What Causes Anemia?

The body needs red blood cells to survive. Red blood cells contain hemoglobin, a complex protein containing iron molecules. Hemoglobin molecules carry oxygen from the lungs to the rest of the body. Anemia occurs when there are not enough red blood cells in the blood. Certain diseases and conditions can cause a decrease in the number of red blood cells. There are many types of anemia, and there is no single cause. Pinpointing the exact cause can sometimes be difficult. So what causes anemia? The causes of anemia can be listed as follows:

  • Inability to produce enough red blood cells in the body
  • Increased loss of red blood cells due to bleeding
  • Destruction of red blood cells in the body in a shorter time than normal



Different types of anemia have different causes. Some of the causes related to the different types of anemia include:

1- Iron deficiency anemia: Iron deficiency anemia is the most common type of anemia. Iron deficiency anemia is caused by a shortage of iron in the body. The bone marrow needs iron to make the hemoglobin that red blood cells need. Without enough iron, the hemoglobin required for the production of red blood cells cannot be produced. This type of anemia occurs in many pregnant women who do not take iron supplements. Also, heavy menstrual bleeding, stomach ulcers, and cancer can cause iron deficiency anemia.

2- Anemia due to vitamin deficiency: Besides iron, the body needs folate and vitamin B12 to produce enough healthy red blood cells. A diet deficient in these vitamins can result in decreased red blood cell production. Also, some people who take adequate amounts of B12 have trouble absorbing the vitamin in the intestines. This malabsorption can lead to vitamin B12 deficiency anemia, also known as pernicious anemia.

3- Anemia of chronic disease: Some inflammatory diseases such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, and Crohn's disease can inhibit the production of red blood cells.

4- Aplastic anemia: Aplastic anemia is a rare but life-threatening type of anemia. It occurs when the body does not produce enough red blood cells. Causes of aplastic anemia include infections, certain medications, autoimmune diseases, and exposure to toxic chemicals.

5- Anemia due to bone marrow disease: Various diseases such as leukemia and myelofibrosis can cause anemia by affecting blood cell formation in the bone marrow. The effects of these types of cancers and cancer-like disorders can be mild or life-threatening.

6- Hemolytic anemias: Hemolytic anemias occur when the breakdown of red blood cells is faster than their production. Some blood disorders increase red blood cell destruction. Hemolytic anemia may be inherited from parents or may appear later.

7- Sickle cell anemia: Sickle cell anemia is an inherited type of hemolytic anemia. It is caused by a faulty form of hemoglobin that results in an abnormal sickle shape of red blood cells. These abnormally shaped blood cells die prematurely. This causes a chronic shortage of red blood cells.

8- Anemia due to chronic lead poisoning


What are the symptoms of anemia?

Symptoms of anemia vary depending on the type and severity of anemia and underlying health problems such as bleeding, stomach ulcers, menstrual problems, or cancer. Specific signs of underlying problems can often be noticed before symptoms related to anemia. The body also has an extraordinary ability to compensate for the early symptoms of anemia. If the anemia is mild or develops slowly over a long period of time, no symptoms may go unnoticed. Symptoms common to many types of anemia include:

  • Easy fatigue and loss of energy
  • An unusually fast or irregular heartbeat, especially with exercise
  • Shortness of breath
  • Chest pain
  • Headache
  • Dizziness
  • Pale skin
  • Cramps in the legs
  • Insomnia

Some forms of anemia can have specific symptoms. These symptoms can be listed as follows:

Iron deficiency anemia: The desire to eat strange substances such as paper, ice, or soil; the upward curvature of the nails called spoon nails, cracks in the corners of the mouth

Vitamin B12 deficiency: tingling and numbness in the hands or feet, loss of sense of touch, staggering or difficulty walking; stiffness in the arms and legs, clumsiness, dementia
Anemia due to chronic lead poisoning: Blue-black line on the gums, abdominal pain, constipation, vomiting

Hemolytic anemia (anemia caused by chronic red blood cell destruction): Jaundice (yellowing of the skin and eyes), brown or red urine, sores on the legs, developmental delay in infancy, symptoms due to gallstone formation

Sickle cell anemia: Fatigue, susceptibility to infections, delayed growth and development in children, episodes of severe pain especially in the joints, abdomen and limbs

Aplastic anemia: fever, frequent infections, and skin rashes

Folic acid deficiency anemia: irritability, diarrhea, and a smooth tongue


High-risk groups to develop anemia?

Anyone can develop anemia, although the following groups have a higher risk:

  • Women: Blood loss during menstruation and childbirth can cause anemia. This is especially true if you have heavy menstrual periods or a condition such as fibroids.
  • Children aged 1 to 2 years: During growth spurts, the body needs more iron.
  • Babies: Babies can get less iron when they switch from breast milk or formula to solid formula. The iron in solid foods is not as easily taken up by the body.
  • People over 65: People over 65 are more likely to have iron-poor diets and certain chronic diseases.
  • People using blood thinners: These drugs include aspirin, clopidogrel, warfarin, heparin products, apixaban, betrixaban, dabigatran, and edoxaban.


How Is Anemia Diagnosed?

Anemia is diagnosed with blood count tests. These tests measure the number of red blood cells in the body, the amount of hemoglobin, and the hematocrit (percentage of red blood cells) values. If these values are low, anemia is considered, and more detailed examinations are performed.

In order to diagnose anemia, the amount of iron stored in the body is also measured. Iron plays an important role in the production of red blood cells in the body, and getting enough of it reduces the risk of anemia. Low iron stores are an indication that you may have anemia.

In order to diagnose anemia, the level of certain hormones in the body is also measured. For example, the level of thyroid gland hormones is measured, and this is important as thyroid gland disorders can be one of the causes of anemia.



Anemia has many causes and treatment is determined by the cause. Iron supplementation is used to restore adequate blood production in the treatment of anemia caused by iron deficiency. Anemia caused by chronic diseases should be treated. In cases of very severe anemia, hospitalization and blood transfusion (transplant) may be required. The decision to do so; The duration of anemia is affected by a wide variety of factors, such as the patient's age and previous illnesses.


In cases where anemia is not treated, results such as heart enlargement and heart failure may occur due to iron deficiency. Shortness of breath occurs, and the lungs begin to strain. Since the amount of oxygen reaching the tissues and muscles decreases, internal organs, fatigue in the muscles, and numbness can be seen. Forgetfulness may also occur.

Is anemia genetic?

The answer to this question varies according to the type of anemia. Some types of anemia are inherited through generations, while others develop later.

Hereditary anemias are caused by genetic mutations that affect the production or function of red blood cells. Examples of hereditary anemias include sickle cell anemia, thalassemia, and hereditary spherocytosis. 

Acquired anemias, on the other hand, are not related to genetics and are caused by other factors such as nutritional deficiencies, chronic diseases, or medication side effects.

It's important to note that while some forms of anemia may have a genetic component, not all cases of anemia are hereditary or genetic. Many cases of anemia are related to other factors, such as poor nutrition or chronic diseases.