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The simplest and most likely cause is a lack of iron in the body (Iron Deficiency Anaemia). The posh term for this condition with small pale red blood cells is "Hypochromic, microcytic anaemia" Iron is essential for the body to make the red pigment in the blood called haemoglobin (Hb). If there's not enough iron, the body can't make enough Hb and so the red blood cells can't get enough to fill themselves properly. This makes them pale and small. This lack of iron can be the result of poor diet or excessive bleeding (eg heavy periods) or both in combination. An iron supplement from the local pharmacy will cure this. Rarely, it might be a problem absorbing iron. Vitamin C might help this. Less likely it could be a feature of a disease caused thalassaemia where the red pigment in the blood is not made properly by the body for other reasons (globin chain synthesis defects). This is an inherited condition and not really treatable though rarely severe enough to cause problems. Only in severe cases would regular blood transfusions be used to treat the symptoms of the associated severe anaemia. IRON WILL NOT HELP AND MIGHT DO YOU HARM. Try iron supplements and if you don't get better within a month or 6 weeks talk about these things with your family doctor. Too much iron, taken for too long is not good for you so, if you don't start to feel better in a few weeks, go to your doctor and get a blood test to exclude thalassaemia and to check your iron levels.

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Q: What can cause your red blood cells to be small and pale?
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