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Microcytic anemia describes when red blood cells are smaller than usual. In fact, the red blood cells are not healthy enough to carry oxygen to the different parts of your body’s organs. Red blood cells in peripheral blood are usually characterized by a low MCV (less than 83 microns 3).

Signs and symptoms include:

  • Cold hands and feet
  • Dizziness or lightheadedness
  • Chest pain and shortness of breath
  • Pale or yellowish skin
  • Irregular heartbeats and headaches
  • Fatigue and weakness

Most Common Cause



So, One of the most common causes of microcytic anemia is iron deficiency. And is caused by diseases that limit your body from producing sufficient hemoglobin as hemoglobin is the protein that helps to transport oxygen to your tissues and gives your red blood cells their red color. Iron deficiency occurs due to inadequate nutritional intake and various health conditions.


1.Microcytic Anemia Types And Causes

Following are the types of microcytic anemia: hypochromic, normochromic, or hyperchromic. And can define according to the amount of hemoglobin present in the red blood cells.

Hypochromic Microcytic Anemias

Iron Deficiency Anemia:

 In short, among the types of microcytic anemia, one of the common types is iron deficiency anemia. Again the common causes of iron insufficiency are nutritional problems worldwide. Thus, the most frequent cause of microcytic anemia is iron insufficiency in the blood. The real reason for iron deficiency often varies according to a person’s age and sex. So, young children, women of childbearing and pregnant women have the highest prevalence of Iron deficiency anemia.

  1. Pregnant women and older adults may have iron deficiency anemia because their diet lacks nutritional elements or have chronic health conditions that impede their body’s ability to absorb iron.
  2. The most common reason behind iron deficiency in adult men and nonmenstruating women is the loss of blood.
  3. Unable to absorb iron because of infectious conditions such as Helicobacter pylori infection and celiac disease.
  4. An article in American Family Physician discovered that the prevalence of anemia ranges from 8-44 % in older men.

http://Ania, Basilio J., et al. “Prevalence of anemia in medical practice: community versus referral patients.” Mayo Clinic Proceedings. Vol. 69. No. 8. Elsevier, 1994.


Sideroblastic Anemia

It is an inherited blood disorder resulting from gene variation. This affects the bone marrow’s capability to produce red blood cells. Additionally can be caused by a disease acquired later in life that impedes your body’s capacity to integrate iron, one of the components needed to produce hemoglobin.

Congenital sideroblastic anemia is usually microcytic and hypochromic.


The thalassemias are a grouped family disorder resulting from decreased globin chain production, alpha-globin (alpha thalassemias) or beta-globin (beta-thalassemias). The abnormalities cause quantitative changes in globins, instead of hemoglobinopathies, in which globin defects are functional or qualitative. In thalassemia, the body doesn’t make an adequate amount of a particular protein present in hemoglobin.


Therefore without this protein, red blood cells will maybe not form precisely. So then provokes anemia and is priced between mild to severe depending on how many genes are affected.

2.Normochromic Microcytic Anemia

Normochromic means that red blood cells have an average amount of hemoglobin, and the color of red is not deep in color or too paler. One of the examples of normochromic microcytic anemia is:

Anemia of inflammation and chronic disease:

Specific chronic diseases and conditions could cause microcytic anemia. Thus this is called anemia of irritation and chronic disease (AI/CD). Anemia resulting from these conditions usually is normochromic and normocytic (red blood cells are normal in proportions). One-fourth to one-third of those types of anemia are categorized as microcytic. Normochromic anemia is microcytic found in individuals with:

  • infectious diseases like tuberculosis, HIV/AIDS
  • certain cancers, such as non-Hodgkin’s lymphoma, Hodgkin’s disease, and breast cancer
  • kidney disease
  • inflammatory diseases, such as Crohn’s disease, rheumatoid arthritis

These are the conditions that can prevent red cells from functioning normally. That is why it leads to decreased iron consumption or absorption.

3.Hyperchromic Microcytic Anemia

Hyperchromic means the red blood cells having more hemoglobin than usual and which is rare. They could be the effect of a hereditary condition known as congenital spherocytic anemia or hereditary spherocytosis.

Congenital Spherocytic Anemia

In this condition, the membrane of your red blood cells doesn’t form correctly; finally, it causes red blood cells to be rigid and spherically misshaped. Thus RBCs are delivered for being broken down and die within the spleen because they don’t travel into the bloodstream properly.

 Other Causes of Microcytic Anemia

  • drug and alcohol use
  • copper deficiency, lead toxicity
  • zinc excess, which causes copper deficiency


complete blood count test:

Initial blood tests come with a complete blood count (CBC). Results may show:

  • Hemoglobin (Hb)—may be normal at the beginning of the disease but will decrease as anemia worsens.
  • The average size of RBCs (mean corpuscular volume, MCV)—decreased.
  • Red blood cell indices—early on, the RBCs may be normal in size and color (normocytic, normochromic), but once the anemia progresses, the RBCs become smaller (microcytic) and paler (hypochromic) than usual.
  • The normal amount of hemoglobin in RBCs suggests corpuscular hemoglobin, MCHC)—decreased.
  • Increased variation in the size of RBCs (red mobile distribution width, RDW).


 Blood smear:

A blood smear may reveal RBCs that can be smaller in size and paler than usual and RBCs that vary in size (anisocytosis) and shape(poikilocytosis).

In this case, if your doctor suspects chronic blood loss, which is the cause of your microcytic anemia. They could refer you to a gastroenterologist. After that, your gastroenterologist might run imaging tests to search for various conditions. These tests consist of:

  1. Abdominal ultrasound
  2. Upper GI endoscopy (EGD)
  3. CT scan of the abdomen

Furthermore, a gynecologist may look for further conditions like uterine fibroids for women with pelvic pain or discomfort and also heavy menstruation that could cause heavier flows for women’s pelvic pain.


Additionally, the treatment will depend on the underlying condition of microcytic anemia. Health practitioners may prefer to carry some tests to determine an underlying cause to develop a treatment plan.

Doctors may recommend iron and vitamin C supplements.

Other treatment options, for example:

  • hormones to treat heavy menstrual cycle 
  • drugs to stimulate the body to make more RBC
  • antibiotics to tackle chronic infections that are causing anemia
  • An operation to correct a bleeding stomach ulcer or a tumor in the gut

In severe microcytic anemia, the risk for complications is high, like a cardiac failure, so you need to get a blood transfusion. Further, lead to an increase in the quantity of healthy red blood cells that your organs require.

Prevention of Microcytic Anemia with Your Diet

 The best way to counter microcytic anemia is to get adequate iron in your diet. Boosting your vitamin C consumption can also help your body to absorb more iron.

Foods rich in vitamin C such as:

  • red peppers
  • strawberries
  • kale
  • citrus fruits, especially oranges and grapefruits
  • Brussels sprouts
  • broccoli

Foods rich in iron such as:

  • dark leafy greens
  • dried fruits such as apricots and raisins 
  • poultry
  • beans
  • red meat like beef




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