Anaemia – an overview

About anaemia

Anaemia is a condition that affects your blood. Your blood is made up of fluid called plasma and blood cells, which include:

  • red blood cells (erythrocytes) that contain haemoglobin
  • white blood cells (leucocytes) that are part of your immune system and help fight infection
  • platelets (thrombocytes) that are tiny fragments of cells that help your blood clot

Blood cells are made by your bone marrow, which is a spongy substance in the centre of your bones.

There are different types of anaemia, which are categorised by their cause. These include:

For more information on specific types of anaemia, see Related topics.

Symptoms of anaemia

Common symptoms of anaemia include:

  • feeling tired
  • feeling short of breath
  • feeling your heart racing or thumping, which is called palpitations

These symptoms may be caused by problems other than anaemia. If you have any of these symptoms, see your GP for advice.

Complications of anaemia

If you have anaemia, your heart has to work harder to get oxygen to your vital organs. If you don't get treatment, this may lead to problems with your heart and lungs. There are other complications related to specific types of anaemia. For more information, see Related topics.

Causes of anaemia

There are many possible causes of anaemia. Most fall into the following four groups.

  • Anaemia caused by bleeding. You can lose a lot of blood through an injury or from having an operation, for example. If you have prolonged or heavy periods, this can also lead to anaemia. These types of bleeding are usually obvious. However, sometimes bleeding can happen quite slowly and you may not be aware of it. For instance, bleeding from a stomach ulcer or from within your bowel.
  • Your body may not make enough healthy red blood cells and/or haemoglobin. This may happen if you don't get enough of the nutrients in your diet that you need to make the red cells. These nutrients include iron, vitamin B12 and folate. It can also happen if you have a health condition that stops your body absorbing nutrients, such as coeliac disease.
  • Your body may have a problem with the normal production of red blood cells. This can happen, for example, if you have kidney disease or a problem with your bone marrow. Anaemia associated with other conditions such as these is known as anaemia of chronic disease.
  • Your body may destroy its own red blood cells prematurely, which is called haemolytic anaemia. Red blood cells usually survive for about 120 days before they are broken down and replaced but in haemolytic anaemia, the breakdown happens too soon. Haemolytic anaemia can be caused by an inherited condition, such as thalassaemia, or you can develop it after certain infections, such as meningitis. You can also develop this type of anaemia if your body produces antibodies against your own red blood cells (autoimmune haemolytic anaemia).

Diagnosis of anaemia

Your GP will ask about your symptoms and examine you. He or she may also ask about your medical history. If your GP suspects you have anaemia, he or she will ask you to have a blood test. Your blood will be sent to a laboratory for the following tests.

  • A full blood count. This is to check the level of haemoglobin in your blood and how many of each of the different types of blood cell you have.
  • A blood film test. This involves looking at your blood under a microscope to check the size and shape of your red blood cells. It will also assess the different white cells that are present.
  • Levels of vitamin B12, iron and folate.

You may need to have further tests to help identify the cause of your anaemia. Depending on the type of anaemia you have, your GP may refer you to a specialist.

Treatment of anaemia

The treatment you have will depend on the cause of your anaemia, and it can vary considerably from person to person. For example, some people may just need to adjust their diet and take supplements of iron, folic acid or vitamin B12. Others may need to have a blood transfusion. If you have anaemia caused by kidney failure, you may need to have injections of the hormone erythropoietin (also known as Epo).

Your GP or specialist will always treat the underlying cause of your anaemia before considering a blood transfusion.

Prevention of anaemia

You can reduce your risk of developing anaemia by eating a healthy, balanced diet. This supplies all the vitamins most people need. Only take supplements if your GP recommends it.

The best sources of iron and vitamin B12 are red meat and fortified foods, such as breakfast cereals and bread. Fortified means particular nutrients are added to the food during their manufacture. Dark green vegetables, dried fruit such as raisins, apricots and prunes, beans and lentils are all also good sources of iron. Dairy products such as eggs are also a good source of vitamin B12.

The best sources of folate are green vegetables, such as broccoli, Brussels sprouts, asparagus and peas. Chickpeas and brown rice are also good sources of folate.

If you have a condition that affects how well you absorb nutrients, or if you’re pregnant, you may need to take supplements. It may benefit you to take iron tablets if you're menstruating. Ask your GP for advice.


Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, December 2013.

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