Table of ContentsView AllTable of ContentsSymptomsCauses and TypesDiagnosisTreatmentOutlook
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes and Types
Diagnosis
Treatment
Outlook
Microcytic anemia is a blood disorder in which the red blood cells are too small due to a lack of hemoglobin.
Hemoglobin, an iron-rich protein, binds to oxygen, delivering it throughout the body. With microcytic anemia, smaller red blood cells carry less oxygen, which leads to low energy and fatigue.
Microcytic anemia may develop due to insufficient dietary iron, blood loss, or other medical problems. It is often found during routine blood work. Iron supplements may help to treat it, but identifying and managing the underlying cause is crucial.
This article explains the symptoms and causes of microcytic anemia and how it is treated and monitored.
Verywell / Michela Buttignol
Signs and Symptoms of Microcytic Anemia
The symptoms of microcytic anemia develop over time. It often does not have any signs during the early stages.
Symptoms tend to be vague, not specifically unique to anemia, and can include:
You can have all or some of these symptoms with varying levels of severity. People with underlying medical conditions may have more severe anemia. More severe anemia tends to cause more severe symptoms.
Types and Causes of Microcytic Anemia
Microcytic anemia occurs when the body cannot make red blood cells of normal size. This can happen if you are deficient in certain components of the red blood cells or it can occur due to illnesses that prevent proper red blood cell development.
There are several types of microcytic anemia with different causes that make it difficult for the body to produce healthy red blood cells.
Hypochromic Microcytic Anemia
This most common type of microcytic anemia; “hypochromic” means the cells are pale in color. Iron and hemoglobin are red. When red blood cells are pale, it often means they do not have enough iron.
Common causes of hypochromic microcytic anemia include:
Normochromic Microcytic Anemias
In normochromic microcytic anemias, the red blood cells are small but the appropriate color. This can indicate a normal amount of iron and hemoglobin.
This type of anemia is often due to anemias to chronic inflammation, infection, or diseases that prevent red blood cells from developing properly. This can include:
These chronic diseases can cause hemolysis and may also interfere with red blood cell production and iron metabolism. These illnesses can make it difficult for the body to produce red blood cells, resulting in microcytic anemia or normocytic (normal-size red blood cells) anemia.
Hyperchromic Microcytic Anemias
Red blood cells that are smaller than normal but have a darker hue are known as hyperchromic microcytic anemia.
Though rare, it is usually due to congenital spherocytic anemia, a genetic condition that causes a defect in the red blood cell membrane. As a result, red blood cells are darker, shaped like spheres, and break down faster.
Other Causes
Other causes of microcytic anemia include:
Sometimes these types overlap, or you can have more than one type of microcytic anemia.For example, lead toxicity can cause sideroblastic anemia.
How Microcytic Anemia Is Diagnosed
Microcytic anemia can cause signs that are detected on a physical examination, but it doesn’t always do so. Microcytic anemia is diagnosed with blood tests.Sometimes, additional specific blood tests are used to determine the cause.
Mycrocytic anemia is sometimes detected during examinations and testing for other conditions or during a routine physical. Your healthcare provider may notice signs such as pale skin, a weak pulse, low blood pressure, a rapid heart rate, or splenomegaly (enlarged spleen).
Often, a complete blood count (CBC) is part of a routine medical checkup, and it is frequently ordered if there are any signs or symptoms of anemia. Other blood tests that you might need for further evaluation of microcytic anemia include a blood smear, iron tests, genetic tests, or tests for lead levels. Additional diagnostic tests are sometimes needed.
Blood tests include:
Red Blood Cell Count: Understanding MCV, MCH, RDW, and More
Other Diagnostic Tests
Tests you might need include:
Your medical history, family history, symptoms, physical examination, and blood tests would be used to determine which, if any, diagnostic test you might need.
What Are the Treatments for Microcytic Anemia?
There are many different treatments for microcytic anemia. Some treatments help resolve the symptoms, and others help your body produce normal red blood cells.
Ablood transfusionmay be necessary to alleviate the effects of severe anemia. This can resolve your anemia if it developed due to an acute event, such as blood loss from trauma or surgery. For chronic conditions, repeat blood transfusions may be needed.
Other treatments are focused on alleviating the cause of the anemia.
Examples of treatments include:
Outlook for Microcytic Anemia
Microcytic anemia can improve with treatment. It may take weeks or months for you to feel better and for your blood tests to show improvement. Depending on the cause, you may need to continue long-term treatment to prevent microcytic anemia from recurring.
For example, if you have a problem absorbing iron from your diet, you may need to continue taking supplements to avoid becoming anemic again. And if you have thalassemia, you would need a long-term treatment regimen.
Living with microcytic anemia can be challenging. The fatigue and low energy of anemia can make it difficult to complete your daily tasks. It can also make exercise more difficult and lead to weight gain.
Summary
Microcytic anemia describes a condition in which the red blood cells are small. This can occur due to several causes, including nutritional deficiency, hereditary conditions, acute or chronic bleeding, or chronic disease. Microcytic anemia causes nonspecific symptoms. The diagnosis relies on blood tests.
Assessment of the cause is critical because the cause guides treatment. Usually, treatment can normalize the red blood cells and alleviate symptoms, but sometimes treatment needs to be maintained long-term.
7 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.Schop A, Stouten K, Riedl JA, van Houten RJ, Leening MJG, Bindels PJE, Levin MD.The accuracy of mean corpuscular volume guided anaemia classification in primary care.Fam Pract.2021;38(6):735-739. doi:10.1093/fampra/cmab034Carlos AM, Souza BMB, Souza RAV, Resende GAD, Pereira GA, Moraes-Souza H.Causes of microcytic anaemia and evaluation of conventional laboratory parameters in the differentiation of erythrocytic microcytosis in blood donors candidates.Hematology.2018;23(9):705-711. doi:10.1080/10245332.2018.1446703Korom VG, Lueff S, Liposits A, Kellner A, Pavlovics A, Egyed M.Is iron deficiency anemia always microcytic?Pol Arch Intern Med.2021;131(2):199-201. doi:10.20452/pamw.15714Cappellini MD, Russo R, Andolfo I, Iolascon A.Inherited microcytic anemias.Hematology Am Soc Hematol Educ Program.2020;2020(1):465-470. doi:10.1182/hematology.2020000158Icahn School of Medicine at Mount Sinai.Congenital sphrocytic anemia.National Library of Medicine.RBC indices.Azam B, Ur Rahman S, Irfan M, Awais M, Alshehri OM, Saif A, Nahari MH, Mahnashi MH.A reliable auto-robust analysis of blood smear images for classification of microcytic hypochromic anemia using gray level matrices and gabor feature bank.Entropy (Basel).2020;22(9):1040. doi:10.3390/e22091040
7 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.Schop A, Stouten K, Riedl JA, van Houten RJ, Leening MJG, Bindels PJE, Levin MD.The accuracy of mean corpuscular volume guided anaemia classification in primary care.Fam Pract.2021;38(6):735-739. doi:10.1093/fampra/cmab034Carlos AM, Souza BMB, Souza RAV, Resende GAD, Pereira GA, Moraes-Souza H.Causes of microcytic anaemia and evaluation of conventional laboratory parameters in the differentiation of erythrocytic microcytosis in blood donors candidates.Hematology.2018;23(9):705-711. doi:10.1080/10245332.2018.1446703Korom VG, Lueff S, Liposits A, Kellner A, Pavlovics A, Egyed M.Is iron deficiency anemia always microcytic?Pol Arch Intern Med.2021;131(2):199-201. doi:10.20452/pamw.15714Cappellini MD, Russo R, Andolfo I, Iolascon A.Inherited microcytic anemias.Hematology Am Soc Hematol Educ Program.2020;2020(1):465-470. doi:10.1182/hematology.2020000158Icahn School of Medicine at Mount Sinai.Congenital sphrocytic anemia.National Library of Medicine.RBC indices.Azam B, Ur Rahman S, Irfan M, Awais M, Alshehri OM, Saif A, Nahari MH, Mahnashi MH.A reliable auto-robust analysis of blood smear images for classification of microcytic hypochromic anemia using gray level matrices and gabor feature bank.Entropy (Basel).2020;22(9):1040. doi:10.3390/e22091040
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.
Schop A, Stouten K, Riedl JA, van Houten RJ, Leening MJG, Bindels PJE, Levin MD.The accuracy of mean corpuscular volume guided anaemia classification in primary care.Fam Pract.2021;38(6):735-739. doi:10.1093/fampra/cmab034Carlos AM, Souza BMB, Souza RAV, Resende GAD, Pereira GA, Moraes-Souza H.Causes of microcytic anaemia and evaluation of conventional laboratory parameters in the differentiation of erythrocytic microcytosis in blood donors candidates.Hematology.2018;23(9):705-711. doi:10.1080/10245332.2018.1446703Korom VG, Lueff S, Liposits A, Kellner A, Pavlovics A, Egyed M.Is iron deficiency anemia always microcytic?Pol Arch Intern Med.2021;131(2):199-201. doi:10.20452/pamw.15714Cappellini MD, Russo R, Andolfo I, Iolascon A.Inherited microcytic anemias.Hematology Am Soc Hematol Educ Program.2020;2020(1):465-470. doi:10.1182/hematology.2020000158Icahn School of Medicine at Mount Sinai.Congenital sphrocytic anemia.National Library of Medicine.RBC indices.Azam B, Ur Rahman S, Irfan M, Awais M, Alshehri OM, Saif A, Nahari MH, Mahnashi MH.A reliable auto-robust analysis of blood smear images for classification of microcytic hypochromic anemia using gray level matrices and gabor feature bank.Entropy (Basel).2020;22(9):1040. doi:10.3390/e22091040
Schop A, Stouten K, Riedl JA, van Houten RJ, Leening MJG, Bindels PJE, Levin MD.The accuracy of mean corpuscular volume guided anaemia classification in primary care.Fam Pract.2021;38(6):735-739. doi:10.1093/fampra/cmab034
Carlos AM, Souza BMB, Souza RAV, Resende GAD, Pereira GA, Moraes-Souza H.Causes of microcytic anaemia and evaluation of conventional laboratory parameters in the differentiation of erythrocytic microcytosis in blood donors candidates.Hematology.2018;23(9):705-711. doi:10.1080/10245332.2018.1446703
Korom VG, Lueff S, Liposits A, Kellner A, Pavlovics A, Egyed M.Is iron deficiency anemia always microcytic?Pol Arch Intern Med.2021;131(2):199-201. doi:10.20452/pamw.15714
Cappellini MD, Russo R, Andolfo I, Iolascon A.Inherited microcytic anemias.Hematology Am Soc Hematol Educ Program.2020;2020(1):465-470. doi:10.1182/hematology.2020000158
Icahn School of Medicine at Mount Sinai.Congenital sphrocytic anemia.
National Library of Medicine.RBC indices.
Azam B, Ur Rahman S, Irfan M, Awais M, Alshehri OM, Saif A, Nahari MH, Mahnashi MH.A reliable auto-robust analysis of blood smear images for classification of microcytic hypochromic anemia using gray level matrices and gabor feature bank.Entropy (Basel).2020;22(9):1040. doi:10.3390/e22091040
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