We all feel a little tired and run-down from time to time. But if the feeling continues, or is excessive, you might start wondering whether something else is wrong. One common cause of feeling run-down is anaemia. Here we look at the signs and symptoms, whether you're at risk and what to do next.
We often associate being anaemic with having low iron levels. However, whilst low iron levels may lead to someone becoming anaemic, there are other factors at play.
"Anaemia is caused when you don't have enough red blood cells or haemoglobin - the part of your red blood cells that carries oxygen," says Dr Luke Powles, associate clinical director of Bupa UK.
Iron is essential for haemoglobin production by the body but other factors can prevent red cells or haemoglobin being produced quickly enough for your needs. Therefore simply upping iron intake may not solve the problem.
What are the symptoms?
Whilst for some the symptoms of anaemia are unmistakable, others may have anaemia without displaying any noticeable symptoms.
However, when symptoms do present, they are often subtle - feeling tired, having low energy or feeling weak. Having these symptoms does not necessarily mean you are anaemic - as many other conditions, including thyroid disorders, diabetes or poor quality of sleep, may present in a similar way.
When anaemia becomes severe, the symptoms increase and become more obvious.
"If you are more severely anaemic, symptoms may include feeling short of breath, having heart palpitations and, sometimes, chest pain. If you have the symptoms associated with more severe anaemia, please seek urgent medical advice," advises Powles.
What causes anaemia?
Anaemia can have a variety of different causes, from dietary deficiencies to loss of blood or disease. It is also commonly experienced during pregnancy.
"Deficiencies in the diet are a common cause of anaemia," explains GP Dr Jeff Foster. "These include iron deficiency, but also deficiencies in B12, folate or riboflavin. Anaemia can also be caused by excess alcohol consumption which can lead to a reduction in the number of oxygen-carrying red blood cells."
Anaemia can also be a sign of blood loss.
"This loss may be obvious - for example, if you are involved in an accident - but could also be the result of undetected bleeding in the gut caused by an ulcer, inflammatory disease or cancer,” explains Foster. "Heavy periods may also cause anaemia."
Finally, there are several diseases that may cause anaemia, including thyroid disease, thalassaemia and cancer. Whilst many cases of anaemia can be easily treated, it is important that you seek medical advice to ensure you receive the correct treatment.
How can I prevent anaemia?
Whilst not all types of anaemia can be prevented, there are some steps you can take to minimise the risk.
Seek advice on heavy periods
"One of the most common causes of anaemia is through menstrual blood loss which leads to reduced iron levels. Managing heavy periods can help prevent anaemia so if you suffer with these then please seek advice from your doctor," advises Powles.
Adjust your diet
Whilst not all anaemia is caused by low iron levels, "making sure you get enough of the right vitamins and minerals from the foods you eat can help prevent some types of anaemia, such as those caused by deficiencies in iron, vitamin B12 and folate," says Powles.
"Try to include more foods that are rich in iron in your diet. For example, dark green leafy vegetables like spinach and kale, red meats, apricots and prunes. You should also cut down on food and drink that make it harder for your body to absorb iron, such as dairy, tea, coffee, milk, and foods with high levels of phytic acid, such as wholegrain cereals."
"Poultry, pork and shellfish are rich in folate, while red meats, eggs and dairy products are high in vitamin B12. You should make sure you get enough of these in your diet, as well as vitamin C, which helps your body take in iron from the food and drink you consume. Orange juice is a great source of vitamin C."
If you suspect you're suffering from anaemia, you'd be forgiven for thinking that an over-the-counter solution might be best; rather than bother the doctor, why not simply dose yourself up with iron tablets? Unfortunately, this can often cause more harm than good.
"Without proper testing, it's impossible to know if the anaemia is due to low iron or not; there could be a host of other causes," explains Foster. "Therefore if you self-medicate, the results may appear normal on a blood test but mask something more serious (such as bowel cancer).
In addition "the over-the-counter dose of iron is too low to treat iron-deficiency anaemia, so is unlikely to be beneficial."