Normocytic anemia is a low number of red blood cells that carry oxygen throughout the body. Most red blood cells in normocytic anemia are normal size and are usually normochromic (normal color).
This common type of anemia can be caused by chronic disease, blood loss, or hemolysis (a condition in which red blood cells rupture and are destroyed). Normocytic anemia can be determined with a blood test. Identifying the cause and receiving treatment are important aspects of managing normocytic anemia.
What are the symptoms of normocytic anemia?
The effects of normocytic anemia can range from mild to severe, depending on red blood cell counts and other medical conditions that may aggravate your symptoms. If the anemia develops slowly, you may experience symptoms gradually over time, but if the anemia develops rapidly, symptoms may suddenly worsen.
Common symptoms of normocytic anemia:
- fatigue, low energy
- feeling of weakness
- pale complexion
- Brain fog (difficulty concentrating and remembering)
- lack of motivation
Several of these symptoms can occur with normocytic anemia, and some people experience only some of the effects, especially if the anemia is mild.
You may also experience other symptoms that are not necessarily directly related to anemia, but they can indicate the cause of the anemia.
Associated symptoms may include:
- Infection may cause fever.
- Blood or black stools may occur due to gastrointestinal (digestive) disease.
- Lung cancer or esophagus (food tube) cancer may cause coughing up blood.
- Weight loss may be related to cancer or chronic disease.
- Shortness of breath may occur if you also have chronic obstructive pulmonary disease (COPD, an irreversible inflammatory lung disease) or heart disease.
Normocytic anemia is a common complication of many different diseases, and associated symptoms can begin before or after symptoms of anemia.
What causes normocytic anemia?
Normocytic anemia occurs when the number of red blood cells in the body falls below normal levels. This can be due to bleeding, chronic disease, or low red blood cell production.
There are many different reasons, and if you have more than one, the situation may be more serious.
Common causes of normocytic anemia:
- heavy menstrual bleeding
- Chronic bleeding, usually due to gastrointestinal problems
- Chronic kidney, heart or liver disease
- chronic obstructive pulmonary disease
- Hemolysis (premature destruction of red blood cells) from sickle cell disease or infection
- cancer or cancer treatment
- bone marrow disease
Chronic diseases can shorten the lifespan of red blood cells, which can lead to anemia.
Sometimes the causes and risks of low red blood cells are known before symptoms of normocytic anemia appear. Alternatively, symptoms of anemia may occur, or a red blood cell count can diagnose anemia before the cause is known.
If you have a known risk of anemia, your doctor may order blood tests to monitor your red blood cell counts.
How is normocytic anemia diagnosed?
The diagnosis of normocytic anemia is made with a blood test. If you are seriously injured and have lost a lot of blood, you will have a complete blood count (CBC), which will give quick information about whether you have anemia.
If your symptoms or physical examination results raise concerns that you may have anemia, you may need blood tests to evaluate your red blood cell count. Occasionally, normocytic anemia is diagnosed incidentally as a result of a routine CBC blood test done to check.
Signs of anemia that your doctor may find during a physical exam include pale skin, a fast, weak pulse, or low blood pressure.
Blood tests to detect anemia:
- CBC: This blood test provides a count of your red blood cells, white blood cells, and platelets, as well as a general assessment of average red blood cell size. According to the World Health Organization, normal hemoglobin levels are higher than 130 grams per deciliter (g/dL) in adult men, 120 g/dL in adult women and children over 12 years old, and higher than 120 grams per deciliter in children aged 5 to 11 years. More than 115 grams per deciliter and more than 110 grams per deciliter for children under 5 years old.
- Blood smear: This is a microscopic assessment of cells in a blood sample. Laboratory analysis of the sample will describe the shape and size of your red blood cells, as well as the characteristics of other cells in the sample.
Red blood cell count: a test that measures oxygen-carrying red blood cells in the blood
Some types of anemia are microcytic (small red blood cells) and some are macrocytic (large red blood cells). These size changes are usually due to a different underlying problem than the cause of normocytic anemia, so the size of the red blood cells can help determine the cause of the anemia.
For example, iron deficiency is a common cause of microcytic anemia (small red blood cells), and vitamin B12 deficiency is a common cause of macrocytic anemia (red blood cells that are too large).
The diagnosis of normocytic anemia usually requires finding the cause, if it is not already known.
Tests you may have during your assessment may include:
- Electrolyte test: This blood test may show signs of systemic disease, such as kidney disease.
- Liver function tests: These blood tests may show signs of liver disease.
- Urinalysis (urine test): This test can show blood in the urine or signs of infection.
- Stool sample or rectal exam: These tests can detect bleeding in the gastrointestinal tract.
- Cervical exam: This exam may be considered for people who have a uterus (uterus) if there is concern about excessive uterine bleeding.
- Imaging tests: Imaging tests, such as computed tomography (CT) scans of the abdomen, may show tumors or other structural problems or sources of bleeding.
During your anemia evaluation, your doctor will perform diagnostic tests based on your symptoms, medical history, and physical examination.
What is the treatment for normocytic anemia?
Treatment of normocytic anemia includes control of blood loss, treatment of the underlying disease, blood transfusions, and drugs to promote red blood cell production. You may benefit from one or more of these treatments, and most people don’t need all of them.
- Blood transfusion: This therapy is a direct infusion of the blood supply. It is needed when the red blood cell count is very low. For example, if you develop anemia due to trauma, your red blood cell count may return to normal after the transfusion and after the bleeding stops.
- Surgical repair: Large traumatic wounds may not heal on their own and may require emergency surgical repair to stop blood loss.
- Erythropoietin: The kidneys naturally produce this hormone to stimulate the production of red blood cells in the bone marrow. It can also be used as a drug to help increase red blood cells in certain conditions, such as chronic kidney disease or cancer.
- Treatment of the underlying condition: If your anemia is caused by a condition such as chronic obstructive pulmonary disease, liver disease, heart disease, kidney disease, or cancer, treating the underlying condition may help relieve symptoms of anemia, and your red blood cell count may improve as well .
Treatment of anemia is important even if you have no symptoms. Anemia can worsen your overall health and make it harder for you to recover from illness.
Prognosis: what will happen?
Red blood cells last an average of 120 days. Your red blood cell counts should improve within a few weeks of treatment.
If the cause of the anemia is acute (sudden and short-term), such as trauma, after short-term treatment to reduce blood loss, if your anemia is severe, you may see lasting improvement after a blood transfusion.
Chronic normocytic anemia may require ongoing treatment of the underlying cause so that red blood cell counts return to normal and prevent the anemia from recurring. Lifestyle approaches can also help you maintain a healthy red blood cell count.
Anemia is a low number or function of red blood cells. Normocytic anemia is a common type of anemia in which the red blood cell count is low and the size of the red blood cells is normal. It may develop due to blood loss, low red blood cell production, or chronic disease.
Red blood cell loss can usually be stopped with medical or surgical intervention. Treating the cause of the anemia usually improves symptoms and red blood cell counts.
Anemia is usually described by the characteristics of red blood cells, including size, shape, and color. Normocytic anemia is a common type of anemia in which red blood cells are normal size, shape and color.
This condition is a common effect of many different medical problems. If you are diagnosed with normocytic anemia, it is important to receive and maintain treatment for the underlying cause of the anemia and your overall health.