed the gene for the condition on to you. Sometimes many RBCs. RBCs contain , a protein that the cause of anemia is unknown. carries throughout your body. When you don’t have enough RBCs or the amount of hemoglobin in Diagnosing Anemia your blood is low, your body doesn’t get all the oxygen People find out they have anemia in a variety of ways. it needs. As a result, you may feel tired or have other You may have symptoms and go to your doctor, who symptoms. discovers the anemia through blood tests. Or, your doctor might find out you have anemia as a result of tests done for another reason.

Your doctor will likely ask about your medical and family histories, do a physical exam, and recommend tests or procedures to find out whether you have anemia, what is causing it, and how severe it is. This The main goals of treatment are to:

n Raise your RBC count or hemoglobin level to im- Possible Signs and prove your blood’s ability to carry oxygen n Treat the underlying condition causing your anemia n Prevent complications of the anemia, such as heart Symptoms of Anemia or nerve damage n Relieve symptoms and improve your quality of life l Tiredness or l Pale or yellowish If you have a mild or moderate anemia with no symptoms—or if your anemia isn’t getting worse—you l Faintness or may not need treatment. Some are treated l Increased thirst with dietary changes and nutritional supplements. l Sweating Other anemias are treated with , procedures, l Weak and rapid , rapid breathing , or blood transfusions (for severe anemia). l l Lower leg cramps Preventing or Controlling Anemia l Heart-related symptoms (abnormal heart rhythms, You can take steps to prevent or control anemia. These heart murmur, enlarged heart, ) actions can give you greater energy and improve your health and quality of life. Here are a few simple things you can do. information will help your doctor treat the anemia and its underlying cause. Most anemias are treatable, so an Follow a Healthy Diet accurate diagnosis is important. Following a healthy diet ensures that you get enough of the nutrients that your body needs to make healthy Medical and Family Histories blood cells. These nutrients include iron, B12, Your doctor will want to know about your signs and , and . These nutrients are found in a symptoms and how long you’ve had them. He or she variety of foods. Healthy eating also is good for your also may ask whether you’ve had an illness that can overall health. cause anemia. You also may be asked about your diet, any medicines or supplements you take, and whether The basics of healthy eating: you have a family history of anemia or anemia-related n Focus on nutrient-dense foods and beverages— conditions. vegetables, fruits, whole grains, fat-free or low-fat Physical Exam dairy products, seafood, lean meats and poultry, A physical exam can confirm and eggs, beans and peas, and nuts and seeds. provide information about what organs or body systems n Limit your intake of salt, solid fats, added sugars, may be involved. As part of a physical exam, your doctor and refined grains. may check the color of your skin, gums, and beds n Maintain a healthy weight by bal- and look for signs of bleeding or . He or she ancing the calories you get from may listen to your heart and lungs, feel your abdomen, or foods and beverages with the do a pelvic or rectal exam to check for internal bleeding. calories you use through physi- cal activity. Tests and Procedures n Follow food safety guidelines Your doctor will recommend tests to identify the type of when preparing and eating anemia you may have and its severity. Often, the first foods to reduce the risk of test is a (CBC), which provides foodborne illnesses. useful information about your blood. Depending on the CBC results, your doctor may recommend further tests Make following a healthy diet a of your blood or (the soft tissue inside family goal. Infants, young bones that makes blood cells). children, and teens grow rapidly. A healthy diet Treating Anemia supports growth and Anemia often is easily treated. The treatment your development and doctor chooses will depend on the type of anemia you can help prevent have, its cause, and how severe it is. anemia. Have Information About Specific Types of Anemia

Iron-Deficiency Anemia Aplastic Anemia Your body needs iron to make hemoglobin, the The term “anemia” usually refers to a condition in protein in RBCs that carries oxygen. The main way which your blood has a lower than normal number you get iron is from food. At certain times—such as of RBCs. However, some types of anemia, such as during pregnancy, growth spurts, or blood loss—your aplastic anemia, cause lower than normal numbers body may need to make more RBCs than usual. of other blood cells, too. Aplastic anemia can occur Thus, your body needs more iron than usual. Iron- if your bone marrow is damaged and can’t make deficiency anemia occurs if your body can’t keep up enough RBCs, WBCs, and platelets. The causes of with its need for iron. aplastic anemia can be acquired or inherited. Groups at risk Groups at risk l Infants and children, adolescents, and women of l People undergoing radiation or , childbearing age exposed to toxins, or taking certain medicines l People who have certain diseases and conditions, l People who have diseases or conditions that such as Crohn’s , celiac disease, or kidney damage the bone marrow failure Treatment: Depends on the cause of the anemia. l People who don’t get enough iron from the foods Treatments may include blood transfusions, they eat medicines, blood and marrow transplants, l People who have internal bleeding and lifestyle changes. Treatment: Iron supplements and dietary changes (eating food rich in iron and vitamin C, which increases iron absorption from food). Normally, RBCs have a lifespan of about 120 days. Your body constantly makes new RBCs to replace Pernicious Anemia ones that die. Sometimes, RBCs are destroyed before their normal lifespan is up. Hemolytic anemia and folate (another B vitamin) are needed occurs if your body can’t make enough RBCs to to make healthy RBCs. Your body absorbs these replace those destroyed. Acquired hemolytic anemia from foods. Pernicious anemia occurs if occurs if your body gets a signal to destroy RBCs your body can’t make enough RBCs because it can’t even though they are normal. Inherited hemolytic absorb enough vitamin B12 from food. anemia is related to problems with the genes that Groups at risk control RBCs. l People who have conditions that prevent them Groups at risk from absorbing vitamin B12 l Risk groups differ depending on the cause and l People who don’t get enough vitamin B12 in their type of hemolytic anemia. diets Treatment: Depends on the cause of the anemia. Treatment: Vitamin B12 supplements and dietary Treatments may include blood transfusions, changes (eating foods rich in vitamin B12, such meat; medicines, surgery and procedures, and lifestyle fish; eggs; dairy products; and breads, cereals, and changes. other foods fortified with vitamin B12).

healthy foods at home, and show your children how to Avoid Substances That Can Cause or Trigger Anemia make healthy choices when they’re away from home. Contact with chemicals or toxins in the environment can cause some types of anemia. Others types of ane- Also, help your parents or other older relatives enjoy a mia are triggered by certain foods or cold temperatures. healthy, nutrient-rich diet. Anemia is common in older If you have one of these types of anemia, avoid these adults because of chronic (ongoing) diseases, lack of triggers if you can. iron, and poor diet. With some types of anemia, you’ll want to reduce your types of anemia are generally straightforward and chances of getting an infection. To do this, wash your easily treated. As a result, the NHLBI’s clinical research hands often, avoid people who have colds, and stay on anemia focuses on a few specific, rarer types of the away from crowds. disorder. Research on these and other blood disorders continues to be an important priority for the NHLBI. Work With Your Doctor Visit your doctor if you have signs or symptoms of The NHLBI’s research efforts often depend on the anemia. If you’re diagnosed with anemia, follow your willingness of volunteers to take part in clinical trials. doctor’s advice about diet, supplements, medicines, and Clinical trials test new ways to prevent, diagnose, or other treatments. treat various diseases and conditions. You can take part in a clinical trial to gain access to new treatments Visit your doctor regularly for checkups and ongoing before they’re widely available and help add to scien- care, and tell him or her about any new or changing tific knowledge. symptoms. For more information about clinical trials related to Older children and teens who have severe anemia may anemia, talk with your doctor. You also can visit the have an increased risk of or infection. Talk with following Web sites to learn more about clinical re- your doctor about ways to keep them as healthy as pos- search and to search for clinical trials: sible and whether they need to avoid certain activities. n www.clinicaltrials.gov Girls and women who have heavy menstrual periods n clinicalresearch.nih.gov may need regular screenings and followup with their n www.nhlbi.nih.gov/studies/index.htm doctors to prevent or control iron-deficiency anemia. To Learn More Talk To Your Family The National Heart, Lung, and Blood Institute Some types of anemia—such as pernicious anemia, (NHLBI) provides information about the causes, pre- , or —can be inherited. If vention, diagnosis, and treatment of anemia and other you’ve been diagnosed with one of these kinds of ane- blood diseases. The NHLBI also provides dependable mia, talk to your family members. Suggest they visit information about heart and lung diseases and condi- their doctors for a checkup to see whether they also tions and sleep disorders. Resources include numerous might have anemia. publications, tools, and the NHLBI Web site. If you have children or teens who have anemia, talk to NHLBI Health Information Center them about how they can take an active role in their P.O. Box 30105 own care. Encourage them to learn about their condi- Bethesda, MD 20824–0105 tion and make decisions with their doctor. This can Phone: 301–592–8573 help young people feel more in control and have a more TTY: 240–629–3255 positive outlook about their health. Fax: 301–592–8563 Web site: www.nhlbi.nih.gov/health/infoctr/index.htm Clinical Trials The National Heart, Lung, and Blood Institute (NHLBI) NHLBI Web Site supports research aimed at learning more about blood The NHLBI Web site offers health education materials, diseases and disorders, including anemia. Common health assessment tools, and resources for patients, the public, and health professionals. www.nhlbi.nih.gov

Diseases and Conditions A–Z Index The NHLBI’s Diseases and Conditions Index (DCI) pro- vides complete, dependable, plain-language information about heart, lung, and blood diseases and sleep disorders. www.nhlbi.nih.gov/health/dci/index.html

USDA ChooseMyPlate.gov The U.S. Department of Agriculture’s (USDA’s) ChooseMyPlate.gov Web site has information, tips, and resources to help you learn more about healthy eating. www.choosemyplate.gov NIH Publication No. 11-7629A September 2011