Not Just Exhaustion: Dr. Shraddha Patel Explains Anemia and What is Really Happening
If you have been dragging yourself through the day, struggling to climb a flight of stairs or watching people around you keep pace with life while you feel like you are running on empty, there may be a medical reason you are overlooking. The answer might not be more sleep, more coffee or more willpower; it could be anemia, one of the most common blood conditions in the world.
Board-certified internist, Dr. Shraddha Patel with CaroMont Internal Medicine in Gastonia explains what anemia is, the various forms it takes and her best tips for living with this condition.
Despite how widespread it is, anemia remains one of the most routinely overlooked diagnoses, largely because its symptoms including fatigue, brain fog, low mood and shortness of breath are so easily mistaken for the effects of a busy schedule, poor sleep or everyday stress.
“Anemia occurs when your body lacks enough healthy red blood cells, or when those cells do not carry enough hemoglobin to transport adequate oxygen to your organs and tissues,” explains Dr. Patel. “Red blood cells are essential to keeping you alive and functioning well. When there are not enough of them, or when they cannot do their job properly, your organs and tissues are starved of the oxygen they need. The body tries to compensate, but over time the strain becomes impossible to ignore, and that is when symptoms begin to surface.”
Recognizing the Signs
"As an anemic person myself, I know firsthand that anemia is a master of disguise," explains Dr. Patel. "The symptoms can overlap with stress, poor sleep, thyroid disorders and even depression, which is part of why so many people go undiagnosed for years. The most common signs include persistent fatigue or low energy, shortness of breath with mild activity, brain fog or difficulty concentrating, an irregular heartbeat, cold hands and feet, pale or yellowish skin, dizziness or lightheadedness and low mood. If several of these symptoms have become a part of your daily life, it is worth talking to your doctor.”
Different Types of Anemia
Anemia is not a single disease, explains Dr. Patel. It is a finding that points toward an underlying cause, and the right treatment depends entirely on identifying which type of anemia you have. Here are some of the most common forms:
Iron-Deficiency Anemia
Iron-deficiency is the most common type of anemia. It occurs when the body does not have enough iron to produce sufficient hemoglobin, the protein inside red blood cells that carries oxygen. It most frequently affects women of reproductive age due to blood loss from heavy menstrual periods, people with diets low in iron-rich foods and those with conditions like celiac disease that limit the body's ability to absorb iron properly.
People with iron-deficiency anemia often experience extreme fatigue, pale skin and brittle nails. Some develop a condition called pica, an unusual urge to chew ice or non-food items, which can be a telling sign that iron levels have dropped significantly.
Vitamin B12 Deficiency Anemia
Vitamin B12 deficiency anemia, sometimes called megaloblastic anemia, occurs when the body lacks enough B12 to produce healthy red blood cells. Without sufficient B12, the cells your body produces are abnormally large and poorly formed, unable to function or move through the bloodstream effectively. This type most commonly affects people who follow a strictly plant-based diet, those who have had certain gastrointestinal surgeries and older adults whose stomachs produce less “intrinsic factor”, the natural protein the body needs in order to absorb B12 properly.
In addition to the typical signs of anemia, B12 deficiency can cause symptoms that feel distinctly neurological, including numbness or tingling in the hands and feet, balance problems, memory problems and noticeable changes in mood.
Anemia of Chronic Disease
Anemia of chronic disease develops as a secondary effect of long-standing health conditions, including rheumatoid arthritis, lupus, chronic kidney disease, inflammatory bowel disease, HIV and certain cancers. It most commonly affects people who are already managing another chronic illness, as persistent inflammation interferes with the body's ability to produce and sustain healthy red blood cells.
Because it develops alongside another condition, symptoms can be easy to attribute to the primary illness rather than anemia itself. Fatigue, weakness and general low energy are the most common signs.
Hemolytic Anemia
Hemolytic anemia occurs when red blood cells are being destroyed faster than the bone marrow can replace them. It can affect people of any age and may be triggered by an autoimmune response, inherited structural abnormalities in the red blood cells, certain infections or exposure to certain medications and toxins.
Symptoms often extend beyond typical anemia fatigue; it can include a yellowing of the skin and eyes, dark-colored urine and an enlarged spleen. These additional signs are the result of the body processing the breakdown of red blood cells faster than it should.
Aplastic Anemia
Aplastic anemia is a rare but potentially life-threatening condition. It occurs when the bone marrow stops producing enough red blood cells, white blood cells and platelets. It can occur at any age and may result from an autoimmune attack on the bone marrow, exposure to toxic chemicals or radiation, certain medications or viral infections. In many cases, no clear cause is identified.
Because all three types of blood cells are affected, symptoms go beyond fatigue alone. Patients may experience frequent infections due to low white blood cell counts and unexplained or prolonged bleeding due to a lack of platelets, in addition to the oxygen-related symptoms that come with reduced red blood cell production.
How is Anemia Treated?
“Treatment plans are uniquely tailored to address the root cause of anemia,” explains Dr. Patel. “Iron-deficiency anemia is often addressed with oral iron supplements and dietary changes, though some patients require IV iron infusions. B12 deficiencies are managed with supplementation or injections. Anemia tied to a chronic illness is usually treated by addressing the underlying condition. More complex types, such as hemolytic and aplastic anemia, may require specialist referral, immunosuppressive therapy or in some cases a bone marrow transplant. The encouraging news is that with the right diagnosis and a thoughtful care plan, most forms of anemia are very manageable.”
Living with Anemia: Tips from Dr. Patel
"As someone who has personally navigated this path, I know how deeply anemia can impact your daily life," says Dr. Patel. "These tips have helped guide my own recovery, helping me reclaim my energy and restore my health. I encourage my patients to incorporate these daily practices into their routine to support healing:"
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Eat iron-rich foods every day. Your body needs a steady supply of iron to build healthy red blood cells. Good sources include lean red meat, poultry, beans, lentils, tofu, dark leafy greens and fortified cereals. Aim for variety by including both plant-based and animal-based options to ensure you get a balanced mix of nutrients.
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Pair iron with vitamin C. Vitamin C acts as a powerful partner, significantly boosting your body's ability to absorb iron, especially from plant-based sources. To maximize nutrition, try a glass of orange juice alongside a spinach salad, or add bell peppers to a bean dish.
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Be mindful of iron blockers at mealtimes. Certain everyday items like coffee, tea, calcium-rich foods and antacids can reduce iron absorption. To get the full benefit of your meals, space these items out from your iron-rich meals or supplements by at least an hour.
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Take supplements as directed and be patient. Replenishing your body’s storage can take time. Iron or B12 supplements can take several weeks to months to fully restore your levels. Do not stop early; continue taking them as prescribed, even after you start feeling better.
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Protect your energy during recovery. Build rest into your day, prioritize quality sleep and reduce unnecessary physical strain while your levels are being restored.
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Stay hydrated. Dehydration can worsen fatigue and make anemia symptoms feel more pronounced. Aim for at least six to eight glasses of water daily, more if you are active or live in a warm climate.
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Keep your follow-up appointments. Anemia is not a one-and-done diagnosis. Regular blood work helps your provider confirm your levels are improving and catch any recurrence early, even before symptoms have a chance to return.
Next Steps for Your Health
If you recognize any of these symptoms in your own life, especially if fatigue, shortness of breath or dizziness have quietly become part of your daily routine, do not wait. You deserve answers, and you deserve to feel healthy. The first step is simply having a conversation with a healthcare provider who will listen to your concerns. That conversation can start today. Our internal medicine team is here to listen to your unique story, evaluate your health and build a care plan that is right for you.