What is Anemia? Symptoms, Causes, and Best Treatments

Anemia is a condition in which your blood lacks enough healthy red blood cells to carry an adequate amount of oxygen to your body's tissues. Often announcing itself through weakness, shortness of breath, and unrelenting fatigue, this condition can seriously lower your daily quality of life if left untreated. A lack of essential building blocks that your body needs, such as iron or vitamin B12, is the most common source of this problem.

• Anemia occurs when the amount of hemoglobin—the protein that carries oxygen in your blood—drops below normal levels.
• The most common type worldwide and in society is iron deficiency anemia.
• Fatigue, pale skin, feeling unusually cold, and heart palpitations are the most common and earliest noticed symptoms.
• A simple complete blood count (CBC or hemogram) test is usually sufficient for a diagnosis.
• The primary goal of treatment is to replace the missing vitamin or mineral and resolve the underlying cause.

What is Anemia?

The simplest answer to the question of what anemia is, is that your body's organs and tissues are not receiving the oxygen they need. The oxygen-carrying protein found inside red blood cells is called hemoglobin. When hemoglobin levels fall below specific reference ranges for women, men, and children, tissues are deprived of oxygen and therefore cannot produce energy. This leaves you feeling completely exhausted, even when doing simple daily chores.

The disease usually progresses slowly and silently. To adapt to decreasing oxygen levels, the body tries to close the gap by making the heart work faster. While this compensatory mechanism works for a while, the clinical picture becomes obvious once your body's reserves are completely depleted. This condition, which can be seen in all segments of society, is especially common in growing children, women of childbearing age, and older adults.

Iron Deficiency Anemia

This is the most common type of anemia both globally and here in Türkiye. The bone marrow needs iron to produce enough hemoglobin. When there is not enough iron in the body, healthy red blood cells cannot be produced. This situation usually stems from a poor diet, blood loss, or absorption issues.

Vitamin B12 and Folic Acid Deficiency Anemia

Vitamin B12 and folic acid (vitamin B9) are critically important for red blood cells to mature healthily. When these vitamins are deficient, the cells become abnormally large and dysfunctional. Insufficient consumption of animal products or absorption defects in the gastrointestinal tract frequently pave the way for this condition.

Causes and Risk Factors of Anemia

Many different factors can play a role in the onset of anemia. Fundamentally, the problem is either that the body cannot produce enough red blood cells, the produced cells are destroyed faster than normal, or there is ongoing blood loss. Accurately identifying the underlying cause is the first and most crucial step toward a permanent cure.

Hidden bleeding, especially in the stomach and intestinal tract, can slowly drain your body's iron stores because it often goes unnoticed for a long time. In women, the physiological processes of the reproductive years significantly increase the need for iron. Additionally, certain chronic diseases can suppress the bone marrow's blood production capacity.

The main causes and risk factors leading to anemia include:

• Hidden or obvious gastrointestinal bleeding caused by stomach ulcers, intestinal polyps, or hemorrhoids.
• Heavy and prolonged menstrual periods in women.
• Monotonous dietary habits lacking in iron, vitamin B12, and folic acid.
• Chronic diseases that affect blood production, such as kidney failure, rheumatoid arthritis, or cancer.
• Increased blood volume during pregnancy and the rising iron demand for the baby's development.
• Conditions that impair nutrient absorption, such as Celiac disease, Crohn's disease, or previous gastric surgeries.

What Are the Symptoms of Anemia?

Anemia symptoms vary depending on the severity of the disease, how quickly it develops, and the person's overall health. In the initial stages, symptoms are so mild that many people attribute them to the stress of daily life or the fast-paced working tempo of a bustling city like Istanbul. However, as stores empty and blood hemoglobin levels drop, the symptoms reach a level that makes daily life difficult.

When adequate oxygen does not reach body tissues, the brain and muscle tissues are the first to react. You might find it hard to wake up in the morning and feel a constant sense of sleepiness throughout the day. In later stages, the heart has to pump more blood to compensate for the reduced oxygen, which brings about complaints of palpitations and shortness of breath.

Symptoms of Iron Deficiency

Particularly in cases developing due to the depletion of iron stores, certain specific signs are more prominent. Common symptoms of iron deficiency include:

• Constant weakness, fatigue, and loss of energy that do not improve with rest.
• Shortness of breath felt even when climbing stairs or taking a light walk.
• Dizziness, blackouts, and loss of balance when standing up suddenly.
• Noticeable paleness in the skin, inside the lips, on the gums, and in the nail beds.
• A constant feeling of coldness in the hands and feet, which becomes even more pronounced during the winter months.
• Unexplained heart palpitations and a feeling of pressure in the chest area.
• Hair loss, dull-looking hair, and easily broken or deformed nails (spoon nails).

How is Anemia Diagnosed?

To diagnose anemia at the hospital, your physician will first take a detailed medical history and perform a physical examination. When your complaints started, your dietary habits, the medications you use, and whether there are similar diseases in your family will be evaluated. Laboratory tests are then used for a definitive diagnosis and to determine the underlying cause.

In the first step, a complete blood count (CBC or hemogram) is requested. This test measures the number, size, and shape of red blood cells, as well as the amount of hemoglobin in the blood. If anemia is detected, levels of ferritin (iron stores), serum iron, iron-binding capacity, vitamin B12, and folic acid are checked to determine the specific type. Additionally, a peripheral smear test may be performed to examine the structure of red blood cells under a microscope.

If blood tests reveal an iron deficiency but no obvious cause (such as dietary deficiency or heavy menstrual bleeding) can be found, your doctor will want to investigate potential sources of hidden bleeding. In this case, imaging methods like endoscopy and colonoscopy may be necessary to examine the stomach and intestinal tract.

How is Anemia Treated?

Anemia treatment is planned entirely according to the underlying cause of the disease and the severity of the condition. Simply raising blood values is not enough; unless the fundamental factor creating the problem is eliminated, the disease will recur. The treatment process usually takes a few months, as it takes time for depleted stores to refill.

For iron deficiency, oral iron pills or syrups are usually prescribed. To increase the absorption of these medications, it is recommended to take them on an empty stomach and alongside foods containing vitamin C. Since dairy products, tea—including our beloved traditional Turkish black tea—coffee, and stomach-protecting medications impair iron absorption, you should leave a time gap of at least two hours between consuming these products and taking your medication. For patients who cannot tolerate oral treatment or have absorption issues, intravenous (IV) iron supplements can be administered.

For vitamin B12 deficiency, if the problem stems from an absorption defect in the stomach, lifelong intramuscular injection treatments may be planned. In the case of folic acid deficiency, successful results are achieved in a short time with oral supplements. For anemias linked to chronic diseases, the primary approach is to bring the main disease under control.

What is Good for Anemia?

Alongside medical treatment, making changes to your dietary habits speeds up the healing process and prevents the disease from recurring. The answer to what is good for anemia lies in consuming the right foods in the right combinations. You should make more room on your table for foods that support iron absorption.

The main foods recommended to combat anemia include:

• Animal-based foods high in iron, such as red meat, liver, and spleen.
• Dark leafy greens like spinach, chard, broccoli, and black cabbage.
• Snacks such as dried black grapes, dried figs, prunes, and dried mulberries.
• Carob molasses (keçiboynuzu pekmezi), grape molasses, and tahini, which are classic staples of a Turkish breakfast.
• Vitamin C sources like oranges, lemons, tomatoes, and red peppers consumed alongside meat and vegetable dishes to increase iron absorption.

Complications and Risk Groups

When anemia is left untreated, the body's oxygen balance is disrupted, paving the way for serious health problems, known as complications. A constant state of fatigue can make it impossible for a person to maintain their work and social life. The heart constantly exerts more effort than normal to deliver enough oxygen to the tissues. Over time, this can lead to heart rhythm disorders (arrhythmias), an enlarged heart, and even heart failure.

Severe anemia during pregnancy increases the risk of premature birth and can lead to the birth of low-weight babies. Furthermore, long-term iron deficiency in children can cause growth retardation and a slowdown in mental development. During seasonal transitions, if you are wondering why vitamin deficiencies increase after summer, you should know that sudden changes in diet and decreased consumption of fresh fruits and vegetables accelerate this process.

On the other hand, advanced vitamin B12 deficiency deeply affects not only the blood profile but also the nervous system. Severe nerve damage developing due to B12 deficiency can lead to numbness, tingling, and loss of strength, which can sometimes be confused with spinal diseases; in these cases, coordinated work with the specialists of our hospital's Neurosurgery department ensures an accurate differential diagnosis and neurological evaluation.

When to See a Doctor?

While weakness and fatigue do not always mean anemia, if you feel an exhaustion that does not pass with rest and restricts your daily life, you should definitely consult an internal medicine specialist. Medical support should be sought without delay, especially if you notice blood in your stool, have black-colored stools, or if women experience menstrual bleeding that is much heavier and lasts longer than normal.

In some cases, the clinical picture of anemia can become severe enough to require emergency intervention. If you experience symptoms such as sudden severe chest pain, a feeling of being unable to breathe even while resting, fainting (syncope), or confusion, you must take the situation seriously and call 112 immediately to reach the nearest hospital's emergency department.

Diagnosis and Treatment Process at BHT CLINIC

At the Internal Medicine department of BHT CLINIC İstanbul Tema Hastanesi, our patients presenting with complaints of anemia are evaluated with a holistic approach. Thanks to our modern laboratory infrastructure, blood counts and vitamin-mineral panels are finalized quickly, and all endoscopic and radiological imaging required to identify the underlying cause can be safely performed in the same center. In cases of bleeding or severe anemia requiring urgent intervention, our 24/7 emergency department offers uninterrupted medical support.

During the treatment process, as you regulate your dietary habits, you will also be asked to pay attention to your tea and coffee consumption. To avoid impairing iron absorption, you can get the answer to how much coffee to consume and receive a personalized nutrition program from our expert dietitians. Bringing any previous blood test results with you when you come to our hospital will contribute to a faster progression of your diagnostic process.

Frequently Asked Questions

Does anemia cause weight gain?

Anemia does not directly cause weight gain; however, the constant fatigue and weakness it causes can reduce your physical activity, thereby lowering your calorie expenditure. Additionally, iron deficiency can slow down your metabolic rate. These indirect effects can make it harder to lose weight or pave the way for weight gain.

Does anemia cause headaches?

Yes, anemia can cause headaches. When adequate oxygen cannot be carried to the brain, blood vessels in the brain expand (vasodilation). This situation leads to throbbing headaches and dizziness, which are especially common in iron deficiency anemia.

Does anemia make you feel cold?

Red blood cells play an important role in regulating body temperature. A lack of adequate oxygen reaching the tissues affects blood circulation, especially in extremities like the hands and feet. For this reason, people suffering from anemia experience a constant feeling of coldness in their hands and feet, even in warm environments.

Does anemia in pregnancy harm the baby?

Severe and untreated anemia during pregnancy can negatively affect the development of the baby in the womb. It increases the risk of premature birth, low birth weight, and postpartum infections for the mother. Therefore, it is of great importance to have regular blood tests during pregnancy and to use iron supplements under a physician's supervision.

Do tea and coffee cause anemia?

The tannins and polyphenols found in tea and coffee seriously inhibit the absorption of iron from the intestines, especially plant-based iron. While they do not directly cause anemia, when consumed with or immediately after meals, they make it difficult for iron stores to fill up. It is recommended to consume these beverages at least one hour after meals.

We wish you healthy days. For appointments and detailed information, you can visit our website or contact our call center.

This article is for informational purposes only; please be sure to consult your physician for diagnosis and treatment.