If you're feeling tired or weak, having trouble sleeping and are unable to tolerate even moderate exercise, anemia could be the culprit.
Anemia develops when there aren't enough healthy red blood cells to carry oxygen through your body. While there are several types of anemia — all of which present a unique set of potential symptoms — the two most common are vitamin-deficiency and iron-deficiency anemia.
Vitamin-deficiency anemia
“An essential vitamin, vitamin B12 is the most common type of vitamin-deficiency anemia,” says Clarence Adoo, MD, a hematologist/oncologist who's an independent member of the HonorHealth medical staff.
This type of anemia sometimes presents symptoms beyond the usual signs of tiredness, weakness and sleep issues. When a deficiency in vitamin B12 reaches a level that causes anemia, neurologic symptoms such as neuropathy (nerve damage that results in numbness or weakness) and unstable gait (walk/step) may develop.
"Because this type of anemia is usually caused by an acquired dietary absorption problem, it's most common among older adults," says Dr. Adoo. "Treatment for vitamin B12-deficiency anemia is lifelong because the issues that prevent the body from absorbing the vitamin usually cannot be resolved."
Treating vitamin B12-deficiency anemia typically requires injections of the vitamin, available only by prescription because most patients are unable to absorb it in a pill. Your doctor may also suggest adding foods high in vitamin B12 to your diet. These include fish, meat, poultry, eggs, milk and other dairy products.
Iron-deficiency anemia
Beyond fatigue, weakness and sleep disturbances, iron-deficiency anemia has been linked to restless legs and flattening of the fingernails. The condition also has been associated with cravings for chewing ice and, though rare, cravings to eat dirt.
Young women, particularly those who have heavy menstrual cycles, are most likely to develop iron-deficiency anemia. It may also be caused by other conditions linked to longstanding bleeding. If the source of blood loss isn't noticeable or easily identifiable, your doctor may want to investigate through additional tests or screening exams.
"Colon polyps can cause chronic bleeding, so a colonoscopy may be ordered to see if that's causing iron-deficiency anemia," says Dr. Adoo.
As with any health condition, it's important to understand the exact cause of iron-deficiency anemia to ensure proper treatment. You can make dietary adjustments — adding iron-rich foods such as meat, fish, poultry, spinach and broccoli. Iron supplements are another common treatment. However, Dr. Adoo stresses the importance of follow-up testing to ensure the supplements are effective because some people cannot absorb iron supplements. When that's the case, iron may need to be given intravenously.
The overall causes of anemia vary, whether they're related to iron deficiency or vitamin deficiency. Stomach surgery such as gastric bypass surgery for weight loss can alter the body's ability to absorb iron and vitamin B12. As a result, individuals who have undergone gastric bypass surgery are subject to both types of deficiency-related anemia. If you've had gastric bypass surgery, be sure to follow all post-surgical maintenance and monitoring guidelines as outlined by your doctor.