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Anemia from Deficient Red Blood Cell Production

There are a number of factors that need to be present in combination to allow the bone marrow in the hollow long bones to manufacture red blood cells. If there is a disbalance with one of the ingredients missing, it will results in anemia.

Anemia from Deficient Red Blood Cell Production (links to these conditions accessible from “Related Topics” below)

Iron deficiency anemia , Sideroblastic anemia , Anemia of chronic disease , Aplastic anemia , Hypoproliferative Anemia , Myelophthisic anemia , Megaloblastic macrocytic anemia (=pernicious anemia)

Iron deficiency anemia

This is the most common form of anemia due to such diverse causes as chronic blood loss (ulcers, polyps in the colon or colon cancer), heavy periods in women or chronic nose bleeds (epistaxis). Iron deficiency leads to a slow down of the metabolic pathway of building up hemoglobin. This results in iron deficiency anemia and is explained under “anemia due to blood loss”.

Sideroblastic anemia

This type of anemia is an iron utilization anemia meaning that the bone marrow has difficulties utilizing iron for hemoglobin synthesis. Sideroblastic anemia can be hereditary. Often it is part of a myelodysplastic syndrome, but it can also be secondary to certain drugs (chloramphenicol, isoniazid, cycloserine etc.) or toxins like alcohol and lead. Symptoms: The symptoms are the same as for all the anemias.

Diagnostic tests

A blood smear shows targeted red blood cells with basophilic stippling (bluish color spots), thanks to for the image. If myelodysplastic syndrome is present, there are other features associated with this condition seen. If not, lead levels should be done to rule out lead poisoning.


In the case of alcohol induced sideroblastic anemia the patient will recover quickly when alcohol is eliminated. Some of the more rare forms of congenital sideroblastic anemias may respond to pyridoxine 50 mg three times per day.


1. Merck Manual (Home edition): Anemia

2. Noble: Textbook of Primary Care Medicine, 3rd ed., Mosby Inc. 2001

3. Goldman: Cecil Medicine, 23rd ed., Saunders 2007: Chapter 162 – APPROACH TO THE ANEMIAS

Last modified: August 24, 2014

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.