Anaemia: Causes, Symptoms, Haemoglobin Test and Treatment

7 min read · Conditions · By the Asthra Health Care team

What is anaemia?

Red blood cells carry oxygen from the lungs to every part of the body. They contain a protein called haemoglobin, which holds the oxygen. Anaemia means the level of haemoglobin in your blood is lower than normal for your age and sex. When this happens, the body's tissues get less oxygen, and you feel weak and tired.

Anaemia is very common in India, especially among women, adolescent girls, pregnant women and young children. It is not a disease on its own but a sign of an underlying problem. Finding and treating that cause is as important as raising the haemoglobin.

Common causes of anaemia

Iron deficiency is the most common cause. It happens when the body does not get enough iron from food, cannot absorb it well, or loses it through bleeding. Heavy periods, pregnancy, piles, stomach ulcers and worm infections are common reasons for iron loss in Indian homes.

Other causes include low vitamin B12 or folic acid, long-term illnesses such as kidney disease, inherited conditions like thalassaemia and sickle cell disease, malaria, and some medicines. In older adults, anaemia can be a sign of bleeding from the gut, which needs careful checking. Frequent blood donation without enough rest between donations can also lower iron.

Symptoms of anaemia

Mild anaemia may cause no symptoms. As it gets worse, symptoms usually build up slowly, so many people get used to feeling tired and do not seek help. Children with anaemia may seem less active, have a poor appetite and struggle to concentrate at school. Common symptoms include:

• Tiredness, weakness and low energy
• Breathlessness on climbing stairs or walking fast
• Pale skin, pale inner eyelids, nails and palms
• Dizziness, headache or a racing heartbeat
• Brittle or spoon-shaped nails and hair fall
• Craving to eat non-food items like mud, chalk or ice

Tests to find anaemia and its cause

A complete blood count (CBC) measures haemoglobin and the size of red blood cells. Small cells usually point to iron deficiency or thalassaemia trait, while large cells suggest vitamin B12 or folate deficiency. Your doctor may then order serum ferritin and iron studies to confirm iron deficiency, and vitamin B12 or folate levels if needed.

Depending on the findings, further tests may include a peripheral smear, a stool test for hidden blood or worms, haemoglobin electrophoresis for thalassaemia, and kidney or thyroid tests. Do not start treatment based only on a single haemoglobin number without knowing the cause.

How anaemia is treated

Treatment depends on the cause. Iron deficiency is usually treated with iron tablets or syrup, and sometimes an iron injection or drip when tablets are not tolerated, not absorbed, or when a quick rise is needed, such as late in pregnancy. Vitamin B12 or folic acid deficiency needs those vitamins instead. Heavy periods, piles or ulcers must also be treated to stop the loss.

Iron tablets can cause constipation, nausea and black stools; the black colour is expected. Keep iron out of reach of children, since an overdose is dangerous for them. People with thalassaemia should not take iron unless a doctor advises it. Follow your doctor's or pharmacist's advice on how long to continue.

Iron-rich foods and daily tips

A balanced diet helps prevent anaemia and supports treatment. Good sources of iron include green leafy vegetables like palak, methi, drumstick leaves and amaranth, dal, rajma, chana, sprouts, ragi, jaggery in moderation, eggs, fish, chicken and liver. Vitamin C from lemon, amla, guava or oranges helps the body absorb iron from plant foods.

Avoid tea and coffee with meals and for about an hour after, as they block iron absorption. Cook in iron vessels if you like, wash hands before eating, and deworm children as advised by health workers. Wear footwear outdoors to reduce the risk of hookworm infection, which enters through bare skin.

Pregnancy, children and older adults

Pregnant women need more iron and folic acid, and routine supplements are given in pregnancy under government and private antenatal care. Anaemia in pregnancy raises the risk of early delivery and a low-birth-weight baby, so blood tests and follow-up matter. Babies and young children need iron-rich weaning foods from six months.

In men and in women after menopause, anaemia always needs a search for the cause, as it may be the first sign of bleeding in the stomach or bowel. Speak to your doctor or pharmacist if you notice any symptoms of anaemia.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.