Lack of Punch' ANEMIA is a medical condition in which the body does not have enough healthy red blood cells to carry oxygen to the tissues. It is caused by a deficiency of iron, vitamin B12, or folate in the diet, or by a decrease in the production of red blood cells. Symptoms of ANEMIA include fatigue, pale skin, shortness of breath, and dizziness. Lack of punch is a phrase used to describe the feeling of tiredness and lack of energy that can be associated with ANEMIA.