Anaemia means the blood carries too little oxygen.
Red blood cells are full of haemoglobin, a red protein that picks up oxygen in the lungs and drops it off everywhere else. In anaemia there is too little haemoglobin, so every part of the body gets less oxygen, and the heart works harder to make up for it.
In plain words.
Haemoglobin below 13 g/dL in men, 12 in women and 11 in pregnancy counts as anaemia. It is very common in India, above all in women.
Anaemia is a sign, not a diagnosis: the real question is why. Low iron is the most common reason. Others are low vitamin B12 (common in vegetarians) or folate, blood loss (heavy periods, piles, a stomach ulcer, or hidden bleeding from the gut), worms, long-term illness such as kidney disease, and inherited conditions such as thalassaemia.
In a man, or in a woman after her periods have stopped, low iron with no clear reason must be looked into for slow bleeding from the stomach or bowel.
Iron tablets often turn the stools dark green or black, and that is harmless. Stools that are black, sticky, tar-like and foul-smelling, above all with dizziness, are different: see the red box below.
How blood carries oxygen
Plenty of red cells flow past, each loaded with oxygen, drawn in blue. They hand it over to the body’s cells, which use it to make energy.
Fewer red cells, and in low iron smaller and paler ones, carry less oxygen. The cells are short of fuel, and the heart beats faster to push more blood round.
Go to hospital now if
- Breathless at rest, chest pain, or fainting: call 112.
- You vomit blood, pass black, sticky, tar-like stools, or pass a lot of fresh blood from the back passage: call 112.
- Very heavy bleeding from anywhere, with dizziness or feeling faint.
Call 112 or go to the nearest emergency department. Ambulance: 108 (102 in some states).
See a doctor within a day or two if
- Your haemoglobin is below 8 g/dL, even if you feel well. In pregnancy, any anaemia needs a doctor, and below 7 g/dL within a day
- Anaemia comes with fever, easy bruising or bleeding gums
- Anaemia comes with yellow eyes or dark urine
Tests that help.
Not everyone needs every test. He decides which ones are worth doing for you.
| Test | What it tells |
|---|---|
| Complete blood count (CBC) | Haemoglobin, the size of the red cells (MCV), white cells and platelets. Small cells point to low iron or thalassaemia trait; large cells to low B12 or folate. |
| Peripheral smear | The blood cells looked at under a microscope. |
| Ferritin | The body’s iron store. It can read falsely normal during an infection or inflammation. |
| Vitamin B12 and folate | When the cells are large, or there is tingling or a vegetarian diet. |
| Stool tests | For hidden blood and worms. An endoscopy or colonoscopy when bleeding from the gut is suspected. |
| HPLC (Hb electrophoresis) | For thalassaemia, when the cells are small but iron is not low. |
Have it ready.
Tick them off as you gather them. The ticks stay on this phone only.
Online, or in person?
Do not take iron for months without a test: in thalassaemia trait the red cells are small but iron is not low, and extra iron does no good.
A video call can
- Read the blood count and work out the likely type of anaemia
- Find the cause: diet, periods, bleeding, or another illness
- Plan iron, B12 or folate, and follow the haemoglobin until it recovers
- Decide when a gut check (endoscopy) or a specialist is needed
Needs a visit in person
- Blood tests, at a laboratory
- Iron by drip, when tablets do not work or cannot be taken
- A blood transfusion, when haemoglobin is very low
- Bleeding with faintness: that is an emergency
Talk it through with Dr. Arya.
Bring your reports and medicines to a video consultation. He goes through them with you, in plain words, and says clearly if you need to be seen in person.
Book a video consultationDr. Prabhat Arya · MBBS, MD (Internal Medicine) · Delhi Medical Council Reg. No. DMC-83759