Normocytic normochromic anemia

Normocytic normochromic anemia means that you have a low red blood cell count, but your red blood cells have a normal shape, size, and color. Other names for it are anemia of inflammation and anemia of chronic disease (ACD). It is usually due to a chronic health condition causing inflammation in the body. This is the second most common form of anemia (after iron deficiency anemia).

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Anemia is a health condition that happens when you have a lower-than-normal amount of healthy red blood cells in your body. Red blood cells are responsible for transporting oxygen from your lungs all around your body and removing carbon dioxide as waste.

Impact on fertility

When not enough oxygen can reach the ovaries, it can harm egg quality. Poor egg quality can make it more difficult for sperm to fertilize an egg. If a lower-quality egg does get fertilized, it may not be able to implant properly or develop normally, resulting in miscarriage.

Many health conditions that cause normocytic normochromic anemia and bodily inflammation can also cause problems with fertility. Finally, inflammation can interfere with the menstrual cycle and implantation.

Potential causes

Most cases of normocytic normochromic anemia are due to an inflammatory health condition, such as:

But it can also be due to:

• Heavy periods
• Complications from a medication
• Pregnancy
• Surgery on the stomach or intestines
• Acute bleeding

Some people are born with normocytic normochromic anemia. Congenital (present at birth) normocytic anemia can affect people with sickle cell disease.

Symptoms

This form of anemia is often mild, and you might not notice symptoms. Signs of anemia include:

• Fatigue
• Weakness
• Pale skin
• Dizziness
• Rapid heartbeat
• Shortness of breath
• Easy bruising

Diagnosis

Anemia is diagnosed with a variety of blood tests. The complete blood count (CBC) shows your hemoglobin levels and red blood cell count. To find the cause of normocytic normochromic anemia, a healthcare provider will do a peripheral blood smear. They may order other lab tests to find the health condition affecting your red blood cells.

With a reticulocyte count, your provider can tell if your bone marrow is making enough healthy red blood cells. You may be referred to a hematologist (a specialist in blood disorders) and an internal medicine doctor for consultation and treatment.

Treatment

Many health conditions can lead to normocytic normochromic anemia, and treatment will vary depending on what’s behind it. Therapy directed at that condition should reduce symptoms of anemia and prevent related health complications. 

Treatments may include anti-inflammatory medications for people with autoimmune disorders like rheumatoid arthritis, weight loss for people with obesity, or antibiotics for people with a bacterial infection.

People with severe cases of anemia may need injections of a medication (erythropoietin) that makes the bone marrow produce more red blood cells. Less commonly, blood transfusions may be necessary.

Iron supplements are used to treat other forms of anemia, including iron deficiency anemia and microcytic anemia, but they may be dangerous if you have this form of anemia and normal iron levels. Be sure to talk to your doctor before taking any supplements to ensure it’s right for your body, and ask what you can do to help prevent anemia in the future.

This article has been verified by a medical professional

• Anemia of Inflammation or Chronic Disease. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed 03 December 2022.
• Normocytic Anemia. Cleveland Clinic. Accessed 03 December 2022.
• Yilmaz G and Shaikh H: Normochromic Normocytic Anemia. StatPearts [Internet]. 2022.
• Normocytic Anemia. Am Fam Physician. 2000;62(10):2264.
• Anemia of chronic disease. Mount Sinai. Accessed 03 December 2022.
• What Is Normocytic Anemia? Healthline. Accessed 03 December 2022.
• What Is Anemia? National Heart, Lung, and Blood Institute. Accessed 05 December 2022.
• Alesi S et al.: Anti-Inflammatory Diets in Fertility: An Evidence Review. Nutrients. 2022;14(3914).