Hemoglobin low symptoms: signs of anaemia in women and what helps

In short: Low haemoglobin (anaemia) often shows up as tiredness that sleep does not fix, breathlessness on stairs, a racing heartbeat, dizziness, headaches, pale skin and nails, hair fall and cold hands and feet. In Indian women it is most often caused by low iron from heavy periods, pregnancy or diet. A simple blood test confirms it. See a gynaecologist if you have these signs, heavy periods or are pregnant, and go to hospital straight away for chest pain or fainting.

So many of us live with low haemoglobin without knowing it. We put the tiredness down to work, the children, the heat or "just being a woman". You are not being lazy or weak. Your body may simply be short of what it needs to carry oxygen.

The good news is that low haemoglobin is easy to check and, once the cause is found, it usually responds well to treatment and a few changes at home.

What is low haemoglobin?

Haemoglobin (often spelt hemoglobin) is the part of your red blood cells that carries oxygen from your lungs to every part of your body. When it drops below the normal range, doctors call it anaemia. Less oxygen reaches your muscles, brain and heart, so everything feels like more effort.

Women are more likely to have it than men because we lose blood every month with our periods, and our needs go up during pregnancy and breastfeeding.

Hemoglobin low symptoms to look out for

Symptoms can creep up slowly, so you may get used to them. Common signs include:

• Feeling tired or weak most of the time, even after rest
• Getting breathless climbing stairs or walking fast
• A fast or pounding heartbeat
• Dizziness or feeling light-headed when you stand up
• Headaches and trouble concentrating
• Pale skin, pale inner eyelids, pale or brittle nails
• Hair fall
• Cold hands and feet
• Craving ice, mud or raw rice (doctors call this pica)
• Restless legs at night

Mild anaemia may cause no symptoms at all, which is why a routine blood test is so useful.

What causes low haemoglobin in women?

• Heavy or long periods. This is one of the most common causes. If you soak through pads quickly or bleed for more than 7 days, read more about iron deficiency due to heavy periods.
• Pregnancy. Your blood volume rises and your baby needs iron too, so haemoglobin often dips.
• After delivery. Blood loss at birth plus breastfeeding can leave you low. This is sometimes called silent postpartum anaemia.
• Diet. Not enough iron, vitamin B12 or folate. Women who eat little or no dairy, eggs or meat may run short of B12.
• Worms in the gut. Hookworms and other worms can cause slow blood loss, especially where hygiene and clean water are hard to manage.
• Hidden bleeding from the stomach or bowel, such as from piles or ulcers.
• Other conditions like thyroid problems, kidney disease or inherited blood conditions such as thalassaemia.

Hemoglobin low in pregnancy

Low haemoglobin is common in pregnancy, and your doctor will check it at your first visit and again later on. It matters because it can leave you exhausted and makes heavy bleeding at delivery harder to cope with.

Go to every antenatal check-up, eat iron-rich foods every day, and follow the treatment your doctor suggests. Do not start anything on your own. If you faint, or feel breathless even while resting, go to hospital straight away.

How a doctor finds the cause

The main test is a complete blood count (CBC), a simple blood test. Your report will show your haemoglobin next to the normal range for women. The cut-off is different in pregnancy, so let your doctor explain what your number means for you.

Your doctor may also check:

• Ferritin, which shows your iron stores (learn more about iron and ferritin)
• Vitamin B12 and folate levels
• Thyroid function
• A stool test for worms or hidden blood
• A pelvic ultrasound if your periods are very heavy, to look for fibroids or other causes

Finding the cause is important. Treating the number without fixing heavy periods, for example, means it will keep dropping.

What helps at home

Food alone may not be enough to correct anaemia, but it helps a lot and keeps your levels up afterwards.

Iron-rich Indian foods:

• Green leafy vegetables like palak, methi, bathua and drumstick leaves
• Dals, rajma, chana, lobia and sprouts
• Ragi, bajra, poha and jaggery
• Dates, raisins, figs and sesame (til)
• Garden cress seeds (halim)
• Eggs, fish, chicken and meat, if you eat them

Help your body absorb the iron:

• Add vitamin C to iron-rich meals: a squeeze of lemon on dal, amla, guava, oranges, tomatoes
• Keep tea and coffee at least an hour away from meals, as they block iron
• Cooking in an iron kadhai can add a little iron to food

For B12 and folate: curd, milk, paneer and eggs for B12; green vegetables, dals and citrus fruits for folate.

Rest when you can, and do not push through heavy exercise until your levels improve.

When to see a gynaecologist

Book a visit if you have any of the symptoms above, heavy or long periods, are pregnant or recently delivered, or have been told before that your haemoglobin is low. A doctor can find the cause and suggest the right treatment.

Go to hospital straight away if:

• You have chest pain or a tight chest
• You are breathless even while resting
• You faint or nearly faint
• You are bleeding heavily, soaking a pad every hour
• You pass black, tarry stools

Go to a doctor the same day if:

• You notice blood in your stool
• You are pregnant and suddenly feel very weak, dizzy or breathless
• You have a fever along with feeling very weak

Questions women ask

What is the low hemoglobin range for a female?

Labs print the normal range for women next to your result, and it is different during pregnancy. Rather than going by a number online, ask your doctor what your level means, how low it is, and what is causing it. Even a mildly low result is worth acting on.

What is the most common cause of low hemoglobin in women?

In India, low iron is the most common cause. It usually comes from heavy periods, pregnancy, breastfeeding or not getting enough iron from food. Low vitamin B12, low folate and worms are other common reasons, so testing helps find yours.

How is anemia in women treated?

Treatment depends on the cause. A doctor will suggest the right treatment to build your levels back up and will also treat the reason, such as heavy periods or worms. Iron-rich food with vitamin C supports recovery. Recheck your blood as advised.

Is it dangerous to have low hemoglobin in pregnancy?

It is common and usually manageable when caught early. If left untreated, it can make you very tired and make blood loss at delivery harder to handle. Go to every check-up, get your blood tested, and follow your doctor's advice.

How quickly can I raise my haemoglobin?

It takes time. Most women start to feel more energetic within a few weeks of the right treatment, but refilling iron stores takes longer. Keep going with your doctor's plan even after you feel better, and have your blood rechecked.