Signs and symptoms of anemia

Anemia may affect multiple biological systems.1,2

Note that some of these symptoms have only been reported in anemia due to specific causes

Neurological

•Fatigue

•Headaches, dizziness, vertigo

•Depression

•Difficulty Sleeping

•Sleep disturbances

Cardiorespiratory

•Tachycardia, palpitations

•Increased pulse pressure, systolic ejection murmur

•Orthostatic hypotension

•Dyspnea

•Cold intolerance

Immune system

•Impaired T-cell and macrophage function

GI system

•Anorexia

•Nausea

Vascular system

•Low skin temperature

•Pallor of skin, mucous membranes, and conjunctiva

Genital tract

•Loss of libido

•Menstrual problems

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Many individuals with mild anemia will have no complaints and be unaware that they are anemic. Others may complain of symptoms such as shortness of breath or fatigue, especially with exercise. Patients with severe anemia are often symptomatic at rest. When signs and symptoms of anemia occur, the most commonly observed include pallor of the skin and mucous membranes, soft systolic murmurs, palpitations of the heart, dyspnea (shortness of breath), lethargy, and fatigability.3,4

How anemia can lead to symptoms1,5

  • Decrease in RBC, Hb, or Hct level

  • Diminished O2-carrying capacity

  • Hypoxia and hypoxia-induced
    effects on organ function

  • Signs and symptoms of anemia

RBC = red blood cell

Hb = hemoglobin

Hct = hematocrit

O2 = oxygen

References: 1. Ludwig H, Strasser K. Semin Oncol. 2001;28:7-14. 2. Lemoine C, Gobel BH. In: Yarbro CH, Wujcik D, Gobel BH, eds. Cancer Nursing: Principles and Practice. 7th ed. Sudbury, MA: Jones and Bartlett; 2010:600-625. 3. Bunn HF. In: Goldman L, Schafer AI, eds. Cecil Textbook of Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2012:1031-1039. 4. Common terminology criteria for adverse events (CTCAE) v4.0. US Dept of Health and Human Services. 2009. Available at: http://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf. Accessed February 17,2011. 5. Hurter B, Bush NJ. Clin J Oncol Nurs. 2007;11:349-359.