Understanding the Different Types of Anemia

There are many types of anemia, and the hematologists of Regional Cancer Care Associates (RCCA) can treat all these forms of anemia, as well as other hematologic conditions.

Let’s look at the different types of anemia, their symptoms and causes, and how they can affect a patient.

What Is Anemia?

The American Society of Hematology reports that anemia affects more than 3 million people in the United States. Routine blood tests can raise a red flag for the presence of anemia, such as by identifying a low hemoglobin level.  As the main protein in red blood cells, hemoglobin carries the oxygen necessary for normal body function. If hemoglobin levels fall too low, the lack of oxygen can weaken the function of tissues and organs.

Anemia can affect anyone, but women, children, and people with chronic diseases are more likely to develop this blood disorder. Just as there are several types of anemia (described below), there are also multiple causes for this condition.

What Are Causes of Anemia?

The most common type of anemia is iron-deficiency anemia, or IDA. This condition is usually caused by a diet low in iron or generally poor in nutrients. Some people are born with genetically influenced anemia, while those with a chronic disease can experience anemia as a side effect of an illness.

Pregnancy also can cause anemia. A pregnant woman can experience low hemoglobin counts and hematocrit values due to increasing blood volume, which can decrease the ratio of red blood cells present in the blood.

What Are the Symptoms of Anemia?

With mild anemia, symptoms can be almost unnoticeable, making it important to pay attention to even slight but persistent symptoms. People with anemia may experience:

• Fatigue, exhaustion, tiredness
• Feeling faint, dizzy, or lightheaded
• Pale or yellowing skin
• Rapid or slow heartbeat or other pulse irregularities
• Rhythmic noises in ears, such as pounding
• Headaches
• Sweating
• Increased thirst
• Cold hands and feet
• Pain in joints or bones
• Low leg cramps
• Discomfort or pain in the chest or belly
• Shortness of breath
• Weakness
• Low growth rates (children and teens)

Of course, symptoms such as fatigue or headaches can represent any number of conditions, or may reflect nothing more than working too hard or being stressed. While most people with these common complaints will not have anemia, all people who persistently experience the symptoms listed above, or whose symptoms are severe or occur with increasing frequency, should see their primary care provider promptly.

What Are the Types of Anemia?

Physicians use many approaches to categories the different types of anemia. One approach divides anemias into three broad categories:

• Nutritional: related to diet and digestion;
• Inherited: related to genetic conditions; and
• Abnormal red blood cells: related to the structure and function of cells in the blood.

Another approach classifies anemias as microcytic, normocytic, or macrocytic, with “cytic” being a medical term referencing a cell.  

Microcytic

Microcytic anemias, which occur when red blood cells lack hemoglobin, lead to the production of red blood cells that are smaller than normal. As a result, the red blood cells are unable to carry enough oxygen throughout the body to ensure vitality and health. Subtypes of microcytic anemia include:

• Iron deficiency: Marked by not enough iron in the diet or an inability to bind or digest iron;
• Thalassemia: a genetic condition that creates abnormal hemoglobin in the blood;
• Sideroblastic: A condition in which the bone marrow cannot produce healthy red blood cells, usually due to genetic inheritance, medication reactions, or exposure to toxins;
• Lead exposure: This can affect the formation of hemoglobin and red blood cells.

Normocytic

This type of anemia occurs when too few red blood cells are present. The size of the red blood cells is normal, but the overall number of those cells is not adequate.

Normocytic anemia often is associated with other conditions, such as a chronic disease that causes inflammation. Chronic diseases that increase the risk of developing normocytic anemia include:

• Autoimmune conditions
• Inflammatory bowel diseases
• Infections
• Cancers

Bone marrow disorders, such as cancers that affect red blood cell production, can also lead to normocytic anemia. Some patients can also develop aplastic anemia, in which the body reduces its production of new blood cells. Aplastic anemia is related to stem cell dysfunction and may occur in the setting of cancers, viral infections, radiation treatments, or toxic exposures.

Normocytic anemia can also develop due to conditions that cause hemolysis, the premature destruction of red blood cells (which normally live about 120 days). Hemolysis can result from inherited diseases, infections, or medication side effects. Loss of blood from menstruation, an injury or wound, or a gastrointestinal disorder are other possible causes.

Macrocytic

Larger-than-normal red blood cells are a hallmark of macrocytic anemias. These anemias often are related to nutritional factors. For example, megaloblastic anemia occurs when the body does not have enough vitamin B12 or folate. Some people experience an autoimmune condition called pernicious anemia because the body cannot process vitamin B12.

Non-megaloblastic anemia is another type of macrocytic anemia. It occurs when medical conditions prevent the absorption of nutrients required for red blood cell production. This includes alcohol use disorder, liver disease, hypothyroidism, and others.

Common Types of Anemia Treated

RCCA’s expert hematologists have the experience, skill, and diagnostic and therapeutic resources needed to treat a variety of anemias. Anemias frequently treated by RCCA’s hematologists include:

• Hemolytic anemias
• Sickle cell disease
• Thalassemia
• Drug-induced hemolytic anemia pyruvate kinase deficiency (PKD)
• Glucose-6-phosphate dehydrogenase (C6PD) deficiency
• Autoimmune hemolytic anemia (AIHA)
• Pregnancy-associated HELLP syndrome

Diagnosing Anemia

Symptoms such as tiredness, weakness, or shortness of breath could be temporary and harmless. But if these symptoms persist, they could warrant evaluation by a primary care provider.

In exploring the possible cause of those symptoms, a primary care provider typically will take a detailed personal history as well as a family history, perform a physical examination, and order tests, which usually will include a complete blood count, or CBC. This test includes measurement of hemoglobin and hematocrit, red blood cell count, and other hematologic indicators of health. Additional blood tests may also be ordered, such as measurement of vitamin B12 or B9 levels. 

Other blood tests and bone marrow tests may be ordered if initial findings suggest the presence of anemia or another serious condition. Once the diagnosis is confirmed, the primary care provider may refer the patient to a specialist, such as a hematologist at RCCA.

Anemia Treatments

Treatment of anemia is tailored to the specific type of anemia, its underlying cause, its severity, and the patient’s overall health.

Dietary changes often are recommended to boost the patient’s iron, vitamin B, and folic acid levels. Recommended foods may include:

• Leafy green vegetables, including chard, spinach, and kale
• Meats, fish, seafood, and tofu
• Eggs
• Iron-fortified cereals and breads
• Brown rice, beans, peas, and lentils
• Nuts and seeds
• Dried fruits, including raisins, prunes, and dates

For many patients with a more severe anemia, additional treatment may be needed. These treatments may include:

• Vitamin and mineral supplements, particularly iron supplements
• Oxygen therapy
• Infusion therapy to increase iron levels
• Blood transfusions
• Immunosuppressant drugs
• Bone marrow transplants
• Surgeries to address conditions causing internal bleeding

Living with Anemia

Depending on its cause, anemia may be curable or may be a chronic condition that has to be managed over the course of a person’s life. In either case, effective treatments are available – either to eradicate anemia or to enable patients to live with it in a way that preserves their health and quality of life.

Contact Hematology Services for Anemia Treatments

The expert, experienced hematologists of RCCA are here to help people manage their anemia. They provide compassionate, comprehensive care at RCCA’s 22 conveniently located community-based locations throughout New Jersey, Connecticut, Maryland, and the Washington, DC area. RCCA oncologists and hematologists see more than 26,000 new patients each year and provide care to more than 245,000 established patients, collaborating closely with their patients’ other physicians.

If you’re considering anemia treatment or need more information, contact us today.