Microcytic Anemia

What is microcytic anemia?

Microcytic anemia happens when your red blood cells are smaller than usual because they don’t have enough hemoglobin. Hemoglobin is a protein in your red blood cells. It helps red blood cells carry oxygen throughout your body. Low hemoglobin also causes your red blood cells to be paler than normal, or “hypochromic.” Most microcytic anemias are hypochromic.

Healthcare providers may refer to microcytic anemia as a medical condition or as a sign of certain anemias and other blood disorders. Providers treat microcytic anemia by identifying and treating what’s causing it.

What are the symptoms of microcytic anemia?

Microcytic anemia symptoms include:

• Fatigue and weakness
• Dizziness
• Skin that’s paler than usual
• Fast heartbeat
• Shortness of breath
• Dry skin
• Skin that bruises easily

What causes microcytic anemia?

The most common cause of microcytic anemia is an iron deficiency. Your red blood cells need iron to make hemoglobin. In some cases, a genetic disorder may affect red blood cell development.

The following medical conditions cause microcytic anemia:

• Iron-deficiency anemia (IDA). This anemia is the most common cause of microcytic hypochromic anemia. You can get IDA from losing too much blood (including from heavy periods) or not getting enough iron in foods you eat.
• Thalassemias. These blood disorders affect your body’s ability to make hemoglobin and red blood cells.
• Anemia of chronic disease. This form of anemia may develop if you have long-term illnesses that cause inflammation. Causes include chronic infections, autoimmune diseases and cancer.
• Sideroblastic anemia. This rare blood disorder affects your bone marrow’s ability to make normal red blood cells.
• Lead poisoning. Exposure to lead for a long time may cause microcytic anemia.

Other causes include:

• Not getting enough copper in foods you eat
• Getting too much zinc in foods or supplements
• Certain prescription drugs
• Excessive alcohol use

What inflammatory diseases cause microcytic anemia?

There are several conditions that cause inflammation. And long-lasting inflammation can impact red cell production and lead to microcytic anemia. Examples include autoimmune conditions, like inflammatory bowel disease, rheumatoid arthritis and lupus. Cancer, chronic kidney disease and chronic infections are also potential causes.

How is microcytic anemia diagnosed?

Healthcare providers use these blood tests to diagnose microcytic anemia:

• Complete blood count (CBC). This test gives providers information about your hemoglobin levels and the size of your red blood cells. You have microcytosis if the mean corpuscular value (MCV) on this test is less than 80 femtoliters (fL).
• Peripheral blood smear (PBS). Providers examine your blood cells beneath a microscope. A PBS can show if your red blood cells are smaller than normal (microcytosis) and pale (hypochromic).
• Iron studies. Your provider may check how your body is storing and using iron. Helpful tests include the ferritin test and total iron-binding capacity (TIBC) test.

After diagnosing microcytic anemia, your provider may do other tests or to find out what’s causing it.

How is microcytic anemia treated?

Providers treat microcytic anemia by treating the underlying cause. For example, if you have iron-deficiency anemia, your provider may prescribe iron supplements. You may need iron infusions if you can’t tolerate the supplements or your body can’t absorb them.

For severe anemia involving heavy blood loss, you may need a blood transfusion.

If a chronic disease is causing microcytic anemia, treating the condition usually improves the anemia.

Can microcytic anemia be prevented?

Microcytic anemia happens when something affects your body’s ability to make healthy red blood cells. And you may not be able to prevent some of those things from happening.

For example, iron deficiency is the most common cause of microcytic anemia. In some cases, you can prevent iron deficiency anemia by eating enough iron-rich foods. But sometimes, medical conditions beyond your control affect your body’s ability to absorb iron or make red blood cells. Much depends on your unique situation.

What can I expect if I have this condition?

Your experience depends on what’s causing your microcytic anemia. Sometimes, microcytic anemia is a sign of a serious condition that requires life-long management. Other times, it’s temporary. Something as simple as taking iron supplements may be enough to reverse it.

Once your healthcare provider diagnoses what’s causing the issue, they’ll explain how it affects your health. If you’re concerned you may have a serious illness, your provider is your best resource for information about your outlook.

How do I take care of myself?

If you have microcytic anemia, care for yourself by following your healthcare provider’s recommendations on treatment and follow-up care. You can also:

• Eat iron-rich foods. (Good options include beef, chicken, lentils, dried peas and beans, broccoli and dark leafy greens.)
• Try to get enough sleep.
• Drink enough water to stay hydrated.
• Do your best to avoid infections by washing your hands frequently.
• Limit your alcohol intake.

Before making big changes — like taking a daily iron supplement — contact a healthcare provider. They can guide you on the safest and most effective ways to make living with microcytic anemia easier.

When should I see my healthcare provider?

Conditions that cause microcytic anemia can lead to symptoms that may develop slowly over time. You may not notice changes in your body right away. This is why it’s important to keep track of your health and talk to a healthcare provider if you notice changes.

Microcytic anemia may be harmless or it may be a sign of a medical condition that can cause serious medical problems without treatment. It’s best to see a provider to get to the bottom of what’s causing your symptoms.

What questions should I ask my healthcare provider?

If you have microcytic anemia, questions to ask include:

• What’s causing my condition?
• How severe is my microcytic anemia?
• What treatments do you suggest?
• How long will I need treatment?
• What treatment side effects should I expect?
• Is my microcytic anemia reversible?
• How long should it take for me to feel better?