10 Causes of Anaemia – When to Worry, and When to See a Doctor

10 Causes of Anaemia – When to Worry, and When to See a Doctor

A sickle cell disease (SCD; see below) blood film is a peripheral blood smear examined under a microscope to diagnose and monitor sickle cell disease. Key findings include the presence of characteristic sickle cells, which are crescent or sickle-shaped red blood cells with pointed ends.

What is Anaemia?

It is a group of conditions where the body has a lower than normal number of red blood cells or the red blood cells do not have enough haemoglobin (Hb), leading to insufficient oxygen delivery to tissues.

In other words, it is a syndrome (group of diseases, each with a cause) not a specific diagnosis. You need to find out the cause – i.e why the patient has anaemia, as the treatments are quite different.

A normal haemoglobin level in a man and woman

• 130-170 g/L for a man
• 110-150 g/L for a woman.

What level of haemoglobin implies you have anaemia?

• Under 130 g/L for a man
• Under 110 g/L for a woman.

• What it is: A group of causes of anaemia, where the body lacks sufficient iron to produce haemoglobin. It is usually caused by chronic bleeding (either from the GI tract, or uterus (womb) in a woman; over the age of 30y, the cause should be considered a cancer until otherwise proven). It has a cause that you need to identify. It is not a diagnosis in itself.
• Symptoms: Fatigue, weakness, pale skin, shortness of breath.
• When to worry: Persistent fatigue, weakness, or shortness of breath.
• When to see a doctor: Consult a doctor if symptoms persist or worsen over time.

• What it is: A group of causes of anaemia, caused by a lack of essential vitamins, such as vitamin B12 or folate. It has a cause that you need to identify.
• Symptoms: Fatigue, weakness, pale skin, neurological problems.
• When to worry: Persistent fatigue, weakness, or neurological problems.
• When to see a doctor: Consult a doctor if symptoms persist or worsen over time.

• What it is: A condition where chronic diseases, such as cancer, HIV or chronic kidney diseases (CKD), lead to anaemia. It has a cause that you need to identify.
• Symptoms: Fatigue, weakness, pale skin, shortness of breath.
• When to worry: Persistent fatigue, weakness, or shortness of breath.
• When to see a doctor: Consult a doctor if symptoms persist or worsen over time.

• What it is: An inherited (genetic) disorder that affects haemoglobin production. It is one cause of haemolytic anaemia. See the blood film above.
• Symptoms: Pain episodes, fatigue, jaundice, pale skin.
• When to worry: Severe pain episodes, fever, or shortness of breath.
• When to see a doctor: Seek immediate medical attention if symptoms worsen or if you experience severe pain episodes.

• What it is: An inherited (genetic) disorder that affects haemoglobin production. It is one cause of haemolytic anaemia.
• Symptoms: Fatigue, weakness, pale skin, jaundice.
• When to worry: Persistent fatigue, weakness, or jaundice.
• When to see a doctor: Consult a doctor if symptoms persist or worsen over time [4].

• What it is: A group of causes of anaemia where the bone marrow fails to produce blood cells. All are serious. The white count and platelets usually fall as well. It has a cause that you need to identify.
• Symptoms: Fatigue, weakness, pale skin, increased risk of infections.
• When to worry: Persistent fatigue, weakness, or increased risk of infections.
• When to see a doctor: Consult a doctor ASAP if bone marrow failure is a possibility.

7. Drugs Causes of Anaemia

• What causes it: Antibiotics (like cephalosporins and penicillin), NSAIDs (such as ibuprofen and diclofenac), levodopa, methyldopa, nitrofurantoin, and phenazopyridine. Other drugs, like chemotherapy drugs, chloramphenicol, anticonvulsants, and gold injections, can also lead to anaemia. It has a cause that you need to identify.
• Symptoms: Fatigue, weakness, pale skin, increased risk of infection.
• When to worry: Persistent fatigue, weakness, or increased risk of infection.
• When to see a doctor: Consult a doctor soon if symptoms persist or worsen over time; especially if may be related to a drug started in the last 3 months.

Note. How do drugs cause anaemia? Via a range of mechanisms especially bone marrow failure, aplastic and haemolytic anaemia

• What it is: A condition that occurs during pregnancy due to increased iron demands.
• Symptoms: Fatigue, weakness, pale skin, shortness of breath.
• When to worry: Persistent fatigue, weakness, or shortness of breath.
• When to see a doctor: Consult a doctor if symptoms persist or worsen over time.

Note. Part of the cause of ‘anaemia’ in pregnancy, is an increase in blood volume (i.e. not a true anaemia). This is why it does not necessarily need to be treated.

• What it is: A rare group of causes of anaemia, where the bone marrow fails to produce blood cells. The white count and platelets may fall as well. It has a cause that you need to identify.
• Symptoms: Fatigue, weakness, pale skin, increased risk of infections.
• When to worry: Persistent fatigue, weakness, or increased risk of infections.
• When to see a doctor: Consult a doctor ASAP if bone marrow failure is a possibility.