Anemia: A Neglected Public Health Issue
"I am always tired." "I feel weak even after sleeping." "I get breathless when I climb stairs." "Maybe it is because I am getting older." These complaints are extremely common. But sometimes, they are not simply the result of a busy life, poor sleep or ageing. They may be signs of anemia, a condition that can remain unnoticed for months before a person realizes that something is wrong.
According to the National Family Health Survey-5 (NFHS-5), 67.1% of children aged 6–59 months, 59.1% of adolescent girls aged 15–19 years and 57.2% of non-pregnant women aged 15–49 years are anemic. Among all women aged 15–49 years, the prevalence is 57%.
The problem is not limited to iron deficiency. Nutritional deficiencies, blood loss, infections, inflammation, chronic diseases and inherited blood disorders can all contribute to anemia. According to the World Health Organization (WHO) 2025 global anemia estimates, anemia remains a major public-health problem, particularly among women of reproductive age. In 2023, around three in ten women aged 15–49 years worldwide were estimated to have anemia. But anemia is much more than a number on a blood report.
What Exactly Is Anemia?
Hemoglobin is a protein inside red blood cells. Its main job is to carry oxygen from our lungs to every part of the body. When hemoglobin becomes too low, the body's ability to deliver oxygen decreases. The heart may have to work harder, and the muscles may tire more easily.
The WHO 2024 guideline on hemoglobin cut-offs emphasizes that anemia should be defined using appropriate hemoglobin thresholds according to age, sex, pregnancy and other relevant factors rather than using one number for everyone. In general, hemoglobin below about 13 g/dL in adult men and 12 g/dL in non-pregnant adult women is considered anemia, although interpretation depends on the individual and the clinical situation.
A simple complete blood count (CBC) can detect anemia. But finding a low hemoglobin level is only the beginning. The more important question is: Why has the hemoglobin fallen?
Anemia Is Not Always Iron Deficiency
This is one of the most important things people need to understand. Iron deficiency is extremely common, but not every anemic person is iron deficient. The World Health Organization emphasizes that anemia has many possible causes, including nutritional deficiencies, infections, inflammation, chronic diseases, blood loss, gynecological and obstetric problems, and inherited disorders of red blood cells. Iron deficiency can occur because the body is not receiving enough iron, is unable to absorb enough iron, or is losing blood.
Vitamin B12 and folate deficiencies can also interfere with the production of healthy red blood cells. Chronic infections and inflammatory diseases can cause another type of anemia in which iron may actually be present in the body but is not properly available for making red blood cells. Kidney disease can also cause anemia. The kidneys normally produce erythropoietin, a hormone that stimulates the bone marrow to produce red blood cells.
How to Address Anemia Scientifically?
- Regular check-ups: Know your hemoglobin levels through blood tests. Don't wait until symptoms become severe.
- Identify the root cause: After detecting anemia, further tests are needed to determine whether it is iron deficiency, vitamin B12/folate deficiency, or caused by chronic disease or genetic factors.
- Balanced diet: Consume foods rich in iron, vitamin B12, and folate, such as red meat, dark leafy greens, legumes, and nuts.
- Follow medical advice: Do not blindly supplement iron on your own. Excessive iron intake can be harmful. Always follow your doctor's guidance.
Anemia is a preventable and treatable condition. The key lies in raising awareness, timely diagnosis, and scientific intervention. By paying attention to your health indicators, you can better protect your own health and that of your family. The Xiaoshu Health App can sync with Apple Health to track relevant indicators, helping you continuously monitor changes in hemoglobin and other health data.