Anemia Symptoms

Iron-deficiency anemia is a progressive condition. It usually develops in stages, so it can take months or even years before symptoms appear. The main symptoms of anemia include fatigue, weakness, loss of appetite, loss of energy, shortness of breath and increased susceptibility to infection. Many of my clients complain of difficulty performing exercise that once posed no problem for them. In the presence of iron deficiency, it is not uncommon to lack motivation to work out. It’s important to keep in mind that you may feel these symptoms even if you are not classified as anemic. A marginal iron deficiency can affect your energy levels, too, although not as severely.

Tongue irritation, cracks at the side of the mouth and spoonlike deformities in the fingernails also may result from iron deficiency. Some people with anemia develop pica, a craving for non-food substances such as ice, dirt or pure starch. In young children, iron deficiency may cause irreversible abnormalities in brain development, resulting in impaired attention span, cognitive function and learning ability. However, scientists don’t know the severity of iron deficiency necessary to produce these developmental changes.

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Anemia ranges from mild to severe, and the symptoms also vary accordingly. Mild anemia does not have any significant long-term consequences. It may simply result in dizziness, faintness, thirst, sweating or a rapid pulse. These symptoms usually disappear when iron supplies are restored. More severe cases of anemia may lead to medical problems involving the heart. Because anemia lowers the amount of oxygen in the bloodstream, the heart must beat faster and deliver more blood to the tissues. If the heart is unable to keep up with this increased demand, symptoms of heart failure may develop, including difficulty in breathing, swollen legs and angina.

The speed at which blood is lost will also affect the symptoms of anemia. When blood loss is sudden and occurs over several hours or less, the loss of only one-third of the body’s blood volume causes death. If bleeding takes place over a longer period, such as days or weeks, the body can tolerate a loss of up to two-thirds of its blood volume, often without suffering anything more than a feeling of fatigue or weakness.

Who’s at Risk?

If you fall into any of the following categories you’re at risk for developing iron-deficiency anemia:

• You’re female

• You’re pregnant

• You engage in regular endurance exercise (e.g., long-distance running, triathlons)

• You follow a low-calorie diet (less than 1300 calories)

• You’re a vegetarian

All women of reproductive age are at risk of developing iron deficiency, and at even greater risk if their diet lacks iron-rich foods. Women who are pregnant or breastfeeding are also predisposed to anemia because of the additional demands of the growing baby and placenta. Female runners or triathletes lose iron through sweat and can become iron deficient, especially if their diet lacks iron. Any woman who reduces her calorie intake to lose weight or eats an unbalanced vegetarian diet is also at risk.

Teenage girls are another high-risk group due to the onset of menstruation, increased growth requirements and a diet that often has an inadequate dietary intake of iron.

Infants are born with sufficient stores of iron, but this iron supply becomes depleted during the first few months of life. Exclusively breastfed babies and babies fed on whole cow’s milk are especially at risk of developing iron deficiency. For this reason, pediatricians recommend that infants receive additional iron from iron-fortified cereals or formulas from the time that they are six months of age.

Surveys indicate that young children also fall into a high-risk category for iron deficiency. Children from low-income families or from ethnic groups such as Chinese and Native American peoples may not eat sufficient quantities of iron-rich foods to maintain a healthy iron supply.


Blood tests are used to diagnose anemia. Your doctor will look at the level of hemoglobin in your blood to determine the degree of iron deficiency. A simple blood test can also determine the amount of iron that’s stored in your liver. On rare occasions it may be necessary to examine a sample of bone marrow to assess the iron content of your red blood cells.

Blood tests that identify the size, shape, color and number of red blood cells are used to identify anemia that is caused by deficiencies in other vitamins, such as vitamin B12, vitamin C and folate (folic acid). Anemia that is a result of chronic disease or other physical disorders will normally be identified as part of the diagnosis of the underlying medical condition.

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