Anemia happens when your blood doesn’t carry enough oxygen to your body — usually because your blood isn’t making enough healthy red blood cells. Although anyone can get anemia, it’s more common in people who have lupus. In fact, anemia affects about half of all people with active lupus.

The good news is anemia is treatable — the first step it to figure out what’s causing it. If you think you might have anemia, talk to your doctor.

What are the symptoms of anemia?

If you have mild anemia, you may not notice any symptoms. But anemia can cause:

• Fatigue (feeling very tired) — also a very common lupus symptom
• Pale or yellow skin
• Chills
• Shortness of breath or trouble breathing
• Headaches
• Dizziness and fainting

What causes anemia?

The most common cause of anemia is a low number of healthy red blood cells. This can happen for lots of different reasons, including:

• The bone marrow, which is responsible for the production of blood, may not work properly
• Some patients may have antibodies that target and destroy red blood cells
• Lack of iron, vitamin B12, or folic acid in your diet
• Pregnancy
• Serious blood loss — like from surgery, injury, or very heavy periods
• Other health conditions — like kidney disease, or cancer
• Certain medicines — including some treatments for lupus like azathioprine or cyclophosphamide which suppress the production of red cells in the bone marrow.
• Older age
• Family history of anemia

How will my doctor check for anemia?

Your doctor may use different tests to figure out if you have anemia — and what’s causing it. They may test your blood or urine (pee). The doctor may also order:

• Blood tests. The doctor will draw some blood to determine whether antibodies are responsible for the destruction of the red blood cells.
• Bone marrow tests. The doctor will use needles to collect bone marrow fluid and tissue. 
• Colonoscopy. The doctor will use a long tube with a tiny camera on it to look directly at the colon and rectum, which are parts of the large intestine.
• Endoscopy. The doctor will insert a camera through your mouth to view your esophagus (throat), stomach, and part of your small intestine.

What are the treatments for anemia?

Treatments for anemia depend on the cause and how serious it is. If you have mild anemia, you may not need treatment at all. If you need treatment for anemia, your doctor may recommend:

• Medicines that weaken your immune system or treat inflammation — like prednisone, which is also a treatment for lupus
• Iron or vitamin B12 supplements — or a plan to get these nutrients through your diet
• Blood transfusions
• Blood and bone marrow transplants
• Hormone treatments
• Surgery to stop bleeding inside the bod