I didn’t think I was “sick.” I thought I was busy. You knowmodern life, a little stress, a little too much coffee, and a lot of “I’ll rest later.” Then my body started acting like a phone stuck at 3% battery: dim screen, random shutdowns, and that suspicious heat coming from nowhere. I could climb one flight of stairs and feel like I’d just tried out for a cardio commercial. My friends said, “You look pale.” I said, “It’s called winter aesthetics.”
Turns out, I wasn’t cultivating an aesthetic. I was cultivating anemia.
This is my story of learning to manage anemiawhat it felt like, what my doctor looked for, what actually helped, and what I wish I’d known before I tried to fix it with vibes and iced lattes.
The Moment I Realized “Tired” Wasn’t a Personality Trait
At first, my symptoms were sneaky. Not dramatic. Not movie-level. More like a slow, annoying software update that you can’t postpone forever.
- Fatigue that didn’t improve with sleep
- Lightheadedness when I stood up too fast (aka “the room doing a small spin”)
- Shortness of breath with normal activity
- Cold hands and feet even when everyone else was fine
- Brain fogthe kind where you walk into a room and forget your own plan
I kept thinking I was “out of shape” or “overworked.” But here’s the thing: anemia can make your body struggle to deliver oxygen efficiently. When your tissues are basically receiving oxygen in economy class instead of first class, everything feels hardermovement, focus, mood, motivation. Even your sarcasm can feel underpowered. (Tragic.)
The Blood Test Plot Twist: What the Labs Actually Said
After one too many days of feeling like a fainting goat in human form, I finally made an appointment. My clinician ordered basic bloodwork, including a complete blood count (CBC). The CBC checks values related to red blood cellslike hemoglobin and hematocritbecause those give clues about anemia and how your red blood cells are functioning.
Then came the extra tests that made the whole situation click: iron studies. Specifically, a ferritin test.
Ferritin is basically your body’s iron “storage closet.” Low ferritin suggests your stored iron is running lowlike you’ve been living off pantry crumbs and calling it meal prep. In many cases, low ferritin points toward iron deficiency, one of the most common causes of anemia.
My results (example numbers, simplified): hemoglobin was low, and ferritin was very low. My clinician explained that this pattern often fits iron-deficiency anemia. My next thought was: “Okay. So I’m not lazy. I’m under-resourced.” I felt oddly validated.
Why Anemia Happens: The “Not One-Size-Fits-All” Part
One of the most important lessons I learned: anemia isn’t a single problem. It’s a sign that something is offlike a “check engine” light. Managing anemia means figuring out the underlying cause, because the best treatment depends on why your red blood cells (or hemoglobin) are low.
Iron-Deficiency Anemia: The Usual Suspect
Iron deficiency happens when your body doesn’t have enough iron to make hemoglobin. That can occur from:
- Blood loss (including heavy menstrual bleeding)
- Not getting enough iron in your diet
- Trouble absorbing iron (some digestive conditions or certain medications can interfere)
In my case, the likely culprit was a combination of diet plus menstrual blood loss. Heavy periods can lead to iron-deficiency anemiasomething I’d heard in passing but never truly respected until it moved into my personal inbox.
Vitamin Deficiency Anemia: When B12 or Folate Is Low
Not all anemia is about iron. Low vitamin B12 or folate can also lead to anemia. B12 deficiency is especially important because, if it goes on too long, it can affect the nervous system. That’s why “just take iron” is not a universal planit depends on your actual labs and diagnosis.
Anemia of Chronic Disease (Including Kidney Disease)
Some chronic conditions can contribute to anemia in different ways. For example, chronic kidney disease can reduce production of erythropoietin (EPO), a hormone that signals your bone marrow to make red blood cells. Different cause, different strategysometimes involving iron, sometimes other therapies, and always clinician-guided care.
My Anemia Management Plan: What Helped (and What Didn’t)
Once the diagnosis was on the table, I wanted a simple checklist. But anemia management is more like a playlist: you need the right tracks, in the right order, and you can’t skip the part where you figure out the genre.
Step 1: Confirm the Cause (Yes, This Matters)
My clinician asked questions that felt random until they weren’t:
- How heavy are your periods?
- Any recent changes in diet?
- Any stomach pain, heartburn meds, or digestive issues?
- Any signs of bleeding (like black stools)?
- Do you eat animal products regularly?
It wasn’t interrogation. It was investigation. The goal was to make sure we weren’t missing a bigger issuebecause treating anemia without addressing a bleeding source is like mopping up water while the sink is still overflowing.
Step 2: Food Upgrades Without Turning Life Into a Spreadsheet
I used to think “eat more iron” meant “eat a sad spinach salad and hope for the best.” But iron in food comes in two forms:
- Heme iron (from meat, poultry, seafood) generally absorbed more efficiently
- Non-heme iron (from beans, lentils, tofu, spinach, fortified cereals) absorption is more affected by what you eat alongside it
I learned that some things can enhance non-heme iron absorption (like vitamin C and certain animal proteins), while others can inhibit absorption (like phytates in grains/legumes, polyphenols in tea/coffee, and calcium). This didn’t mean banning my beloved coffee. It meant timing it.
My practical food strategy:
- Pair iron-rich meals with vitamin C foods (bell peppers, citrus, strawberries, tomatoes).
- Keep coffee/tea a little away from iron-focused meals or supplements when possible.
- Use fortified foods as “easy wins” (some cereals and breads add iron).
- Choose realistic meals I could repeat without resentment.
A day that worked for me (example): fortified cereal with berries in the morning; lentil soup with a tomato-based broth at lunch; salmon or lean beef with roasted peppers at dinner; snacks like pumpkin seeds or hummus with bell pepper slices. Not perfect. Just better.
Step 3: Iron SupplementsThe Helpful, Slightly Dramatic Friend
My clinician recommended an oral iron supplement. Here’s what I learned quickly: iron supplements work, but they can be… intense.
Iron is often best absorbed on an empty stomach, but it can cause stomach upset (nausea, cramps, diarrhea, constipation). If you’re miserable, you’re less likely to stick with itso sometimes taking it with a small amount of food is a reasonable compromise.
The timeline also surprised me. I expected instant results. Instead, I learned that blood counts can improve over weeks, and many people continue iron longer to rebuild iron storesnot just raise hemoglobin. In other words, the goal isn’t only to “look normal on paper,” but to refill the iron storage closet.
My “I can actually do this” supplement routine (with clinician guidance):
- Take iron at a consistent time so I don’t forget.
- Adjust timing around calcium supplements or antacids if I’m using them.
- Use food strategically if my stomach complains.
- Track side effects like constipation so I can troubleshoot early.
And yesmy poop got darker. Nobody warned me. I thought something was wrong. Turns out this can happen with iron supplements. Nothing keeps you humble like texting a friend: “Is your digestive system… okay?”
Step 4: Follow-Up Labs, Because Guessing Is Not a Plan
One of the most empowering parts of managing anemia was re-testing. Instead of guessing whether I was “better,” we checked hemoglobin and iron markers again. Seeing progress made it easier to stay consistent. Seeing slow progress helped us adjust rather than quit.
Also: if your anemia is related to heavy menstrual bleeding, the plan may include addressing that bleedingbecause otherwise you’re refilling a bucket with a hole in it.
Things Nobody Told Me (But I’m Telling You)
1) “Eat spinach” is not a complete strategy
Spinach has iron, surebut absorption for non-heme iron can be tricky. Pairing iron sources with vitamin C-rich foods, understanding inhibitors, and building repeatable meals mattered more than heroically eating greens once and declaring victory.
2) Coffee isn’t evil, but timing can be smart
Tea and coffee contain compounds that can interfere with non-heme iron absorption, and calcium can also reduce iron absorption. I didn’t quit coffee; I just stopped treating it like a hydration plan.
3) If you might have B12 deficiency, don’t self-treat with iron
Vitamin B12 deficiency anemia can look like “tired and pale,” tooand it can come with neurologic symptoms over time. That’s why testing and accurate diagnosis are such a big deal.
When to Call a Clinician ASAP
Anemia can range from mild to serious. If you or someone you care about has symptoms like chest pain, fainting, severe shortness of breath, a very fast heartbeat, or signs of bleeding (like black/tarry stools), don’t try to “power through.” Get medical help. Managing anemia is a team sport when symptoms are severe.
Wrapping Up: The Real Lesson I Learned
Learning to manage anemia taught me something weirdly beautiful: I’m not a machine, and my “fuel gauge” isn’t optional data. When I treated exhaustion like a character flaw, I stayed stuck. When I treated it like information, I got answersand then a plan.
If you suspect anemia, let curiosity win. Ask for the labs. Learn what your numbers mean. Find the cause. Build habits you can actually keep. And if you do end up on iron supplements, remember: you’re not failing because your stomach has opinions. Your stomach just has… feedback. Loud, inconvenient feedback.
Bonus: 500-ish Words From My Real Life Anemia “Practice Mode”
Once I had the diagnosis, I expected the rest to be linear: take supplement, eat better, feel amazing, become a radiant wellness icon, start a podcast called “Hemoglobin & Chill.” Instead, my early weeks looked more like a messy training montage with snacks.
Week 1: I set an alarm for my iron supplement and immediately learned that my digestive system is a dramatic critic. Day two included mild nausea. Day three featured constipation and me Googling “how many prunes is too many prunes” like it was a serious research question. I adjusted by taking my supplement with a small snack when needed, drinking more water, and adding fiber slowly. I also learned to be patientbecause my body didn’t get depleted overnight, and it wasn’t going to rebuild overnight either.
Week 2: I started “stacking” meals in a way that felt doable. I wasn’t trying to be perfect; I was trying to be consistent. I made a list of easy iron-friendly options: lentil soup, chili with beans and tomatoes, fortified cereal, tuna packets, eggs, and a couple of “backup meals” for busy days. I paired these with vitamin C foods when it made sensestrawberries in the morning, bell peppers in a salad, tomato sauce with dinner. My coffee stayed in my life, but it got demoted from “main character” to “supporting actor,” especially around supplement time.
Week 3: The fatigue didn’t vanish, but it started loosening its grip. I noticed I wasn’t getting winded as easily. My brain fog improved in small, unglamorous wayslike being able to read an email and remember what it said five minutes later. I celebrated the boring wins: I made it through a grocery store trip without needing a nap afterward. I walked up stairs without bargaining with the universe.
Week 4: I stopped treating anemia management like punishment and started treating it like self-respect. I kept a tiny notes app log: energy level, dizziness, sleep, and anything that seemed linked to my cycle. This helped me talk to my clinician more clearly. Instead of “I feel weird,” I could say, “I’m lightheaded three days a week, usually mid-afternoon, and I’ve been consistent with supplements.” That made follow-up conversations faster, smarter, and less stressful.
By the time my follow-up labs rolled around, the biggest change wasn’t just the numbersit was my mindset. I wasn’t “broken.” I was rebuilding. And honestly? That felt like progress you can’t measure with a blood test.