Anemia occurs when the blood cannot carry enough oxygen due to low red blood cells or hemoglobin. There are two main categories: disturbed blood formation and increased breakdown or loss of red blood cells. Nutrient deficiencies, bone marrow disorders, kidney disease, bleeding, and infections are common causes. Correct classification is essential because treatment depends entirely on the underlying cause.

In This Article:

• What Is Anemia?
• How Anemia is Classified
• Anemia Caused by Disturbed Blood Formation
• Anemia Caused by Increased Breakdown or Loss of Red Blood Cells
• Why Correct Classification Matters
• Supportive & Holistic Considerations

What Is Anemia?

Anemia is a lack of red blood pigment (hemoglobin) and/or red blood cells. Simply put, the proportion of blood cells in the body is too low, which can reduce oxygen delivery to tissues and organs.

How Anemia Is Classified

Clinically, anemia is broadly divided into two main categories:

• Disturbed blood formation
• Increased breakdown or loss of red blood cells

This classification helps practitioners identify the underlying cause and choose the most effective treatment approach.

Anemia Caused by Disturbed Blood Formation

Stem Cell Diseases & Bone Marrow Involvement

Red blood cells are produced in the bone marrow from pluripotent stem cells. Diseases affecting these stem cells—or conditions that displace healthy bone marrow—can impair red blood cell production.

Examples include:

• Aplastic anemia (AA)
• Myelodysplastic syndrome (MDS)
• Paroxysmal nocturnal hemoglobinuria (PNH)
• Congenital dysplastic anemia
• Bone marrow infiltration from tumors, leukemia, or lymphoma

Although rare, these conditions highlight why identifying the cause of anemia is essential.

Folic Acid & Vitamin B12 Deficiency

Folic acid and vitamin B12 are vital for DNA synthesis and red blood cell maturation.

• Folic acid is found in leafy greens, whole grains, legumes, and eggs
• Vitamin B12 is primarily found in animal-based foods

A deficiency in either nutrient lead to the production of fewer, abnormally large red blood cells (macrocytic anemia).

Iron Deficiency Anemia

Iron is an essential component of hemoglobin. Without adequate iron, red blood cells form but contain too little hemoglobin to transport oxygen efficiently.

Key points:

• Iron deficiency accounts for up to 80% of all anemia cases worldwide
• Increased risk during pregnancy, breastfeeding, growth phases, and intense physical activity
• Common causes include inadequate intake, chronic bleeding, absorption issues, and parasitic infections

Kidney-Related (Renal) Anemia

Healthy kidneys produce erythropoietin (EPO), a hormone that stimulates red blood cell production. Chronic kidney disease can reduce EPO production, leading to anemia.

Renal anemia is associated with:

• Reduced quality of life
• Increased cardiovascular risk
• Higher mortality in kidney patients

Other Causes of Impaired Blood Formation

Additional factors that may disrupt red blood cell production include:

• Genetic conditions
• Chronic inflammatory diseases
• Malignant disorders
• Certain medications

Anemia Caused by Increased Breakdown or Loss of Red Blood Cells

Blood Loss (Acute & Chronic Bleeding)

Anemia can result from:

• Trauma or surgery
• Gastrointestinal bleeding
• Heavy or prolonged menstruation

Chronic, low-grade blood loss often goes unnoticed until anemia develops.

Enlargement of the Spleen (Splenomegaly)

The spleen removes old or damaged red blood cells from circulation. If enlarged, it may remove too many cells too quickly, leading to anemia.

Increased Red Blood Cell Breakdown (Hemolysis)

Hemolytic anemia occurs when red blood cells are destroyed faster than they can be replaced.

Possible causes include:

• Genetic disorders (thalassemia, sickle cell disease)
• Enzyme deficiencies (G6PD deficiency)
• Autoimmune hemolytic anemia (AIHA)
• Mechanical damage (artificial heart valves)
• Infections, toxins, or medications

Why Correct Classification Matters

Correctly classifying anemia is critical because:

• Treatments vary widely depending on the cause
• Supplementing iron or vitamins may be ineffective—or harmful—if misapplied
• Underlying conditions such as kidney disease or autoimmune disorders require targeted care

Supportive & Holistic Considerations

Alongside medical diagnosis and treatment, supportive approaches may help overall wellbeing. For some individuals, Holistic Colon Hydrotherapy may assist digestive health and nutrient absorption, supporting the body during recovery from anemia and other health challenges.