Skip to Accessibility Tools Skip to Content Skip to Footer

Anemia & RA

Do you feel tired or weak all the time? Do you have any strange cravings, like chewing or eating ice? Do you get a lot of headaches? I can often answer “yes” to all three questions, and it’s because I’m usually anemic and I have been the majority of the time I’ve had RA (18 years).

Anemia and rheumatoid arthritis often go together

Anemia and RA often go together, which you may or may not know. If you didn’t know this already and you notice yourself feeling fatigued, weak, dizzy, or lightheaded–you might want to check with your doctor and get lab work done to see if you’re anemic. According to the Mayo Clinic’s website, other symptoms of anemia include: pale or yellowish skin, shortness of breath, headaches, chest pain, irregular heartbeat, and cold hands and/or feet.

My experience with anemia

Last fall, not long after I returned from New York City in September, my lab work showed that my hemoglobin was the lowest I’ve ever remembered it being–8-something grams per deciliter. According to the Mayo Clinic’s website, the normal range for women is 12.0-15.5 grams per deciliter.  

Taking iron supplements to help

Once again I started regularly taking Slow-FE over-the-counter iron supplements every day, hoping they would give my blood a boost. Unfortunately, after diligently taking the supplements for months, my hemoglobin level wasn’t increasing very much; I was still anemic.

Iron infusions to treat anemia

If the iron pills don’t work, then what’s next? How do you get your hemoglobin (and other iron-related blood tests) in the normal, healthy range? I spoke with my primary doctor about it and she recommended that I get a round of iron infusions by I.V. This idea seemed better to me, and that it might be more effective than supplements (who knows what’s really in THOSE anyway, right?). Receiving the iron by I.V. didn’t worry or faze me a bit, because I’m used to infusions and injections from years of being on different biologic RA medications.

How are anemia and RA related?

So what’s the anemia-RA connection? In an Everyday Health article, Robert W. Lightfoot, MD. explains, “The most common cause of anemia in RA patients is anemia of chronic illness.” Also known as anemia of inflammation and/or anemia of chronic disease, AI/ACD is caused by red blood cells not functioning normally, so they cannot absorb and use iron efficiently.

An NIH article states that the body also cannot respond normally to erythropoietin (EPO), a hormone made by the kidneys that stimulates bone marrow to produce red blood cells.  Over time, this abnormal functioning causes a lower than normal number of red blood cells in the body.

Chronic diseases that can lead to AI/ACD

Some chronic diseases that lead to AI/ACD include infectious and inflammatory diseases (such as RA, lupus, diabetes, Crohn’s, IBD, HIV/AIDS), kidney disease, and cancer.  Certain treatments and medications for chronic diseases may also impair red blood cell production and contribute to AI/ACD.

RA medications may promote the development of anemia

According to Everyday Health, medications commonly used to manage RA, including NSAIDs and steroids, may promote the development of anemia. These drugs can cause chronic irritation and bleeding of the stomach lining.

Reversing this case of anemia

I’m hoping to get started again having iron infusions soon, as part of a recent mission and determination to take care of my whole self. I want to have lab work done to test for vitamin and mineral deficiencies and look at other additional forms of more integrative medical treatment, such as the roles of diet and exercise and other things. Ideally, my iron should be coming from my diet, but if it can’t, I want to find the safest and healthiest way to not be anemic anymore.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • jan curtice
    4 weeks ago

    Iron absorption anemia caused by my autoimmune disorders is something I have been struggling with for awhile. Right now, I am going through a series of 5 iron infusions to hopefully help. I also take an iron supplement (doctor recommended brand) and magnesium specifically for this problem. My iron levels still are low. My hematologist has become a very active part of my medical care. Right now, he is at the top of the list. There are things you can do to help yourself. Be aware of what meds you are taking and which ones can slow down the iron absorption. Discuss them with your doctor. Eat iron-rich foods … if it doesn’t have protein, it isn’t in my diet. Make sure you get those blood tests. The iron levels can drop rapidly. My hematologist told me that if the levels are too low, it isn’t possible for my body to produce more iron which makes it impossible for it to produce red blood cells. Some of the symptoms that tell me there is a problem are generalized weakness/dizziness, leg cramps/spasms, tinnitus, shortness of breath, and fatigue. I hope you are able to get a handle on anemia soon and find ways to manage/prevent it in the future. BTW, the iron infusions are very different than the ones for the autoimmune diseases. These are made up of more organic substances, rather than chemicals.

  • Carla Kienast
    4 years ago

    Hi Angela: A few years ago I “banked” blood prior to my hip replacement surgery. After the first donation, my blood count was so low they wouldn’t draw the second unit. Like you, I tried the Slow FE with no significant improvement. With only a week to go where they could get the second unit, I started taking desiccated liver (in capsule form from the health food store), and was in a short amount of time, able to get my blood count improved enough for the second draw. Interesting article. I wasn’t aware of the connection between chronic disease and anemia. Thank you so much for sharing.

  • Angela Lundberg author
    4 years ago

    Hi Carla! Thanks for your comment. Hmm, liver in capsule form? I’ve never heard of that. Thanks for sharing! I’ll check into it…might be easier than infusions, especially if it’s effective.

    Yeah, I’m almost constantly anemic, and I never was before I had RA. I feel fatigued all the time, but it’s hard to tell if it’s from anemia, RA, and/or pain. I really should get my hemoglobin up though to see if that helps.

    Hope you’re doing well! 🙂

  • Poll