What are the first signs of anaemia?

The first signs of anaemia can include unusual tiredness, weakness, dizziness, breathlessness, palpitations and feeling cold. Symptoms may build gradually, so you might notice less energy during routine activity before anything else.

Anaemia means the blood is carrying less oxygen than the body needs, often because haemoglobin or red blood cells are reduced. You may tire more quickly, feel light-headed when standing, or notice a racing or pounding heartbeat as the body works harder. Cold hands and feet, cold intolerance and daytime sleepiness can also occur. These symptoms have other possible causes, so a symptom alone does not establish anaemia. A blood test can check for anaemia and help identify patterns such as iron or vitamin B12 deficiency.

Arrange a primary-care appointment if tiredness, dizziness or reduced stamina persists, recurs, or affects work and daily activities. Mention heavy or prolonged periods, recent bleeding, dietary restrictions, digestive symptoms, pregnancy, long-term illness and medicines that may affect bleeding or absorption. Do not start high-dose iron without advice; the right treatment depends on the cause. Keep a note of when symptoms began and whether exertion, standing or meals change them.

Seek urgent medical help for severe breathlessness, fainting, new chest pain, confusion, a very fast or irregular heartbeat, or visible heavy bleeding. Call emergency services if symptoms are sudden or severe. Breathlessness and palpitations can occur with anaemia, but they can also signal another urgent problem.

Ask which blood tests are needed, whether bleeding or low iron could explain the result, and when follow-up should happen. You can also ask whether vitamin B12 deficiency or another condition needs checking.