What Are Blood Disorders?

A blood disorder is a condition that interferes with your blood performing its essential tasks. Blood constantly flows through the body to deliver oxygen and other nutrients to organs and tissues, protect the body from infections, manage bleeding, remove waste products, and regulate body temperature.

Blood disorders can be cancerous or noncancerous (also called benign). This guide focuses on noncancerous blood disorders.

There are many types of benign blood disorders; some have little impact on health or daily living and may not even require treatment, while others cause serious illness and can be life-threatening.

Blood Clotting Disorders

People with a blood clotting disorder have blood that forms clots too easily; it’s also called a hypercoagulable state, or thrombophilia. Normally, when you have an injury, the body forms blood clots to manage and stop the bleeding so the healing process can begin. But too much clotting can cause a blood clot to form where it’s not wanted — in the arteries or veins — and cause a heart attack, stroke, or a dangerous blood clot in the lung, called a pulmonary embolism.

• Factor V Leiden A common inherited blood disorder
• Prothrombin Gene Mutation Another common inherited blood disorder
• Antiphospholipid Syndrome A rare autoimmune disorder that’s more common in people with lupus
• Protein S Deficiency A rare inherited disorder that occurs when a person doesn’t have enough protein S, a protein that helps regulate clotting in the blood
• Protein C Deficiency A disorder that can be inherited or caused by another condition. Like protein S, protein C is a natural anticoagulant that keeps the blood from forming too many clots.
• Antithrombin Deficiency An inherited or acquired disorder. Inherited antithrombin deficiency raises the risk of blood clots, while acquired antithrombin deficiency may not.
• Paroxysmal Nocturnal Hemoglobinuria A blood disorder that happens when the immune system attacks the red blood cells, which increases the risk of clots
• Disseminated Intravascular Coagulation A rare blood clotting condition that is a complication of other serious disorders and that can cause uncontrollable bleeding or clotting

Bleeding Disorders

In people with a bleeding disorder, the blood doesn’t contain enough platelets or clotting factors, or they don’t function the way they should. This makes people bleed more than they should.

• Von Willebrand Disease People with von Willebrand, the most common bleeding disorder, lack a protein that helps blood clot. Most people with the disease have an inherited mutated gene, though von Willebrand can also occur as a complication of certain cancers, autoimmune disorders, and heart and blood vessel diseases.
• Inherited Hemophilia This genetic disorder can cause prolonged bleeding after injuries. There are three types: type A, or classic hemophilia; type B, or Christmas disease; and type C, Rosenthal syndrome.
• Thrombocytopenia A condition caused by too few platelets in the blood. Immune thrombocytopenia and thrombotic thrombocytopenic purpura are diseases that can cause thrombocytopenia.
• Fibrinogen Deficiency Conditions Rare disorders where the blood lacks or has defective fibrinogen, a protein needed to form clots, resulting in excessive or unusual bleeding.

Anemia

Anemia happens when your body doesn’t have enough healthy red blood cells to carry oxygen to your tissues, which can make you feel tired or weak. It’s the most common type of noncancerous blood disorder: An estimated three million people in the United States have some form of it.

• Aplastic Anemia This rare type of anemia occurs when the bone marrow stops making enough new blood cells. It can cause fatigue, frequent infections, and easy bruising.
• Iron Deficiency Anemia The most common type of anemia, it’s caused by not having enough iron in the body. Without iron, your body can’t make enough healthy red blood cells, leading to tiredness and weakness.
• Sickle Cell Anemia A genetic disorder in which red blood cells are shaped like sickles or crescents, rather than flat disks, and are inflexible, rather than flexible, making it hard for them to flow smoothly through blood vessels and carry oxygen properly. This can cause pain, fatigue, and other serious health problems.
• Thalassemia An inherited blood disorder where the body doesn’t make enough healthy hemoglobin, the part of red blood cells that carries oxygen. It can lead to anemia, fatigue, and slowed growth in children.
• Vitamin Deficiency Anemia This happens when your body doesn’t get enough vitamins like B12 or folate, which are needed to make healthy red blood cells. It can cause weakness, fatigue, and sometimes nerve problems.

Eosinophilic Disorders

Eosinophils are a type of white blood cell that are key players in how the body responds to allergic reactions and asthma. Some people can have too few or too many of these cells. A low number is usually detected by chance when blood work is performed for other reasons, and it usually doesn’t cause any issues because other parts of the immune system step in to compensate.

A high number of eosinophils (called eosinophilia or hypereosinophilia) can be caused by allergic disorders, infections caused by parasites, or certain types of cancer.

The increased number can cause inflammation and organ damage, and the diagnosis and symptoms depend on the affected organ. Types of eosinophilic disorders include:

• Eosinophilic cardiomyopathy (heart)
• Eosinophilic colitis (large intestine)
• Eosinophilic enteritis (small intestine)
• Eosinophilic esophagitis (esophagus)
• Eosinophilic gastritis (stomach)
• Eosinophilic pneumonia (lungs)

The symptoms of blood disorders can vary depending on whether you’re at risk for a blood clot, bleed too easily because your blood doesn’t clot enough, have anemia, or have an eosinophilic disorder.

Blood Clotting Disorder Symptoms

Blood clotting disorders (when the risk for clotting is increased) can be life-threatening, and symptoms can include:

• Swelling, tenderness, and pain in your leg, which could be caused by deep vein thrombosis
• Chest pain with shortness of breath, which can mean a possible blood clot in the lungs, called a pulmonary embolism
• Heart attack, which could come with symptoms
• Stroke, which could come with symptoms

Anyone experiencing the above symptoms should seek emergency care.

Bleeding Disorder Symptoms

Bleeding disorder symptoms, when the blood doesn’t clot to slow down bleeding appropriately, can include:

• Excessive and continuous bleeding: This is the most common symptom of a bleeding disorder. Excessive bleeding is defined as cuts or small injuries that bleed for longer than 10 minutes.
• Nosebleeds: Nosebleeds that last longer than 10 minutes and occur five or more times a year.
• Internal bleeding: This can cause joint pain.
• Easy bruising: Minor trauma that didn’t use to cause bruises now does.
• Post-surgery bleeding: Heavy bleeding after surgery
• Menorrhagia: Heave menstrual bleeding that’s so heavy that it requires a new pad or tampon every hour or bleeding during your period for longer than seven days.
• Heavy bleeding after childbirth or miscarriage
• Blood in stool: Blood in feces or blood after a bowel movement may be a sign of a medical condition that needs treatment. Talk to your healthcare provider right away.
• Blood in urine (pee): Also called hematuria, blood when you pee, especially if you need to pee urgently, should be discussed with your provider.

Anemia Symptoms

• Dizziness
• Feeling tired all the time
• Fast heartbeat
• Shortness of breath
• Skin that’s paler than usual

Eosinophilic Disorder Symptoms

• Shortness of breath and fatigue when the heart is affected
• Stomach pain when the stomach is affected
• Difficulty swallowing, nausea, burping, regurgitation when the esophagus is affected
• Wheezing and shortness of breath when the lungs are affected
• Diarrhea when the colon is affected
• Vomiting, nausea, abdominal pain when the small intestine is affected

• Inherited Blood Disorders The increased tendency for the blood to form risky clots or for bleeding easily is often inherited from one or both parents.
• Acquired Blood Disorders Surgery, trauma, medications, or a medical condition may cause an acquired blood disorder.

Different types of anemia have different causes.

• Iron Deficiency Anemia This condition is caused by a lack of iron in the body or because of blood loss.
• Vitamin Deficiency Anemia This type of anemia can occur when a person isn’t consuming enough vitamin B12 to make enough red blood cells. In some cases, people can’t absorb B12, a condition called pernicious anemia.
• Aplastic Anemia This rare and life-threatening condition in which the body doesn’t make enough new blood cells can be caused by infections, certain medications, autoimmune conditions, and exposure to toxic chemicals.
• Hemolytic Anemias This type of anemia happens when red blood cells are destroyed faster than bone marrow can make them. The increased risk for some types of these anemias is passed through families.
• Sickle Cell Anemia This is an inherited condition. To have sickle cell anemia, a person must inherit two sickle hemoglobin genes, one from each parent. People who inherit only one sickle hemoglobin gene are said to have sickle cell trait.

Factors that may increase the chances of developing an acquired blood disorder include:

• A diet that lacks important vitamins and minerals such as iron, B12, and folate
• Medical conditions that involve the small intestine, such as Crohn’s disease and celiac disease
• Heavy menstrual periods
• Chronic conditions such as cancer, inflammatory bowel syndrome, autoimmune disorders, kidney failure, and diabetes
• Certain infections like HIV or complications of infection like sepsis
• Alcohol misuse, toxic chemical exposure, and certain medications
• Age; people over 65 are at higher risk
• Not moving for a long time because of bed rest or long plane rides
• Decreased physical activity due to heart attack, heart failure, stroke, or other illnesses
• Pregnancy
• Obesity

To diagnose a blood disorder, your provider will do a physical exam, review your medical history and ask about your symptoms.

Blood tests: These can check for the number, volume, size, shape, and type of cells in the blood. These tests can also be used to check the function of different organs, such as the liver and kidneys — information that can be used later to determine the best treatment for your condition.

Red blood cell tests may include a hemoglobin test or hematocrit test; a low count or percentage may be caused by a type of anemia.

White blood cells are an important part of the immune response. Levels that are too low or too high may indicate an infection or a type of cancer.

Platelets help to make blood clots and control bleeding. Tests to evaluate your platelet health may include a platelet count, mean platelet volume, which measures the average size of the platelets, or a peripheral blood smear, which will examine the platelets under a microscope to look for any abnormalities.

Blood tests can also look for chromosome changes that can help classify your condition. If you have a condition that requires a blood transfusion or bone marrow transplant, blood tests are used to check that you and your donor are compatible.

Bone marrow tests and tests on other tissues: Because stem cells in the bone marrow are responsible for making blood cells, tests of the marrow can tell doctors more about your condition and the health of your blood.

Some blood disorders directly affect other organs, and so samples make be taken from the lymph nodes, liver, skin, spinal cord, or lungs to make a diagnosis.

A thin, hollow needle is used to remove a sample of bone marrow liquid or tissue, typically from the pelvis or breastbone.

Imaging tests: Tests like ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) may be used to help diagnose blood disorders.

Genetic testing: People who have a family history that includes blood disorders may choose to have genetic testing. This can tell you if you have a higher risk of certain conditions or if you carry a specific mutated gene that you could pass on to your child.

Treatments for blood disorders typically focus on addressing the root cause of the underlying condition or the symptoms.

Some types of blood disorders don’t have noticeable or bothersome symptoms. For those people, providers will do what’s called “watchful waiting.” Your overall health will be monitored at regular intervals, and your healthcare team will pay attention to any new signs or symptoms.

Medications

Anticoagulants These medications are used in clotting disorders to prevent dangerous blood clots.

Bone Marrow Growth Factor Supplementation This treatment stimulates the bone marrow to increase the number of red and white blood cells your body makes. It can be delivered via an injection or infusion.

Corticosteroids If the immune system is overactive, steroids may be used to suppress the immune system.

Pain Management Some blood disorders, such as hemophilia, can cause chronic pain. This may be managed with over-the-counter pain relievers such as acetaminophen (Tylenol). Many NSAIDs such as aspirin or ibuprofen may increase bleeding and bleeding risk and should be avoided.

Procedures

Bone marrow transplant or stem cell transplant: One or both of these may be used to treat anemia or bleeding disorders. This procedure replaces unhealthy stem cells with donor cells. Bone marrow cells are collected from the donor’s blood marrow, while stem cells are collected from the peripheral blood. Once transplanted, the new stem cells make healthy new blood cells. This is a major procedure with potentially serious complications, so it is generally reserved for more severe conditions.

Transfusion: A transfusion delivers blood, platelets, or plasma from a healthy donor into your body through a vein in the arm. This may be necessary if you don’t have enough blood cells, or it may be done to replace damaged blood cells with healthy ones.

There are lifestyle habits that may help improve your overall health and reduce your risk of complications.

Follow a heart-healthy diet. Consume a balanced diet that includes plant-based proteins, fruits and vegetables, iron-rich foods, and healthy fats. Limit processed foods.

Seek nutritional help. If you have anemia due to vitamin or mineral deficiencies, talk with your healthcare provider or a registered dietitian to help address the shortfalls.

Aim for a healthy weight. Obesity does raise the risk of some types of blood disorders.

Increase your physical activity. If possible, get the recommended amount of physical activity each week — 150 to 300 minutes of moderate physical activity or 75 to 150 minutes of vigorous-intensity aerobic physical activity. If you have a bleeding disorder, talk with your healthcare provider about ways to lower the risk of bleeding while staying active.

Quit smoking. Not only does smoking harm overall health, but it also increases the risk of bleeding.

Some blood disorders are inherited, and that means they can’t be prevented. But in some cases you may be able to reduce your risk for a condition that could cause a blood disorder.

The recommended lifestyle habits for people with a blood disorder — healthy eating, maintaining a healthy weight, being physically active, and not smoking — may also help with prevention.

Additional recommendations for prevention include:

Reduce your risk of infection. Although everyone gets sick occasionally, try to reduce your risk of getting an infection with frequent and thorough handwashing. Stay up-to-date on your seasonal flu and COVID-19 shots.

People who begin to experience any symptoms of a blood disorder or who notice changes in their body should check in with their healthcare provider.

• Chest pain
• Shortness of breath
• Sudden weakness or inability to move a part of the body
• Uncontrolled bleeding

If you have a blood clotting or bleeding disorder and experience these symptoms, call 911 or go to the emergency room immediately.

There are many organizations that provide support and education for people living with a blood disorder. The American College of Hematology’s website provides links to dozens of organizations, organized by the type of blood disorder.

Here are a few of the many advocacy organizations.

National Bleeding Disorders Foundation

The foundation works to develop and execute strategies to support the inheritable bleeding disorders community.

Platelet Disorder Support Association

The nonprofit aims to educate and empower people with platelet disorders.

National Blood Clot Alliance

The National Blood Clot Alliance (NBCA) is a patient advocacy organization dedicated to advancing the prevention, early diagnosis, and treatment of blood clots.

Sickle Cell Disease Association of America

This organization works to promote the search for a cure, connect people with clinical trials, and keep people with the disease informed about the latest medical news.

• Blood disorders affect the blood's ability to function properly and can range from mild to life-threatening.
• Noncancerous blood disorders like anemia, clotting disorders, and bleeding disorders often respond well to treatment.
• Lifestyle changes and routine monitoring can reduce risks and help manage symptoms.
• Seek medical attention right away if you experience signs of excessive bleeding, a heart attack, stroke, or pulmonary embolism.