All About Anemia

Anemia is one of the most common conditions I see in primary care and yet many people don’t realize they have it until they feel completely exhausted. The good news? Anemia is very treatable once we identify the cause. In this post, I’ll walk you through what anemia actually is, the symptoms to watch for, and how we approach diagnosis and treatment in a direct primary care (DPC) setting.

What Is Anemia?

Anemia happens when your body doesn’t have enough healthy red blood cells or hemoglobin. Red blood cells are responsible for carrying oxygen throughout your body; hemoglobin is the protein that binds that oxygen and delivers it to your tissues.

When these levels drop, your body struggles to get the oxygen it needs, leading to the common symptoms listed below.

Common Symptoms of Anemia

Some people barely notice symptoms at first, while others feel the effects quickly.

Here are some signs I encourage patients to watch for:

• Fatigue or feeling worn out even after resting

• Shortness of breath, especially with activity

• Dizziness or lightheadedness

• Heart palpitations

• Pale or yellowish skin, though this can be harder to tell for people with more melanin

• Cold hands and feet

• Headaches

• Brittle nails or hair loss

• Cravings for non-food items (ice, clay) also known as PICA

Types of Anemia

Anemia is not a one-size-fits-all diagnosis. I like to think of it like an umbrella term for a variety of anemia types. Understanding the type helps guide the right treatment.

1. Iron-Deficiency Anemia

The most common type.

Causes include:

• Low iron intake

• Heavy menstrual periods

• Pregnancy

• Chronic blood loss (e.g., GI issues)

  
  

2. Vitamin B12 or Folate Deficiency

These vitamins help your body produce red blood cells. Low levels can be caused by:

• Diet low in B12 (common in vegans/vegetarians)

• Malabsorption (celiac disease, Crohn’s, stomach surgeries)

• Certain medications

  
  

3. Chronic Disease Anemia

Long-term conditions like kidney disease, autoimmune disorders, or chronic inflammation can affect blood production.

4. Hemolytic Anemia

Red blood cells break down faster than they’re produced.

5. Genetic Anemias

Such as sickle cell disease or thalassemia. I love getting to teach my patients about thalassemia as that is one many of my patients are surprised to learn about, not really something that we ask about at family parties LOL ("Grandma, who in our family has thalassemia? Also, thanks for cooking us dinner!")

Each type requires a different treatment approach—so diagnosis matters.

How I Diagnose Anemia

In my DPC practice, we keep testing straightforward and affordable.

Evaluation usually includes:

• Complete Blood Count (CBC) which measures hemoglobin, hematocrit, and red blood cell indices

• Iron panel which includes iron, ferritin, TIBC

• B12 and folate levels

• Thyroid panel (because thyroid issues can mimic anemia symptoms)

• Kidney function tests

• Other labs depending on symptoms and risk factors

A single blood test often gives us enough information to identify the cause and start treatment.

Treatment Options

Once we know the type of anemia, treatment becomes clear.

Iron Deficiency

• Oral iron supplements (occasionally we will coordinate IV iron if my patients have any digestive challenges).

• Increasing iron-rich foods (spinach, red meat, beans, lentils, fortified cereals)

• Vitamin C to help absorption

• Addressing underlying causes (e.g., heavy periods, GI bleeding)

  
  

B12 Deficiency

• B12 injections or high-dose oral supplements

• Diet adjustments

  
  

Folate Deficiency

• Folic acid supplements

• Improving dietary intake

  
  

Anemia of Chronic Disease

• Managing the underlying condition

• In some cases, medications that stimulate red blood cell production

  
  

Severe or Longstanding Anemia

Occasionally requires IV iron or specialist referral.

Why Treating Anemia Matters

Anemia affects more than your energy level. Long-term, untreated anemia can strain your heart, reduce your immune function, worsen chronic conditions, and impact overall quality of life. The sooner we treat it, the faster patients feel better and many notice improvement within a few weeks.

How DPC Improves Anemia Care

One of the biggest benefits of DPC is time to listen, to dig into root causes, and to follow up closely as you heal. I keep labs simple and transparent, and check in frequently to make sure you’re improving. For many patients, the combination of accessible care, low-cost labs, and ongoing support leads to faster diagnosis and recovery.

Final Thoughts

If you’ve been feeling unusually tired, short of breath, or just “off,” anemia might be the reason. The good news is that it’s very treatable once identified. If you're interested in a personalized evaluation or want to get your blood levels checked, my DPC practice offers accessible, patient-focused care without the hassle of rushed appointments or insurance barriers.

Wishing you energy and health today and beyond!