A patient sat across from me last month and said, almost apologetically, "I'm just so tired all the time. I figured it was my age." She'd been pushing through it for nearly a year. Her bloodwork told a different story: she had anemia, and a treatable one.
That conversation happens more than you'd think. Anemia means your blood doesn't carry enough oxygen, usually because you're low on healthy red blood cells or the hemoglobin inside them. The result is fatigue that sleep doesn't fix, and it's one of the most common things I catch on routine labs here in Los Angeles. The good news is that it's almost always something we can name and treat once we know what's driving it.
What are the symptoms of anemia?
The most common signs are tiredness, weakness, and feeling winded doing things that never used to wind you. Some people notice pale skin, cold hands and feet, a pounding heart, or headaches. Others feel foggy or dizzy.
Here's the tricky part. Anemia often comes on slowly, so your body quietly adjusts and you assume this is just your new normal. I've had patients chalk it up to stress, parenting, or simply getting older. Sometimes that's true. Sometimes it isn't.
If you've been dragging for weeks and can't explain it, that's worth a real look — not a guess.
What causes anemia, and why does the cause matter so much?
The cause matters because "anemia" is a finding, not a diagnosis. It's a clue pointing to something else, and the treatment depends entirely on what that something is.
By far the most common driver I see is low iron. That can come from blood loss (heavy periods are a frequent and very fixable culprit), from not absorbing iron well, or from diet. But iron is only one chapter.
- Low B12 or folate, which affect how red blood cells are built
- Thyroid problems — hypothyroidism can quietly drag your blood counts down
- Chronic conditions, kidney issues, or inflammation
- Sometimes gastrointestinal bleeding you can't see, which is why I take new iron-deficiency anemia in certain patients seriously
This is why I never want a patient to grab an iron supplement off the shelf and call it solved. If the real problem is B12 or a slow bleed, iron won't fix it and you'll lose months you didn't need to lose.
How is anemia diagnosed?
It starts with a simple blood test, usually a complete blood count, which tells me whether you're anemic and gives early hints about why. From there I tailor the next round of labs to your story.
Depending on what I find, that often includes iron studies, B12 and folate levels, and thyroid testing, since fatigue rarely has just one explanation. I'm also asking questions across the desk: your diet, your periods, your digestion, any family history, what medications you take.
The labs and the conversation work together. One without the other misses things.
How do you treat anemia?
Treatment follows the cause, which is the whole point of doing the workup first. For straightforward iron deficiency, the answer is often iron supplementation done correctly — the right form, taken in a way your gut tolerates, with a recheck to confirm it's actually working.
If the issue is a vitamin deficiency, we address that directly. If your thyroid is involved, we treat the thyroid. And when the picture suggests something that needs a specialist — a gastroenterologist or hematologist, for instance — I coordinate that referral and stay in the loop. Being credentialed at Cedars-Sinai means I can hand you off to the right person without you getting lost in the system.
One thing I tell almost everyone: don't stop at "your numbers are better." We confirm the cause is handled, because anemia that returns is anemia we didn't fully understand the first time.
When should I see a doctor about fatigue?
If exhaustion has lasted more than a few weeks, or you have shortness of breath, chest discomfort, or you're noticeably pale, please get checked. And if you've already been told you're anemic but no one explained why, that's reason enough to come in.
Fatigue is so easy to dismiss. But it's also one of the most fixable complaints I treat, and it sits next to other quiet causes like vitamin D deficiency that are simple to test for.
If any of this sounds like you, I'd genuinely like to help you sort it out. You can reach out to my practice and we'll start with a real conversation and the right labs — not a shrug and a "let's wait and see." You deserve to know why you feel the way you do.