Anemia is the most common alteration in blood hemoglobin levels. It features a reduction of hemoglobin below 13.5 grams per deciliter in men and 12 grams per deciliter in women. Anemia is experienced by patients differently depending on their physical health, their levels of physical activity, and both inner and outer elements such as nutritional state and altitude. Therefore, patients with a very low hemoglobin level may not display too many symptoms while another patient with low-grade anemia has many different alterations and symptoms. Thus, we can’t assume anything with anemia, and we may have it and yet feel nothing at all.
However, there are a series of signs and symptoms commonly experienced in patients with anemia, and they are as follows:
1-Pale skin
The blood contributes to the colouration of the skin because there are millions of minute blood vessels continuously circulating blood near the surface of the skin. These blood vessels contain red blood cells, which are filled with hemoglobin. Hemoglobin has a bright red colour when it contains oxygen, and gives your skin a reddish appearance that contributes to the normal tone of the skin. Conversely, patients with anemia reduce their circulating levels of hemoglobin and do not give the same reddish tone to the skin. It looks rather pale and whitish, and sometimes might turn a bit yellow and become difficult to differentiate from jaundice.
2-Brittle nails
In long-standing cases of iron deficiency and vitamin B12 deficiency, patients usually develop brittle and fragile nails. Both deficiencies are associated and coexist with anemia because iron is an essential part of the structure of hemoglobin and vitamin B12 is needed to produce new red blood cells. Therefore, patients with chronic anemia (low levels of hemoglobin in the blood for a very long time) are likely to develop brittle nails, especially when the condition is caused by nutritional problems.
3-Fatigue
Oxygen is essential to create energy from glucose and other energy sources. Similar to what happens in the lungs, there’s a place in the cell where oxygen is received, and the respiration process creates molecules called ATP. These ATP molecules speed up metabolic process and help us keep moving and thinking properly. A shortage of oxygen leads to an energy deficiency and both physical and mental tiredness that is maintained over a very long period of time. In most cases, the severity of this symptom increases as the circulating levels of hemoglobin are reduced.
4-Malaise
Patients with anemia usually feel a general sense of malaise. They feel unwell, tired and lightheaded. They are more susceptible to various infections and other conditions, especially if they have a nutritional deficiency. Anemia is often accompanied by other diseases, and it may result from health conditions, including alcohol toxicity, bleeding stomach ulcers, kidney disease, or congenital problems affecting our red blood cells.
5-Lightheadedness
Since there is a shortage of energy, patients commonly feel lightheaded or dizzy when they suffer from anemia. This is because the oxygen supply to the brain is reduced, and this organ requires a great deal of oxygen and ATP to function correctly. Therefore, patients may have a series of neurologic symptoms starting with dizziness and fainting, especially when there are other nutritional deficits coexisting with anemia. A pale patient who fainted might not have anemia but hypoglycemia, which is a temporary alteration in blood readings. Therefore, if you find any of these symptoms in yourself or any other, you should not immediately think about anemia without getting a lab test done.
6-Rapid heartbeat
The heart has impressive machinery that is automated to execute its functions and maintain the body in an optimal state. It detects low energy levels and low pulse that is common in anemic patients and tries to rebalance the problem by increasing the heartbeat to make up for the deficiency. Patients with anemia that is secondary to blood loss have a severe reduction in the circulating volume of blood, and the heart detects this alteration and tries to provide more oxygen to the body by moving faster the volume of blood that is left, thus leading to a rapid heartbeat.
7-Breathing difficulty
In severe cases of anemia, patients may also have breathing difficulties and feel shortness of breath. This is because similar to the heart, the lungs enter into a compensatory phase trying to make up for the low levels of oxygen in the blood. Low oxygen is perceived by the brain centers, and they give a signal to the lungs to make it work harder. Thus, patients feel as if they were not breathing properly when, in reality, this is not a real problem. The symptoms will be aggravated or triggered during intense physical activity and activities such as lifting the stairs or carrying heavy weight.
8-Low endurance in exercise
Depending on the severity of anemia, patients may feel restless and tired after performing light physical activity or intense bouts of exercise. Endurance depends on various factors, including how accustomed your body is to perform physical activity, your nutritional levels, and many other things. However, if you detect a sudden change in your physical endurance, it is a good idea to talk to your doctor about your symptoms. He might need to rule out cardiovascular causes, anemia, and many other alterations.
9-Muscle soreness and muscle cramps
Anemia has various signs and symptoms associated with physical activity and muscle function, including muscle cramps. When anemia is severe, and there is a significant reduction in the transport of oxygen, the muscle becomes unable to use energy the same way and might start to use an alternate metabolic way that does not require oxygen but leads to the formation of lactic acid. This substance starts accumulating and causes the known muscle soreness associated with exercise.
10-Concentration problems
Nutrients and oxygen are essential for the normal function of the brain, including processing thoughts, creating and recalling memories, and the capacity of focus and concentration. Thus, patients with anemia might also display a series of cognitive deficiencies that include concentration problems. It is more common in severe cases of anemia and chronic anemia and might be associated with nutritional deficits. This is why it is important to assess the nutritional state of children and adolescents because it is a common cause of poor performance at school.
11-Headache
Another common symptom of anemia is a headache, and it is even more common than low concentration problems. Low oxygen levels in the brain trigger a dilatation of blood vessels as a way to increase the circulating levels of oxygen in the brain. Dilatation of blood vessels in the brain is the same way migraines are formed. They start pounding against the outer linings of the brain where the pain sensation is felt and trigger a headache. Keep in mind that there are many other causes of headaches, and it is a rather common symptom that requires medical attention to trace the cause.
12-Seizures
Seizures are small shortcuts in the brain signalling that often manifest as jerking movements and loss of consciousness. However, this is only one type of seizure, and there are many other, often underdiagnosed. In some patients, especially children, very low levels of hemoglobin in the blood may contribute to fever-induced seizures. The exact mechanism of seizures is not always known, and chronic anemia is another risk factor in developing this symptom.
13-Insomnia
Many patients with anemia experience insomnia or difficulty to get asleep. There are many different mechanisms proposed to explain the link between anemia and insomnia. One of them is that fatigue makes the patient stay indoors for a longer time, reducing their exposure to sunlight and altering his circadian rhythms and the normal timing of sleep. Regardless of the cause, insomnia might also result from other nutritional deficiencies and health problems associated with anemia, or it might be a completely different symptom pointing out to an overlapped health condition. Thus, it is important to ask your doctor about your symptoms and not trying to solve it by yourself without professional help.
As you have seen, there are many signs and symptoms beside the common headache, fatigue, and lightheadedness. You will probably not have them all because some of them are only found in very severe cases, but having two or three symptoms and feeling that there is something wrong with your body is enough to go to your doctor and ask him about your symptoms.
Anemia is a common health condition, and most people know it is associated with nutritional deficiencies. Therefore, the first thing people might be tempted to do if they have anemia is using vitamin supplements, and they may help sometimes. However, there are different types of anemia, and not all of them respond to the same vitamins or supplements. Some would not be affected at all by supplements. So, the best idea is to talk to your doctor and give him your lab report. In analyzing the numbers in your report, he will have a better idea as to what type of anemia is affecting you and how to fix it. He might also need to run additional tests according to your symptoms if there is an underlying condition that might be contributing to anemia.