Anemia, Fatigue and Iron Deficiency: Facts and Myth

Have you ever been told you were anemic? Were you advised to take iron? Did it make you feel better?

Anemia is common. By some estimates, up to 30% of the world’s population is anemic. It is particularly common among young women (largely attributed to the blood loss during the menstrual cycle) and in places where nutrition is poor, where chronic disease (such as HIV) is common, or where the water is contaminated with lead or copper.

Because anemia is common, you often hear a recommendation to take iron. But anemia is often blamed for symptoms that are unrelated, and iron deficiency is only one cause of anemia - and there are many. Read on for the facts and fiction about anemia.

What Is Anemia?

The word “anemia” means there is a reduction in the number of red blood cells. Even though that may seem like a straightforward definition, it’s important to next define “reduction” and there are at least two ways to determine what a “low” number of red cells is:

Less than the number needed to carry on normal bodily function, or,
Lower than most other healthy people

It is the latter definition that is usually reported; that is, a laboratory defines its normal values by measuring hundreds or even thousands of normal, healthy people’s red blood counts and defining the normal range as the values of 95% of that population; the remaining 5% - the very highest and lowest values – are then considered abnormal.

Red cells are important because they carry oxygen throughout the body. There are several ways to measure and report anemia; the most common of which are volume and concentration of hemoglobin (the oxygen-carrying molecule within the red blood cell). For adult women, the normal volume of red blood cells, called the hematocrit, ranges from approximately 36% to 48% (representing 95% of the healthy female population as above); the volume is a bit higher for men (40% to 52%). The concentration of hemoglobin is normally 11.5 milligrams per deciliter (mg/dl) to 17.5 mg/dl, with some variation depending on one’s gender and the laboratory testing the blood.

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