Anemia must be known to all of us, and most people think that it can be cured by dietary adjustment or by taking some “blood tonic”, but in fact, there are many causes of anemia, but the most common cause is iron deficiency anemia, which is only effective by iron supplementation. However, you may not have heard that drinking alcohol can also cause anemia. Here is a patient we recently saw in the Department of Hematology and Rheumatology at the First Affiliated Hospital of Henan University. He Moumou, male, 44 years old, was admitted to the hospital with the complaint of “yellowing face for more than 10 days”. The patient was found to have a yellowish complexion more than 10 days before admission, but he did not pay attention to it, and it gradually worsened, with weakness and chest tightness after activity. The patient was admitted to our hospital for further diagnosis and treatment, and was admitted to the outpatient clinic with “anemia investigation”. The patient had been drinking alcohol for more than 25 years, about 1 kg of liquor per day. He was admitted to the hospital for physical examination: obese, no yellow sclera staining, grade 2 systolic murmur could be heard in the precordial region, liver and spleen were not detected under the ribs. Routine hematology indicated erythrocytes 3.03×1012/L↓, hematocrit 59g/L↓, erythrocyte pressure volume 0.196↓, average erythrocyte volume 64.7fl↓, average hemoglobin content 19.4pg↓, average hemoglobin concentration 300g/L↓, erythrocyte volume distribution width 34.1%, platelet count 350×109/L↑, ferritin 809.34 ng/ml ↑, serum vitamin B12 and folic acid levels were normal, and abdominal ultrasound suggested mild fatty liver and splenomegaly. The blood picture showed small cell hypochromic anemia. Further examination of the bone marrow: external iron (++), internal iron positive rate 70% (type I 20%, type II 17%, type III 11%), and ringed iron granulocytes 22%. The diagnosis of iron-granulocytic anemia was made by combining the above data. Under the guidance of Director Yan Kuang Hua of the Department of Hematology, the patient was advised to stop drinking alcohol and given high doses of vitamin B6, as well as folic acid and vitamin B12. Iron granulocytic anemia is anemia caused by impaired hemoglobin synthesis and poor iron utilization. It is characterized by a small-cell hypochromic anemia in which there is a proliferation of young red blood cells in the bone marrow, with the appearance of a large number of ring-shaped iron granulocytes and ineffective red blood cell production, and an increase in tissue iron stores and serum iron. The disease is hereditary and acquired. The patient had been drinking alcohol for a long time, in large amounts, and had significant efficacy after treatment with high doses of vitamin B6 supplementation, so the diagnosis of acquired iron granulocytic anemia due to alcoholism can be made. Iron granulocyte anemia often occurs in chronic alcoholism, accounting for 31% of a group of alcoholic hospitalizations. Iron-granulocytic anemia due to alcoholism may be accompanied by reduced serum folate. Alcohol inhibits the conversion of pyridoxine (i.e., vitamin B6) to pyridoxal phosphate (a coenzyme in heme synthesis) and exacerbates the effects of folic acid deficiency. Iron granulocytic anemia is particularly prevalent in alcoholics with reduced intake, which is associated with reduced intake of vitamin B6. Therefore, we would like to advise our patients not to blindly rely on blood-raising drugs or blood transfusions, but to consult a hematologist to identify the cause of anemia and treat it accordingly.