Why Am I Short of Breath with Anemia?

Shortness of breath is a common symptom for those with anemia, but treatment can resolve it.

Anemia is a blood disorder that can be short term or chronic. From vitamin deficiencies caused by eating a diet limited in key nutrients to other temporary life moments like pregnancy or having recently given birth, multiple causes can lead to a lower red blood cell count.

Formally, this is what anemia is — when a person has an abnormally, low red blood cell count. Although most people associate the condition with having low iron levels, multiple forms of anemia exist.

One common symptom that can manifest from it is shortness of breath (dyspnea). Understanding why this unique symptom occurs, as well as how to manage it in everyday life can help people with anemia better manage their condition.

Anemia is a condition that exists on a spectrum. As with many other disorders, no one single type exists. There are roughly five different types of anemia. While all of these versions affect the red blood cell count, the causes and symptoms associated with each version can vary.

Both the acute and chronic forms of anemia can lead to shortness of breath because there are not enough red blood cells to transport oxygen throughout the body.

The body relies on a precise ecosystem that consistently exchanges carbon dioxide (CO2) for oxygen (O) — and for this to occur efficiently, you need enough red blood cells circulating.

Consistent research into anemia as the sole cause for shortness of breath is thin. However, many studies have focused on the development of anemia in people with chronic obstructive pulmonary disease (COPD) and if there is a link between decreased physical function and oxygenation recovery.

The results of these studies are somewhat inconclusive. One study involving COPD patients found that although anemia is not linked as a sole cause of shortness of breath in COPD patients, it did have a slight influence on oxygen recovery rates after exercise.

Why does it get worse at night?

Similar to many other breathing conditions like asthma or COPD, just simply lying down can make it harder to breathe. This is because your supine (lying down) position puts additional pressure on your diaphragm, making it feel like you have to work harder for each breath.

Likewise, other contributing factors like mucus buildup or even a postnasal drip can all make nighttime breathing more difficult.

Did you know?

The most commonly known type is iron deficiency anemia, with estimates that roughly 50% of people with anemia have this form. This is where low iron levels — usually linked to eating a low-nutrient diet or experiencing blood loss — cause a reduction in the red blood cell count.

Note that this type of anemia features shortness of breath as one of the hallmark symptoms in more severe or chronic cases. So if you have anemia and experience shortness of breath, know that it can commonly occur.