Anemia
Description
An in-depth report on the types, diagnosis, treatment, and prevention of anemia.
Alternative Names
Iron deficiency; Pernicious anemia
Symptoms
Symptoms of anemia vary depending on the severity of the condition. Anemia may occur without symptoms and be detected only during a medical examination that includes a blood test. When they occur, symptoms may include:
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Weakness and fatigue are the most common symptoms of even mild anemia. Even iron deficiency without anemia can reduce working capacity in some people.
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Shortness of breath on exertion
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Rapid heartbeat
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Lightheadedness or dizziness
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Headache
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Ringing in the ears (tinnitus)
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Irritability and other mood disturbances
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Pale skin (however, healthy-looking skin color does not rule out anemia if a patient has risk factors and other symptoms of anemia)
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Iron deficiency, even at a level too mild to cause anemia, has been linked to restless legs syndrome (RLS) in some people. Some studies have reported RLS in 25 - 30% of people with low iron levels. Studies suggest, in fact, that RLS in some people may be due to impaired iron acquisition in cells that regulate dopamine in the brain. Dopamine abnormalities are known to play a role in RLS.
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Mental confusion
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Loss of sexual drive
Unusual Symptoms
Pica.
One odd symptom, (which in some cases is a cause of iron deficiency), is
pica
. This is the habit of eating unusual substances, such as ice (called
pagophagia
), clay, cardboard, foods that crunch, or raw starch. For example, in one study, half of people whose pica took the form of pagophagia (eating at least one tray of ice every day for 2 months) or eating foods that crunch (such as raw potatoes, carrots, or celery) were iron deficient. The pica often stops, particularly in children, when iron supplements are given. Pica is difficult to detect because patients are often ashamed to admit to such cravings.
Frequent Breath Holding.
Studies have also indicated that children who hold their breath frequently when angry or upset, even to the point of fainting, may be iron-deficient. In one study, taking iron supplements reduced this phenomenon in 88% of treated children.
Symptoms of Megaloblastic Anemia and its Causes
Symptoms of Megaloblastic Anemia.
The symptoms of megaloblastic anemia from vitamin B12 or folic acid deficiencies include not only standard anemic symptoms but also:
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Inflammation of the mouth (
stomatitis
).
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Inflammation of the tongue (
glossitis
), which involves shrinkage at the surface and edges of the tongue
Over time, psychiatric and neurologic problems develop. Vitamin B12 deficiencies cause neurologic symptoms (numbness and tingling, depression, memory loss, and irritability), and folate deficiency may result in depression and dementia (in severe cases).
Symptoms of Pernicious Anemia.
Early neurologic symptoms of pernicious anemia are due to B12 deficiency. They include numbness and tingling, depression, memory loss, and irritability. Advanced nerve damage can cause loss of balance and staggering, confusion, dementia, spasticity, loss of bladder control, and erectile dysfunction. Folic acid deficiency does not cause neurologic damage, although people with this deficiency can be irritable, forgetful, and experience personality changes. Of concern for patients with pernicious anemia and B12 deficiency anemia is that folic acid supplements can mask the presence of this disease in its early stages but not cure it. The only cure is vitamin B12 supplementation.
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Review Date: 1/17/2007
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Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital
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