Overview
Anaemia means the blood does not carry enough oxygen to the body's tissues, either because there are too few red blood cells or the red blood cells do not contain enough haemoglobin. It causes tiredness, paleness, and breathlessness. Iron deficiency is the most common cause worldwide.
How common is it?
Anaemia affects over 1.6 billion people globally. Iron deficiency anaemia is especially common in women of childbearing age, young children, and people in low-income countries.
Causes and risk factors
Red blood cells can be reduced by blood loss, reduced production, or increased destruction. The cause determines the type of anaemia and guides treatment.
Common risk factors
- Low dietary iron, folate, or vitamin B12 intake
- Heavy menstrual periods
- Internal bleeding from ulcers or bowel cancer
- Pregnancy (increased iron demand)
- Chronic diseases such as kidney disease or rheumatoid arthritis
- Inherited conditions like sickle cell disease or thalassaemia
Symptoms
- Persistent tiredness and weakness
- Pale or yellowish skin
- Shortness of breath on mild exertion
- Headaches and dizziness
- Cold hands and feet
- Rapid or irregular heartbeat
- Brittle nails or hair loss (iron deficiency specifically)
When to see a doctor
See a doctor if you have unexplained fatigue lasting more than a few weeks, especially with pallor. Always investigate anaemia in men and post-menopausal women as it may signal blood loss from the gut.
Diagnosis
A full blood count identifies anaemia and gives information about the size and appearance of red blood cells. Further blood tests identify the cause. Occasionally, bone marrow examination or endoscopy is needed.
Treatments
Iron supplements
Oral ferrous sulphate taken daily for at least 3 to 6 months to replenish iron stores. Taking with orange juice improves absorption.
Treating the underlying cause
Stopping bleeding sources, adjusting medications, managing chronic disease, or addressing dietary deficiencies prevents recurrence.
Blood transfusion or intravenous iron
Used when anaemia is severe, symptomatic, or when oral iron is not absorbed or tolerated.
Self-care and lifestyle
- Eat iron-rich foods: red meat, lentils, fortified cereals, dark leafy greens
- Pair plant iron sources with vitamin C to improve absorption
- Avoid tea and coffee with meals as they reduce iron absorption
- Cook in cast iron cookware which can add small amounts of dietary iron
Prevention
Women of childbearing age, pregnant women, and vegetarians should ensure adequate iron and B12 intake through diet or supplements. Screening for bowel cancer in adults over 50 catches hidden bleeding early.