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Anemia: Symptoms, Causes, and Treatment

By Dr. Kirti Malviya | Diseases | Posted on :   11-Jan-2021

Anemia is defined as a low hemoglobin concentration/ may be due to either low red cell mass/ increased plasma volume. Low Hb is <13.5 g/dL for men and <11.5g/dL for women. It can be due to reduced RBCs production/ loss of RBCs due to several causes. Some forms of anemia include aplastic anemia/ folic acid deficiency anemia/ hemolytic anemia/ sickle cell anemia.

According to the Ayurveda concept, Anemia is generally known as Pandu Roga. It is due to less amount of blood( rakta-alpata). Pandu is considered as Rakta Pradoshaja Vikara. In this case, the patient skin color changes to shveta peet(pandu varna).

Pandu ( Anaemia) according to Acharya Charak is mainly classified into five types:-
1) Vataja
2) Pittaja
3) Kaphaja
4) Sannipataja
5) Mridu Bhakshan Janya

Anemia Causes

  • Blood loss/ decreased red blood cell production/ increased red blood cell breakdown
  • Trauma/ gastrointestinal bleeding
  • Iron deficiency
  • Vitamin b12 deficiency
  • Thalassemia
  • Bone marrow neoplasms
  • Genetic conditions ( sicke cell anemia/haemophilia)
  • Certain autoimmune diseases
  • Blood loss/fluid overload
  • Kidney failure
  • Some endocrine disorders
  • Protein malnutrition
  • Hepatic failure
  • Aplastic anemia
  • Drug-induced anemia
  • Scurvy

Anemia Symptoms

  • Fatigue/ Weakness
  • Decreased energy
  • Weakness/ Numbness
  • Palpitations
  • Lightheadedness
  • Looking pale
  • Cramps
  • Breathlessness
  • Dyspnoea
  • Tinnitus
  • Anorexia
  • Coronary Artery Disease
  • Dryness of skin
  • Excessive salivation
  • Indigestion
  • The yellowness of urine/stool
  • Loss of glow
  • Tinnitus/ vertigo
  • Fever
  • Hair fall
  • Excessive sleep/excessive salivation
  • Cramps in the calf region

When to See Your Doctor for Anemia Disease?

If signs and symptoms appear for a long-duration / some of the following symptoms appear, then you should consult doctor as soon as possible :

  • Tiredness/ vertigo/ excessive fatigue
  • Pale skin/ pale eyes
  • Rapid heartbeat ( tachycardia)
  • Palpitations occur for long
  • Blood in urine/ stool
  • Heavy menstrual periods
  • Hereditary anemia conditions


  • Hb Examination and levels
  • CBC ( Complete Blood Count)
  • Vit B12 levels
  • Homocystene Serum
  • Ferritine Serum’
  • Peripheral smear microscopic examination
  • MCV (Mean Cell Volume) investigation.
  • In Ayurveda, differential diagnosis is examined by checking vata/pitta/kapha prakriti.

Prevention of Anemia

  • Proper nutrition and diet of Iron.
  • Prevent yourself from infectious and parasitic diseases.
  • When signs and symptoms appear then consult doctor soon.
  • By examining yourself by doctor to check any other disease leading anemia.
  • Take iron supplements under the guidance of Doctor.

Risk Factors of Anemia

  • Premature birth
  • Excessive menstruation
  • Being pregnant/ giving birth
  • Diet low in vitamins
  • Family history
  • Chronic illness ( AIDS/Diabetes/ Kidney disease/ Heart failure/ Liver disease)
  • Trauma

General Tips

  • 3 gm Gooseberry powder three times a day with honey.
  • Dry Grapes intake
  • 1cup beetroot juice + 1 cup apple juice + mixed with sugar/honey = once a day
  • Fresh pomegranate/ fresh bananas
  • Intake of jaggery
  • Intake of anjeer ( fig)
  • Broccoli/ green leafy vegetables/ carrot/ spinach.
  • Peanut butter
  • Intake of kidney beans/ black- eyed peas
  • Avocadoes

What to Avoid?

  • Salty/ sour/ spicy /hot diet
  • Exposure to sunlight
  • Drinking and smoking
  • Excessive exercise
  • Junk foods

What to Eat?

  • Green leafy vegetables such as spinach
  • Carrot/carrot dishes
  • Dates
  • Cherry/ cranberry
  • Jaggery
  • Anjeer ( fig)
  • Pomegranate/ banana
  • Grapes/ mango/ apple
  • Eggs
  • Beetroot juice
  • Apple juice

Questions & Answers

Q.1 What are the reference ranges of Hb in adults and children?
Reference ranges are -

  • Men  = 14- 18 g/ dL
  • Women = 12-16 g/dL
  • Pregnant women > 11g/dL
  • Newborn = 14-24 g/dL
  • 0-2 weeks = 12-20 g/dL
  • 2-6 months = 10-17 g/dL
  • 6 months/ 1 year = 9.5-14g/dL
  • 1) 6 years = 9.5 - 14 g/dL
  • 6-18 years = 10-15.5 g/dL

Q.2 Is it normal to have Hb value high?
No, it's not to be normal while having high Hb values. High Hb values occur when the body requires an increased Oxygen carrying capacity. It may result in polycythemia/ Heart diseases/ COPD/ emphysema/ heart failure/ kidney Cancer/ liver cancer/ dehydration/ etc.

Q.3 What are the causes of High Hb values?
Many factors and various causes are associated with high Hb values like -

  • Smoking
  • Increase count of RBCs
  • Bone marrow produces many RBCs
  • Drugs that increase your erythropoietin that further will stimulate RBCs production.
  • Chronic kidney disease, etc.

Q.4 What sign does eyelid color shows when anemia occur?
‘Conjunctival pallor’ is the classic sign of anemia. The pallor refers to the vasculature on the inner surface of the lid lacking Hb conc. It is usually caused by a reduction in blood flow and oxygen / by decreased no. Of RBCs.

Q.5 What are the classifications of Anemia?
Anemia is generally classified by two methods:-
1) Morphological
2) Etiological

1) Morphological - It mainly depends upon the size and color RBC. It includes:-

  • Normocytic Normochromic Anemia
  • Macrocytic Normochromic Anemia
  • Macrocytic Hypochromic Anemia
  • Microcytic Hypochromic Anemia

2) Etiological - Depends on cause/ origin, it includes -

  • Hemorrhagic Anemia
  • Hemolytic Anemia
  • Nutrition deficiency Anemia
  • Aplastic Anemia
  • Anemia of chronic disease

Q.6 What happens when Hb value gets lower in Pregnant women? How can it overcome?
Hb value gets lower due to insufficiency of RBCs to carry oxygen to tissues. During pregnancy, as a growing fetus also requires oxygen and blood supply, so, it is important to increase iron supplements and dietary intake. Hb low value in pregnancy leads to weakness/ fatigue/ pale/yellowish skin/ breathing shortness/ chest pain/ cold hands and feet/ headaches.

Q.7 What are the various dietary intake to come over the deficiency of Anemia?
Various dietary intake includes:-
- consumption of fortified foods.
- vitamin A-rich foods/folic acid/ vitamin B-12/ Iron-rich supplements and food in the diet
- Foods that rich in vitamin-c ( fruits/tuber/ green leafy vegetables) should be consumed at mealtimes.
- Vitamin B-12 rich animal products
- Folic acid rich legumes.
- beta-carotene/ vitamin A-rich foods
- restrict consumption of tea/coffee/ cocoa between meals/ 1 hr after meals, since it inhibits iron absorption.
- avoid intake of milk/ milk-related products at meals as calcium in milk inhibits iron absorption.

Q.8 How the deficiency of Iron affect the Nervous and Endocrine system?
It alters the production of Triiodothyronine ( T3) and thyroid function in general,  production of catecholamines and other neurotransmitters, it results in impaired temperature response to a cold environment.

Q.9 Where Folate is found and what are the causes of its deficiency?
It is found in green vegetables, nuts, yeast & liver/ synthesized by gut bacteria. Causes of its deficiency include poor diet e.g. poverty, alcoholics, elderly/ increased demand, e.g. pregnancy/ increase cell turnover/
Malabsorption/ drugs/alcohol/ antiepileptics etc.

Q.10 What kind of treatment is available in Ayurveda for Anemia?
In Ayurveda medicine, treatment generally includes Nidaan Parivarjan, Samshodhana chikitsa( nidan parivarjan, aabhyantar snehana, tikshana samshodhan with vamana or virechana,raktabasti, Samshamana chikitsa includes rasa, virya ayurveda drug formulations according to vata/pitta/kaphaja/sannipataja prakritis.



1. Longmore, Wilkinson, Davidson, Foulkes, Mafi, Oxford Handbook of Clinical Medicine 8th Edition.
2. Kayachikitsa Volume-2 by Prof. Ajay Kumar Sharma (2017)
3. Charak Samhita, Chikitsa Sthana - ch-16
4. Madhava Nidana, Ch-8
5. J.Alastair Innes, Davidson’s Essential of Medicine 2nd edition
6. K Sembulingam, P Sembulingam, Essentials of Medical Physiology 6th Edition.

Disclaimer - The aim of the article is just to convey information to you. Use any medicine, therapy, herb or fruit please do it under the guidance of a qualified Ayurveda doctor.