Signs and Symptoms of Anemia

woman lying on a sofa holding her head

VioletaStoimenova / Getty Images

Anemia occurs when your blood has a reduced number of red blood cells, making it difficult to transport oxygen from your lungs to the rest of your body. People who have cancer, an autoimmune disease, or heavy periods are at higher risk of developing anemia.

Typically, treatment for anemia involves taking supplements or medications that help your blood develop more red blood cells. If your anemia is more severe, you may need intravenous drugs, a blood transfusion, or even surgery.

There are several types of anemia based on the cause of the condition, but many of the symptoms remain the same. Common symptoms of anemia include headaches, tiredness, or shortness of breath.

The symptoms you experience can range from mild to severe depending on how serious your anemia is and how quickly it develops. In the early stages of anemia, you may have no symptoms at all. As your anemia progresses, your symptoms may worsen if they are not treated.

Extreme Tiredness and Fatigue

Feeling fatigued or tired is the most common symptom of iron-deficiency anemia. The symptom is also associated with aplastic anemia and hemolytic anemia.

Red blood cells carry oxygen through the body, and the body needs oxygen for energy. When you have low red blood cell levels, your body's tissues and muscles can't get enough oxygen, or energy.

Additionally, your heart is working harder than normal to move the oxygen-rich blood you do have around your body. All of these things combined can lead to extreme tiredness and fatigue.

Pale Skin

Having pale skin is common in all types of anemia. Paleness is related to blood flow. When you have a decreased number of red blood cells, less of that red blood will flow to the surface, causing your skin to lose some color.

Pale skin is one of the first things a healthcare provider will look for when diagnosing anemia.

Paleness may cover the entire body or be limited to a particular area. People with anemia may particularly notice paleness on the nails, palms, and around the lining of the eyes.


Headaches, and sometimes migraines, are common with multiple types of anemia, but the reason for this is still unclear. There is some evidence that iron deficiency, the most common cause of anemia, may be the root cause of the headaches. This may be particularly true for women and girls, and during menstruation.

Anemia is also considered a risk factor for idiopathic intracranial hypertension, a condition in which increased pressure around the brain causes headaches, among other symptoms. This relatively rare disorder tends to affect adult women with obesity.

Shortness of Breath

When your hemoglobin (a protein in red blood that carries oxygen) levels are low during anemia, your oxygen levels are also low. Consequently, your muscles and tissues are being deprived of oxygen-rich blood.

When this happens, doing normal, everyday activities like walking, climbing stairs, or even just making the bed, can become more challenging. You may feel short of breath and sometimes dizzy or lightheaded.

If you find yourself consistently short of breath, it is important to see a healthcare provider right away. Not only is shortness of breath a sign of anemia, but breathing problems could also be a sign of another serious medical condition.

Irregular Heartbeat or Palpitations

Hemoglobin helps transport oxygen around the body. When you have anemia, low levels of hemoglobin can cause your heart to work harder to transport oxygen.

This extra strain on your heart may lead to irregular heartbeats or the feeling that your heart is beating too fast or abnormally. However, more research is needed to confirm this connection.

Nail, Skin, and Hair Changes

Anemia may cause a nail abnormality called koilonychia. Characterized by thin, brittle, and spoon‐shaped nails, this condition is frequently observed in chronic iron deficiency.

Dry skin and hair loss may also be related to anemia since low oxygen levels can cause dryness and weakness. If you have iron-deficiency anemia, you may notice your hair is not growing or you are losing more hair than normal.

If you notice a change in your nails, hair, or skin, it is important to talk with a healthcare provider. Even if the changes are not related to anemia, they could be a sign of another medical condition.

Tongue Swelling or Soreness

Sometimes the inside of your mouth or your tongue will exhibit signs and symptoms of anemia. For instance, one study found that 76% of people with iron-deficiency anemia reported a burning sensation in their mouth.

In the same study, the people also reported inflammation and dry mouth, as well as a smooth, pale, and swollen tongue. Other potential symptoms associated with anemia include mouth ulcers and sore, red cracks at the corners of the mouth.

Nerve Damage

If you have pernicious anemia, which is caused by a vitamin B12 deficiency, you may experience nerve damage. This damage can cause tingling and numbness in your hands and feet.

The nerve damage may also cause you to lose your reflexes and experience muscle weakness. This can lead to feeling unsteady on your feet, having balance issues, and struggling to walk.

Anemia Symptoms in Children

Children and infants can experience iron-deficiency anemia since they grow rapidly and need more iron. Eating a diet too low in iron or consuming a lot of dairy milk, which can impact iron absorption, can cause anemia.

Signs of anemia in children and infants include:

  • Tiredness
  • Shortness of breath
  • Unusual food cravings or decreased appetite
  • Irritability
  • Headaches or dizziness
  • Sore tongue
  • Paleness
  • Whites of eyes that are very pale or blue-tinged
  • Brittle nails

When to See a Healthcare Provider

If you are experiencing any of the above symptoms, it's important to see a healthcare provider. Cases of mild to moderate anemia are typically asymptomatic, so even seemingly mild symptoms like fatigue and headaches can be a sign of more serious anemia.

When left untreated, anemia can lead to serious complications including organ failure and the worsening of other conditions like cardiovascular disease.

People who are pregnant should also talk to a healthcare provider about symptoms related to anemia. The condition can cause premature birth, low weight in the baby, and an increased risk for anemia in the baby.

A healthcare provider can offer a diagnosis to confirm if you have anemia or another health condition. From there, they can determine a treatment plan that's right for you.

A Quick Review

Anemia is a condition in which your blood has a reduced number of red blood cells. Since red blood cells carry oxygen, this can reduce the amount of oxygen transported from your lungs to the rest of your body.

Symptoms of anemia include tiredness, paleness, and shortness of breath. Some people may also experience headaches, heart palpitations, and changes in the hair, skin, and nails.

If you experience any symptoms of anemia, talk to your healthcare provider. They can confirm if you have the condition and help you get treatment.

Was this page helpful?
19 Sources uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Heart, Lung, and Blood Institute. Your guide to anemia.

  2. Rhodes CE, Denault D, Varacallo M. Physiology, oxygen transport. In: StatPearls. StatPearls Publishing; 2023.

  3. Hanif N, Anwer F. Chronic iron deficiency. In: StatPearls. StatPearls Publishing; 2023.

  4. MedlinePlus. Paleness.

  5. Auerbach M, Adamson JW. How we diagnose and treat iron deficiency anemia. Am J Hematol. 2016;91(1):31-8. doi:10.1002/ajh.24201

  6. Turner J, Parsi M, Badireddy M. Anemia. In: StatPearls. StatPearls Publishing; 2023.

  7. Tayyebi A, Poursadeghfard M, Nazeri M, Pousadeghfard T. Is there any correlation between migraine attacks and iron deficiency anemia? A case-control studyInt J Hematol Oncol Stem Cell Res. 2019;13(3),164–171.

  8. Gür-Özmen S, Karahan-Özcan R. Iron deficiency anemia is associated with menstrual migraine: A case–control studyPain Med. 2015:pnv029. doi:10.1093/pm/pnv029

  9. Ma Z, Jiang H, Meng C, Cui S, Peng J, Wang J. Idiopathic intracranial hypertension in patients with anemia: A retrospective observational studyPLoS One. 2020;15(7):e0236828. doi:10.1371/journal.pone.0236828

  10. Stugiewicz M, Tkaczyszyn M, Kasztura M, Banasiak W, Ponikowski P, Jankowska EA. The influence of iron deficiency on the functioning of skeletal muscles: experimental evidence and clinical implications: Iron deficiency and skeletal musclesEur J Heart Fail. 2016;18(7):762-773. doi:10.1002/ejhf.467

  11. MedlinePlus. Breathing problems.

  12. Lee WH, Hsu PC, Chu CY, et al. Anemia as an independent predictor of adverse cardiac outcomes in patients with atrial fibrillationInt J Med Sci. 2015;12(8):618-624. doi:10.7150/ijms.11924

  13. Moiz B. Spoon nails: Still seen in today's worldClin Case Rep. 2018;6(3):547-548. doi:10.1002/ccr3.1404

  14. Salinas M, Leiva-Salinas M, Flores E, López-Garrigós M, Leiva-Salinas C. Alopecia and iron deficiency: An interventional pilot study in primary care to improve the request of ferritinAdv Hematol. 2020;2020:7341018. doi:10.1155/2020/7341018

  15. Goluch-Koniuszy ZS. Nutrition of women with hair loss problem during the period of menopausePrz Menopauzalny. 2016;15(1):56-61. doi:10.5114/pm.2016.58776

  16. Wu YC, Wang YP, Chang JY, Cheng SJ, Chen HM, Sun A. Oral manifestations and blood profile in patients with iron deficiency anemia. J Formos Med Assoc. 2014;113(2):83-7. doi:10.1016/j.jfma.2013.11.010

  17. MedlinePlus. Anemia caused by low iron—infants and toddlers.

  18. MedlinePlus. Anemia caused by low iron—children.

  19. National Heart, Lung, and Blood Institute. Iron-deficiency anemia.

Related Articles