The clinical manifestations vary with the age, degree and rapidity of onset, presence of subjacent illness and other factors.

Mild anemia is often asymptomatic.

Symptoms of Anemia:

  * exercise dyspnea,
  * fatigue,
  * heart palpitation,
  * pica (consumption of substances such as ice, starch or clay, frequently found in iron deficiency anemia),
  * syncope (particularly following exercise)
  * bounding pulse
  * Dizziness,
  * headache,
  * syncope,
  * tinnitus or vertigo,
  * irritability,
  * difficulty sleeping or concentrating (more frequent in severe chronic anemia)

Common observable signs are:

  * pallor of skin, palms, oral and conjunctive mucous membrane and nail beds),
  * tachycardia,
  * ejection systolic murmur,
  * mild peripheral edema
  * venous hums
  * wide pulse pressure.

In old people, angina pectoris can be an important clinical manifestation.  Females commonly develop abnormal menstruation, both amenorrhea and increased bleeding.  Males can develop decrease in libido and impotence.