If you get tired during routine activities and feel drained of energy by end of the day, it is possible you could be anemic. Fatigue is the main symptom of most types of anemia, along with dizziness, shortness of breath, and fainting. The severity of symptoms is related to the severity of the anemia. Mild anemia can occur without symptoms, and may be detected only with a medical exam that includes a blood test. Normocytic anemia is a common anemia that is often not diagnosed or treated. 

Understanding Normocytic Anemia
Normocytic anemia is the most common type of anemia. It can affect all ages, but is most commonly found in the elderly. Normocytic anemia is a condition where a person has normal sized red blood cells, but a low number of them. It is the presence of normal sized blood cells that helps a doctor diagnose normocytic anemia rather than another type of anemia. For example, the presence of small red blood cells indicates a lack of iron in a diet: microcytic anemia. The presence of large red blood cells indicates deficiencies in folic acid and/or vitamin B12 in a diet: macrocytic anemia.

Normocytic anemia is caused when there is an inadequate production of red blood cells in the marrow. This can happen for a number of reasons: an excess of fluid in the blood leading to dilution, an electrolyte imbalance due to an eating disorder like anorexia nervosa, an increased destruction of red cells caused by a genetic condition, exposure to toxins like arsenic or anti-malaria drugs, or overactive antibodies, which are special proteins produced by the body to attack red blood cells.

Normocytic anemia can be a problem from birth, which is called congenital, or it can be caused by an infection or disease, which is known as acquired. The most common cause of acquired anemia is long-term chronic diseases like cancer, kidney disease, rheumatoid arthritis, and thyroiditis. These diseases either suppress the production of red cells or increase their destruction. Normocytic anemia can also develop as a side effect to some medications used to treat these diseases. The drugs may either cause a breakdown of red cells or trigger the production of antibodies that target red cells. 

In pregnancy, iron requirements go up significantly. Iron is responsible for making hemoglobin, the protein that carries oxygen to other cells. During pregnancy the amount of blood increases to where a woman may have almost 50 percent more than usual, and her body needs to make more iron to make more hemoglobin for the additional blood. It is possible to reach a point where the body is unable to make more iron, which results in anemia. To avoid this, doctors recommend that pregnant women take iron supplements daily.

Normocytic anemia usually starts slowly. It does not have many signs at first. A person may find that they become tired easily. They may look pale. Their nails may lose their pink color and turn white. The inner surfaces of their lower eyelids may turn pale. If Normocytic anemia develops more swiftly, symptoms may include dizziness, fainting, and shortness of breath.

A doctor will ask for a detailed history of a patient’s complaints and symptoms. The doctor will also conduct an examination of the eyes, nails, skin, and other parts of the body. Normocytic anemia is best diagnosed by studying a detailed blood analysis, so a patient will most likely undergo a complete blood count (CBC). In a CBC, a sample of blood is tested by an automated analyzer (a medical laboratory instrument designed to measure different chemicals and other characteristics in the blood quickly, in a number of samples, without human assistance) for the number of red blood cells, hemoglobin levels, and the size of red blood cells, which is important in determining the exact type of anemia.

Examining a stained blood smear using a microscope may also be helpful, and is sometimes a necessity in regions of the world where automated analysis is less accessible.

When diagnosis remains difficult, a bone marrow examination allows direct access to red blood cells. If normocytic anemia runs in the family, other family members may need to undergo a medical exam as well.

There are many different treatments for anemia and they depend on severity and cause. In many cases, normocytic anemia is not directly treated. Instead, treatment focuses on any underlying conditions that may be causing the anemia.

Mild to moderate iron deficiency anemia is treated by oral iron supplementation. When taking iron supplements it is very common to experience an upset stomach or darkened feces. Vitamin supplements taken orally (folic acid) or subcutaneously, under the skin, (vitamin B12) will also replace any deficiencies.

In anemia connected with chronic disease, anemia associated with chemotherapy, or anemia associated with renal disease, some clinicians prescribe injections of Erythroprotein, EPO. This is a hormone that promotes red cell growth. It is generally safe to use though it may cause pain at the injection site and increase blood pressure in some patients. Other drugs or medications that a patient may be taking in connection with a chronic disease can also cause Normocytic anemia. If symptoms develop, immediately stop taking the medication and consult a physician.

In severe cases of anemia, a blood transfusion may be necessary.

 

Outlook
Anemia is a condition that develops when your blood lacks enough healthy red blood cells. These cells are the main transporters of oxygen to organs. Symptoms of anemia, like fatigue, occur because your organs are not getting enough oxygen. There are many types of anemia, all different in their causes and treatments, so it is important to see a doctor to identify which specific type you have. Most types are treatable with diet changes and iron supplements. However, some types of anemia may present lifelong health problems. If your anemia has not been responding to treatment, you need to go back to your doctor reconfirm the specific anemia diagnosis.