Tired all the time? It could be a symptom of anemia

With demanding schedules and so much vying for our attention, it’s no wonder a third of healthy adults report feeling fatigued or sleepy. Ongoing fatigue results in having no energy or motivation, and it could also be a sign of something more serious, including anemia.
Anemia is a condition in which an individual lacks enough healthy red blood cells to carry adequate oxygen to tissues within the body. There are more than 400 types of anemia which are divided into three groups: Those caused by blood loss, those caused by decreased red blood cell production, and those caused by destruction of red blood cells.
Trisha Clevenger, RN, oversees infusion services at OSF HealthCare Saint Anthony’s Health Center and its Moeller Cancer Center in Alton, Illinois. As the sole provider of hematology services in the region, it can be a busy place.
Clevenger says a blood test is used to diagnose anemia. Symptoms vary depending on the cause. They include:
- Fatigue and weakness
- Dizziness, lightheadedness or feeling faint
- Fast or unusual heartbeat
- Shortness of breath
- Cold hands and feet
- Pain in bones, chest, belly and joints
- Skin that’s pale or yellow
- Problems with growth for children and teens
An estimated 5 million people in the U.S. have a simple iron deficiency that can be treated with oral supplements, but in some cases, individuals need intravenous (IV) infusions because iron supplements can cause gastrointestinal issues. Depending on what caused the deficiency, Clevenger says, treatment can be brief or ongoing.
“If it’s not strictly diet-related, many times for women it can be related to their menstrual cycle and how that affects their body. It can also be related to trauma or surgery, where there was increased blood loss. For many of those patients, once we’ve treated the acute issue, then the patient doesn’t see us except potentially on an as-needed basis.”
There are also genetic anemias such as sickle cell anemia, a chronic disease in which cells are shaped incorrectly and don’t function properly in the body. For a baby to be born with sickle cell anemia, both parents must carry the sickle cell gene. In the United States, sickle cell anemia most commonly affects African Americans.
“Those patients will be on multiple oral medications and monitoring very closely to keep them at a healthy level, watching their iron and their hemoglobin and helping them to stay as functional as possible.”
Sickle cell disease can result in painful episodes when sickle-shaped cells stick together and cause severe pain in the chest, stomach, arms and legs. It can also lead to infection, acute chest syndrome and stroke. The only cure is a bone marrow or stem cell transplant.
The second-most commonly treated anemia related to red blood cell production happens when a person doesn’t get enough vitamin B12, folate or both. It also happens when the body has trouble absorbing enough B12. Clevenger says the condition can be treated with B12 supplements, but it also requires regular monitoring.
“Many times we start with oral (medication) if possible, but if the oral isn’t tolerated or absorbed, then we do injections and then it’s just continuous monitoring. Most of those patients we will monitor every three months, and then of course they give us a call if they have issues and symptoms.”
Clevenger says anemia treatment plans often include dietary changes.
“A healthy diet (includes) non-processed foods; eating healthy, high-iron foods. If you’re not a meat eater, that’s ok. Spinach and beans will have the same amount of iron in them as any meats that we eat and more than some.”
A multi-vitamin can be useful but Clevenger says it’s not a replacement for a healthy diet. Before taking any supplements, it’s always best to consult with your primary care provider.