Ask The Doctor

Anemia Has Many Different Causes

Dear Dr. Garner,

I am 54 years old and, up until now, have been in pretty good health. I noticed lately that I have been short of breath with tiredness all the time. My heart beats irregularly.

I went to the doctor, and he took a blood test and told me that I am anemic. He scheduled a long appointment for me next week.

I was wondering what you think he is going to be looking for and if I should be worried.

Anemic in Astoria


Dear Anemic,

Anemia is fairly common and has many different causes. Basically, it is a condition in which there aren’t enough normal red blood cells to carry oxygen to your tissues. Blood cells are produced in a part of the body known as bone marrow.

Blood is made up of three main parts: red blood cells, white blood cells and platelets. Red blood cells carry oxygen to the body’s tissues. White blood cells help fight infection and platelets help stop bleeding.

Anemia has three causes: blood loss from an accident or internal bleeding; inadequate production of red blood cells; and/or destruction of red blood cells.

Many types of anemia are mild and can be treated or prevented with a healthy diet. Some other symptoms that people experience, in addition to yours, include headaches, dizziness, chest pain and pale skin.

A common type of anemia is iron-deficiency anemia. In this anemia, your body does not have enough iron, which your bone marrow needs to make new blood cells. This type of anemia can be caused by blood loss from heavy menstrual bleeding, ulcers, cancers, polyps, prolonged use of aspirin, Motrin or other types of medications, or from lack of iron in your diet.

Some anemia is caused by vitamin deficiencies. In addition to iron, the body needs two vitamins, folate and B12, to produce healthy red blood cells. A diet lacking these nutrients can cause anemia.

Anemia may also be caused by chronic disease. Examples include cancer, Crohn’s disease and chronic arthritis. Kidney failure can also cause anemia. Some people develop anemia when red blood cells are destroyed faster than the bone marrow can replace them. Sickle-cell anemia is a condition in which red blood cells are made incorrectly, do not function properly and die prematurely.

Diagnosis and Treatment

Your doctor can diagnose anemia based upon medical and family history as well as a physical examination. Your doctor may ask if you have the common signs or symptoms mentioned earlier and will want to know about your diet. Your doctor will also order a complete blood test to see if there is lack of normal red blood cells.

The goal of treatment is to increase the amount of oxygen to your body. This is done by raising the number of red blood cells that carry oxygen. Another goal is to treat the underlying cause of the anemia. Your doctor will check your iron and vitamin levels.

Some good sources of vitamin B12 include breakfast cereals, meat and eggs. Folic acid can be obtained from bread, pasta, rice, spinach, dried beans, beef liver and eggs.

Vitamin C helps the body absorb iron. Good sources of Vitamin C include vegetables and fruit. Your doctor may prescribe medication to treat underlying causes of anemia such as infections.

As you can see, anemia has many different causes. I am glad that you have seen your doctor and have a follow-up appointment. Please keep me updated on your situation.


Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET-TV, Tuesdays at 8 p.m. on Time Warner Channel 97 and Cablevision Channel 30.

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