Anemia and COPD

Authors Tim J. McMahon and Ann C. Prybylowski, in their book, Management of Anemia, discuss the relationship between anemia and chronic lung disease. Anemia occurs when the fraction of blood that is occupied by red blood cells decreases. Normally, blood is composed of roughly 40-45% red blood cells Anemia, they state, is relatively common in patients with chronic lung disease such as COPD, especially when there is chronic hypoxemia (low oxygen levels in the blood). Interestingly, when healthy people are exposed to low oxygen levels, the red cell concentration increases.  In those with a chronic disease like COPD, a decrease, not an increase in red cell percentage (i.e., anemia) often occurs.

The authors state that it is important to recognize anemia in COPD patients, because the condition may worsen the symptoms of dyspnea (shortness of breath), limit the patient’s ability to perform normal functions, and worsen overall prognosis.

Anemia alone can cause shortness of breath, dizziness, headache, coldness in your hands and feet, pale skin, chest pain, weakness, and fatigue (tiredness). When you have anemia, you don’t have enough hemoglobin-carrying red blood cells, so your heart has to work harder to move oxygenated blood through your body. Coupled with the impaired lung function common in COPD patients, anemia can create a “double whammy” effect, making the symptoms of COPD much worse than COPD alone would cause.

Anemia of Chronic Disease (ACD) is the most common form of anemia in COPD patients, but other forms of anemia can occur as well. It’s important to identify the type of anemia present in patients with chronic lung diseases such as emphysema, chronic bronchitis, idiopathic pulmonary fibrosis, and cystic fibrosis because different forms of anemia require different courses of treatment, and effective management of a patient’s anemia helps to improve the patient’s overall prognosis.

Information for this article was obtained from “Anemia in the Patient with Chronic Lung Disease,” located at pages 143-155 in the book, Management of Anemia and from Healthgrades.

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    Posted at 12:39h, 05 February Reply

    A reader wrote to us to ask, “In regards to the article about anemia and COPD, I was wondering what doctors do for anemia caused by COPD other than iron supplements.”

    Dr. Richard Casaburi, President of PERF, provided this response:

    People who have COPD can have high, normal or low numbers of red blood cells circulating in their blood. If it is low (this is called anemia), this is often (but not always) related to what is called “anemia of chronic disease”. The bone marrow, where red cells get produced, essentially gets pooped. Your physician will do blood tests to try to identify the cause of the anemia. The tests may reveal that the body iron stores are low. In this case, iron supplements are usually tried. There are other drugs that can be used to reverse anemia, but only under the direction of a physician and only for certain causes of anemia. For example, for some causes of anemia, a drug called erythropoietin can stimulate the bone marrow to reverse anemia.

    I hope that this helps you, and thank you for writing to us.

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    Kathy segura
    Posted at 20:27h, 10 December Reply

    I have had COPD for 10 years & have been on oxygen for the same. I have been anemic for 6 years. My iron level is always normal & I have been taking folic acid for 5 years. My Dr has referred me to a hemoglobinist. Will they be able to find the cause of my anemia?

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      Posted at 15:44h, 11 December Reply

      Dear Kathy,

      Unfortunately, much as we would like to help, a blog is not the place to answer a question such as this, even if we had a complete copy of your blood work and a physical examination. I assume you have seen the response given by Dr. Casaburi on 05 February 2018 to another question regarding anemia with COPD. We agree that your referral to a hematologist is the best way to find the cause of your anemia. I am so sorry we are not able of offer more help at this time.

      If you find out something from your hematologist that might be interest to share with other readers, please come back and let us know what you discover!

      Best wishes,

      Mary Burns, RN, BS

      • Avatar
        Posted at 06:37h, 12 December Reply

        Dear Kathy,

        There are many causes of anemia. A hematologist is skilled in dissecting out the possibilities. Seeing a hematologist is an excellent idea.

        With best wishes,

        Richard Casaburi, PhD, MD.

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