Anemia in Older Adults

Anemia is common in older adults and often goes unrecognized. Many people assume feeling tired or weak is “just part of aging,” but anemia is not normal and is often treatable once the cause is identified.

Understanding anemia can help you feel better, prevent complications, and support overall health.

What Is Anemia?

Anemia occurs when your blood does not have enough healthy red blood cells or hemoglobin to carry oxygen throughout the body.

When tissues don’t get enough oxygen, you may feel tired, weak, short of breath, or lightheaded.

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Why Anemia Is More Common in Older Adults

Anemia is more likely as we age due to:

• Chronic medical conditions
• Nutrient deficiencies
• Changes in digestion or absorption
• Certain medications
• Kidney disease or inflammation

Anemia often has more than one cause, especially in people with multiple chronic conditions.

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Common Causes of Anemia in Older Adults

Iron Deficiency Anemia

Iron is needed to make hemoglobin.

Possible causes include:

• Poor dietary intake
• Blood loss (including slow blood loss from the stomach or intestines)
• Difficulty absorbing iron

Learn more about Iron Deficiency Anemia from the National Heart, Lung, and Blood Institute: Iron-Deficiency Anemia

Vitamin B12 Deficiency

Vitamin B12 helps make red blood cells and supports nerve health.

Risk factors include:

• Reduced stomach acid with aging
• Certain medications
• Digestive conditions affecting absorption

💡 B12 deficiency can cause nerve symptoms, even before anemia is severe.

Learn more about Vitamin B12 Deficiency from the National Heart, Lung, and Blood Institute: Vitamin B12-Deficiency Anemia

Anemia of Chronic Disease

Long-term conditions can interfere with red blood cell production.

Common related conditions include:

• Kidney disease
• Inflammatory conditions
• Cancer
• Chronic infections

This type of anemia is often mild to moderate, but persistent.

Learn more about Anemia of Chronic Disease from the National Heart, Lung, and Blood Institute: Anemia of Inflammation or Chronic Disease

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Common Symptoms of Anemia

Symptoms may develop slowly and can be easy to overlook.

Anemia Symptom Checklist

☐ Fatigue or low energy
☐ Weakness
☐ Shortness of breath with activity
☐ Dizziness or lightheadedness
☐ Pale skin
☐ Cold hands or feet
☐ Headaches
☐ Heart palpitations
☐ Difficulty concentrating
☐ Numbness or tingling (more common with B12 deficiency)

⚠️ Symptoms may worsen over time if untreated.

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When Should Older Adults Be Tested?

Testing is important if symptoms are present or risk is high.

Blood Tests May Be Recommended If You:

• Feel persistently tired or weak
• Have chronic kidney disease
• Have digestive problems or poor appetite
• Take medications that affect absorption
• Have unexplained weight loss
• Have a history of anemia
• Have nerve symptoms or balance issues

Common tests include:

• Complete blood count (CBC)
• Iron studies
• Vitamin B12 level
• Kidney function tests

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Managing Anemia: What Helps

Treatment depends on the cause, not just the number.

Possible Management Approaches

• Iron supplementation (if iron deficient)
• Vitamin B12 replacement (oral or injections)
• Treating underlying chronic conditions
• Adjusting medications
• Nutrition support

⚠️ Do not start supplements without medical guidance, as too much supplementation can be harmful.

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Daily Energy & Symptom Tracking

Use this checklist to monitor changes:

☐ Energy level today
☐ Shortness of breath
☐ Dizziness or balance issues
☐ Ability to complete daily tasks
☐ New numbness or tingling
☐ Appetite changes

Bring this information to medical visits.

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Anemia Action Plan

My Health Goals

• I will report symptoms to my provider
• I will complete recommended lab tests
• I will take supplements only as prescribed
• I will follow up on abnormal results
• I will track energy and symptoms weekly

Write questions or concerns here:

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When to Seek Medical Help

Contact your healthcare provider if you experience:

🚨 Worsening fatigue or weakness
🚨 Dizziness or fainting
🚨 Shortness of breath with minimal activity
🚨 New heart palpitations
🚨 Numbness, tingling, or balance problems
🚨 Pale skin or worsening symptoms

Seek urgent care or emergency services for chest pain, severe shortness of breath, fainting, or confusion.

Always ask your healthcare provider for specific advice on when to call to report symptoms, and when to seek urgent/emergency care.  

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Key Takeaways

• Anemia is common but not a normal part of aging
• Iron, B12, and chronic disease are frequent causes
• Symptoms may be subtle but meaningful
• Testing helps identify the cause and guide treatment
• Treating anemia can improve energy, safety, and quality of life

Feeling better may start with a simple blood test — and the right next step.

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Medical Disclaimer

This information is provided for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a qualified healthcare professional. Anemia and chronic medical conditions vary from person to person, and treatment should be individualized.

Always consult your physician, nurse practitioner, or other licensed healthcare provider regarding symptoms, lab results, medications, supplements, or changes in your health. Do not delay or avoid seeking medical care based on information in this resource.

If you experience severe symptoms such as chest pain, fainting, trouble breathing, or sudden confusion, call 911 or seek immediate medical attention.

Sources:

•  https://www.niddk.nih.gov/health-information/blood-diseases