Anemia related to fatigue

Do you feel drained and exhausted, no matter how much rest you get? There are multiple reasons this may happen, but one that’s often overlooked is anemia. Anemia is a medical condition characterized by insufficient red blood cells in the body to transport oxygen to the organs and tissues. There are different types of anemia, but two of the most common anemias related to nutrition and fatigue are iron deficiency anemia and pernicious anemia. These two conditions, although different in nature, share one common symptom: fatigue.

So, let’s dive in and discover what you need to know about these two types of anemias related to nutrition and fatigue.

Iron Deficiency Anemia

One of the most common type of anemias related to fatigue is iron deficiency anemia. It arises due to insufficient iron levels in the body. Iron is essential for the production of hemoglobin, so without enough iron, the body cannot make enough red blood cells, can not carry enough oxygen, and leaves you feeling lethargic and tired. 

Signs and Symptoms

The most common signs and symptoms of iron deficiency anemia include:

  • Fatigue and weakness
  • Shortness of breath
  • Dizziness or lightheadedness
  • Pale skin
  • Brittle nails
  • Cold hands and feet
  • Irritability
  • Headaches
  • Chest pain or rapid heartbeat, especially during physical activity
  • Craving for non-food items, such as dirt, ice, or starch (pica)

These symptoms are more likely if you have a lack of iron in your diet, such as being are a vegetarian or “just not a big meat eater.” It’s also common during pregnancy, if you have had a loss of blood, or if you have heavy menstrual cycles. Additionally you may be consuming enough iron but have difficulty with absorbing iron for a variety of reasons.

If you experience any of these symptoms, it is important to speak with your provider, asking for an evaluation or iron deficiency anemia.


Typically, a medical history, physical examination, and laboratory tests are used to identify iron deficiency anemia. The lab testing that’s done consists of? 

  • Complete Blood Count (CBC): This test analyses the amount of red blood cells and hemoglobin in your blood. When hemoglobin or hematocrit are low it is a good indication that you have iron deficiency. To further tease out your iron in the body, additional testing may be warranted. 
  • Serum ferritin: Ferritin is a blood protein that stores iron. Low ferritin levels (or even low-normal) indicate that you don’t have enough iron being stored, which along with a low hemoglobin level from a CBC is a good indicator of iron deficiency.
  • Iron studies: This test assesses your blood’s levels of iron as well as other indicators of iron metabolism, including transferrin and transferrin saturation.

Furthermore, your healthcare provider might suggest further examinations to identify the root cause of your iron deficiency anemia.


The treatment for iron deficiency anemia typically involves increasing the amount of iron in the diet through food sources or through supplements. 

Food sources of iron differ depending on the source. There’s heme iron, which is readily absorbable and found in animal products. The other type of iron is a non-heme iron which is found in plant based foods. While it can be beneficial, it requires more non-heme iron to increase iron in the body.

Good food sources of iron include:

  • Red meat
  • Poultry
  • Seafood
  • Beans and lentils
  • Tofu
  • Spinach
  • Broccoli
  • Fortified cereals
  • Whole grains

Supplement Sources:

Iron supplementation can also be used to replenish the body’s depleted iron stores. These can be given orally or intravenously, depending on the severity of the anemia.

It is important to know that, iron is something that can be taken in excess, so having your iron tested regularly if you are supplementing is a good idea. 

Pernicious Anemia:

Pernicious anemia is a type of anemia that occurs when the body cannot absorb enough vitamin B12 and/or folate (vitamin B9). These B vitamins are essential for the production of red blood cells, so without enough of it, the body cannot make enough red blood cells which again leads to fatigue.

Signs and Symptoms:

The most common signs and symptoms of pernicious anemia are similar to iron deficiency, and include:

  • Fatigue and weakness
  • Pale skin
  • Shortness of breath
  • Tingling or numbness
  • Difficulty walking
  • Cognitive changes (memory loss, confusion, and depression)
  • Glossitis (inflammation of the tongue)


The diagnosis of pernicious anemia usually involves a combination of medical history, clinical examination, blood tests, and occasionally additional diagnostic tests. Common methods used to diagnose pernicious anemia include:

  • Blood tests: Blood tests are used to measure the levels of vitamin B12 and a CBC which identifies other markers, such as red blood cell count, hemoglobin, and mean corpuscular volume (MCV). A low vitamin B12 level and high MCV are common indicators of pernicious anemia.
  • Intrinsic factor antibody test: This blood test measures the presence of antibodies to intrinsic factor, a protein needed for the absorption of vitamin B12. The presence of intrinsic factor antibodies can confirm a diagnosis of pernicious anemia.
  • Schilling test: This test involves taking a small amount of radioactive vitamin B12 orally and measuring the amount of vitamin B12 that is absorbed and excreted in urine. The test can determine if there is a problem with the body’s ability to absorb vitamin B12.


The treatment of pernicious anemia involves addressing the underlying cause of the deficiency. There are a few reasons why you may have vitamin B12 and/or folate deficiency, including not consuming enough foods that contain vitamin B12, certain types of gastrointestinal issues which would lead to a decrease in absorption of the B vitamins, or some genetic polymorphisms such as MTHFR. 

Here are some food sources of vitamin B12:

  • Shellfish, such as clams, mussels, and crab
  • Fish, such as salmon, trout, and tuna
  • Beef, liver, and other meats
  • Dairy products, such as milk, cheese, and yogurt
  • Eggs
  • Fortified breakfast cereals and nutritional yeast

Supplement sources of vitamin B12  and folate include oral supplements, vitamin B12 injections, and intranasal vitamin B12. 

In conclusion, iron deficiency anemia and pernicious anemia are two types of anemias that are related to nutrition and fatigue. While iron deficiency anemia can be treated by increasing the amount of iron in the diet, pernicious anemia requires vitamin B12 and or folate supplementation. Ultimately, it is important to talk to a practitioner if you are experiencing symptoms of anemia, as it can be a serious condition if left untreated.