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Blood Health

What the Guidance Really Says About Anaemia

It is a finding rather than a diagnosis, and the reason for it matters far more than the number.

Dr Amara Nwosu, PhD, RD Editor-in-chief and registered dietitian 3 min read 1 views
What the Guidance Really Says About Anaemia

Key takeaways

  • Diagnosed by: low haemoglobin on a full blood count
  • Red cell size (MCV): narrows the cause considerably
  • Most useful single change: Ask what type of anaemia it is, not just that you are anaemic.
  • Commonest mistake: Self-supplementing iron without a blood test.
  • See a doctor if any of the signs under "When to speak to a doctor" below apply to you.

What it is

Too little haemoglobin to carry oxygen efficiently, from many possible causes. It sits within Blood Health. The table below gives the figures guidance actually works from.

The numbers, in one place

Published figures for Anaemia
MeasureFigure
Diagnosed bylow haemoglobin on a full blood count
Red cell size (MCV)narrows the cause considerably
Small cellssuggest iron deficiency or thalassaemia
Large cellssuggest B12 or folate deficiency, alcohol, thyroid disease
Common symptomsfatigue, breathlessness, palpitations, pallor

What helps

The advice below comes straight from the guidance cited at the foot of this page.

  • Ask what type of anaemia it is, not just that you are anaemic
  • Ask for ferritin, B12 and folate alongside the blood count
  • Establish the cause before starting long-term supplements
  • Complete any prescribed course fully, which outlasts symptom relief

What to avoid

A few of these are widely believed. That is precisely why they are here.

  • Self-supplementing iron without a blood test
  • Assuming anaemia is always dietary
  • Ignoring it because symptoms developed slowly

Where to go next

When to speak to a doctor

See a GP promptly for fatigue with breathlessness or palpitations. Iron deficiency in a man, or in a woman past menopause, requires investigation of the gut and must never simply be supplemented. Seek urgent help for black tarry stools, visible blood in stool, vomiting blood, chest pain, or breathlessness at rest.

Where this comes from

  • NICE — Anaemia clinical knowledge summaries
  • NHS — Iron deficiency anaemia

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarised or generalised beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to a GP, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 999.

Spotted something wrong? Report an error on this page. We correct on the page and say what changed.

Dr Amara Nwosu

Editor-in-chief and a registered dietitian of fourteen years. Spent six of them in NHS outpatient clinics, which is where she learned that the advice people actually follow beats the advice that is technically optimal.

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