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Anaemia and its types: Restless Legs Syndrome (RLS): Causes, Symptoms, Diagnosis


Restless Legs Syndrome (RLS): Causes, Symptoms, Diagnosis


What is restless legs syndrome (RLS)?

Restless legs syndrome (RLS), also called Willis-Ekbom disease, is a sleep disorder that causes an intense, often irresistible urge to move your legs (and even your arms or body). It occurs along with other sensations in your limbs described as pulling, creeping, tugging, throbbing, itching, aching, burning or crawling.

These sensations usually occur when lying down in bed or when sitting for long periods of time, such as while driving or while at a theater. RLS typically occurs in the evening, making it difficult to fall asleep. Often times people with RLS want to walk around and shake their legs (or arms) to help relieve the uncomfortable sensations.

Who gets restless legs syndrome (RLS)?

People of any age, including children, can have RLS. Symptoms of RLS may begin in childhood or adulthood, but the chance of having the syndrome increases significantly with age. RLS is more common in women than in men. Up to 10 percent of the United States population has RLS.

Symptoms and Causes

What causes restless legs syndrome (RLS)?

Restless legs syndrome (RLS) has been found to be a genetic syndrome in some cases, meaning that parents with RLS can pass it down to their children. Up to 92% of patients with RLS have a first-degree relative with the disorder. These patients tend to develop symptoms earlier in life (before age 45) than those with RLS without the genetic link.

In addition to the genetic source, many medical problems are closely associated with the development of RLS, including:

Medications can also contribute to the development of RLS. Such known medications include antidepressants, allergy drugs and anti-nausea medications. Caffeine, nicotine and alcohol can also make symptoms worse.

What are the symptoms of restless legs syndrome (RLS)?

Symptoms of restless legs syndrome include:

  • Leg (or arm) discomfort: These uncomfortable limb sensations are often described by adults as creeping, itching, pulling, crawling, tugging, throbbing, burning, or gnawing. These sensations usually occur at bedtime but can occur at other times of limb inactivity.
  • Urge to move legs (or arms): To relieve limb discomfort, you have an uncontrollable urge to move your limbs especially when resting, such as when sitting or lying down.
  • Sleep disruption: Additional time is often needed to fall asleep because of the urge to move your limbs to relieve the discomfort. Sometimes staying asleep may also be difficult.
  • Bedtime behavior problems: Because of the discomfort, you may need to get out of bed to stretch your limbs to relieve the discomfort.
  • Daytime sleepiness: Problems with falling asleep and staying asleep may result in daytime sleepiness.
  • Behavior and work performance problems: Again, due to sleep disruption, problems may emerge in daytime behavior (irritability, moodiness, difficulty concentrating, hyperactivity, etc) and work performance.

Diagnosis and Tests

How is restless legs syndrome (RLS) diagnosed?

Unfortunately, there is no specific test for restless legs syndrome (RLS). The diagnosis is made based on your symptoms. A medical history, complete physical and neurological exam and blood tests may be conducted to rule out any other possible health problems associated with RLS. An overnight sleep study may be recommended to evaluate for other sleep disorders, especially obstructive sleep apnea.

Your healthcare provider will ask about any family history of RLS. They will also ask if you have any sleep complaints, such as insomnia (difficulty falling asleep or staying asleep) due to your symptoms. Your healthcare provider will also ask if you have trouble staying awake during the day and ask about other behavior or work performance problems.

To confirm a diagnosis of RLS, you must meet the following five criteria:

  • Have an urge or desire to move your legs (or arms), usually occurring together with uncomfortable sensations such as pulling, tugging, crawling, itching, aching, or burning.

Also, the urge to move or uncomfortable sensations:

  • Begin or worsen during periods of rest or inactivity.
  • Are partially or totally relieved by activities such as stretching, walking or exercising the affected muscles.
  • Are worse or occur solely in the evening or at night.
  • Are not solely due to another medical or behavioral problem.

Management and Treatment

How is restless legs syndrome (RLS) treated?

Treatment of restless legs syndrome depends on the intensity of the symptoms. Treatment should be considered if quality of life is affected by insomnia and excessive daytime drowsiness. In cases of RLS due to ongoing medical disorders, specific treatment is also necessary.

Non-drug treatments. Non-drug treatments are tried first, especially if symptoms are mild. Non-drug treatments include:

  • Getting regular exercise, such as riding a bike/stationary bike or walking, but avoiding heavy/intense exercise within a few hours of bedtime.
  • Following good sleep habits, including avoiding reading, watching television or being on a computer or phone while lying in bed; getting 7 to 9 hours of sleep and following other healthy sleep habits. Not getting enough sleep can worsen RLS symptoms.
  • Avoiding or limiting caffeinated products (coffees, teas, colas, chocolates, and some medications [check labels]), nicotine, and alcohol.
  • Applying a heating pad, cold compress, or rubbing your legs to provide temporary relief to the leg discomfort. Also consider massage, acupressure, walking, light stretching or other relaxation techniques.
  • Soak in a warm tub.
  • Try magnesium supplements. They may be helpful.
  • Reduce stress as much as possible. Try meditation, yoga, soft music or other options.

Iron supplementation. Iron deficiency is a reversible cause of RLS. If blood tests reveal you have low iron levels, your doctor may recommend taking an iron supplement.

Prescription medications. When RLS symptoms are frequent or severe, your healthcare provider will likely prescribe medications to treat the disorder. Medications options include:

  • Dopamine agonists control the urge to move, sensory symptoms in the legs, and reduce involuntary leg jerks in sleep. Ropinirole (Requip®), pramipexole (Mirapex®) and the rotigotine patch (Neupro®) are the FDA-approved dopamine agonists used for RLS.
  • Anti-seizure medications can slow or block pain signals from nerves in the legs. Examples include gabapentin enacarbil (Horizant®), gabapentin (Neurontin®) and pregabalin (Lyrica®). These drugs are particularly effective in patients with painful RLS due to neuropathy. Gabapentin enacarbil is the only medication in this class that is FDA-approved for RLS. However, the others may be effective.
  • Benzodiazepines, clonazepam (Klonopin®) in particular, are sometimes prescribed for RLS but are usually reserved for more severe cases due to their addictive potential and side effects including daytime drowsiness.
  • Opioids, such as methadone or oxycodone, can be used to relieve symptoms of RLS but because of the risk of addiction, they are usually not prescribed unless the case is severe and other medications have not been effective.

You and your doctor will discuss the treatment that might be best for you.

Symptoms, Causes, Risk Factors & Treatment


What are uterine fibroids?

Uterine fibroids (also called leiomyomas) are growths made up of the muscle and connective tissue from the wall of the uterus. These growths are usually not cancerous (benign). Your uterus is an upside down pear-shaped organ in your pelvis. The normal size of your uterus is similar to a lemon. It’s also called the womb and it’s the place where a baby grows and develops during pregnancy.

Fibroids can grows as a single nodule (one growth) or in a cluster. Fibroid clusters can range in size from 1 mm to more than 20 cm (8 inches) in diameter or even larger. For comparison, they can get as large as the size of a watermelon. These growths can develop within the wall of the uterus, inside the main cavity of the organ or even on the outer surface. Fibroids can vary in size, number and location within and on your uterus.

You may experience a variety of symptoms with uterine fibroids and these may not be the same symptoms that another woman with fibroids will experience. Because of how unique fibroids can be, your treatment plan will depend on your individual case.

Are fibroids common?

Fibroids are actually a very common type of growth in your pelvis. Approximately 40 to 80% of women have fibroids. However, many women don’t experience any symptoms from their fibroids, so they don’t realize they have fibroids. This can happen when you have small fibroids — called asymptomatic because they don’t cause you to feel anything unusual.

Who is at risk for uterine fibroids?

There are several risk factors that can play a role in your chances of developing fibroids. These can include:

  • Obesity and a higher body weight (a person is considered obese if they’re more than 20% over the healthy body weight).
  • Family history of fibroids.
  • Not having children.
  • Early onset of menstruation (getting your period at a young age).
  • Late age for menopause.

Where do fibroids grow?

There are several places both inside and outside of your uterus where fibroids can grow. The location and size of your fibroids is important for your treatment. Where your fibroids are growing, how big they are and how many of them you have will determine which type of treatment will work best for you or if treatment is even necessary.

There are different names given for the places your fibroids are located in and on the uterus. These names describe not only where the fibroid is, but how it’s attached. Specific locations where you can have uterine fibroids include:

  • Submucosal fibroids: In this case, the fibroids are growing inside the uterine space (cavity) where a baby grows during pregnancy. Think of the growths extending down into the empty space in the middle of the uterus.
  • Intramural fibroids: These fibroids are embedded into the wall of the uterus itself. Picture the sides of the uterus like walls of a house. The fibroids are growing inside this muscular wall.
  • Subserosal fibroids: Located on the outside of the uterus this time, these fibroids are connected closely to the outside wall of the uterus.
  • Pedunculated fibroids: The least common type, these fibroids are also located on the outside of the uterus. However, pedunculated fibroids are connected to the uterus with a thin stem. They’re often described as mushroom-like because they have a stalk and then a much wider top.

What do fibroids look like?

Fibroids are typically rounded growths that can look like nodules of smooth muscle tissue. In some cases, they can be attached with a thin stem, giving them a mushroom-like appearance.

Are fibroids cancer?

It’s extremely rare for a fibroid to go through changes that transform it into a cancerous or a malignant tumor. In fact, one out of 350 women with fibroids will develop malignancy. There’s no test that’s 100% predictive in detecting rare fibroid-related cancers. However, people who have rapid growth of uterine fibroids, or fibroids that grow during menopause, should be evaluated immediately.

Symptoms and Causes

What causes uterine fibroids?

The causes of fibroids are not known. Most fibroids happen in women of reproductive age. They typically aren’t seen in young women who haven’t had their first period yet.

What are the symptoms of uterine fibroids?

Most fibroids do not cause any symptoms and don’t require treatment other than regular observation by your healthcare provider. These are typically small fibroids. When you don’t experience symptoms, it’s called an asymptomatic fibroid. Larger fibroids can cause you to experience a variety of symptoms, including:

The symptoms of uterine fibroids usually stabilize or go away after you’ve gone through menopause because hormone levels decline within your body.

What does uterine fibroid pain feel like?

There are a variety of feelings you might experience if you have fibroids. If you have small fibroids, you may feel nothing at all and not even notice they’re there. For larger fibroids, however, you can experience discomforts and even pains related to the condition. Fibroids can cause you to feel back pain, severe menstrual cramps, sharp stabbing pains in your abdomen and even pain during sex.

Can fibroids change over time?

Fibroids can actually shrink or grow over time. They can change size suddenly or steadily over a long period of time. This can happen for a variety of reasons, but in most cases this change in fibroid size is linked to the amount of hormones in your body. When you have high levels of hormones in your body, fibroids can get bigger. This can happen at specific times in your life, like during pregnancy. Your body releases high levels of hormones during pregnancy to support the growth of your baby. This surge of hormones also causes the fibroid to grow. If you know you have fibroids before a pregnancy, talk to your healthcare provider. You may need to be monitored to see how the fibroid grows throughout the pregnancy.Fibroids can also shrink when your hormone levels drop. This is common after menopause. Once a woman has passed through menopause, the amount of hormones in her body is much lower. This can cause the fibroids to shrink in size. Often, your symptoms can also get better after menopause.

Can fibroids cause anemia?

Anemia is a condition that happens when your body doesn’t have enough healthy red blood cells to carry oxygen to your organs. It can make you feel tired and weak. Some women may develop intense cravings for ice, starch or dirt. This is called pica and is associated with anemia. Anemia can happen to women who have frequent or extremely heavy periods. Fibroids can cause your periods to be very heavy or for you to even bleed between periods. Some treatments like oral iron pills — or if you’re significantly anemic, an iron infusion (by IV) — can improve your anemia. Talk to your healthcare provider if you are experiencing symptoms of anemia while you have fibroids.

Diagnosis and Tests

How are uterine fibroids diagnosed?

In many cases, fibroids are first discovered during a regular exam with your women’s health provider. They can be felt during a pelvic exam and can be found during a gynecologic exam or during prenatal care. Quite often your description of heavy bleeding and other related symptoms may alert your healthcare provider to consider fibroids as a part of the diagnosis.There are several tests that can be done to confirm fibroids and determine their size and location. These tests can include:

  • Ultrasonography: This non-invasive imaging test creates a picture of your internal organs with sound waves. Depending on the size of the uterus, the ultrasound may be performed by the transvaginal or transabdominal route.
  • Magnetic resonance imaging (MRI): This test creates detailed images of your internal organs by using magnets and radio waves.
  • Computed tomography (CT): A CT scan uses X-ray images to make a detailed image of your internal organs from several angles.
  • Hysteroscopy: During a hysteroscopy, your provider will use a device called a scope (a thin, flexible tube with a camera on the end) to look at fibroids inside your uterus. The scope is passed through your vagina and cervix and then moved into your uterus.
  • Hysterosalpingography (HSG): This a detailed X-ray where a contrast material is injected first and then X-rays of the uterus are taken. This is more often used in women who are also undergoing infertility evaluation.
  • Sonohysterography: In this imaging test, a small catheter is placed transvaginally and saline is injected via the catheter into the uterine cavity. This extra fluid helps to create a clearer image of your uterus than you would see during a standard ultrasound.
  • Laparoscopy: During this test, your provider will make a small cut (incision) in your lower abdomen. A thin and flexible tube with a camera on the end will be inserted to look closely at your internal organs.

Management and Treatment

How are uterine fibroids treated?

Treatment for uterine fibroids can vary depending on the size, number and location of the fibroids, as well as what symptoms they’re causing. If you aren’t experiencing any symptoms from your fibroids, you may not need treatment. Small fibroids can often be left alone. Some women never experience any symptoms or have any problems associated with fibroids. Your fibroids will be monitored closely over time, but there’s no need to take immediate action. Periodic pelvic exams and ultrasound may be recommend by your healthcare provider depending on the size or symptoms of your fibroid.If you are experiencing symptoms from your fibroids — including anemia from the excess bleeding, moderate to severe pain, infertility issues or urinary tract and bowel problems — treatment is usually needed to help. Your treatment plan will depend on a few factors, including:

  • How many fibroids you have.
  • The size of your fibroids.
  • Where your fibroids are located.
  • What symptoms you are experiencing related to the fibroids.
  • Your desire for pregnancy.
  • Your desire for uterine preservation.

The best treatment option for you will also depend on your future fertility goals. If you want to have children in the future, some treatment options may not be an option for you. Talk to your healthcare provider about your thoughts on fertility and your goals for the future when discussing treatment options. Treatment options for uterine fibroids can include:


  • Over-the-counter (OTC) pain medications: These medications can be used to manage discomforts and pain caused by the fibroids. OTC medications include acetaminophen and ibuprofen.
  • Iron supplements: If you have anemia from the excess bleeding, your provider may also suggest you take an iron supplement.
  • Birth control: Birth control can also be used to help with symptoms of fibroids — specifically heavy bleeding during and between periods and menstrual cramps. Birth control can be used to help control heavy menstrual bleeding. There are a variety of birth control options you can use, including oral contraceptive pills, intravaginal contraception, injections and intrauterine devices (IUDs).
  • Gonadotropin-releasing hormone (GnRH) agonists: These medications can be taken via a nasal spray or injection and they work by shrinking your fibroids. They’re sometimes used to shrink a fibroid before surgery, making it easier to remove the fibroid. However, these medications are temporary and if you stop taking them, the fibroids can grow back.
  • Oral therapies: Elagolix is a new oral therapy indicated for the management of heavy uterine bleeding in premenopausal women with symptomatic uterine fibroids. It can be used up to 24 months. Talk to your doctor for pros and cons of this therapy. Another oral therapy, Tranexamic acid, is an antifibrinolytic oral drug that’s indicated for the treatment of cyclic heavy menstrual bleeding in women with uterine fibroids. Your doctor will monitor you during this therapy.

It’s important to talk to your healthcare provider about any medication you take. Always consult your provider before starting a new medication to discuss any possible complications.

Fibroid surgery

There are several factors to consider when talking about the different types of surgery for fibroid removal. Not only can the size, location and number of fibroids influence the type of surgery, but your wishes for future pregnancies can also be an important factor when developing a treatment plan. Some surgical options preserve the uterus and allow you to become pregnant in the future, while other options can either damage or remove the uterus.

Myomectomy is a procedure that allows your provider to remove the fibroids without damaging the uterus. There are several types of myomectomy. The type of procedure that may work best for you will depend on where your fibroids are located, how big they are and the number of fibroids. The types of myomectomy procedure to remove fibroids can include:

  • Hysteroscopy: This procedure is done by inserting a scope (a thin, flexible tube-like tool) through the vagina and cervix and into the uterus. No incisions are made during this procedure. During the procedure, you provider will use the scope to cut away the fibroids. Your provider will then remove the fibroids.
  • Laparoscopy: In this procedure, your provider will use a scope to remove the fibroids. Unlike the hysteroscopy, this procedure involves placing a few small incisions in your abdomen. This is how the scope will enter and exist your body. This procedure can also be accomplished with the assistance of a robot.
  • Laparotomy: During this procedure, an incision is made in your abdomen and the fibroids are removed through this one larger cut.

If you aren’t planning future pregnancies, there are additional surgical options your healthcare provider may recommend. These options are not recommended if pregnancy is desired and there are surgical approaches that remove the uterus. These surgeries can be very effective, but they typically prevent future pregnancies. Surgeries to remove fibroids can include:

  • Hysterectomy: During this surgery, your uterus is removed. A hysterectomy is the only way to cure fibroids. By removing your uterus completely, the fibroids can’t come back and your symptoms should go away. If your uterus alone is removed — the ovaries are left in place — you will not go into menopause after a hysterectomy. This procedure might be recommended if you’re experiencing very heavy bleeding from your fibroids or if you have large fibroids. When recommended, the most minimally invasive procedure to perform hysteroscopy is advisable. Minimally invasive procedures include vaginal, laparoscopic or robotic approaches.
  • Uterine fibroid embolization: This procedure is performed by an interventional radiologist who works with your gynecologist. A small catheter is placed in the uterine artery or radial artery and small particles are used to block the flow of blood from the uterine artery to the fibroids. Loss of blood flow shrinks the fibroids — improving your symptoms.
  • Radiofrequency ablation (RFA): This is a safe and effective treatment for women with symptomatic uterine fibroids and can be delivered by laparoscopic, transvaginal or transcervical approaches.

There’s also a newer procedure called magnetic resonance imaging (MRI)-guided focused ultrasound that can be used to treat fibroids. This technique is actually done while you’re inside a MRI machine. You are placed inside the machine — which allows your provider to have a clear view of the fibroids — and then an ultrasound is used to send targeted sound waves at the fibroids. This damages the fibroids.

Are there any risks related to fibroid treatments?

There can be risks to any treatment. Medications can have side effects and some may not be a good fit for you. Talk to your healthcare provider about all medications you may be taking for other medical conditions and your complete medical history before starting a new medication. If you experience side effects after starting a new medication, call your provider to discuss your options.

There are also always risks involved in surgical treatment of fibroids. Any surgery places you at risk of infection, bleeding, and any inherent risks associated with surgery and anesthesia. An additional risk of fibroid removal surgery can involve future pregnancies. Some surgical options can prevent future pregnancies. Myomectomy is a procedure that only removes the fibroids, allowing for future pregnancies. However, women who have had a myomectomy may need to deliver future babies via Caesarean section (C-section).

How large do uterine fibroids need to be before being surgically removed?

The normal uterine size is the size of a lemon or 8 cm. There isn’t a definitive size of a fibroid that would automatically mandate removal. Your healthcare provider will determine the symptoms that are causing the problem. Fibroids the size of a marble for instance, if located within the uterine cavity, may be associated with profound bleeding. Fibroids the size of a grapefruit or larger may cause you to experience pelvic pressure, as well as make you look pregnant and see increased abdominal growth that can make the abdomen enlarged. It’s important for the healthcare provider and patient to discuss symptoms which might require surgical intervention.


Can fibroids be prevented?

In general, you can’t prevent fibroids. You can reduce your risk by maintaining a healthy body weight and getting regular pelvic exams. If you have small fibroids, develop a plan with your healthcare provider to monitor them.

Can I get pregnant if I have uterine fibroids?

Yes, you can get pregnant if you have uterine fibroids. If you already know you have fibroids when you get pregnant, your healthcare provider will work with you to develop a monitoring plan for the fibroids. During pregnancy, your body releases elevated levels of hormones. These hormones support the growth of your baby. However, they can also cause your fibroids to get bigger. Large fibroids can prevent your baby from being able to flip into the correct fetal position, increasing your risk of a breech birth or malpresentation of the fetal head. In very rare cases, you may be at higher risk of a pre-term delivery or a C-section delivery. In some cases, fibroids can contribute to infertility. It can be difficult to pinpoint an exact cause of infertility, but some women are able to become pregnant after receiving treatment for fibroids.

Outlook / Prognosis

Will fibroids go away on their own?

Fibroids can shrink in some women after menopause. This happens because of a decrease in hormones. When the fibroids shrink, your symptoms may go away. Small fibroids may not need treatment if they aren’t causing any symptoms.

A note from Cleveland Clinic

Uterine fibroids are a common condition that many women experience during their life. In some cases, fibroids are small and don’t cause any symptoms at all. Other times, fibroids can cause challenging symptoms. Talk to your healthcare provider if you experience any kind of discomfort or pain. Fibroids can be treated and, often, your symptoms can be improved.

Iron in Your Diet

What is iron?

Iron is a mineral that combines with protein to form hemoglobin, the red substance in blood that carries oxygen to the body’s cells. Iron helps prevent nutritional anemia and increase resistance to infection. Hemochromatosis is a disease in which too much iron builds up in the body, causing iron overload. How much iron we need depends on age and gender.

Recommended Dietary Allowances (RDAs) for Iron (*adequate intake)
Age Male Female Pregnancy Lactation
Birth to
6 months
0.27 mg* 0.27 mg*
7 to 12
11 mg 11 mg
7 mg 7 mg
10 mg 10 mg
8 mg 8 mg
11 mg 15 mg 27 mg 10 mg
8 mg 18 mg 27 mg 9 mg
8 mg 8 mg

Which foods contain iron?

There are two forms of iron found in foods: heme and nonheme. Iron from heme food sources is better absorbed into the body than nonheme sources. Heme iron is found in animal foods that contain hemoglobin.

Heme food sources of iron include red meats, poultry and fish. Choose the leanest cuts of meats, such as tenderloin, sirloin, beef round, and reduced-fat ground meat. Plant foods contain the nonheme iron, which is not as well absorbed. Most sources of dietary iron are in the nonheme form. Good food sources of nonheme iron include fortified cereals, beans, lentils, tofu, spinach, dried fruits (apricots, prunes, raisins), prune juice, enriched breads, broccoli and nuts.

Food Amount Iron
Total™ Raisin Bran Cereal 3/4 cup 18
Cream of Wheat®,
instant, cooked
3/4 cup 9
Clams, canned, drained
1/4 cup 8
Grits, instant 1/2 cup 7
Liver, beef, cooked
3 1/2 oz 7
Tofu, raw 1/2 cup 7
Lentils, boiled 1/2 cup 7
Oysters, raw
6 5
Navy beans, cooked 1 cup 5
Molasses, blackstrap 1 Tbsp 4
Spinach, cooked 1/2 cup 3
Beef, sirloin
3 1/2 oz 4
3 oz 3
Green peas, frozen, boiled 1 cup 3
Vegetable or soy burger 1 patty 3
Soy milk 1 cup 3
Beef, ground, cooked
3 1/2 oz 2
Turkey, dark meat
3 1/2 oz 2
Turkey, light meat
3 1/2 oz 2
Pistachio nuts 1 oz (47 nuts) 2
Pork, tenderloin
3 1/2 oz 2
Prune juice 1/2 cup 2
Broccoli, boiled 1 cup 1
Tuna, light meat, canned
3 oz 1
Bread, white, enriched 1.6 oz 1
Potato, baked

1 medium (3 1/2 oz)

Sesame seeds 2 Tbsp 1
Haddock, cooked
3 oz 1
Raisins 1/4 cup 1
Dried apricots 5 halves 1
Chicken, breast
3 oz 1

Should I take an iron supplement?

Your doctor or registered dietitian may recommend an iron supplement. A commonly reported side effect when taking iron supplements is constipation. Increasing fiber in the diet (whole grain breads, cereals, fruits, and vegetables), increasing your fluid intake, and moderately increasing exercise will all help to relieve constipation. Do not take iron and calcium supplements together.

What is the role of Vitamin C?

To increase absorption of iron in foods of plant origin, include vitamin C-rich foods such as:

  • Citrus fruits and juices
  • Broccoli, Brussels sprouts, cabbage
  • Tomatoes and peppers
  • Baked potatoes
  • Melon, berries and kiwi

If you take medication and eat grapefruit or drink grapefruit juice, check with your pharmacist about possible food-drug interactions.

Sample high-iron diet

Food item (Iron content in mg)


  • 3/4 cup iron-fortified cream of wheat (9.0 mg)
  • 4 oz orange juice (1.0 mg)
  • 8 oz skim milk (0.1 mg)


  • 1 cup bean soup (2.0 mg)
  • 1/2 chicken breast (1.0 mg)
  • 2 slices enriched bread (3.0 mg)
  • 1/4 tomato, sliced (–)
  • 2 large leaves of lettuce (–)
  • 1 tsp mustard (–)
  • 1 cup fresh strawberries (0.6 mg)
  • 8 oz skim milk (0.1 mg)


  • 5 oz lean roast beef (2.9 mg)
  • 1 medium baked potato (1.0 mg)
  • 1 tsp margarine (–)
  • 1 cup tossed spinach salad (2.0 mg)
  • 1 oz walnuts (1.0 mg)
  • 2 tbsp balsamic vinaigrette (–)
  • 1/4 cup raisins (1.0 mg)
  • 5 dried apricot halves (1.0 mg)

Total iron content of menu (25.6 mg)

The iron content of margarine and balsamic vinaigrette is unknown.

Symptoms, treatments, types, and causes

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Anemia occurs when the number of red blood cells circulating in the body decreases. It is the most common blood disorder.

Around one-third of the world’s population has a form of anemia, according to a 2015 article in The Lancet.

It often develops as a result of other health issues that interfere with the body’s production of healthy red blood cells (RBCs) or increase the rates of the breakdown or loss of these cells.

In this article, we explain the types, symptoms, and causes of anemia, as well as the treatments available.

Share on PinterestA person with anemia may experience fatigue, an irregular heartbeat, and chest pain.

The most common symptom of anemia is fatigue. Other common symptoms include:

  • pale skin
  • a fast or irregular heartbeat
  • shortness of breath
  • chest pain
  • headaches
  • light-headedness

People with mild anemia may experience few or no symptoms.

Some forms of anemia cause specific telltale symptoms, including:

  • Aplastic anemia: This can cause a fever, frequent infections, and skin rashes.
  • Folic acid deficiency anemia: This can cause irritability, diarrhea, and a smooth tongue.
  • Hemolytic anemia: This can cause jaundice, dark urine, a fever, and abdominal pain.
  • Sickle cell anemia: This can cause painful swelling in the feet and hands, as well as fatigue and jaundice.

The body needs RBCs to survive. They transport hemoglobin, a complex protein that attaches to iron molecules. These molecules carry oxygen from the lungs to the rest of the body.

Various health conditions can result in low levels of RBCs.

There are many types of anemia and no single cause. In some people, it can be difficult to identify what is causing a low low RBC count.

The three main causes of anemia are:

Blood loss

Iron-deficiency anemia is the most common type of anemia, and blood loss is often the cause. A shortage of iron in the blood leads to this form of the condition, and low iron levels frequently occur as a result of blood loss.

When the body loses blood, it draws water from tissues beyond the bloodstream to help keep the blood vessels full. This additional water dilutes the blood, reducing the RBC count.

Blood loss can be acute and rapid or chronic. Some causes of rapid blood loss include surgery, childbirth, and trauma.

Chronic blood loss is more often responsible for anemia. It can result from a stomach ulcer, cancer, or another type of tumor.

Other causes of anemia due to blood loss include:

  • gastrointestinal conditions, such as ulcers, hemorrhoids, cancer, or gastritis
  • the use of nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen
  • heavy menstrual bleeding

Decreased or impaired RBCs

Bone marrow is soft, spongy tissue at the center of bones, and it plays an essential role in creating RBCs. The marrow produces stem cells, which develop into RBCs, white blood cells, and platelets.

A number of diseases can affect bone marrow, including leukemia. This is a type of cancer that triggers the production of excessive and abnormal white blood cells, disrupting the production of RBCs.

Problems with bone marrow can cause anemia. Aplastic anemia, for example, occurs when few or no stem cells are present in the marrow.

In some cases, anemia results when RBCs do not grow and mature as usual, as with thalassemia — a hereditary form of anemia.

Other types of anemia that occur due to decreased or impaired RBCs include:

Sickle cell anemia

This causes RBCs to be shaped like crescents. They may break down more quickly than healthy RBCs or become lodged in small blood vessels.

This blockage can reduce oxygen levels and cause pain further down in the bloodstream.

Iron-deficiency anemia

This involves the body producing too few RBCs due to a lack of iron in the body.

Iron-deficiency anemia may develop as a result of:

  • a diet low in iron
  • menstruation
  • frequent blood donation
  • endurance training
  • certain digestive conditions, such as Crohn’s disease
  • medications that irritate the gut lining, such as ibuprofen

Vitamin-deficiency anemia

Vitamin B-12 and folate are both essential for the production of RBCs. If a person does not consume enough of either vitamin, their RBC count may be low.

Some examples of vitamin-deficiency anemia include megaloblastic anemia and pernicious anemia.

Destruction of RBCs

These cells typically have a life span of 120 days in the bloodstream, but the body may destroy or remove them before they complete their natural life cycle.

One type of anemia that results from the destruction of RBCs is autoimmune hemolytic anemia. It occurs when the immune system mistakes RBCs for a foreign substance and attacks them.

Many factors can cause an excessive breakdown of RBCs, including:

  • infections
  • certain drugs, including some antibiotics
  • severe hypertension
  • vascular grafts and prosthetic heart valves
  • toxins produced by advanced kidney or liver disease
  • an autoimmune attack, due to hemolytic disease, for example
  • snake or spider venom

There is a range of treatments for anemia. Each aims to increase the number of RBCs, which, in turn, increases the amount of oxygen in the blood.

Below, we outline treatments for several types of anemia:

  • Iron-deficiency anemia: Iron supplements and dietary changes can help, and, when relevant, a doctor will identify and address the cause of excessive bleeding.
  • Vitamin deficiency anemia: Treatments can include dietary supplements and vitamin B-12 shots.
  • Thalassemia: Treatments include folic acid supplements, iron chelation, and, for some people, blood transfusions and bone marrow transplants.
  • Anemia due to chronic disease: The doctor will focus on resolving the underlying condition.
  • Aplastic anemia: Treatment involves blood transfusions or bone marrow transplants.
  • Sickle cell anemia: Treatment typically involves oxygen therapy, pain relief medication, and intravenous fluids, but it can also include antibiotics, folic acid supplements, blood transfusions, and a cancer drug called hydroxyurea.
  • Hemolytic anemia: The treatment plan may include immunosuppressant drugs, treatments for infections, and plasmapheresis, which filters the blood.

Iron supplements are available to purchase online.

If nutritional deficiencies are responsible for anemia, eating more iron-rich foods can help.

The following foods are high in iron:

  • iron-fortified cereals and breads
  • leafy green vegetables, such as kale, spinach, and watercress
  • pulses and beans
  • brown rice
  • white or red meats
  • nuts and seeds
  • fish
  • tofu
  • eggs
  • dried fruits, including apricots, raisins, and prunes

Anemia can occur in people of all ages, sexes, and ethnicities.

The following factors increase the risk of developing a form of the condition:

  • having been born prematurely
  • being between 6 months and 2 years old
  • menstruating
  • being pregnant and giving birth
  • having a diet low in vitamins, minerals, and iron
  • regularly taking medications that inflame the stomach lining, such as ibuprofen
  • having a family history of inherited anemia, such as sickle cell anemia or thalassemia
  • having an intestinal disorder that affects the absorption of nutrients, such as Crohn’s disease
  • losing blood, due to surgery or trauma, for example
  • having a chronic illness, such as AIDS, diabetes, kidney disease, cancer, rheumatoid arthritis, heart failure, or liver disease

There are various ways to diagnose anemia, but the most common way involves a blood test called a complete blood count (CBC).

This measures a number of components, including:

  • hematocrit levels, which involves comparing the volume of RBCs with the total volume of blood
  • hemoglobin levels
  • an RBC count

A CBC can give an indication of overall health. It can also help the doctor decide whether to check for underlying conditions, such as leukemia or kidney disease.

If RBC, hemoglobin, and hematocrit levels fall below the normal range, a person is likely to have some form of anemia.

However, it is possible for a healthy person’s levels to fall outside this range — a CBC is not conclusive, but it is a helpful starting point.

The outlook for a person with anemia depends on the cause. People can sometimes prevent or manage anemia by making dietary changes alone.

Other types of anemia are lasting, and some can be life threatening without treatment.

If a person feels continually weak and tired, they should see a doctor for testing.

Anemia occurs when a low number of RBCs are circulating in the body. This reduces the person’s oxygen levels and can lead to symptoms such as fatigue, pale skin, chest pain, and breathlessness.

There are over 400 types of anemia. Common causes are blood loss, reduced or impaired RBC production, and the destruction of RBCs.

The most common type is iron-deficiency anemia. It sometimes develops due to a diet lacking in nutrients, Crohn’s disease, or the use of certain medications.

A doctor can use a CBC blood test to help detect anemia. Treatment varies, depending on the type, but it may include iron or vitamin supplements, medications, blood transfusions, and bone marrow transplants.

However, for some people with anemia, dietary changes can resolve the issue.

Anemia – Causes, Symptoms, Treatment, Diagnosis

The Facts

Anemia is a condition where the number of healthy red blood cells (RBCs) in the blood is lower than normal. RBCs transport oxygen throughout the body, so a shortage of these cells can be serious.

Iron-deficiency anemia is the most common type of anemia. It commonly affects children and women of all ages – especially women who are menstruating. It’s estimated that at least 2 out of every 10 women in North America does not have enough iron in her blood. It can also seriously affect men when it is caused by colon polyps, colon cancer, or other gastrointestinal (GI) malignancies (cancers). Iron-deficiency anemia is often one of the first warning signals that a person may have a GI malignancy.

Sickle cell anemia is another well-known type of anemia. This condition affects millions of people worldwide. It is a hereditary disease, passed on to children by parents with the altered genetic material. People most commonly affected include those of African, Middle Eastern, Mediterranean, or Indian descent. Every year, 1 in 12 babies of African descent are born with a genetic potential to pass sickle cell anemia on to their children. It’s estimated that 1 out of 400 babies of African descent will have the disease.

Aplastic anemia is a form of anemia where the bone marrow stops producing all types of blood cells. This type of anemia is very serious, but fortunately rare. It affects 2 to 12 out of every 1 million people each year. Aplastic anemia occurs in both adults and children.

Anemia of chronic disease is the second most common form of anemia worldwide. It’s a mild form of anemia that occurs with people who have diseases that last more than 1 to 2 months. Such diseases include tuberculosis, HIV, cancer, kidney disease, rheumatologic disorders, and liver disease.

Pernicious anemia is a form of anemia more common in seniors and is caused by either a lack of dietary intake or poor absorption of vitamin B12 from their diet. It is also a common condition seen in alcoholics.


Anemia is not an actual disease – it’s a condition caused by some other problem. Even mild anemia should be assessed by your doctor to determine the underlying cause. There are three basic ways you can develop anemia:

Blood loss

The most common cause of anemia in North America is blood loss. Many women are borderline anemic, usually because their diets lack the proper nutrients to replace their monthly blood loss from menstrual flow. Another frequent cause is gastrointestinal (GI) bleeding due to illnesses like ulcerative colitis, diverticulitis, and colon cancer. Use of certain medications such as acetylsalicylic acid* (ASA) and nonsteroidal anti-inflammatory drugs (NSAIDs) may also cause GI bleeding.

Other conditions that can cause bleeding include:

  • gastric ulcers
  • hemophilia
  • hemorrhoids
  • hookworms

Low production of healthy RBCs

The body needs iron to make hemoglobin, a protein on RBCs that carries oxygen from the lungs to the rest of the body. Hemoglobin is what gives blood its red colour. In addition to lack of iron, there tends to be a lack of vitamin B12 and folic acid in the diet as well. These deficiencies are less common in North America, but they still occur. People with increased iron requirements include infants, pregnant women, and teenagers going through a growth spurt.

Slow bleeding can also cause iron-deficiency anemia. Even healthy people lose a small amount of blood a day in their stool. A slightly larger amount can easily go unnoticed and yet be enough to cause anemia.

The cause of anemia of chronic disease is not completely understood. It is related to a decreased production of RBCs.
Individual RBCs only last about 4 months and must be replaced by new ones, which are made in the bone marrow. Aplastic anemia is caused when the marrow is destroyed or so badly damaged that it can’t produce enough RBCs. Some medications and radiation therapy can kill bone marrow, but the most common cause is an autoimmune reaction. This occurs when cells that normally protect you against disease attack your own tissue instead. In 50% of cases the cause of the autoimmune reaction is unknown.

Other conditions that can destroy bone marrow and cause aplastic anemia include viral hepatitis and severe rheumatoid arthritis. Fanconi anemia is a rare inherited aplastic condition in which the bone marrow is deficient. Anemia is common for people who have severe kidney disease. This is because healthy kidneys make a hormone called erythropoietin, a natural hormone that causes the bone marrow to produce more RBCs as they are needed by the body. Diseased kidneys cannot produce enough of this hormone to keep the body supplied with RBCs, leading to anemia.

Rapid destruction of RBCs

Healthy bone marrow can only produce so many RBCs a month. If the body is destroying cells faster than they are made, anemia will result. Old, “worn out” RBCs are mostly broken down in the spleen, which is the organ that filters the blood, checks it for infection, and removes undesirable substances. Some conditions can cause the spleen to grow larger. A variety of conditions may cause hypersplenism (enlarged spleen), including liver disease, malaria, lupus, or tuberculosis. An oversized spleen can trap and destroy even healthy RBCs, causing anemia

Sickle cell anemia and thalassemia are inherited diseases in which the RBCs are deformed. Sickle cell anemia is widespread among people of African descent, while thalassemia tends to run in families of Mediterranean descent. Sickle cell anemia is a genetic disease that occurs when individuals receive a copy of the sickle cell gene from both parents, resulting in misshapen or crescent-shaped RBCs. The spleen recognizes them as abnormal, and it grows to cope with the extra workload of killing them. This destruction of RBCs causes anemia. Interestingly, the gene that causes sickle cell disease also gives people resistance to, or protection from, a parasite that causes malaria.

Anemia can also be caused by a combination of factors. Anemia is very common in people with cancer. In fact, about half of people with cancer develop anemia. It can have a variety of different causes, including tumours in the bone marrow, blood loss, poor nutrition, chemotherapy or radiation therapy that damages the bone marrow where RBCs are produced, or a combination of these reasons.

In people with severe kidney disease, anemia is caused by a combination of decreased production of RBCs, decreased RBC lifespan, and blood loss related to dialysis.

Symptoms and Complications

The symptoms of anemia vary, depending on the degree of RBC loss or shortage.

Menstrual bleeding or iron deficiency tends to cause mild chronic anemia with symptoms of fatigue, pallor (pale skin colour), shortness of breath, and weakness. Those with iron deficiency may experience a craving to eat ice, clay, dirt or other substances. This is known as pica. Treating the iron deficiency will resolve pica.

If anemia is due to major blood loss, such as in cases of severe GI bleeding caused by ulcers, you may feel dizzy and very weak, especially if you stand up suddenly.
Severe anemia can cause tissues and organs to be completely starved of blood and oxygen. When this happens, cells rapidly die in a process called ischemia.

In sickle cell anemia, RBCs, which are normally disc-shaped, become sickle-shaped. This abnormal shape of the cells causes them to get lodged in small blood vessels, blocking normal blood flow. People with this disease may get serious ischemia in their feet, sometimes requiring amputation, or in other organs, causing pain. People with sickle cell anemia are at a high risk of stroke, since the sickle-shaped cells can easily bunch together, forming masses (clots) that block blood flow in the brain’s blood vessels.

For those with cancer, the most common symptoms of anemia are usually fatigue and shortness of breath. This makes it difficult to keep up usual energy levels and activities, and can have very negative effects on daily life.

Making the Diagnosis

Your doctor will ask for a blood sample that will be sent to the laboratory for a hemoglobin level. This measures the number of grams of hemoglobin per litre of your blood. Your blood will also be checked for levels of white blood cells, platelets, and various other blood components. The laboratory will also look at the size and shape of your RBCs.

The different levels, and how the blood cells look, can tell the doctor a lot about what’s causing the anemia. For instance, low red and white cells suggest a condition involving the bone marrow or spleen. The doctor will then test for other conditions, depending on the results of your initial blood test.

Treatment and Prevention

The treatment for anemia depends on the underlying illness causing it. Severe bleeding is usually treated with blood transfusions. You may also need regular transfusions of blood if you have a serious chronic type of anemia (e.g., Fanconi anemia or sickle cell anemia).

There has been a great improvement in lifespan for people with sickle cell anemia. In the past, those with the disease often did not make it to adulthood. The expected life span has now surpassed 50 years of age. The disease is managed by general health maintenance, vaccinations, folate supplementation, and the medication hydroxyurea. Currently, the only cure is a hematopoietic stem cell transplant (a procedure which replaces the abnormal bone marrow). This procedure has many risks, and is generally used only for those with advanced complications of the disease.

Iron supplements are used to treat iron-deficiency anemia. Infants who have this problem tend to be bottle-fed. A baby is able to absorb more iron from breast milk than from cow’s milk. You may want to take iron supplements for yourself when breast-feeding your child. Iron supplements will also help in cases of mild anemia that’s due to GI or menstrual bleeding. It may take 3 to 6 weeks of taking iron supplements to replenish the iron your body needs.
Vitamin B12, vitamin C, and folic acid are all crucial to RBC production, and a deficiency in any one of these vitamins puts you at risk for anemia. Good sources of vitamin B12 include beef and fish. Vegetables don’t contain this vitamin, so if you don’t eat meat, fish, or dairy products, you’ll need to take vitamin B12 supplements. Sources of folic acid include spinach, green peas, oranges, and cantaloupe.

When anemia is caused by decreased production of RBCs, such as in cancer or severe kidney disease, medications such as epoetin alfa and darbepoetin alfa can be used. These medications mimic the action of erythropoietin, the natural hormone that causes the bone marrow to produce more RBCs.

All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Anemia

The seven types of anaemia

The most common types of anaemia are

  • Iron deficiency anaemia
  • Thalassaemia
  • Aplastic anaemia
  • Haemolytic anaemia
  • Sickle cell anaemia
  • Pernicious anaemia
  • Fanconi anaemia

Iron Deficiency Anaemia


The most common form of anaemia is iron deficiency anaemia which is usually due to chronic blood loss caused by excessive menstruation. Increased demands for iron, such as foetal growth in pregnancy, and children undergoing rapid growth spurts in infancy and adolescence, can also cause iron deficiency anaemia.

This condition is treated with iron supplementation as well as the treatment of the underlying cause of the iron deficiency.


Iron deficiency occurs when the rate of loss or use of iron is more than its rate of absorption and use. The reasons for this are

  • Chronic blood loss: Most commonly due to excessive menstruation or bleeding into or from the gut as a result of a peptic ulcer, gastritis, haemorrhoids or in children, worm infestation.

  • Increased use of iron: In pregnancy, due to the growth of the foetus or children undergoing rapid growth spurts in infancy and adolescence.

  • Decreased absorption of iron

Signs and symptoms

The most common symptoms of chronic anaemia include tiredness, weakness, shortness of breath and sometimes, a fast heartbeat. The tongue may also become smooth, shiny and inflamed – this is called glossitis. Angular stomatitis (erosion, tenderness and swelling at the corners of the mouth) may also occur. In some instances, the patient also suffers from pica, a craving for strange foods such as starch, ice and clay.

The symptoms of the underlying cause of the iron deficiency may be present such as heavy menstrual bleeding or abdominal pain due to peptic ulceration.


Treatment for iron-deficiency anaemia will depend on the cause and severity of the condition. Treatments may include dietary changes and supplements, medicines, and surgery. Severe iron-deficiency anaemia may require treatment in hospital, blood transfusions, iron rejections, or intravenous iron therapy.


Infants and young children, women, and adults who have internal bleeding are at highest risk for iron-deficiency anaemia.

Aplastic Anaemia


Aplastic anaemia is a blood disorder in which the body’s bone marrow doesn’t make enough new blood cells. This may result in a number of health problems including arrhythmias, an enlarged heart, heart failure, infections and bleeding.

Aplastic anaemia is a rare but serious condition. It can develop suddenly or slowly and tends to worsen with time, unless the cause is found and treated.


Damage to the bone marrow’s stem cells causes aplastic anaemia. In more than half of people who have aplastic anaemia, the cause of the disorder is unknown.

A number of acquired diseases, conditions, and factors can cause aplastic anaemia including

  • Toxins, such as pesticides, arsenic, and benzene
  • Radiation and chemotherapy
  • Medicines such as chloramphenicol
  • Infectious diseases such as hepatitis, Epstein-Barr virus, cytomegalovirus, parvovirus B19, and HIV
  • Autoimmune disorders such as lupus and rheumatoid arthritis

Inherited conditions, such as Fanconi anaemia, Shwachman-Diamond syndrome, dyskeratosis congenital and Diamond-Blackfan anaemia may also cause aplastic anaemia.

Signs and symptoms

The most common symptoms of aplastic anaemia are

  • Fatigue
  • Shortness of breath
  • Dizziness
  • Headache
  • Coldness in your hands or feet
  • Pale skin, gums and nail beds
  • Chest pains


Treatment for aplastic anaemia includes blood transfusions, blood and marrow stem cell transplants, and medication. These treatments can prevent or limit complications, relieve symptoms, and improve quality of life.

In some cases, a cure may be possible. Blood and marrow stem cell transplants may cure the disorder. Removing a known cause of aplastic anaemia, such as exposure to a toxin, may also cure the condition.


People of all ages can get aplastic anaemia. However, it is most common in adolescents, young adults and the elderly. Men and women are equally likely to have it.

A person’s risk for aplastic anaemia is higher if you have

  • Been exposed to toxins
  • Taken certain medicines or had radiation or chemotherapy treatment
  • Certain infectious diseases, autoimmune disorders, or inherited conditions

Haemolytic Anaemia


Haemolytic anaemia is a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is up. A number of diseases, conditions and factors can cause the body to destroy its red blood cells. Haemolytic anaemia can lead to various health problems such as fatigue, pain, arrhythmias, an enlarged heart and heart failure.

There are many types of haemolytic anaemias – some of which are inherited and others that are acquired.

Inherited haemolytic anaemias include

  • Sickle cell anaemia
  • Thalassaemias
  • Hereditary spherocytosis
  • Hereditary elliptocytosis
  • Glucose-6-phosphate dehydrogenase (G6PD) deficiency
  • Pyruvate kinase deficiency

Acquired haemolytic anaemias include

  • Immune haemolytic anaemia
    • Autoimmune haemolytic anaemia
    • Alloimmune haemolytic anaemia
    • Drug-induced haemolytic anaemia
  • Mechanical haemolytic anaemias
  • Paroxysmal nocturnal haemoglobinuria
  • Certain infections and substances can also damage red blood cells and lead to haemolytic anaemia


The immediate cause of haemolytic anaemia is the early destruction of red blood cells. A number of diseases, conditions, and factors can cause the body to destroy its red blood cells. These causes can be inherited or acquired. Sometimes, the cause of haemolytic anaemia isn’t known.

  • In inherited haemolytic anaemias, the genes that control how red blood cells are made are faulty. Different types of faulty genes account for the different types of inherited haemolytic anaemias. In each type of inherited haemolytic anaemia, the body makes abnormal red blood cells. The problem with the red blood cells may involve the haemoglobin, cell membrane, or enzymes that maintain healthy red blood cells.
  • In acquired haemolytic anaemias, the body makes normal red blood cells, however, some disease, condition, or factor destroys the cells too early. Examples include immune disorders, infections and reactions to medicines or blood transfusions.

Signs and Symptoms

The most common symptom of all types of anaemia is fatigue. A low red blood cell count can also cause shortness of breath, dizziness, headache, coldness in your hands or feet, pale skin, gums and nail beds, as well as chest pain.

Symptoms of haemolytic anaemia include

  • Jaundice
  • Pain in the upper abdomen
  • Leg ulcers and pain
  • A severe reaction to a blood transfusion


Treatments for haemolytic anaemia include blood transfusions, medicines, plasmapheresis, surgery, blood and marrow stem cell transplants and lifestyle changes.

People who have mild haemolytic anaemia may not need treatment, as long as the condition doesn’t worsen. People with severe haemolytic anaemia usually need ongoing treatment.


Haemolytic anaemia can affect people of all ages, races and sexes.



Thalassaemias are inherited blood disorders which cause the body to make fewer healthy red blood cells and less haemoglobin (an iron-rich protein in red blood cells).

The two major types of thalassaemia are alpha- and beta thalassaemia. The most severe form of alpha thalassaemia is known as alpha thalassaemia major or hydrops fetalis, while the severe form of beta thalassaemia is known as thalassaemia major or Cooley’s anaemia.

Thalassaemias affect both males and females and occur most often in people of Italian, Greek, Middle Eastern, Asian, and African descent. Severe forms are usually diagnosed in early childhood and are lifelong conditions.


Haemoglobin in red blood cells has two kinds of protein chains: alpha globin and beta globin. If your body doesn’t make enough of these protein chains, red blood cells don’t form properly and can’t carry enough oxygen.

Genes control how the body makes haemoglobin protein chains. When these genes are missing or altered, thalassaemias occur.

Thalassaemias are inherited disorders – they are passed on from parents to their children through genes. People who get abnormal haemoglobin genes from one parent but normal genes from the other are carriers. Carriers often have no signs of illness other than mild anaemia. However, they can pass the abnormal genes on to their children.

Signs and symptoms

Symptoms of thalassaemias are caused by a lack of oxygen in the blood stream. This occurs because the body doesn’t make enough healthy red blood cells and haemoglobin. The severity of symptoms depends on the severity of the disorder:

  • People who have alpha or beta thalassaemia can have mild anaemia, which can make you feel tired.
  • People with beta thalassaemia intermedia have mild to moderate anaemia. They may also have other health problems including: slowed growth and delayed puberty; bone problems; and an enlarged spleen.
  • People with haemoglobin H disease or beta thalassaemia major have severe thalassaemia. Symptoms occur within the first two years of life and include severe anaemia and other serious health problems
    • Pale and listless appearance
    • Poor appetite
    • Dark urine
    • Slowed growth and delayed puberty
    • Jaundice
    • Enlarged spleen, liver and heart
    • Bone problems


Treatment for thalassaemias depends on the type and severity of the disorder. People who are carriers or who have alpha or beta thalassaemia need little or no treatment.

Three standard treatments are used to treat moderate and severe forms of thalassaemia, these include blood transfusions, iron chelation therapy, and folic acid supplements.


Family history and ancestry are the two risk factors for thalassaemias.

Sickle Cell Anaemia


Sickle cell anaemia is a serious disease in which the body makes sickle-shaped (“C”-shaped) red blood cells. Normal red blood cells are disk-shaped and move easily through your blood vessels. Red blood cells contain the protein haemoglobin (an iron-rich protein that gives blood its red colour and carries oxygen from the lungs to the rest of the body).

Sickle cells contain abnormal haemoglobin that causes the cells to have a sickle shape, which don’t move easily through the blood vessels – they are stiff and sticky and tend to form clumps and get stuck in the blood vessels.

The clumps of sickle cells block blood flow in the blood vessels that lead to the limbs and organs. Blocked blood vessels can cause pain, serious infections, and organ damage.

In sickle cell anaemia, a lower-than-normal number of red blood cells occurs because sickle cells don’t last very long. Sickle cells usually die after about 10 to 20 days and the body can’t reproduce red blood cells fast enough to replace the dying ones, which causes anaemia.


Sickle cell anaemia is an inherited, lifelong disease. People who have the disease inherit two copies of the sickle cell gene – one from each parent.

Signs and Symptoms

The most common symptoms of sickle cell anaemia are linked to anaemia and pain.

Common symptoms for anaemia include

  • Fatigue
  • Shortness of breath
  • Dizziness
  • Headache
  • Coldness in the hands and feet
  • Pale skin
  • Chest pain

Sudden pain throughout the body is a common symptom of sickle cell anaemia. This pain is called a “sickle cell crisis”, and often affects the bones, lungs, abdomen, and joints.


Sickle cell anaemia has no widely-available cure. However, treatments can help relieve symptoms and treat complications. The goals of treating sickle cell anaemia are to relieve pain, prevent infections, eye damage and strokes, and control complications.

Bone marrow transplants may offer a cure in a small number of sickle cell anaemia cases.


Sickle cell anaemia is most common in people whose families descended from Africa, South or Central American, Caribbean islands, Mediterranean countries, India and Saudi Arabia.

Pernicious Anaemia


Pernicious anaemia is a condition in which the body can’t make enough healthy red blood cells because it doesn’t have enough vitamin B12 (a nutrient found in certain foods). People who have pernicious anaemia can’t absorb enough vitamin B12 due to a lack of intrinsic factor (a protein made in the stomach). However, other conditions and factors can also cause vitamin B12 deficiency.


  • A lack of intrinsic factor is a common cause of pernicious anaemia as the body can’t absorb enough vitamin B12.
  • Some pernicious anaemia occurs because the body’s small intestine can’t properly absorb vitamin B12 which may be due to the wrong bacteria in the small intestines; certain diseases that interfere with vitamin B12 absorption; certain medicines; surgical removal of part of the small intestine; and tapeworm infection.
  • Sometimes people develop pernicious anaemia because they don’t get enough vitamin B12 in their diets.

Signs and symptoms

Apart from the symptoms of anaemia (fatigue, dizziness, etc.), the vitamin B12 deficiency may also have some serious symptoms such as

  • Nerve damage
  • Neurological problems such as confusion, dementia, depression, and memory loss.
  • Symptoms in the digestive tract include nausea and vomiting, heartburn, abdominal bloating and gas, constipation or diarrhoea, loss of appetite, and weight loss.
  • An enlarged liver
  • A smooth, beefy red tongue
  • Infants who have vitamin B12 deficiency may have poor reflexes or unusual movements, such as face tremors.


Pernicious anaemia is treated by replacing the missing vitamin B12 in the body. People who have this disease may need lifelong treatment.


You are at higher risk for pernicious anaemia if you

  • Have a family history of the condition.
  • Have had part or all of your stomach removed.
  • Have certain autoimmune disorders that involve the endocrine glands, such as Addison’s disease, type 1 diabetes, Graves’ disease, and vitiligo.
  • Have had part or all of your small intestine removed.
  • Have certain intestinal diseases or disorders that prevent your body from properly absorbing vitamin B12.
  • Take medicines that prevent your body from properly absorbing vitamin B12.
  • Are a strict vegetarian who doesn’t eat any animal or diary products and doesn’t take a vitamin B12 supplement, or if you eat poorly overall.

Fanconi Anaemia


Fanconi anaemia, or FA, is a rare, inherited blood disorder that leads to bone marrow failure. FA is a type of aplastic anaemia that prevents your bone marrow from making enough new blood cells for your body to work normally. FA can also cause your bone marrow to make many abnormal blood cells. This can lead to serious health problems, such as leukemia.

FA is a blood disorder, but it can also affect many of the body’s organs, tissues, and systems. Children who inherit FA are at higher risk of being born with birth defects, and people who have FA are at higher risk of some cancers and other serious health problems.

FA is an unpredictable disease. The average lifespan for people with FA is between 20 and 30 years. The most common causes of death related to FA are bone marrow failure, leukemia, and solid tumours.


FA is an inherited disease – it is passed on from parents to children through the genes. At least 13 faulty genes are associated with FA. FA develops when both parents pass the same faulty FA gene to their child. People who have only one faulty gene are FA carriers which means they don’t have FA, but they can pass the faulty gene to their children.

Signs and symptoms

The symptoms of FA include

  • Anaemia
  • Bone marrow failure
  • Birth defects
  • Developmental or eating problems


Treatment for FA is based on a person’s age and how well or poorly the person’s bone marrow makes new blood cells.

The four main types of treatment for FA are

  • Blood and marrow stem cell transplant
  • Androgen therapy
  • Synthetic growth factors
  • Gene therapy


FA occurs in all racial and ethnic groups and affects men and women equally. You are at an increased risk of developing the disease if you have a family history of FA.

Reviewed by Drs Natasha Sewpersad and Yasmin Goga, Inkosi Albert Luthuli Central Hospital, and Sunil Soni, Chairperson: South African Thalassaemia Association, June 2010

Anemia – familydoctor.org

What causes anemia?

There are three main reasons why anemia occurs.

  1. Your body can’t produce enough red blood cells.

Not being able to produce enough red blood cells can happen for several reasons, including diet, pregnancy, disease, and more.


Your body may not produce enough red blood cells if you lack certain nutrients. Low iron is a common problem. People who don’t eat meat or follow “fad” diets are more at risk of low iron. Infants and toddlers are at risk of getting anemia from a low-iron diet. Not having enough vitamin B12 and folic acid can cause anemia as well.

Absorption difficulty

Certain diseases affect your small intestine‘s ability to absorb nutrients. For example, Crohn’s disease and celiac disease can cause low iron levels in your body. Some foods, like milk, can prevent your body from absorbing iron. Taking vitamin C can help this. Medicines, such as antacids or prescriptions to reduce acid in your stomach, can affect it as well.


People who are pregnant or breastfeeding can get anemia. When you’re pregnant, you need more blood (up to 30% more) to share with the baby. If your body lacks iron or vitamin B12, it can’t produce enough red blood cells.

The following factors may increase your risk of anemia during pregnancy:

  • Vomiting a lot from morning sickness
  • Having a diet low in nutrients
  • Having heavy periods before pregnancy
  • Having 2 pregnancies close together
  • Being pregnant with multiple babies at once
  • Becoming pregnant as a teenager
  • Losing a lot of blood from an injury or surgery

Growth spurts

Children younger than 3 years of age are prone to anemia. Their bodies grow so fast that they can have a hard time getting or keeping enough iron.

Normocytic anemia

Normocytic anemia can be congenital (from birth) or acquired (from a disease or infection). The most common cause of the acquired form is a chronic (long-term) disease. Examples include kidney disease, cancer, rheumatoid arthritis, and thyroiditis. Some medicines can cause normocytic anemia, but this is rare.

  1. Your body destroys red blood cells early and faster that they can be replaced.

Treatments, such as chemotherapy, can damage your red blood cells and/or bone marrow. Infection caused by a weakened immune system can lead to anemia. You may be born with a condition that destroys or remove red blood cells. Examples include sickle cell disease, thalassemia, and a lack of certain enzymes. Having an enlarged or diseased spleen can cause anemia, too.

  1. You have blood loss that creates a shortage of red blood cells.

Heavy periods may cause low iron levels in women. Internal bleeding, such as in your digestive or urinary tract, can cause blood loss. This can be caused by conditions such as a stomach ulcer or ulcerative colitis. Other reasons for blood loss include:

  • Cancer
  • Surgery
  • Trauma
  • Taking aspirin or a similar medicine for a long time

90,000 types and symptoms – Aksimed Clinic of Modern Neurology

Anemia is a condition in which the concentration of hemoglobin and / or red blood cells in the blood decreases. This entails a number of problems in the body’s work, physical signs of the disease appear, which can be expressed in general weakness or cause skin defects.

General symptoms of all types of anemia

  • Dizziness, blurred vision;
  • weakness;
  • shortness of breath with slight physical exertion, heart palpitations;
  • pallor of the skin;
  • in the elderly – the occurrence of angina attacks;
  • violation of the menstrual cycle.

Types of anemia

Post-hemorrhagic anemia. This anemia results from severe blood loss. The level of hemoglobin decreases sharply, cells experience oxygen starvation, blood circulation is impaired.

Hemolytic anemia indicates that the body is actively destroying red blood cells, in which the bone marrow does not have time to replenish them.

Symptoms of anemia in hemolysis:

  • Yellow skin and whites of eyes;
  • Urine with a reddish or brown tinge;
  • Pain in the abdomen;
  • Ulcers on the legs;
  • The appearance of subcutaneous bruising;
  • Renal failure;
  • Convulsions

Sickle cell anemia is inherited.With this type of anemia, the shape of the erythrocytes is changed, and therefore, their functions are impaired.

Iron deficiency anemia develops as a result of a lack of iron in the human body. This type of anemia is most common.

Symptoms of iron deficiency anemia:

  • Ulcers on the tongue;
  • Craving for non-food components: paper, earth, chalk, ice, etc.;
  • Bulge of nails;
  • Cracked lips.

Vitamin B12 deficiency anemia. Hemopoiesis can also be impaired due to vitamin B12 deficiency.

Symptoms of anemia caused by a lack of B12:

  • Loss of smell, insensitivity to odors;
  • Tingling in the limbs;
  • Stiffness of movement;
  • Uneven gait;
  • Intellectual disorder.

Folic acid deficiency anemia occurs due to vitamin B9 deficiency.

Treatment of anemia

In order to prescribe the correct treatment for anemia, first of all, it is necessary to determine the causes of the development of the disease and eliminate them. If blood loss led to anemia, then after stopping the bleeding, it is necessary to direct all efforts to treating the disease that led to such serious consequences. If there is a lack of certain substances in the body, including iron, protein, vitamins, it is imperative to provide yourself with a varied, nutritious diet.

The most common iron deficiency anemia is usually treated with a diet enriched with foods high in protein and iron, which the body needs to produce hemoglobin, and special iron supplements.

Only a doctor can prescribe the correct treatment tactics, taking into account all analyzes and characteristics of the course of the disease.

Hematology: Anemia – diagnosis and treatment in St. Petersburg, price

Anemia is a condition in which the number of hemoglobin and red blood cells (red blood cells) per unit of blood volume decreases.Anemia due to blood loss is also called “posthemorrhagic” (from the Latin post – “after” and the Greek haimorrhagia – “bleeding”).

Symptoms of anemia

  • weakness,
  • dizziness,
  • fatigue,
  • chilliness,
  • drowsiness,
  • “flies” before the eyes,
  • heartbeat,
  • shortness of breath with habitual physical exertion,
  • pallor of the skin and mucous membranes.

In older people, attacks of angina pectoris may occur and become more frequent, in young women – menstrual irregularities. Explanations for this are familiar: “tired”, “stress in the family and at work”, “lack of sleep”, “overworked”. Meanwhile, quite often these are signs of anemia.

There are criteria for anemia adopted by the WHO (World Health Organization). They are very simple. The diagnosis of “anemia” is made when the concentration of hemoglobin decreases: in men – below 130 g / l, in women – below 120 g / l, in pregnant women – below 110 g / l.

Hemoglobin is an uncontested oxygen carrier to all cells and tissues of the human body. With a decrease in the amount of hemoglobin, oxygen delivery suffers, hence all the signs of this disease.

There are different groups of anemias, they are distinguished mainly for reasons of development.

Most common causes

  • Profuse or prolonged menses.
  • Bleeding hemorrhoids.
  • Gastrointestinal bleeding.
  • Nosebleeds.


Since these anemias are not independent diseases, it is necessary to eliminate the cause that caused them: remove the hemorrhoidal node, treat peptic ulcer disease, etc. When bleeding stops, the development of anemia usually stops. In severe cases, blood transfusion is sometimes necessary.

Iron deficiency anemias

They develop with insufficient intake of iron, which leads to a lack of building material for hemoglobin.

This type of anemia is the most common. According to the WHO, iron deficiency anemia in the world is on average about 80% (in Russia this figure is even higher – more than 90%). The most often sick are young children and women of childbearing age.

Causes of iron deficiency anemia
  • increased need for iron due to accelerated growth of the body (in children and adolescents),
  • pregnancy and lactation,
  • insufficient intake of iron from food during vegetarianism and fasting (unbalanced diets),
  • impaired absorption of iron in the stomach in gastritis with low acidity, after stomach operations.

Treatment is prescribed only after a complete examination. A special diet based on iron-rich foods should be followed. But changing the diet alone is not enough, so doctors prescribe various iron preparations: for oral administration in tablets, capsules, pills, and sometimes in the form of intramuscular injections or intravenous drip injections. In severe cases, transfusion of blood components may be necessary.


12 – deficiency anemias

Developed with a lack of vitamin B in the body 12 (cyanocobalamin). For the formation of red blood cells, vitamin B 12 and folic acid are required. Vitamin B 12 enters the body with food. For its absorption, an internal factor is required – a substance that is produced in the gastric mucosa. With a deficiency of vitamin B 12 , the normal metabolism of folic acid compounds is disrupted, as a result of which excessively large erythrocytes overloaded with hemoglobin are produced in the bone marrow.These extra-large cells are easily destroyed as they move through the blood vessels.

Causes B

12 – deficiency anemias

  • decrease in the production of intrinsic factors in the stomach (atrophic gastritis, gastric resection),
  • genetic (hereditary) factors,
  • autoimmune thyroid diseases and diabetes mellitus,
  • oncological diseases of the gastrointestinal tract,
  • the presence of parasites (worms).
  • injections of vitamin B preparations 12,
  • folic acid intake,
  • appointment of a special diet,
  • blood transfusion (in severe cases),
  • course of treatment with anthelmintics (for parasitic diseases).

Hemolytic anemias

This is a large group of hereditary and acquired anemias caused by increased destruction of red blood cells (hemolysis).

1. Acquired hemolytic anemias
  • Immune. They develop as a result of a failure in immunity, when antibodies begin to be produced not to pathogens, but to their own cells – erythrocytes.
  • Hemolytic disease of the newborn. Develops with Rh-conflict between mother and fetus.
  • Anemia with mechanical damage to erythrocytes (prosthetics of heart valves, hemolysis in chronic hemodialysis – “artificial kidney”).With repeated contact of the erythrocyte with a mechanical obstacle, its membrane is destroyed, and the cell simply wears out.
  • Anemia in infections (malaria, toxoplasmosis). Red blood cells are destroyed by pathogens.
  • Anemia when exposed to external factors: physical (burns), chemical agents, poisons (lead).
2. Hereditary hemolytic anemias

They develop with a congenital defect in the membrane of erythrocytes, which leads to a violation of the shape and size of red blood cells.The life span of such red blood cells is shortened. With hereditary hemolytic anemia, stones in the gallbladder are often found at a young age.

The symptoms of hemolytic anemia are very similar to those of liver disease (hepatitis):
  • Icteric coloration of the skin and mucous membranes. Increase in the level of bilirubin in the blood.With an increased content in the blood, bilirubin becomes toxic and causes the same complex of symptoms as in hepatitis: nausea, lack of appetite, dry mouth, general weakness.
  • Enlargement of the spleen. It is accompanied by heaviness and pain in the left hypochondrium.
  • Darkening of urine due to the release of bilirubin and products of its destruction.

Treatment for hemolytic anemia is carried out only in a hospital setting, since the signs of the disease are in many respects similar to the symptoms of hepatitis and cirrhosis of the liver, and it is very difficult to make a correct diagnosis. If treatment is delayed, a hemolytic crisis, a life-threatening condition, may develop.Due to the rapidly developing anemia, heart weakness sharply increases, heart rate increases, blood pressure drops.

High doses of hormones are prescribed – glucocorticosteroids. With a recurrent course of the disease, it is necessary to remove the spleen.

Aplastic anemia

This is a disease in which there is a significant decrease in the number of cells of all types in the blood as a result of a decrease in their production in the bone marrow.The signs of aplastic anemia are similar to those of radiation sickness. Anemia is accompanied by the development of cardiovascular failure. Due to a decrease in the number of platelets, patients have a tendency to bleeding, hemorrhage, bleeding.

A decrease in the number of leukocytes causes a weakening of the immune system and, as a result, various infectious complications: pneumonia, bronchitis, tonsillitis, generalized fungal lesions, and in the most severe cases, sepsis (blood poisoning).The disease itself usually begins with an infectious process. That is why, if the body temperature is increased for more than 3 days, it is necessary to do a blood test.


Due to the fact that aplastic anemia is one of the most severe types of anemia, it requires examination and treatment in a specialized hospital. Its treatment includes stem cell transplantation, immunosuppressive therapy (administration of anti-lymphocytic immunoglobulin, cyclosporin A).Transfusion of blood components, prevention and treatment of infectious complications are also used. Antibiotics are prescribed, they try to protect patients from all contacts, since any infection can cause the most serious complications.

Clinic of high medical technologies. NI Pirogova has laboratory and technical capabilities for the diagnosis of all types of anemias. In no case should you be treated with the help of “googlotherapy”, that is, by the method of self-selection of drugs based on information from search engines.Experimenting with your health can waste precious time. If warning signs appear, you need to seek help from specialists.

90,000 Anemia during pregnancy

Anemia is understood as a decrease in the level of hemoglobin in the blood.

During pregnancy, the amount of fluid in a woman’s body increases, and hence the volume of circulating blood. Due to this, the blood “liquefies” and the proportion of hemoglobin in its total volume falls.This is considered normal, and therefore the lower limit of the amount of hemoglobin during pregnancy is set at 110 g / l (the norm for a non-pregnant woman is 120-140 g / l). But a further drop in hemoglobin levels is dangerous for the health and even the life of the expectant mother.

Depending on the values ​​of this indicator, anemia during pregnancy can be:

  • mild severity – 110–90 g / l;
  • moderately expressed – 89–70 g / l;
  • heavy – 69-40 g / l.

The most common complications of anemia during pregnancy are:

  • threat of termination of pregnancy;
  • gestosis;
  • low blood pressure;
  • Premature placental abruption;
  • fetal growth retardation;
  • premature birth;
  • anemia in the first year of a child’s life.

So anemia during pregnancy is by no means a harmless condition. It has serious consequences for both the mother and the fetus.

During pregnancy, iron is consumed not only for the mother’s hematopoiesis, but also for the needs of the fetus. This consumption increases especially actively at 16–20 weeks, when the process of hematopoiesis starts in the fetus. By the end of pregnancy, iron stores are depleted in any woman and it takes 2-3 years for them to fully recover.

Other causes of anemia in pregnancy are:

  • iron deficiency in food mainly due to an insufficient amount of meat in the diet;
  • deficiency of vitamins B and C, necessary for normal absorption of iron;
  • diseases in which there is a lack of proteins involved in iron metabolism, including severe gestosis;
  • early preeclampsia (toxicosis), which interferes with proper nutrition;
  • frequent delivery with a short interval.

If we talk about the risk groups for the development of anemia during pregnancy, then these include women: with multiple pregnancies and multiparous; who had menstruation lasting more than 5 days before pregnancy; who have had symptoms of anemia during a previous pregnancy; with gestosis; with chronic diseases of the gastrointestinal tract, liver, chronic infections; vegetarians. All at risk should be especially careful to monitor their condition and, if possible, take care of the prevention of anemia during pregnancy.

Considering that during pregnancy the need for a woman’s body in a microelement increases by 15–33%, symptoms indicating hypoxia usually come to the fore: weakness, rapid fatigability; sleep disturbance: during the day – drowsiness, at night – insomnia; headaches; dizziness, tinnitus; dyspnea; palpitations; fainting.

The tolerance of the symptoms of anemia is individual: someone faints with relatively high hemoglobin values, someone refuses to be hospitalized with hemoglobin at a level of about 70 g / l, sincerely not understanding the severity of anemia and its danger during pregnancy.That is why a clinical blood test during pregnancy is mandatory and several times. The drop in serum iron and serum ferritin values ​​is also significant. A decrease in the amount of the latter to 12 μg / l indicates an iron deficiency, even if hemoglobin is still normal.

Treatment of anemia while waiting for the baby will include diet therapy. One of the foundations of both the prevention and treatment of anemia during pregnancy is proper nutrition. Food for the prevention of anemia during pregnancy should contain a sufficient amount of substances necessary for normal blood formation – these are meat, fish.In these products, iron is initially bivalent, therefore it is easily absorbed. But diet alone may not be enough even for prevention.

Iron preparations are prescribed for the treatment of anemia. Usually they are limited to means for oral administration (i.e., inside) – iron preparations in injections are recommended only in severe cases and only in a hospital setting.

Both Russian and foreign experts note that the prevention of anemia in pregnant women is more effective than its treatment, and the higher the hemoglobin level, the easier it is to bring it back to normal.However, common sense also speaks of the same. Therefore, when planning a pregnancy, and even more so when expecting a child, it is better to engage in the prevention of anemia without waiting for the iron deficiency to become noticeable.

Hematologist (head),

Consulting Department Rachkova T.A.

Heading health: what is the danger of anemia

There are no anemias of all kinds – hemolytic, iron deficiency, etc.This problem is not uncommon. Iron deficiency is one of the most common diseases. According to WHO experts on the globe, 700 – 800 million people suffer from this disease with symptoms of anemia or latent iron deficiency. This is most common in children, adolescents, and women. In highly developed countries, approximately 12% of women suffer from an iron deficiency state with symptoms of anemia, and a quarter has a latent iron deficiency. In countries with low living standards and ineffective health care systems, these rates are much higher.

For a number of reasons, we will describe them below, anemia is becoming a common disease. Maybe our advice will be useful to someone.

What is anemia?
Anemia , or anemia, is a painful condition characterized by a decrease in the concentration of hemoglobin and, in the overwhelming majority of cases, the number of red blood cells per unit of blood volume. Anemia occurs during all periods of a person’s life, not only with various diseases, but also with certain physiological conditions, for example, during pregnancy, during a period of increased growth, breastfeeding.The problem of anemia in young children is of great social importance, since anemia at this age can lead to impaired physical development and iron metabolism. The development of anemia may be associated with puberty and menopause, hormonal disorders, dietary habits, diseases of the digestive tract, liver, kidneys, malabsorption, autoimmune conditions, surgery and other factors. Often, anemia is an independent or concomitant symptom of many internal diseases, infectious and oncological diseases.

Common symptoms for all forms of anemia are pallor of the skin and mucous membranes, shortness of breath, palpitations, as well as complaints of dizziness, headaches, tinnitus, discomfort in the heart, severe general weakness and rapid fatigue.

How do I know if I have anemia?
Of great importance in the diagnosis of anemia is a laboratory blood test – determination of the concentration of hemoglobin, the number of erythrocytes, the size and saturation of their hemoglobin.

Precise determination of the type and cause of anemia is the basis for choosing the correct treatment. The relative ease of diagnosis of anemia often leads to the unjustified use of “antianemic” drugs without clarifying the cause and mechanism of anemia development.

Such treatment, as a rule, is ineffective, and in some cases even harms the patient. Late diagnosis of anemia or erasure of its clinical manifestations due to treatment without establishing the cause of anemia can lead to late recognition of a number of serious diseases; therefore, in the event of an anemic condition, it is necessary to adhere to the following rule: first, you need to establish the nature and cause of the anemia and only then prescribe the appropriate treatment.

How else can anemia manifest itself?
Other symptoms of anemia, primarily due to a lack of iron in the body, are:
– Brittle nails
A very important element that ensures the normal functioning of various tissues of the human body is iron. If, for some reason, the body’s iron supply decreases, then this circumstance immediately manifests itself as increased fragility of the nails.

Thinning and fragility of hair
To ensure the normal development and growth of hair, in addition to vitamins, an element such as iron is also needed.Insufficient iron content in the human body very quickly leads to thinning hair and the development of their increased fragility.

Unusual craving for chalk, clay, toothpaste, raw pasta?
With a decrease in iron reserves in the human body, the normal work of special proteins is disrupted, which leads to a change in the taste perception of food and the appearance of unusual food addictions.

Beginning to like the smell of oil paint, nail polish remover, gasoline and kerosene?
To provide a mechanism for the perception of odors, special sensitive receptor cells are required.The work of these receptors largely depends on the iron content in the human body. Already with a slight decrease in the iron store, the work of the receptors changes significantly.

What causes iron deficiency anemia?
Blood loss is the most important cause of iron deficiency anemia. The main cause in women is menstrual blood loss. The timing of the appearance of signs of anemia depends on the iron stores in the woman’s body.

Blood loss from the gastrointestinal tract is the second most common cause of iron deficiency anemia in women and the most common cause in men.In the development of iron deficiency anemia, prolonged bleeding with a small amount of daily blood loss (10-20 ml / day) is most significant. Such bleeding can remain invisible to the patient for a very long time, since it only changes the color of the stool to a darker one.

The third most important group of reasons for the development of iron deficiency anemia is the increased need for iron. In this group, special attention should be paid to the increased need for iron during pregnancy and lactation.

A person receives the main supply of iron during intrauterine development through the placenta from his mother and after birth with breast milk. During the period of gestation and lactation, a woman spends more than 800 mg of iron. The period of pregnancy and lactation requires adequate iron stores in the woman’s body.

Insufficient or monotonous nutrition is another cause of anemia. In most cases, there is an insufficient intake of iron (iron deficiency anemia), protein, which disrupts the formation of the protein part of hemoglobin (protein-deficient anemia).The deficiency of vitamins such as B6, B12 and folic acid (vitamin deficiency anemia), which are involved in the synthesis of hemoglobin, is also of a certain importance in the development of deficiency anemias. Often, deficiency anemias are observed in diseases accompanied by impaired absorption in the intestine. The development of deficiency anemias is promoted by frequent diseases, as well as prematurity.

How is anemia treated?
Treatment consists in eliminating the causes of the disease, normalizing nutrition and regimen, prescribing appropriate drugs: for example, with iron deficiency anemia – iron preparations (sorbifer durules, etc.).

Which foods have the most iron?
Foods such as meat, green apples and pomegranates contain more iron than others.

90,000 Anemia in children | Blood Clinic

Anemia is a syndrome or an independent disease characterized by a decrease in the level of hemoglobin and (or) erythrocytes per unit of blood volume. Anemia in children has a complex developmental mechanism. All types of anemias can occur in childhood.However, iron deficiency anemia is most common in children. It accounts for up to 90% of all childhood anemias. According to statistics, latent iron deficiency is observed in every second child under 3 years of age.

The most common anemia occurs in children under 3 years of age, the second peak in the incidence occurs during adolescence. This is due to the high growth rate of the child in the first years of life and in adolescence. During these periods, the body constantly requires a large amount of complete proteins, vitamins, iron and other trace elements necessary for hematopoiesis.

Factors that lead to the development of anemia in early childhood: prematurity, feeding disorders, infectious diseases, the use of drugs that inhibit the function of the bone marrow.

The adolescent period is also characterized by active growth, high iron requirements. Hormonal “restructuring” of the body, the appearance of menstruation in girls, a rapid increase in muscle mass in boys and other factors can lead to the development of anemia.

When detecting changes in the general analysis of the child’s blood, you should contact a pediatric hematologist as soon as possible.Diagnostic criteria:

  • in children under 5 years of age – hemoglobin (Hb) level less than 110 g / l,
  • over 5 years old – less than 120 g / l;
  • in adolescent girls, the hemoglobin level is less than 120 g / l,
  • for boys – less than 130 g / l.

Anemia in children is manifested by various signs that depend on the type of anemia, its severity and rate of development. These features are:

  • Permanent pallor of the skin and visible mucous membranes;
  • in children under 1 year of age: lethargy, tearfulness, sleep disturbance, loss of appetite, vomiting after feeding;
  • dry skin, increased fragility of nails, hair loss, the appearance of painful cracks in the corners of the mouth;
  • decreased concentration of attention, increased fatigue, emotional instability, delayed psychomotor development;
  • frequent ARVI and intestinal disorders.

It is important to remember that only a doctor can prescribe and interpret the test results.

Self-medication of anemia may have adverse effects.

A pediatric hematologist-hemostasiologist attends the “Blood Clinic” Saneeva Olga Borisovna , Candidate of Medical Sciences, doctor of the highest qualification category.

You can make an appointment with a pediatric hematologist by calling 8 (383) 303-45-24, 8-983-000-40-24.

Hemolytic anemia – Diagnosis and Treatment

Hemolytic anemia is a heterogeneous disease characterized by pathological damage and subsequent breakdown of red blood cells (hemolysis).

Distinguish between hereditary and acquired hemolytic anemias, associated and not associated with a defect in erythrocytes. Autoimmune hemolytic anemias are common, in which red blood cells are destroyed by antibodies produced by the body itself.

Erythrocytes are red blood cells that circulate in the bloodstream and carry oxygen to the organs and take carbon dioxide from them.Normally, the cell lives for about 120 days and after that itself is destroyed in the spleen.

If there are few red blood cells in the body, then it receives little oxygen, which causes malfunctions in the whole body.

Etiology of development of hemolytic anemia

There are two major causes of hemolytic anemia:

Congenital . Most often, these are various defects in the development of erythrocytes that are inherited from parent to child.It includes sickle cell anemia, thalassemia. This leads to the fact that red blood cells do not live as long as normal cells.

Acquired . This group of reasons includes the so-called immune hemolytic anemia, it can be provoked by:

  • Uncontrolled intake of antibiotics, paracetamol, anti-malaria drugs;
  • Infectious diseases;
  • Oncological diseases;
  • Autoimmune disorders
  • Rheumatoid arthritis, systemic lupus, and many other autoimmune diseases;
  • Increase in activity and size of the spleen and it begins to destroy too many red blood cells;
  • Artificial heart valves, which can damage red blood cells by their strokes;

https: // www.stanfordchildrens.org/en/topic/default?id=hemolytic-anemia-in-children-90-P02321

Clinical manifestations

Symptoms of hemolytic anemia can be acute and develop rapidly or chronic. The main symptoms are:

  • Pathological pallor and / or yellowness of the skin. Due to the lack of red blood cells, the skin loses its natural color.
  • Constant fatigue, weakness, decreased physical activity.
  • Dizziness, headache and confusion.
  • Decreased or no appetite.
  • Increased heart rate, even at rest.
  • Exacerbations of chronic diseases.
  • Shortness of breath;
  • Decrease in blood pressure.
  • Jaundice during the period of acute loss of erythrocytes.
  • Enlargement of the liver and spleen.
  • Constantly cold extremities.
  • Chest pain.

The symptoms of concomitant diseases are additionally added, which can increase hemolytic anemia : fever, joint pain, hormonal disorders.

In the case of critical anemia, the patient may experience loss of consciousness, drowsiness, lethargy and complete lack of energy. In this case, it is necessary to carry out treatment only in an intensive care hospital.

Features of hemolytic anemia in children

Since one of the causes of hemolytic anemia is heredity, the disease often manifests itself at a newborn age. Such children may have special anatomical features: pathological changes in the jaw and teeth, polydactyly, deformity of the cervical vertebra, tower skull and many others.More details

Diagnostic measures

It all starts with a detailed collection of complaints and anamnesis: what exactly worries when it started, periods of exacerbation and remission, medical history and much more

For the purpose of differential diagnosis, the doctor sends the patient for tests:

  • General blood test with a detailed formula, determination of reticulocytes. The very first and main indicator of blood, which makes it clear about the presence of anemia and its type.
  • Biochemistry. The level of lactate dehydrogenase, bilirubin and haptoglobin in the blood is assessed;
  • Urinalysis for the presence of urobilinogen, hemoglobinuria;
  • Peripheral blood smear. A drop of blood is examined in detail under a microscope and the quality of the cells is assessed;
  • Coombs’ tests for antibodies to red blood cells that attack their cells.

In order to check erythropoiesis, bone marrow is aspirated and the process of erythrocyte formation is examined in detail.They also carry out ultrasound and CT diagnostics of the liver and spleen.


The protocol for the treatment of hemolytic anemia depends on many factors: the cause of the disease, the patient’s age, the general condition of the body, acute or chronic condition.

In the case of an acquired cause of the development of pathology, first of all it is necessary to cope with it. For infectious diseases, broad-spectrum antibiotics or antiviral drugs are prescribed.

If an immune component is present, glucocorticosteroids are indicated.Medium or high doses of methylprednisolone are prescribed, followed by a decrease to maintenance doses. In severe cases, other immunosuppressive therapy is used.

Cancer requires complete chemistry or radiation therapy to bring the tumor into remission.

Folic acid is always added to the general therapy of hemolytic anemia, which promotes the formation of new blood cells. Rituximab, as a drug that affects the immune system, is used in the second and subsequent lines of therapy

https: // emedicine.medscape.com/article/201066-treatment#d1

In case of acute anemia, which leads to disruption of important vital functions, according to absolute indications, doctors carry out blood transfusion therapy. It consists in the direct restoration of the number of red blood cells by blood transfusion.

Also, with an increase in the size and activity of the spleen, surgical removal is performed.


It should be borne in mind that it is important not only full treatment, but also a certain way of life.Protect yourself as much as possible from injury, exposure to low temperatures. Carry out the prevention of infectious diseases, protect yourself from contact with patients and get vaccinated on time.



Treatment of anemia

Anemia, or anemia, is a pathological condition characterized by a decrease in the concentration of hemoglobin and, in the overwhelming majority of cases, the number of erythrocytes per unit of blood volume.Hemoglobin is a protein found in red blood cells (erythrocytes) that carries oxygen from the lungs to the tissues and organs of the body.

Anemia occurs at all periods of a person’s life, not only with various diseases, but also with certain physiological conditions, for example, during pregnancy, during the period of increased growth, lactation. The most common cause of anemia is iron deficiency in the body (iron is needed to make hemoglobin).

Symptoms of anemia:

  • Often no symptoms
  • Pallor
  • Fatigue
  • Unusual shortness of breath during sports
  • Rapid heartbeat
  • Cold hands and feet
  • Brittle nails
  • Headaches

What causes iron deficiency?

Iron deficiency in the body can be caused by a number of reasons:

  • Lack of iron in the diet.This phenomenon is especially common among children and young girls. Iron deficiency threatens children who drink a lot of milk but dislike iron-rich foods and girls who follow trendy diets.
  • Enhanced growth of the organism. Children under 3 years of age grow so fast that their bodies cannot make enough iron in time.
  • Pregnancy. Women who are pregnant or breastfeeding (lactating) need two and a half times more iron than men.Therefore, pregnant women are encouraged to get tested for anemia and supplement their diet with foods high in iron (such as apples) or take daily iron supplements.
  • Blood loss. This is one of the most common causes of iron deficiency in adults. For example, heavy periods can cause anemia. Blood loss can also be associated with internal bleeding, such as in the gastrointestinal tract. A stomach ulcer, ulcerative colitis, cancer, or long-term use of drugs such as aspirin and the like can cause stomach or intestinal bleeding.Therefore, it is so important to determine the cause of iron deficiency in the body as soon as possible.

How is anemia diagnosed?

If you suspect you have anemia, see your doctor. A blood test is done to diagnose anemia. To find out the causes of the disease, a number of other tests are necessary.

Can anemia be prevented?

Some types of anemia can be prevented, in particular those caused by a lack of iron in the diet.To prevent this kind of anemia, enrich your diet with iron-rich foods, a sample list of which is shown below.

  • liver and meat;
  • seafood;
  • dried fruits – dried apricots, prunes and raisins;
  • nuts;
  • beans, especially lima beans;
  • green leafy vegetables such as broccoli and spinach.

How is anemia treated?

Treatment of anemia depends on its cause. So, if the anemia is caused by blood loss, the cause of the bleeding must be treated.If the anemia is caused by inadequate intake of iron-containing foods, your doctor will recommend changing your diet or taking iron supplements.

How to increase your iron intake?

The body absorbs iron in meat best of all. Eating small amounts of meat along with other sources of iron, such as certain vegetables, will provide the body with the necessary amount of iron. Combining iron-containing foods with vitamin C or foods rich in vitamin C (citrus fruits and juices) promotes better absorption of iron by the body.

Several foods interfere with the absorption of iron, including coffee, tea, egg yolk, milk, fiber, and soy protein. If possible, try not to use these foods in combination with iron-containing foods.

Are iron supplements dangerous?

Iron supplements may cause indigestion, heartburn, and constipation. Be sure to tell your doctor if you notice these side effects.

Anemia can be encountered by a doctor of any specialty.Some of these diseases are simply diagnosed and simply treated, while others, which are less common, require the use of modern high medical technologies both in the process of diagnosis and in the process of treatment.

Contact us and we will help you understand the causes of your illness and prescribe the correct treatment !!!