Can you fully recover from anemia?

What is anemia?

Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues. Having anemia can make you feel tired and weak.

There are many types of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe. Many types of anemia are treatable, so it’s important to determine the cause and get appropriate treatment.

What causes anemia?

Anemia has many possible causes, including:

• Iron deficiency. Iron deficiency anemia is the most common type of anemia overall and is caused by a lack of iron in your body.
• Vitamin deficiency anemia. In addition to iron, a lack of folate, vitamin B-12 or vitamin C could cause anemia.
• Anemia of chronic disease. Certain chronic diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn’s disease and other chronic inflammatory diseases — can interfere with the production of red blood cells.
• Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn’t produce enough new blood cells.
• Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow.
• Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them.
• Sickle cell anemia. This inherited and sometimes serious condition is caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape.

What are the symptoms of anemia?

The signs and symptoms of anemia vary depending on the cause. Most types of anemia cause similar signs and symptoms, including:

• Fatigue
• Weakness
• Pale or yellowish skin
• Irregular heartbeats
• Shortness of breath
• Dizziness or lightheadedness
• Chest pain
• Cold hands and feet
• Headache

Can anemia be cured?

Whether anemia can be cured depends on what’s causing it. In many cases, yes, the underlying condition can be treated and resolved, restoring normal red blood cell production and hemoglobin levels.

But in some situations, damage is permanent and can only be managed. Treatment focuses on increasing hemoglobin levels and managing symptoms.

Types of anemia that can often be cured:

Iron deficiency anemia

This very common type of anemia is caused by a lack of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can’t produce enough hemoglobin for red blood cells.

Iron deficiency can happen when:

• You have heavy periods or pregnancy-related iron loss
• Your diet is consistently low in iron
• Your body can’t properly absorb iron

Treatment is focused on adding more iron to your diet or taking iron supplements. Most people respond well and iron deficiency anemia goes away within a couple months.

Vitamin deficiency anemia

A lack of certain vitamins can cause a reduction in hemoglobin. Vitamin deficiency anemia can result from:

• Low vitamin B12 due to pernicious anemia (poor vitamin B12 absorption), inadequate dietary intake or other causes
• Low folate due to inadequate dietary folate, certain digestive disorders, medications or other reasons
• Low vitamin C typically from very limited dietary intake

Treatment involves supplementing the vitamin you’re lacking or adjusting medications. With proper treatment, vitamin levels and hemoglobin production usually improve.

Aplastic anemia

Aplastic anemia is rare but serious. It happens when your body’s immune system attacks the bone marrow so it can’t make enough new blood cells. It’s often severe upon diagnosis.

But in up to half of people with aplastic anemia, bone marrow regains its cell-making ability and blood cell counts improve significantly in the first three months. Complete blood count recovery is seen most often in young patients. Overall, younger people have better recovery rates.

Anemia from chronic disease

Some chronic conditions can alter the lifespan of red cells and lower hemoglobin. Examples include rheumatoid arthritis, cancer, HIV/AIDS, kidney disease, Crohn’s disease and other inflammatory diseases.

Treatment of the underlying condition can resolve anemia of chronic disease. As inflammation is reduced, hemoglobin levels rebound. However, damage from some chronic diseases can’t be reversed.

Hemolytic anemia

In hemolytic anemia, red blood cells are destroyed prematurely. This can occur when:

• Red cell membranes are defective, as in hereditary spherocytosis
• Red cells are abnormally shaped, as in sickle cell anemia and thalassemia
• The immune system mistakenly attacks red cells
• Infections, drugs, toxins or mechanical heart valves damage red cells
• A enlarged spleen traps and destroys red cells

Treatment varies based on the cause but can include avoid triggers, managing infections, stopping problematic medications, removing the spleen, or blood transfusions.

Types of anemia that can be managed but not cured:

Sickle cell anemia

Sickle cell anemia is an inherited red blood cell disorder. Abnormal hemoglobin causes red cells to become rigid, sticky and misshapen or “sickled”. Sickled cells clog blood vessels, limiting blood flow and oxygen delivery.

Sickle cell anemia has no widely available cure at this time. Treatment focuses on avoiding complications, controlling pain and preventing infection. Blood transfusions can dilute sickled cells and hydroxyurea can reduce cell sickling. Stem cell transplants are a possibility but have serious risks.

Thalassemia

Thalassemia is an inherited blood disorder that affects hemoglobin production. Severe forms require regular blood transfusions and extensive medical care to manage symptoms and complications.

Milder cases of thalassemia may require little or no treatment. Overall, thalassemia has no cure beyond a stem cell transplant. Even with a transplant, there’s a risk the disease will return.

Fanconi anemia

Fanconi anemia is a rare inherited disorder that can cause bone marrow failure, blood cancers and other serious health problems. Treatment focuses on preventing and treating infections, boosting blood counts and reducing complications.

Standard treatments don’t cure Fanconi anemia itself. However, some people with the disease are cured if a successful stem cell transplant replaces their blood stem cells.

Aplastic anemia

While some people see improved blood cell counts with aplastic anemia, in severe cases bone marrow function may never recover — even with treatment. People who don’t respond typically need blood transfusions and medications long term to survive.

A stem cell transplant can cure aplastic anemia when a matched donor is available. However, transplant risks can be significant.

Anemia from chronic disease

When anemia is caused by rheumatoid arthritis, cancer, kidney failure, HIV/AIDS or similar conditions, curing the underlying disease can resolve the anemia — if that’s possible. Often these chronic diseases persist, and so does anemia of chronic disease.

If the anemia causes symptoms, ongoing treatment includes erythropoiesis-stimulating medications and iron supplements. In severe cases, blood transfusions are used to improve oxygen delivery.

When should you see a doctor?

It’s important to see your doctor if you experience signs and symptoms of anemia, such as:

• Unexplained fatigue
• Weakness
• Pale appearance
• Rapid heartbeat
• Shortness of breath with little exertion
• Dizziness
• Strange cravings to chew ice or dirt
• Brittle nails
• Soreness in your mouth or tongue

Schedule an appointment to get tested if you’re at increased risk of anemia, including:

• A vegetarian or vegan diet
• Very heavy menstrual bleeding
• Pregnancy
• History of GI surgery, such as weight loss surgery
• Frequent blood donation
• A chronic condition
• Unexplained signs and symptoms

Early diagnosis and treatment can restore normal hemoglobin levels before complications arise.

Diagnosing anemia

A diagnosis starts with an exam and questions about your symptoms, health history and lifestyle. Diagnostic tests help determine the type and severity of anemia. These may include:

• Complete blood count: This measures levels of red cells, white cells, hemoglobin and platelets.
• Serum iron level: This helps detect iron deficiency.
• Serum ferritin: Low levels indicate iron deficiency.
• TIBC and UIBC: These measure blood’s capacity to transport iron.
• Vitamin B12 and folate levels: Useful in evaluating vitamin deficiency anemia.
• Hemoglobin electrophoresis: This helps diagnose sickle cell or thalassemia.
• Bone marrow biopsy: Examines bone marrow to evaluate cell production.
• Stool sample: Checks for blood, which may indicate gastrointestinal issues.

Additional testing provides important details on the type and origin of anemia to guide treatment.

Treating anemia

Anemia treatment focuses on addressing the underlying cause:

• Iron supplements treat iron deficiency. You may also need vitamin C and folate.
• Diet changes or supplements reverse vitamin deficiencies.
• Underlying conditions must be managed, which may resolve other types of anemia.
• Medications that damage red blood cells may need to be changed or stopped.
• Surgery can remove a damaged spleen and improve some forms of hemolytic anemia.

In addition:

• Erythropoiesis-stimulating medications promote red cell production.
• Immunosuppressants prevent the immune system from attacking red blood cells.
• Blood transfusions to increase red cell levels quickly may be used in severe anemia.

Treatment helps restore normal hemoglobin levels, often within a few weeks to months if anemia is mild or moderately severe. Getting an accurate diagnosis is key, as the underlying cause must be addressed.

What is the outlook for anemia?

When treated properly, many types of anemia resolve. Mild iron and vitamin deficiency anemia typically improve within 1 to 2 months. Recovery may take longer with severe deficiencies.

Unfortunately, some forms of inherited anemia have no cure. However, symptoms can be managed with careful, lifelong treatment.

Rarely, severe aplastic anemia and other extremely severe types can be fatal if not treated aggressively. The prognosis is best when treatment begins before anemia becomes life-threatening.

Work closely with your doctor for an accurate diagnosis and prompt treatment. Report any worsening symptoms. With effective therapy tailored to the cause, most people with anemia can achieve a full recovery.

Preventing recurrent anemia

Here are some tips to help prevent future anemia after successful treatment:

• Take iron, vitamin and other supplements as directed, even after anemia resolves.
• Eat iron-rich foods like red meat, beans, lentils, spinach and fortified cereals.
• If you had surgery that removed part of your stomach or small intestine, be diligent about vitamin supplements.
• Avoid medications that may damage your red blood cells or bone marrow production.
• Use the lowest steroid dose possible and avoid NSAIDs if you have chronic kidney disease.
• Protect yourself from malaria and other infections if you have a hemoglobin disorder.
• Live a healthy lifestyle and properly manage any chronic medical conditions.
• Limit alcohol to avoid interfering with nutrient absorption and red blood cell production.

Let your doctor know if you develop any recurring symptoms of anemia. Early retreatment can prevent complications of low hemoglobin levels.

When to seek emergency care

Most cases of anemia don’t require emergency care. However, seek immediate medical help if you experience:

• Severe shortness of breath at rest
• Lightheadedness or dizziness that causes fainting
• Rapid heartbeat noticeable at rest
• Chest pain
• Very pale color from severe anemia
• Bleeding that won’t stop
• Coughing or vomiting blood
• Black, tarry stools
• Confusion

These may be signs of a life-threatening complication from severe anemia. Prompt emergency care is crucial.

Conclusion

Anemia has many causes, and the ability to make a full recovery depends on which type you have. Iron and vitamin deficiency anemia is usually temporary and curable with proper treatment. Other types may persist lifelong but can often be well managed.

Some rare, inherited anemias have no cure. However, newer treatment options are emerging. Work with a hematologist to pinpoint your specific type of anemia. Follow your doctor’s treatment plan, take medications as directed, and report any concerning symptoms right away. Most people with anemia go on to lead full, active lives.