3 Signs Your Anemia Might Be Back

The signs of anemia can be sneaky. Its symptoms can be similar to many other disorders. And unless your doctor does bloodwork, you won’t know for sure whether you have it or not.

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Sometimes it’s helpful to look for signs of anemia on your own before going to a doctor. Or maybe you’ve already been diagnosed with anemia and told to treat it yourself by taking an iron supplement (this is one I love and recommend).

But you also need a way to tell if your fatigue is just anemia bothering you again – or something new. These little self-checks were recommended to me by a nurse practitioner and they will help you know when it’s time to see a doctor.

Just remember: these are not actual medical tests. They are only indicators that your already properly diagnosed anemia might be back.

When to See a Doctor Immediately

Let’s start with the most important issue: should you be at home reading a website or should you be seeing a doctor right now? Sometimes anemia symptoms may signal a more urgent problem.

See a doctor right away if you experience:

• Severe shortness of breath or chest pain
• Fainting or dizziness that won’t go away
• Very fast or irregular heartbeat
• Heavy bleeding or sudden blood loss
• Severe weakness that affects daily activities

These could be signs that your anemia is serious or caused by another health issue needing prompt treatment.

Who is At Risk for Anemia?

Certain groups of people are more likely to develop anemia. Knowing if you fall into one of these groups can help you stay alert to possible symptoms.

• Women of Childbearing Age: Menstruation causes blood loss each month, which can lead to iron deficiency if not replaced through diet.
• Pregnant Women: Pregnancy increases iron needs because both the mother and growing baby require more blood.
• Children and Teens: Rapid growth during childhood and adolescence increases iron requirements.
• People with Chronic Conditions: Diseases like kidney disease, cancer, or autoimmune disorders may cause anemia.
• Vegetarians and Vegans: Since iron from plant foods is not absorbed as well as from meat, these diets may increase risk if not carefully planned.
• Older Adults: Aging can affect how well your body absorbs nutrients and produces red blood cells.

If you belong to any of these groups, routine checkups and blood tests are important to catch anemia early.

How Anemia is Diagnosed

Only a blood test can confirm if you have anemia and what kind it is. Common tests include:

• Complete Blood Count (CBC): This measures overall red blood cells, hemoglobin levels, and other blood components.
• Serum Ferritin Test: Checks iron stores in your body.
• Vitamin B12 and Folate Levels: These tests help find if deficiencies in these vitamins are causing anemia.
• Reticulocyte Count: Measures young red blood cells to see if your bone marrow is making enough.
• Peripheral Blood Smear: A lab looks at the shape and size of your red blood cells under a microscope.

Your doctor will use these results along with your symptoms and medical history to determine the cause of anemia and the best treatment plan.

Understanding Anemia and Its Causes

If you’ve been diagnosed with anemia but your doctor didn’t explain it to you, here’s a brief summary. Anemia happens when your blood doesn’t have enough healthy red blood cells or hemoglobin.

Hemoglobin is important because it carries oxygen from your lungs to the rest of your body. Without enough oxygen, your body parts don’t work as well as they should, which causes many of the symptoms you might feel.

There are different types of anemia, each caused by different reasons. The most common type is iron-deficiency anemia, which happens when your body doesn’t have enough iron to make hemoglobin.

But anemia can also come from other causes like vitamin B12 deficiency, chronic diseases, inherited disorders, or a loss of blood. Knowing what type of anemia you have is important because the treatment depends on the cause.

For example, iron supplements help iron-deficiency anemia but won’t fix anemia caused by vitamin B12 lack or other issues.

Stressed?  Exhausted?

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Feeling lethargic and unable to cope? Needing more sleep and not feeling rested even when you get it? Those are typical anemia symptoms. You may also get headaches, cold feet and hands, and dizziness.

But a lot of other health issues can bring on any or all of those symptoms. You don’t want to be self-treating anemia like usual, only to find out this time you’ve got something else that needs different treatment. Especially if it’s something serious.

Signs of anemia

These three signs don’t prove whether you do or don’t have anemia. The only way to be sure is with blood work drawn by a doctor and tested in a lab. The blood work will show your iron levels, and your doctor can tell you if you’re anemic or not.

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Remember, you can be anemic without having any of these signs – or any symptoms at all. These little self-tests are useful if you’re trying to decide whether to have a doctor test you for anemia, or if you’re managing your own anemia care on a doctor’s advice.

1. Check your eyelids

Look in the mirror, and get up close to it so you can see your face very well. Quickly pull your lower eyelid down and look at the skin inside that eyelid. You’re examining the color.

Pale eyelids, in which the inside bottom eyelid looks white, can be a sign of anemia.

If you’re healthy, it will start off a very pale whitish color and then quickly become more pink (close to the color of raw chicken). But if the switch to pink takes a few seconds – or seems not to be happening at all – this could indicate you’re anemic.

And, yes, this tip works for people of all skin colors, as the inner eyelid goes through the same process in everyone. In fact, the nurse practitioner who taught me this trick was African American.

2. Check your lips

Anemia tends to make you pale, and this is often most obvious at the lips. If your lips seem paler than usual, that’s an indicator of anemia.

This tip also works for people of all skin tones, even though what’s pale for you may be a different shade than what’s pale for someone else. Every skin tone can have a lot of different lip colors ranging from very light pinkish to shades of brown.

3. Check your nails.

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Your nails, and in particular the nail beds (the little half-moon near the cuticle), can also turn pale when you’re anemic. This tip is considered a bit less reliable for people of color because the skin under nails can be many shades of brown, pink and even yellow with warmer skin tones.

The trick here is to notice what color your nails and nail beds are normally, when you’re feeling fine. Then you can check to see if they’re becoming paler. If so, that could be a sign of anemia.

More Signs to Watch For

In addition to checking your eyelids, lips, and nails, there are other signs that might point to anemia. These can help you decide if you need to see a doctor for testing.

• Shortness of Breath: If you find yourself getting out of breath easily during activities that didn’t used to tire you, it could be because your body isn’t getting enough oxygen.
• Rapid or Irregular Heartbeat: Your heart may try to make up for low oxygen by beating faster or harder. This can sometimes feel like a fluttering or pounding in your chest.
• Cold Hands and Feet: Poor blood circulation caused by anemia can make your hands and feet feel cold.
• Brittle or Spoon-Shaped Nails: In some cases, severe iron-deficiency anemia can cause nails to become brittle or develop a spoon-like shape.
• Cracks at the Corners of the Mouth: This can be a sign of iron deficiency or other nutrient shortages.
• Unusual Cravings (Pica): Some people with anemia crave non-food items like ice, dirt, or starch.

If you notice several of these signs along with the ones mentioned earlier, it’s a good idea to get checked by a healthcare provider.

Treatment Options Beyond Iron Supplements

While iron supplements are common for treating iron-deficiency anemia, other approaches might be necessary depending on the cause.

• Diet Changes: Adding iron-rich foods like red meat, beans, spinach, and fortified cereals can help. Vitamin C rich foods like oranges help your body absorb iron better.
• Vitamin Supplements: If you’re low on vitamin B12 or folate, supplements or injections may be needed.
• Treating Underlying Conditions: Anemia caused by chronic diseases needs treatment for the main illness.
• Blood Transfusions: In severe cases where anemia causes serious symptoms or complications, transfusions may be required.
• Medications: Some types of anemia respond to medicines that stimulate red blood cell production.

It’s important not to self-treat without a proper diagnosis since taking iron unnecessarily can cause other health problems.

Tips for Managing Anemia Day-to-Day

If you have been diagnosed with anemia and are managing it at home, here are some helpful tips:

• Take Supplements as Directed: Follow your doctor’s instructions carefully regarding dose and timing.
• Eat Balanced Meals: Include good sources of iron and vitamins every day.
• Avoid Drinking Tea or Coffee With Meals: These drinks can reduce iron absorption.
• Stay Hydrated: Drinking enough water can help reduce fatigue.
• Rest When You Need To: Don’t push yourself too hard when feeling weak or tired.
• Keep Track of Symptoms: Note any changes or new symptoms and report them to your healthcare provider.

Staying aware and proactive helps you keep anemia under control and avoid complications.

Sources

• 14 Signs of Iron Deficiency Anemia (Healthline)
• What to Know About Pale Lips (WebMD)
• What Your Nails Say About Your Health (WebMD)