Anemia is a condition in which the blood has a below-normal level of red blood cells, hemoglobin, or hematocrit. In general, the patient is diagnosed as anemic if their hemoglobin content is lower than 13 grams per 100 ml in men, or 12g per 100 ml in women.

Not every case of dizziness is diagnosed as anemia.

Though many people think they are same, dizziness and vertigo are often not caused by anemia. Anemia could be one reason behind dizziness, but there are many other possible reasons including dysfunction of the inner ear, problems with the brainstem, or a sudden decrease of blood flow to the brain. 

So the first thing that a doctor should do is check whether the patient is actually suffering from anemia. After that they should check the severity and type of anemia, any etiologic disease and the best treatment method should be considered before undergoing examination and beginning treatment.

There are several types of anemia, which can roughly be divided into these three categories. First, aplastic anemia is caused by a lack of bone marrow substances that make red blood cells. Second, anemia could be caused by deficiencies of materials the body needs to make red blood cells, such as iron and vitamin B12. Third, anemia could also be caused by excessive hemolysis of red blood cells caused internally or externally, or by excessive bleeding.

Probable patients of anemia should undergo a blood test to check for the condition, its severity and estimate the type. Confirmation of the type of anemia could be followed by detailed blood tests and a bone marrow biopsy, if needed.

Patients generally think negatively about bone marrow biopsies because they think that the procedure will be painful and could result in damage to the spinal cord. In fact, the marrow fluid is harvested not from the spine but from the pelvic bone, because that area has fewer nerves and blood vessels.

A bone marrow biopsy is just like having an injection with a somewhat thick needle in the buttock. On the other hand, receiving blood transfusions or taking medicines like oral iron supplements for anemia before undergoing any examination can make it hard to determine the cause of the anemia and delay a correct diagnosis.

So, any treatment for anemia should take place after the cause is identified, unless it is certain that acute bleeding has induced the anemia or the patient does not have severe hemodynamic dysfunctions like decreased blood pressure and accelerated heart rate.

Different treatment methods should be chosen by each type and cause of anemia.

People feeling dizziness can easily buy drugs (oral iron supplements) for anemia at pharmacies without taking any examination. Actually, iron deficiency is the most common cause of anemia and accounts for about 90 percent of anemic patients. This kind of medicine could improve their symptoms.

But most of them do not take those drugs for a sufficient period of time, and most of all, they only take drugs without trying to find out the reason for their iron deficiency, which commonly leads to a recurrence after they stop taking the supplements.

Chronic loss of iron is the most common etiologic disease, and can be caused by peptic ulcers, fibroids and hemorrhoids. So, gastric endoscopy and obstetric and gynecologic care should be carried out, and if any etiologic disease is found, it should be treated together to prevent the recurrence of anemia.

On the other hand, regular, balanced meals are important to prevent anemia caused by deficiency of nutritional elements.

Different treatment methods for anemia should be chosen considering not only the type of disease, but also the patient’s age and severity, even when they have the same type of anemia. Therefore, patients should consult a physician about their disease and detailed treatment methods.

By Jung Chul-won

The author is a professor of Sungkyunkwan University School of Medicine and doctor at Department of Hematology Oncology of Samsung Medical Center ― Ed.