Rheumatoid Arthritis and Anemia: How Are They Connected

Anemia is one of several blood disorders that could trouble a patient with rheumatoid arthritis.
Rheumatoid Arthritis and Anemia: How Are They Connected
RA can be associated with different types of anemia. Shutterstock Images

Rheumatoid Arthritis and Anemia Overview

Let us ask you if this sounds familiar – you developed rheumatoid arthritis a while ago, but now it seems that you are also suffering from anemia?

If the answer is yes, you should know that the two may be related.

We will explain how, in a moment, but let’s take a look at the characteristics of anemia.

Anemia occurs when a person is suffering from a reduced count of red blood cells, which is also accompanied by an inadequate amount of hemoglobin. This protein is essential because it is an oxygen carrier.

The symptoms you may feel when suffering from anemia include general tiredness and weakness, which can be additionally troublesome if you are already suffering from anemia.

The Link Between Rheumatoid Arthritis and Anemia

The statistics clearly show that anemia is a possible side-effect or an additional problem that follows rheumatoid arthritis. According to the Archives of Rheumatology[1], up to 70% of patients dealing with RA also tend to suffer from anemia. Naturally, it doesn’t have to occur immediately, but it is a considerable threat down the road.

You should be aware of the existence of several types of anemia:

  • Chronic disease anemia – patients dealing with a chronic inflammation problem are suffering from this type of anemia, explains Sioban Keel, MD, an associate professor of medicine in the division of hematology at the University of Washington School of Medicine in Seattle. There are two reasons why it occurs – either the red blood cells have a shorter lifespan or the body’s capability of producing them decreases.
  • Iron-lacking anemia – if you are suffering from a deficiency of this mineral, it may lead to anemia. This occurs because iron is necessary for red blood cell production. There are two underlying causes of iron deficiency – either your diet is not optimized properly, or your organism is having problems absorbing it.
  • Hemolytic anemia – it happens when your organism mistakenly works on eliminating healthy red blood cells. As the body cannot compensate in production, their amount starts reducing. Infections and immune disorders can cause hemolytic anemia, but medications may work on resolving the issue.
  • Megaloblastic anemia – this condition leads to overgrowing of red blood cells in your body. That creates a problem in efficient oxygen delivery.

Now, how can rheumatoid arthritis[2] lead to anemia?

The most common way is because of the medications the patients are using, such as methotrexate or steroids. These work in a way that lesions start appearing in gut membranes, which negatively affects iron digestion. As a result, anemia occurs. Other patients may also take immunosuppressing drugs like cyclophosphamide or azathioprine. These negatively affect the production of bone marrow. The problem occurs because bone marrow is in charge of red blood cells production.

Additionally, RA may shorten red blood cells’ lifespan. The body is not able to compensate them at an adequate rate, and anemia appears.

What are the Symptoms of Anemia?

Symptoms of Anemia

Signs and symptoms that are associated with anemia. Shutterstock Images

The problem is that mild anemia might not have any visible symptoms. You only start exhibiting them once the red blood cell count decreases so much that oxygen transport is endangered.

Some of the symptoms you may experience when suffering from anemia are:

  • heart rhythm changes
  • tiredness
  • dizziness
  • weakness
  • shortness of breath
  • headaches

The problem occurs because the patients, as well as doctors, sometimes attribute these symptoms to rheumatoid arthritis. This is why a medical professional needs to assess the complete medical history of the patient and ensure what causes their symptoms.

In case there is even the least reason to suspect anemia, blood tests should be ordered. Red blood cell and hemoglobin levels are something that will be measured, as well as chemicals like serum iron, vitamin B12[3], folic acid, and ferritin.

A doctor may order even additional blood tests, and it all has the purpose of determining the exact anemia type the patient is suffering from.

Anemia and Rheumatoid Arthritis – Treatment

A Doctor Is Taking a Blood Sample From The Patient To Treat Anemia

A doctor is taking a blood sample from the patient who is suffering from anemia. Image – fergon.com

Treating arthritis may be helpful to manage anemia, too. It is why you should follow the doctor’s orders so that the inflammation is minimized. While it might not be eliminated in chronic conditions, it still means to reduce the severity of inflammation.

Aside from this, you may get a recommendation from your healthcare provider to take some supplements or other health products containing iron and nutrients like vitamin B12 and folic acid. Whatever the instructions are, it is essential to stick to them and be consistent in utilizing therapies and treatments.


Anemia may occur unrelated to rheumatoid arthritis, but if you have RA, there is a moderate risk that you will also develop anemia. This is why regular doctor visits are essential because they enable them to discover any problems as soon as they appear.

Treating anemia is possible, and following doctor’s instructions is vital. If you stick to their orders, the chances are that you may feel an improvement in terms of energy and overall quality of life. Treatments can also help to prevent any future issues with anemia.


Franz Gliederer, MD, MPH

Franz Gliederer (MD, MPH) is a specialist in Preventive Medicine with a Medical Doctorate from the University of Vienna, Austria and a

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