Is Anemia Serious? Loss of Blood due to Unknown Causes

KerryTR73 Asked :

After weeks of feeling weak and tired and a couple of fainting spells, I discovered that I am severely anemic. I used to have anemia when I was in my teens and twenties but this stopped after having 2 kids and going on the injection. My doctor now tells me that he wants to do an endoscope and colon check to investigate the cause of the anemia.

Why is this necessary because many women that I know have anemia and it is usually not a problem? My doctor says that my anemia could be more serious and I am losing blood from somewhere since I do not menstruate. I am so tired of all these tests and I am wondering if it is necessary or should I just be on iron supplements?


This question was posted under the Blood Iron Levels – High, Abnormal, Low Iron in the Blood article.

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Dr. Chris Answered :

Anemia means that there is a shortage of healthy red blood cells. There are many different types of anemia due to a wide range of causes. The type of anemia that you probably had earlier in life, which is common among menstruating women, is iron-deficiency anemia. This is also referred to as hypochromic microcytic anemia and is an indication of chronic blood loss. What your doctor may have found now is another type of anemia known as normocytic normochronic anemia and this is often linked to bleeding within the gut or any other short term blood loss.

All types of anemia can be considered as a serious condition depending on the severity and cause. The red blood cells carry oxygen and carbon dioxide in the blood so if this is severely impaired, you can experience a host of signs and symptoms with serious complications later on. More importantly, it could be due to a very serious cause, for example a bleeding tumor. You have not indicated what type of anemia that you have so for now we can only make assumptions about these types of anemia.

It is routine procedure to try to identify the cause of the bleed in normocytic normochromic anemia and as mentioned the gut is always suspected first. It could be gastric bleeding due to a stomach ulcer or there may be other possible causes that are a concern in your case. Then there are other types of anemia which may be due to a vitamin B12 deficiency since the body is not getting enough B12 or not absorbing or utilizing it properly and this could be linked to a number of gastrointentestinal conditions. In all likelihood though, it appears that your doctor is suspecting a recent gastrointestinal hemorrhage which is evident by normocytic normochromic anemia.

An upper GI endoscopy and colonoscopy are routine procedures to try to identify any pathology which could be causing the bleeding. There is nothing to be concerned about just yet. Once your doctor identifies the cause, he can begin with the appropriate treatment. Iron supplements are only helpful in cases where there is an iron deficiency as is the case with most menstruating women, especially if there is heavy menstrual bleeding. In these instances, the source of the blood loss is known. This may not be a consideration in your case since you are not having your period and your blood loss may be short term. The fact that you have fainted a few times is serious and if it is due to anemia, the cause has to be identified and treated as soon as possible. It needs immediate medical attention and the procedures that your doctor is considering is necessary.

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