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Mechanism Examples Chronic excessive bleeding Bladder tumors Cancer in the digestive tract Heavy menstrual bleeding Hemorrhoids Kidney tumors Nosebleeds Polyps in the digestive tract Ulcers in the stomach or small intestine Sudden excessive bleeding Injuries Childbirth A ruptured blood vessel Surgery Decreased red blood cell production Aplastic anemia Chronic disorders Folate deficiency Iron deficiency Leukemia Lymphoma Metastatic cancer Myelodysplasia abnormalities in bone marrow tissue Myelofibrosis Multiple myeloma Vitamin B 12 deficiency Vitamin C deficiency Increased red blood cell destruction Autoimmune reactions against red blood cells An enlarged spleen Glucose-6-phosphate dehydrogenase G6PD deficiency Hemoglobin C disease Hemoglobin E disease Hemoglobin S-C disease Hereditary elliptocytosis Hereditary spherocytosis Mechanical damage to red blood cells Paroxysmal nocturnal hemoglobinuria Sickle cell disease Thalassemia Cause Mechanism Treatment Comments Enlarged spleen An enlarged spleen traps and destroys too many red blood cells. 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