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Anemia from Deficient Red Blood Cell Production

There are a number of factors that will produce anemia from deficient red blood cell production. In other words, they need to be present in combination to interfere with the manufacture of red blood cells in the bone marrow of the hollow long bones. Consequently, 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

In short, this is the most common form of anemia due to such diverse causes as firstly chronic blood loss (ulcers, polyps in the colon or colon cancer), secondly heavy periods in women or chronic nose bleeds (epistaxis). Consequently, iron deficiency leads to a slow down of the metabolic pathway of building up hemoglobin. As a result iron deficiency anemia can develop. Find further discussion of this under “anemia due to blood loss”.

Sideroblastic anemia

This type of anemia is an iron utilization anemia; this is to say that the bone marrow has difficulties utilizing iron for hemoglobin synthesis. First, sideroblastic anemia can be hereditary. Second, it can be part of a myelodysplastic syndrome, but in addition 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

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


In the case of sideroblastic anemia from alcohol overuse the patient will certainly recover quickly after elimination of alcohol. In addition, 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: December 9, 2018

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.