Anemia: What to watch for and what to do

Anemia means your blood carries less oxygen than it should. You might feel tired, weak, short of breath, or lightheaded. Sometimes the only sign is low energy that won’t go away. Knowing the likely causes and simple steps to fix it can save time and worry.

What causes anemia?

The common types are iron-deficiency anemia, vitamin B12 or folate deficiency, anemia of chronic disease, and blood loss. Iron deficiency usually comes from not enough iron in the diet, heavy periods, or slow internal bleeding (for example, from the gut). B12 and folate shortages come from poor absorption or not eating enough of those nutrients. Chronic illnesses — like kidney disease or inflammatory conditions — can also lower your red blood cell count.

Symptoms overlap: tiredness, pale skin, rapid heartbeat, shortness of breath with activity, headaches, and cold hands or feet. Older adults may notice confusion or falls. If you have these symptoms, testing is the next step.

Practical steps: testing, diet, and treatment

Start with simple blood tests: a CBC (complete blood count) checks hemoglobin and MCV (average red blood cell size). Ferritin and TIBC help find iron deficiency. If MCV is high, doctors check B12 and folate. A reticulocyte count shows if your bone marrow is making new cells. Your doctor may order stool tests or scopes if bleeding is suspected.

Diet helps but often isn’t enough alone. Eat iron-rich foods: red meat, chicken, fish, beans, lentils, tofu, and fortified cereals. Pair plant-based iron with vitamin C (orange juice, bell peppers) to boost absorption. Avoid drinking coffee or tea with iron-rich meals and keep calcium or antacids two hours away from iron pills.

Oral iron supplements are the usual first-line treatment. A common supplement is ferrous sulfate (one 325 mg tablet contains about 65 mg elemental iron). Many people take one tablet once or twice daily; your provider will set the dose. Expect dark stools, nausea, or constipation at first—these are common. If pills cause bad side effects, talk to your clinician about lower doses, alternate-day dosing, or different iron forms.

For B12 deficiency, high-dose oral B12 or injections are effective depending on the cause. Folate supplements are simple and fast. If anemia is from chronic disease or severe blood loss, treatment focuses on the underlying condition and sometimes involves IV iron or transfusion in urgent cases.

Seek immediate care if you have chest pain, fainting, severe shortness of breath, or very rapid heartbeat. For mild to moderate symptoms, follow-up with your primary care provider for testing and a treatment plan. Small changes—checking labs, adjusting diet, and starting the right supplement—often make a big difference in weeks.

Want clear guides on tests or what a specific supplement does? Browse our medication and condition pages for practical, no-nonsense info you can use in a doctor’s visit.