Breaking Down Anaemia: the big, the small and the normal
Anaemia isn’t just “low iron”—it’s a condition where your body doesn’t have enough healthy red blood cells (RBCs) to carry oxygen efficiently. But did you know anaemia comes in different types, based on the size of your red blood cells? Let’s break down the three most common classifications: microcytic, normocytic, and macrocytic anaemia.
Microcytic Anaemia: Tiny Cells, Big Problem
In microcytic anaemia, red blood cells are smaller than normal (low Mean Corpuscular Volume, or MCV). The most common cause?
Iron deficiency. Without enough iron, haemoglobin production is impaired, leading to small, pale cells [1]. Other causes include thalassemia and chronic disease.
Normocytic Anaemia: Right Size, Wrong Number
Here, RBCs are normal in size (MCV), but fewer in number. Normocytic anaemia is often linked to chronic diseases (like kidney disease), acute blood loss, or bone marrow suppression [2]. It’s a subtle type that can be missed without lab tests.
Macrocytic Anaemia: Oversized and Underperforming
Macrocytic anaemia means your red blood cells are larger than normal (MCV > 100 fL). This often results from vitamin B12 or folate deficiencies, which are essential for DNA synthesis [3]. Alcoholism, liver disease, and certain medications can also trigger this type.
Why It Matters
Understanding the type of anaemia helps guide effective treatment. For example, iron supplements won’t help a B12 deficiency—and may even make things worse if misused.
If you’re feeling chronically fatigued, cold, or short of breath, talk to The Nutrient Naturopath about what tests you need and what you can do to get your blood the right size and number to feel fantastic!
References:
Cappellini, M.D. et al. (2020). Iron-deficiency anemia. The Lancet.
Weiss, G. & Goodnough, L.T. (2005). Anemia of chronic disease. New England Journal of Medicine.
O’Leary, F. & Samman, S. (2010). Vitamin B12 in health and disease. Nutrients.
