Anemia in Surgery (PDF)

What is anemia?

Anemia is a medical term which means that a person does not have enough red blood cells or hemoglobin in their body. Hemoglobin is the part of the red blood cell that carries oxygen to all parts of your body. Anemia is sometimes called ‘tired blood’ because it can make you feel tired – you don’t have enough ‘gas’ (oxygen) getting to your ‘engine’ (body).

Anemia is a common blood disorder. It can be a temporary or a long term condition. It can range from mild to severe. People with mild anemia may not have any symptoms or may have only mild symptoms. Symptoms can include weakness, fatigue, shortness of breath, headache and difficulty with thinking and concentrating.

How common is anemia in surgery patients?

Studies have shown anemia may be present in up to 56% of patient before surgery. This depends on the type of problem that they are having surgery for or their overall health.

What causes anemia in surgery patients?

Anemia may be present before surgery in people who have cancer or other chronic disease (example Diabetes, kidney disease). Another cause of anemia before surgery is low levels of iron due to bleeding (caused by disease or medications). Women, children, vegetarians and older adults may have iron or vitamin deficiency anemia.

How do I know if I have anemia?

The best way to determine if you have anemia is to discuss your blood counts and changes in hemoglobin with your doctor. It is important to see your doctor to check for anemia while waiting for elective surgery. Know your blood count numbers:

Normal Hemoglobin Range for Adults

Males Females
140-180 g/L 120-160 g/L

How is Anemia treated?

Treatment of anemia varies and depends on the cause. Health Care Providers will recommend treatment for each individual.

  • Iron Deficiency anemia – is treated by improving iron sources in your diet or iron administration (pills or intravenous).  This may require several months (or longer) of treatment.   See Iron Treatment Page for more information.  If the underlying cause of iron deficiency is blood loss, the source of the bleeding must be located and stopped.
  • Vitamin deficiency anemia – includes pernicious anemia which is treated with vitamin B12 administration (pills or intramuscular injection).  Folic Acid deficiency anemia is treated with folic acid pills.
  • Anemia of Chronic Disease – there is no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. In the pre-operative patient, injections of an Erythropoiesis Stimulating Agent (ESA) may be of benefit.   ESA Patient Information (pdf)
  • Other anemia’s – other types exist and require the expertise of blood specialist doctors (Hematologists).

Can Anemia be prevented?

Many types of anemia can’t be prevented. However, iron deficiency anemia and vitamin deficiency anemia can be avoided by eating a healthy, balanced diet that includes foods rich in iron, folate and vitamin B12. It is often difficult to meet the daily requirement for iron. Sometimes a multivitamin with iron is beneficial.

Adequate iron stores PRIOR to surgery have been demonstrated to improve your post-operative recovery from anemia.

What should I do while waiting for surgery?

If you are anticipating surgery, talk to your doctor about your hemoglobin count. Discuss ways you can build your strength and increase your blood counts before the operation.

Should I take Iron pills?

Some people are at a risk for iron overload which is why you should discuss iron supplementation with your doctor first. There are different kinds of iron supplements – it may take you a few tries to find the best one.   They are found behind the Pharmacists counter – please ask for their assistance.