Anemias: Causes and symptoms

Anemia is caused by bleeding, decreased red blood cell production, or increased red blood cell destruction. Poor diet can contribute to vitamin deficiency and iron deficiency anemias in which fewer red blood cells are produced. Hereditary disorders and certain diseases can cause increased blood cell destruction. However, excessive bleeding is the most common cause of anemia, and the speed with which blood loss occurs has a significant effect on the severity of symptoms. Chronic blood loss is usually a consequence of:

• cancer
• gastrointestinal tumors
• diverticulosis
• polyposis
• heavy menstrual flow
• hemorrhoids
• nosebleeds
• stomach ulcers
• long-standing alcohol abuse

Acute blood loss is usually the result of:

• childbirth
• injury
• a ruptured blood vessel
• surgery

When a lot of blood is lost within a short time, blood pressure and the amount of oxygen in the body drop suddenly. Heart failure and death can follow.

Loss of even one-third of the body's blood volume in the space of several hours can be fatal. More gradual blood loss is less serious, because the body has time to create new red blood cells to replace those that have been lost.

Weakness, fatigue, and a run-down feeling may be signs of mild anemia. Skin that is pasty or sallow, or lack of color in the creases of the palm, gums, nail beds, or lining of the eyelids are other signs of anemia. Someone who is weak, tires easily, is often out of breath, and feels faint or dizzy may be severely anemic.

Other symptoms of anemia are:

• angina pectoris (chest pain, often accompanied by a choking sensation that provokes severe anxiety)
• cravings for ice, paint, or dirt
• headache
• inability to concentrate, memory loss
• inflammation of the mouth (stomatitis) or tongue (glossitis)
• insomnia
• irregular heartbeat
• loss of appetite
• nails that are dry, brittle, or ridged
• rapid breathing
• sores in the mouth, throat, or rectum
• sweating
• swelling of the hands and feet
• thirst
• tinnitus (ringing in the ears)
• unexplained bleeding or bruising

In pernicious anemia, the tongue feels unusually slick. A patient with pernicious anemia may have:

• problems with movement or balance
• tingling in the hands and feet
• confusion, depression, and memory loss

Pernicious anemia can damage the spinal cord. A doctor should be notified whenever symptoms of this condition occur.

A doctor should also be notified if a patient who has been taking iron supplements develops:

• diarrhea
• cramps
• vomiting

— Maureen Haggerty