Anemia Treatments and Medications

Anemia is a condition that occurs when there aren’t enough healthy red blood cells or hemoglobin in them to carry oxygen. When less oxygen reaches the body’s tissues, a person may feel more tired, weak, dizzy, and short of breath. Anemia can have several causes, such as low iron levels, low vitamin levels, or genetic blood conditions, which means treatment will vary. If you often feel run-down, ask a healthcare provider about getting a blood test before starting any supplement, since taking iron you don’t need could do more harm than good.

How is anemia diagnosed?

A healthcare provider can diagnose anemia through a physical exam and by asking questions about your symptoms, diet, and medical or family history. They may also order blood work to better determine the type of anemia and the potential cause. Common diagnostic tests include:

• Complete blood count (CBC): This measures red blood cells, white blood cells, platelets, hemoglobin, hematocrit, and the average size of your red blood cells (mean corpuscular volume or MCV).

• Reticulocyte count: This test counts young red blood cells to see whether the bone marrow is keeping up with demand.

• Blood smear: A microscope is used to examine a drop of blood to assess the size and shape of red blood cells, which can help diagnose sickle cell disease and vitamin deficiencies.

• Ferritin and iron studies: These studies measure your body's iron stores to check for iron deficiency.

Together, these measurements can point to a root cause or underlying condition. For example, deficiencies in all three types of blood cells could indicate aplastic anemia, while a low MCV might suggest iron deficiency anemia. 

Blood cell size is also important, says Dr. Shikha Jain, MD, FACP, a hematology-oncology physician at Rush University Medical Center. “If they are too small, it can be indicative of anemia due to iron deficiency or bleeding,” she says. “But if the red blood cells are too large, it may be due to a vitamin deficiency such as vitamin B12 or folate.”

Anemia treatment options

Whether anemia can be completely cured or only managed will depend on its causes. For example, anemia caused by a nutritional deficiency or blood loss after a single incident can usually be corrected. However, anemia from an inherited disorder or a chronic disease will need to be treated long-term. 

Treatments can range from oral or intravenous (IV) iron and vitamin supplements to medications that help the body make more red blood cells. In severe cases, a blood transfusion or bone marrow transplant will be needed. A healthcare provider will look at the underlying cause and other medical conditions you have before recommending a treatment. 

Types of anemia medication

The medication used to treat anemia depends on what’s causing it. The main types of treatments include specific supplements and prescription drugs. 

Iron supplements

Iron supplements replenish the body's iron so it can make hemoglobin and healthy red blood cells. They're often the most commonly recommended supplements for treating iron-deficiency anemia. Options include ferrous sulfate, ferrous gluconate, and polysaccharide iron complex. They’re best absorbed on an empty stomach or with vitamin C from a glass of orange juice. Unlike other vitamins and minerals in the body, it's possible to overdose on iron, so follow your healthcare provider's dosing instructions carefully.

Vitamin B supplements

Vitamin deficiency anemia often requires replacing the nutrients causing the problem, which is usually vitamin B12 (cyanocobalamin) or folic acid (vitamin B9). These are available over the counter at pharmacies and health food stores. Once levels are restored, the body can resume its production of normal red blood cells. Some people only need them for a short period, while others, such as those with pernicious anemia who can't absorb B12 from food, may need them for life.

Erythropoiesis-stimulating agents (ESAs)

Erythropoietin (EPO) is a hormone made by the kidneys that helps stimulate the bone marrow to produce red blood cells. If the body doesn't make enough EPO, potentially due to chronic kidney disease or chemotherapy, ESAs such as Procrit and Epogen can help. Both medications contain epoetin alfa, which can help the body produce more red blood cells. Side effects may include high blood pressure, headache, body aches, and nausea.

Over-the-counter anemia medicine

Anemia caused by nutritional deficiencies typically responds to over-the-counter supplements, including iron and vitamin B12. However, OTC supplements can’t treat anemia caused by blood loss or a chronic blood disorder. Therefore, it’s important to consult a healthcare provider for an accurate diagnosis, especially if symptoms such as fatigue persist or worsen.

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