Table of ContentsView AllTable of ContentsNormal HemolysisEffects of Abnormal HemolysisCausesRisksHemolysis IndexTreatmentPrognosisLiving Well
Table of ContentsView All
View All
Table of Contents
Normal Hemolysis
Effects of Abnormal Hemolysis
Causes
Risks
Hemolysis Index
Treatment
Prognosis
Living Well
Hemolysisis the process of red blood cell (RBC) breakdown. Normally, your body makes new RBCs to replace those that have exceeded their healthy lifespan.Some of the materials released into your bloodstream when your RBCs decompose are used as your body makes new ones.
Sometimes, medical conditions can cause abnormal hemolysis. This can result in symptoms ranging from fatigue to dizziness to loss of consciousness—depending on the extent and cause of abnormal hemolysis. This article will describe normal and abnormal hemolysis and what to expect.
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Hemolysis: What Happens Normally
Your body is constantly replenishing RBCs, and they typically last for about 120 days.This requires a healthy supply of nutrients such as protein, iron, folate, and vitamin B12.
When you’re healthy, you won’t feel the effects of RBC breakdown or regeneration. But if any part of the RBC lifecycle or renewal process is disrupted, you may developsymptoms of anemia(low RBCs). If the cause of anemia is hemolysis, you may also experience symptoms related to hemolytic processes.
The effects of abnormal hemolysis may develop gradually or can occur abruptly—this depends on the triggers for abnormal RBC disintegration.You will likely develop symptoms of anemia. Other symptoms can develop due to the accumulation of RBC breakdown products in the liver or other organs of the body.
General Symptoms
Mild hemolysis can cause gradually progressive fatigue, dizziness, pale skin, and feeling cold. Rapid hemolysis can causehematuria(blood in the urine), a significant drop in blood pressure, and loss of consciousness.
Other symptoms can develop due to the accumulation of RBC breakdown products in the liver or other organs of the body. Examples are jaundice (yellowing of skin) or scleral icterus (yellowing of eyes).
Related Conditions
Many different medical conditions can cause hemolysis. Some of these disorders are chronic, inherited conditions that make the RBCs especially fragile. Hemolysis can also develop due to health issues that damage RBCs.
A few of the illnesses that can cause abnormal hemolysis include:
Medications That May Induce Hemolysis
Several medications can trigger hemolysis. The way that each medication leads to hemolysis differs.
Some of the medications that can cause hemolysis include:
This is not a complete list of hemolysis-inducing drugs—many over-the-counter (OTC) and prescription medications can cause this reaction.
Understanding the Many Types of Hemolytic Anemia
Why Does Abnormal Hemolysis Happen?
With normal hemolysis, the rate of RBC breakdown is about the same as the rate of RBC regeneration.
Conditions that lead to abnormal hemolysis disrupt the stability of the RBCs, causing them to disintegrate.This can happen as a result of toxic injury to any part of the RBC structure.A key feature of abnormal hemolysis is that symptoms usually develop when the RBCs break down faster than the body can replenish them.
Risks of Untreated Abnormal Hemolysis
An acute episode of severe hemolysis can cause substantial and irreversible organ damage—and may even result in death.
Chronic hemolytic disease may damage the joints throughout the body, sometimes causing joint aches and pains.Liver damage due to hemolysis can lead to liver dysfunction. Symptoms may include feeling generally sick, jaundice (yellowing of the eyes and skin), an enlarged abdomen, difficulty with digestion, and susceptibility to infections.
If it’s not treated, chronic hemolysis may lead to death. There are many causes of hemolysis, and the severity can vary significantly.
Hemolysis and Life ExpectancyIt’s impossible to predict with certainty how this condition will affect a person’s life expectancy. Treatment can prolong survival and reduce the symptoms. Organ damage associated with hemolysis can lead to worse outcomes and a lower chance of survival.
Hemolysis and Life Expectancy
It’s impossible to predict with certainty how this condition will affect a person’s life expectancy. Treatment can prolong survival and reduce the symptoms. Organ damage associated with hemolysis can lead to worse outcomes and a lower chance of survival.
How the Hemolysis Index Measures RBC Ranges
Anemia is diagnosed with blood tests that measure thesize and concentration of RBCs in a person’s bloodstream. Additionally, measures of hemoglobin and iron can also be used to assess causes of anemia, and consideration of the overall results can be used to determine whether you have abnormal hemolysis.
Blood samples can also be examined with a microscope, which may reveal important information about the shape of RBCs and whether there are abnormal numbers of broken-down RBCs.
If you have evidence of abnormal hemolysis based on the results of your blood tests, you may also have tests to identify the cause.These tests may include genetic tests or diagnostic procedures to identify underlying risks (such as heart disease or cancer).
Red Blood Cell Count: Understanding MCV, MCH, RDW, and More
Treatment for Abnormal Hemolysis
Treatment for abnormal hemolysis involves replacing RBCs, treating the complications, and managing the underlying medical condition to prevent excessive RBC breakdown. For example, infections such as malaria require specific antiparasitic treatment.
In some cases, blood transfusions may benefit people who have hemolytic anemia. Blood transfusions can restore a normal RBC count, alleviating symptoms and complications.
Long Term Treatment and Prevention
The cause directs long-term treatment. For example, if you are diagnosed with sickle cell disease or an autoimmune disease, you would need individualized treatment.
The treatment of G6PD deficiency involvesavoiding exposure to substances that can induce hemolysis. If a person with G6PD deficiency develops hemolytic anemia, a prompt blood transfusion may benefit them.
Prognosis for Autoimmune Hemolytic Anemia
If you are diagnosed with autoimmune hemolytic anemia, you need to have ongoing surveillance of your RBC measures,and your treatment may need to be adjusted based on the severity and fluctuation of your condition.
Living Well With Abnormal Hemolysis
Abnormal hemolysis is a dangerous consequence of several different medical disorders. If diagnosed with abnormal hemolysis, you can have a healthy life and a good outcome. It would be best to keep up with your medical care and monitoring to prevent symptoms or severe consequences of your disease.
Additionally, lifestyle factors can help prevent anemia:
Summary
Hemolysis is a normal part of the RBC lifespan as aging RBCs disintegrate. Abnormal hemolysis can occur as a consequence of many different medical conditions. If your RBC breakdown exceeds your RBC production, you can experience symptoms such as fatigue, dizziness, pale skin, and feeling cold.
If you develop extreme hemolytic anemia, you may develop low blood pressure, loss of consciousness, and organ damage. Routine blood tests can help detect signs of hemolysis.
If you develop any symptoms, it’s important that you see a healthcare provider so you can be diagnosed and treated before serious consequences occur.
How Can You Increase Your Red Blood Cells?
14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Health.Hemolytic anemia.Gyldenholm T, Stengaard C, Sørensen JT, Bøtker MT, Ladefoged SA.Haemolysis in prehospital blood samples.Scand J Clin Lab Invest. 2021;81(6):508-510. doi:10.1080/00365513.2021.1941234Phillips J, Henderson AC.Hemolytic anemia: evaluation and differential diagnosis.Am Fam Physician.2018;98(6):354-361.Van Avondt K, Nur E, Zeerleder S.Mechanisms of haemolysis-induced kidney injury.Nat Rev Nephrol.2019;15(11):671-692. doi:10.1038/s41581-019-0181-0Hoffman KR, Burrell AJC, Diehl A, Butt W.Elevated carboxyhaemoglobin as a novel indicator for extracorporeal membrane haemolysis and oxygenator exchange.Crit Care. 2021;25(1):159. doi:10.1186/s13054-021-03582-wGbotosho OT, Kapetanaki MG, Kato GJ.The worst things in life are free: the role of free heme in sickle cell disease.Front Immunol. 2021;11:561917. doi:10.3389/fimmu.2020.561917Centers for Disease Control and Prevention.Complications of sickle cell disease.Shan S, Zhao XY, Jia JD.[Hepatic manifestations of hematological diseases].Zhonghua Gan Zang Bing Za Zhi. 2022;30(4):347-351. Chinese. doi:10.3760/cma.j.cn501113-20220317-00117Lippi G, Favaloro EJ, Franchini M.Haemolysis index for the screening of intravascular haemolysis: a novel diagnostic opportunity?Blood Transfus.2018;16(5):433-437. doi:10.2450/2018.0045-18Brando B, Gatti A, Preijers F.Flow cytometric diagnosis of paroxysmal nocturnal hemoglobinuria: pearls and pitfalls - a critical review article.EJIFCC. 2019;30(4):355-370.Hill QA, Hill A, Berentsen S.Defining autoimmune hemolytic anemia: a systematic review of the terminology used for diagnosis and treatment.Blood Adv.2019;3(12):1897-1906. doi:10.1182/bloodadvances.2019000036Jäger U, Barcellini W, Broome CM, et al.Diagnosis and treatment of autoimmune hemolytic anemia in adults: recommendations from the First International Consensus Meeting.Blood Rev. 2020;41:100648. doi:10.1016/j.blre.2019.100648World Health Organization.Anaemia.Schmitt M, Ewendt F, Kluttig A, et al.Smoking is associated with increased eryptosis, suicidal erythrocyte death, in a large population-based cohort.Sci Rep. 2024;14(1):3024. doi:10.1038/s41598-024-53258-y
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Health.Hemolytic anemia.Gyldenholm T, Stengaard C, Sørensen JT, Bøtker MT, Ladefoged SA.Haemolysis in prehospital blood samples.Scand J Clin Lab Invest. 2021;81(6):508-510. doi:10.1080/00365513.2021.1941234Phillips J, Henderson AC.Hemolytic anemia: evaluation and differential diagnosis.Am Fam Physician.2018;98(6):354-361.Van Avondt K, Nur E, Zeerleder S.Mechanisms of haemolysis-induced kidney injury.Nat Rev Nephrol.2019;15(11):671-692. doi:10.1038/s41581-019-0181-0Hoffman KR, Burrell AJC, Diehl A, Butt W.Elevated carboxyhaemoglobin as a novel indicator for extracorporeal membrane haemolysis and oxygenator exchange.Crit Care. 2021;25(1):159. doi:10.1186/s13054-021-03582-wGbotosho OT, Kapetanaki MG, Kato GJ.The worst things in life are free: the role of free heme in sickle cell disease.Front Immunol. 2021;11:561917. doi:10.3389/fimmu.2020.561917Centers for Disease Control and Prevention.Complications of sickle cell disease.Shan S, Zhao XY, Jia JD.[Hepatic manifestations of hematological diseases].Zhonghua Gan Zang Bing Za Zhi. 2022;30(4):347-351. Chinese. doi:10.3760/cma.j.cn501113-20220317-00117Lippi G, Favaloro EJ, Franchini M.Haemolysis index for the screening of intravascular haemolysis: a novel diagnostic opportunity?Blood Transfus.2018;16(5):433-437. doi:10.2450/2018.0045-18Brando B, Gatti A, Preijers F.Flow cytometric diagnosis of paroxysmal nocturnal hemoglobinuria: pearls and pitfalls - a critical review article.EJIFCC. 2019;30(4):355-370.Hill QA, Hill A, Berentsen S.Defining autoimmune hemolytic anemia: a systematic review of the terminology used for diagnosis and treatment.Blood Adv.2019;3(12):1897-1906. doi:10.1182/bloodadvances.2019000036Jäger U, Barcellini W, Broome CM, et al.Diagnosis and treatment of autoimmune hemolytic anemia in adults: recommendations from the First International Consensus Meeting.Blood Rev. 2020;41:100648. doi:10.1016/j.blre.2019.100648World Health Organization.Anaemia.Schmitt M, Ewendt F, Kluttig A, et al.Smoking is associated with increased eryptosis, suicidal erythrocyte death, in a large population-based cohort.Sci Rep. 2024;14(1):3024. doi:10.1038/s41598-024-53258-y
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Health.Hemolytic anemia.Gyldenholm T, Stengaard C, Sørensen JT, Bøtker MT, Ladefoged SA.Haemolysis in prehospital blood samples.Scand J Clin Lab Invest. 2021;81(6):508-510. doi:10.1080/00365513.2021.1941234Phillips J, Henderson AC.Hemolytic anemia: evaluation and differential diagnosis.Am Fam Physician.2018;98(6):354-361.Van Avondt K, Nur E, Zeerleder S.Mechanisms of haemolysis-induced kidney injury.Nat Rev Nephrol.2019;15(11):671-692. doi:10.1038/s41581-019-0181-0Hoffman KR, Burrell AJC, Diehl A, Butt W.Elevated carboxyhaemoglobin as a novel indicator for extracorporeal membrane haemolysis and oxygenator exchange.Crit Care. 2021;25(1):159. doi:10.1186/s13054-021-03582-wGbotosho OT, Kapetanaki MG, Kato GJ.The worst things in life are free: the role of free heme in sickle cell disease.Front Immunol. 2021;11:561917. doi:10.3389/fimmu.2020.561917Centers for Disease Control and Prevention.Complications of sickle cell disease.Shan S, Zhao XY, Jia JD.[Hepatic manifestations of hematological diseases].Zhonghua Gan Zang Bing Za Zhi. 2022;30(4):347-351. Chinese. doi:10.3760/cma.j.cn501113-20220317-00117Lippi G, Favaloro EJ, Franchini M.Haemolysis index for the screening of intravascular haemolysis: a novel diagnostic opportunity?Blood Transfus.2018;16(5):433-437. doi:10.2450/2018.0045-18Brando B, Gatti A, Preijers F.Flow cytometric diagnosis of paroxysmal nocturnal hemoglobinuria: pearls and pitfalls - a critical review article.EJIFCC. 2019;30(4):355-370.Hill QA, Hill A, Berentsen S.Defining autoimmune hemolytic anemia: a systematic review of the terminology used for diagnosis and treatment.Blood Adv.2019;3(12):1897-1906. doi:10.1182/bloodadvances.2019000036Jäger U, Barcellini W, Broome CM, et al.Diagnosis and treatment of autoimmune hemolytic anemia in adults: recommendations from the First International Consensus Meeting.Blood Rev. 2020;41:100648. doi:10.1016/j.blre.2019.100648World Health Organization.Anaemia.Schmitt M, Ewendt F, Kluttig A, et al.Smoking is associated with increased eryptosis, suicidal erythrocyte death, in a large population-based cohort.Sci Rep. 2024;14(1):3024. doi:10.1038/s41598-024-53258-y
National Institute of Health.Hemolytic anemia.
Gyldenholm T, Stengaard C, Sørensen JT, Bøtker MT, Ladefoged SA.Haemolysis in prehospital blood samples.Scand J Clin Lab Invest. 2021;81(6):508-510. doi:10.1080/00365513.2021.1941234
Phillips J, Henderson AC.Hemolytic anemia: evaluation and differential diagnosis.Am Fam Physician.2018;98(6):354-361.
Van Avondt K, Nur E, Zeerleder S.Mechanisms of haemolysis-induced kidney injury.Nat Rev Nephrol.2019;15(11):671-692. doi:10.1038/s41581-019-0181-0
Hoffman KR, Burrell AJC, Diehl A, Butt W.Elevated carboxyhaemoglobin as a novel indicator for extracorporeal membrane haemolysis and oxygenator exchange.Crit Care. 2021;25(1):159. doi:10.1186/s13054-021-03582-w
Gbotosho OT, Kapetanaki MG, Kato GJ.The worst things in life are free: the role of free heme in sickle cell disease.Front Immunol. 2021;11:561917. doi:10.3389/fimmu.2020.561917
Centers for Disease Control and Prevention.Complications of sickle cell disease.
Shan S, Zhao XY, Jia JD.[Hepatic manifestations of hematological diseases].Zhonghua Gan Zang Bing Za Zhi. 2022;30(4):347-351. Chinese. doi:10.3760/cma.j.cn501113-20220317-00117
Lippi G, Favaloro EJ, Franchini M.Haemolysis index for the screening of intravascular haemolysis: a novel diagnostic opportunity?Blood Transfus.2018;16(5):433-437. doi:10.2450/2018.0045-18
Brando B, Gatti A, Preijers F.Flow cytometric diagnosis of paroxysmal nocturnal hemoglobinuria: pearls and pitfalls - a critical review article.EJIFCC. 2019;30(4):355-370.
Hill QA, Hill A, Berentsen S.Defining autoimmune hemolytic anemia: a systematic review of the terminology used for diagnosis and treatment.Blood Adv.2019;3(12):1897-1906. doi:10.1182/bloodadvances.2019000036
Jäger U, Barcellini W, Broome CM, et al.Diagnosis and treatment of autoimmune hemolytic anemia in adults: recommendations from the First International Consensus Meeting.Blood Rev. 2020;41:100648. doi:10.1016/j.blre.2019.100648
World Health Organization.Anaemia.
Schmitt M, Ewendt F, Kluttig A, et al.Smoking is associated with increased eryptosis, suicidal erythrocyte death, in a large population-based cohort.Sci Rep. 2024;14(1):3024. doi:10.1038/s41598-024-53258-y
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