Anaemia

Also called Iron deficiency anaemia, Low haemoglobin

Too few healthy red blood cells to carry oxygen. Common, easily treated, and often a signpost to something else.

What it is

Anaemia gets dismissed as being a bit tired, which undersells it badly. Oxygen reaches every cell in the body on red blood cells. Run short and everything gets harder, including thinking.

Iron deficiency is the usual cause. But the more useful question is almost always why. In a woman of reproductive age, heavy periods explain most of it. In a man, or in anyone past the menopause, unexplained iron deficiency needs investigating properly, because it can be the first sign of bleeding in the gut.

Vitamin B12 and folate deficiency cause a different type, and long-term conditions such as chronic kidney disease cause another.

Signs you might notice

Tiredness that sleep does not touch. Breathlessness on stairs that were fine last year.

Pale skin, though this is unreliable, and easier to judge inside the lower eyelid.

Headaches, cold hands and feet, brittle nails.

Occasionally something odd and diagnostic: a craving for ice, or for chalk. That is called pica, and it is worth mentioning to a doctor.

How it can affect day-to-day life

In an older person, anaemia does not present as tiredness. It presents as falling over, as confusion, or as a heart problem getting worse, and it gets attributed to age instead.

In a child, it costs concentration and growth. In pregnancy it raises real risks.

None of that is inevitable. This is one of the most treatable things in this library, which is precisely why leaving it unchecked is such a waste.

Supporting someone well

Take iron tablets properly or don't bother. With vitamin C, on an empty stomach if tolerated, and never within two hours of tea, coffee, milk or calcium tablets, all of which block absorption substantially.

Expect constipation and black stools. Both are normal, and both are why people quietly stop taking iron before it has worked.

Keep taking it for three months after the blood count recovers. The count comes back long before the body's iron stores do, and stopping early is the commonest reason anaemia returns.

Push for the cause to be found, not just the number corrected.

Where to get help

A GP diagnoses this with a full blood count and ferritin. Ask what the cause is, and if nobody has said, ask again.

Sudden severe breathlessness, chest pain or fainting needs urgent assessment rather than a routine appointment.