Anaemia and Bruising Easily

Anaemia concerns red blood cells or haemoglobin, whereas bruising commonly relates to blood vessels, platelets or clotting. The two can appear together when ongoing blood loss causes iron deficiency, when a condition affects several blood-cell types, or when a medicine or illness increases bleeding.

Bruises after a remembered bump, especially on exposed limbs, differ from large spontaneous bruises or clusters in protected areas. Other useful clues include nosebleeds, bleeding gums, very heavy periods, blood in urine, black stools, fever, weight change and recent infection.

A full blood count can assess haemoglobin, red-cell features and platelet numbers. A blood film, iron studies, clotting tests, liver or kidney checks, and tests for vitamin deficiencies may be selected from the history and examination. Normal platelet numbers do not rule out every problem with platelet function or clotting.

Book a medical review for new, frequent or unexplained bruising, particularly if you also have fatigue, breathlessness, dizziness or pallor. Photograph bruises with the date and note their location, possible injuries and any other bleeding. List prescription medicines, painkillers, herbal remedies and supplements for the clinician.

Do not stop an anticoagulant or antiplatelet medicine on your own, and do not start iron merely because bruising is present. Treatment must match the cause: iron may help proven iron deficiency, but it will not correct a platelet or clotting problem. Protect bruised areas from further knocks while waiting for assessment.

Seek emergency care for bleeding that will not stop, vomiting blood, black sticky stools, red urine, fainting, chest pain, severe breathlessness, confusion or a sudden severe headache after a head injury. Same-day assessment is appropriate for rapidly appearing widespread bruises, pinpoint red or purple spots with fever, or bruising accompanied by marked weakness.

Ask whether the blood count shows low platelets as well as anaemia, whether blood loss could explain the red-cell pattern, which medicines may contribute, and whether clotting or iron tests are needed. Clarify how soon to return if new bruises or bleeding develop.