Anaemia
Anaemia means the blood carries less oxygen than usual. Assessment looks for possible causes and guides treatment; further investigation or referral may be needed.
Who should see an internist about this
- A blood test showed low haemoglobin or low ferritin (iron stores).
- Persistent tiredness, breathlessness on effort, dizziness or pale appearance.
- Heavy periods, or a vegetarian or restricted diet.
- You were told your red cells are small and iron never helped.
- Anaemia found in pregnancy planning, before surgery, or on a routine check.
What happens at your visit
Dr. James asks about diet, periods, gut symptoms, previous blood counts and family blood conditions, then examines for pallor and other clues. Your blood count is reviewed properly: not just haemoglobin but cell size and pattern, which point toward the cause.
Further tests are chosen by the pattern: ferritin for iron stores, B12 and folate, thyroid function, or screening for thalassemia trait. Treatment follows the cause, and possible hidden blood loss is investigated when indicated.
Iron tablets may help when iron deficiency is confirmed. They can cause nausea, abdominal discomfort, constipation or dark stools, and can interact with other medicines. Response varies; follow-up blood tests check progress and investigation of the cause may still be needed.
How to prepare
- Bring all previous blood count reports, even old ones, because the trend tells a story.
- Bring your medicine and supplement list, including iron already tried.
- Note diet pattern and, for women, period heaviness.
After your visit
The findings, likely causes, treatment options and follow-up plan are discussed. Further tests or referral may be needed if the cause remains uncertain.
Common questions
What does low haemoglobin actually mean?
Haemoglobin is the protein in red blood cells that carries oxygen. When it is low, organs get less oxygen, which is why you feel tired, breathless on stairs, dizzy or look pale. It is a finding, not a diagnosis; the cause has to be named.
Is anaemia always an iron problem?
No. Iron deficiency is the commonest cause, but low B12 or folate, thyroid problems, chronic illness, kidney disease and inherited conditions like thalassemia trait (common in this region) all cause anaemia. Each needs a different treatment.
Should I just take iron tablets?
Not before the cause is known. Iron tablets may help when iron deficiency is confirmed, but they can cause nausea, abdominal discomfort, constipation or dark stools, and can interact with other medicines. The reason for the deficiency matters too: diet, heavy periods, or hidden gut blood loss. Response varies; follow-up blood tests check progress and investigation of the cause may still be needed.
What is thalassemia trait?
It is an inherited blood variant common in the Gulf, South Asia and the Mediterranean. Trait carriers are usually healthy but have small red cells that look like iron deficiency on reports. Knowing your trait status prevents years of unnecessary iron.
How long until iron treatment works?
Haemoglobin usually starts rising within two to four weeks and normalises in two to three months, but stores take longer to refill. Feeling better often comes first. A repeat blood count confirms the response rather than assuming it.
