Better Me

Feeling Tired and Weak? You Could Have Anemia.

Feeling tired and exhausted even after a good night’s rest? Anemia could be the reason.

Anemia is one of the most common blood conditions in the United States that develops when you have a low red blood cell count or your hemoglobin (iron-rich protein) is less than normal.

Hemoglobin carries oxygen and delivers it throughout your body. If you have anemia, your lungs, tissues and organs won’t get enough oxygen, which can cause you to feel tired and weak.

In fact, half of the three million Americans living with anemia report feeling overtired—so you aren’t alone.


“There are many different causes of anemia, “said Jennifer Nelson, DO, an internal medicine physician at Banner – University Medicine Internal Medicine Clinic. “Women and those with chronic diseases are at the greatest risk for anemia, but it can affect anyone.”

According to the National Institutes of Health’s National Heart, Lung and Blood Institute, there are more than 400 types of anemia. Different forms of anemia have different causes. Some of these include:

  • Iron-deficiency anemia: This common type of anemia, especially in women, is when your body has a shortage of iron. Without adequate iron levels, your body won’t produce enough hemoglobin for red blood cells. This can occur in pregnant women or through blood loss—such as from heavy periods, ulcers and GI issues and other vascular abnormalities.
  • Vitamin-deficiency anemia (pernicious anemia): Your body also needs folate and vitamin B12, so if you have a diet lacking in these three key nutrients, you also won’t produce enough healthy red blood cells. This is often seen in patients who have dietary restrictions, such as veganism.
  • Chronic inflammatory anemia: Certain diseases such as kidney disease, rheumatoid arthritis, Crohn’s disease, autoimmune diseases and other inflammatory diseases can interfere with red blood cell production.
  • Hemolytic anemia: This occurs when the red blood cells are destroyed prematurely. You might have this condition at birth or later in life.
  • Aplastic anemia: A rare bone marrow failure disorder aplastic anemia can occur as a result of the destruction or deficiency of blood-forming stems cells in your bone marrow.
  • Genetic abnormalities: Inherited conditions like sickle cell anemia, alpha and beta thalassemia and hereditary spherocytosis can prompt the body to destroy red blood cells.

Am I anemic?

“For patients with healthy cardiovascular systems, they will not have symptoms of mild anemia,” Dr. Nelson said. “It’s often not until the anemia becomes more severe that we see more visible signs, such as fatigue and pale skin.”

Depending on the cause, you might not have symptoms. If they do occur, symptoms of anemia include:

  • Fatigue and exhaustion
  • Weakness
  • Shortness of breath
  • Cold hands and feet
  • Unhealthy, pale complexion
  • Lightheadedness or dizziness
  • Brittle nails
  • Chest pains


Similar to the symptoms, treatment of anemia also depends on its cause. Your doctor will run a blood test known as a complete blood count (CBC) to look at components of your blood: red blood cells, white blood cells and platelets. This will give your doctor additional information about the size and shape of your red blood cells and help the doctor determine the type of anemia to be concerned about and what further testing may be necessary.

What happens if my anemia is left untreated?

“Depending on the severity of the anemia, how rapidly it developed and the cause, if left untreated, it can have serious, life-threatening complications,” Dr. Nelson said. “When you don’t have enough red blood cells, your heart has to work harder to get enough oxygen to your organs. It can lead to pregnancy complications and hypovolemia, which can cause cardiac stress, heart failure, myocardial infarction, shock and even death.”

Can anemia be prevented?

Many types of anemia cannot be prevented, although eating healthy, iron-rich foods high in B12 and folic acid and taking iron supplements prescribed by your provider can help prevent iron- and vitamin-deficient anemias.

Dr. Nelson added, “If you follow any specific dietary restrictions, discuss with your doctor so they can monitor you for signs of deficiency and help you supplement your diet to prevent them.”

When should I see a doctor?

If you suspect you have any of the causes or symptoms of anemia, schedule an appointment to speak with your primary care physician.

To find a Banner Health specialist, visit

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