Anemia is a common symptom and many diseases can be accompanied by anemia. With the improvement of people’s living standard, giving gifts and tonic has become a popular social gift. Unbeknownst to us, some supplements containing certain therapeutic ingredients should not be taken indiscriminately, and even for anemic patients who “look bad”, they should not abuse blood supplements. Patients with anemia do look “bad”, but “bad” does not necessarily mean they have anemia. In medical science, anemia has its own specific meaning. Anemia is defined as the amount of hemoglobin, red blood cell count and/or hematocrit per unit volume of peripheral blood that is lower than the normal reference value, and a single routine blood test can contain all of these data. The criteria for diagnosing anemia vary slightly in China and abroad, and different altitudes also have different diagnostic criteria. In general, the foreign criteria for diagnosing anemia are: hemoglobin value at sea level is less than 110g/L for children aged 6 months to 6 years, less than 120g/L for children aged 6 to 14 years, less than 130g/L for adult males, less than 120g/L for adult females (non-pregnant), and less than 110g/L for pregnant females; domestic criteria are: less than 120g/L for adult males, less than 110g/L for adult females, and less than 110g/L for pregnant females at sea level. women below 110g/L and pregnant women below 100g/L. In anemia, the amount of hemoglobin decreases, the oxygen-carrying capacity of blood decreases, and the whole body tissues and organs undergo hypoxic changes. Early and common symptoms include pale skin and mucous membranes, fatigue, weakness, dizziness, tinnitus, memory loss, and lack of concentration, etc. Anemia can also include shortness of breath, tachycardia, loss of appetite, menstrual disorders, and loss of libido. In severe cases, heart failure may occur. However, with chronic mild anemia, the body may adapt and patients often do not have any uncomfortable symptoms and only find out they have anemia when they visit the doctor for other diseases or during routine physical examination. Mr. Li has been feeling dizzy and weak lately, and his colleagues and family members also said that he looked bad, fearing that he had anemia and advised him to go to the hospital for a checkup. He thought he was too busy at work, socializing and tired, and that the company would have a routine physical examination in 3 months anyway, so he would go for it then. It just so happens that there is a blood tonic prepared by his wife at home, and the effect seems to be quite good, and his wife, who was anemic, is now red and glowing. So, I took my wife’s blood medicine and took it, and resolved to rest for 2 days, and I felt a little better. But 3 months later the physical examination results still found that Mr. Li has moderate anemia, hemoglobin only 79g / L. This Mr. Li nervous, go to the hospital a check, the doctor said that iron deficiency anemia. Asked Mr. Li if he had found any bleeding in any place, the answer was no. The doctor said that iron-deficiency anemia in middle-aged men should not be taken lightly, and it is feared that there are digestive tract tumors if things go wrong. The doctor prescribed iron supplements to Mr. Li and took care of him to check his stool routine and occult blood test three times. The stool test results showed occult blood (+) in all three times, and gastroscopy was arranged immediately. Finally, the diagnosis of stomach cancer was confirmed. The previous medical checkup report was brought to see, in fact, the hemoglobin was found to be only 109g/L during the checkup last year, but the careless and busy Mr. Li left the advice of the medical doctor behind. If he had gone to the hospital in time a year ago, the prognosis would have been much better, and Mr. Li regretted it. Anemia is only a symptom, not a specific disease. Poor hematopoiesis, excessive red blood cell destruction and blood loss can all cause anemia. Aplastic anemia, nutritional anemia, leukemia and tumor invasion of bone marrow that we often hear about are all causes of poor hematopoiesis. The average life span of red blood cells is 120 days. Any defect inherent in red blood cells or excessive destruction of red blood cells due to external factors can lead to a shortened life span of red blood cells, and if it exceeds the compensatory proliferation of bone marrow, it will cause anemia, called hemolytic anemia. The most common clinical causes of anemia are acute or chronic blood loss. Chronic blood loss anemia is essentially iron deficiency anemia. Mr. Li had chronic occult bleeding in his stool due to gastric cancer. He did not feel uncomfortable when he was mildly anemic, and did not pay attention to it until he was moderately anemic. Although he felt better after taking blood supplements, the nature and cause of anemia were not diagnosed. Sometimes, the diagnosis of the nature and cause of anemia is more important because the cause can often be an important disease such as a malignant tumor. Nowadays, with better living conditions, nutritional anemia should be less common, but it is not. Shi’s grandmother is already in her 70’s, and she is usually very efficient in taking care of herself, but recently she has been feeling numbness in her hands and feet from time to time. But gradually Granny Shi can’t walk steadily, and she has no taste for food, and she has become lazy and cheerful. She was brought to the hospital for examination and found that her red blood cell, hemoglobin, white blood cell and platelet counts were all very low, and finally it was clear that she had megaloblastic anemia caused by folic acid and vitamin B12 deficiency. It turns out that Granny Shi is a Ningbo native, usually likes to eat salted fish and salted vegetables, and her younger generation is busy with social engagements and often does not come home for dinner, so Granny Shi just makes some pickled rice and salted vegetables to eat by herself, and over time, her body is depleted of folic acid and vitamin B12. Numbness in the hands and feet and unstable walking are actually neurological symptoms caused by vitamin B12 deficiency, which may cause paralysis if it continues to develop, and such symptoms in the elderly are sometimes easily misdiagnosed as “stroke”. After taking folic acid and vitamin B12 supplements, Ms. Shi soon regained her former energy. Ms. Zhang was over 50 years old and was worried about her fat body. She did not dare to take weight loss pills, and dieting did not seem to work either, because she did not know why she was tired and had a poor appetite recently, and ate less than before, but she was gaining weight, and her face seemed to be swollen and pale. Once she had a blood test for a cold, the doctor said she was a little anemic. She remembered that she had anemia when she was young, and the doctor seemed to say that it was iron deficiency anemia caused by excessive menstruation, and that she got better after taking iron supplements. So Ms. Zhang went to the pharmacy to buy her own iron-containing supplements to eat. After a period of time to eat the unit physical examination, anemia is not good at all, but worsened, had to go to the hospital for examination. The doctor said that Ms. Zhang had hypothyroidism and her anemia was not iron deficiency anemia, but hypothyroid anemia. Ms. Zhang was already menopausal and should not be blindly supplemented with iron. After thyroxine supplementation, Ms. Zhang’s appetite improved, but her body was lighter, her face was not swollen, and she looked refreshed and rosy. Zhang is a senior student with good academic performance and is facing intense revision for exams. Perhaps because of staying up late, Zhang always doze off in class, his face is also very poor, sometimes even fall asleep on the desk, the results naturally fell. Parents see in the eyes, pain in the heart, bought a variety of supplements, but to no avail. To take Zhang to the hospital, Zhang could not afford to take time off. After the teacher’s persuasion, the parents finally took their exhausted son to the hospital. A check of the blood routine, not only has severe anemia, but also abnormal cells, the doctor immediately issued a hospitalization card. 2 days later the test results came out, it turned out to be acute leukemia! Acute leukemia was delayed for a month, and treatment became even more difficult. Since anemia is a concomitant symptom of many diseases, if anemia symptoms appear, you should go to a specialist for further examination in a timely manner. Abusing supplements will not only fail to treat the disease, but is likely to delay it. It is also important to identify the cause of anemia after clarifying the nature of the anemia, as often the diagnosis and treatment of the cause is more important.