What are the common causes of anemia. How is anemia diagnosed and treated. What are the potential complications of untreated anemia. Who is at highest risk for developing anemia.

Understanding Anemia: A Common Blood Disorder

Anemia is a prevalent blood condition that occurs when the body lacks sufficient healthy red blood cells or hemoglobin to transport oxygen effectively throughout the body. This deficiency can lead to a range of symptoms and health complications if left untreated.

Hemoglobin, an iron-rich protein found in red blood cells, plays a crucial role in carrying oxygen from the lungs to various parts of the body. When anemia develops, the body’s tissues and organs may not receive adequate oxygen, causing them to function below optimal levels.

Types of Anemia

There are several types of anemia, each with distinct causes and treatment approaches:

• Iron-deficiency anemia
• Vitamin B12 deficiency anemia
• Anemia of folate deficiency
• Hemolytic anemia
• Sickle cell anemia
• Cooley’s anemia (beta thalassemia)
• Aplastic anemia
• Chronic anemia
• Kidney failure associated anemia

Common Causes of Anemia

Anemia often manifests as a symptom of an underlying condition. The primary mechanisms leading to anemia include:

1. Excessive blood loss
2. Insufficient production of red blood cells
3. Accelerated destruction of red blood cells
4. A combination of these factors

Various factors can contribute to the development of anemia:

• Certain infections
• Underlying diseases
• Medication side effects
• Poor nutrition
• Chronic blood loss

Is blood loss a significant factor in anemia development?

Yes, blood loss is a major contributor to anemia. Chronic bleeding, whether from heavy menstrual periods, gastrointestinal conditions, or other sources, can deplete the body’s iron stores, leading to iron-deficiency anemia. Acute blood loss, such as from trauma or surgery, can also cause anemia if not promptly addressed.

Identifying At-Risk Populations for Anemia

While anemia can affect anyone, certain groups are more susceptible to developing this condition:

• Women of childbearing age
• Pregnant individuals
• Infants and young children
• Older adults

Several risk factors increase the likelihood of developing anemia:

• A diet low in iron-rich foods
• Heavy menstrual periods
• Chronic diseases such as kidney disease, rheumatoid arthritis, HIV, Crohn’s disease, and heart, liver, or thyroid disorders

Why are women of childbearing age at higher risk for anemia?

Women of childbearing age face an increased risk of anemia due to regular menstrual blood loss and the increased iron demands during pregnancy. Menstruation can deplete iron stores, while pregnancy requires additional iron to support fetal development and increased blood volume. These factors make iron-deficiency anemia particularly common among this demographic.

Recognizing the Symptoms of Anemia

Anemia symptoms primarily result from reduced oxygen delivery to the body’s cells and tissues, a condition known as hypoxia. The severity of symptoms often correlates with the degree of anemia, with mild cases potentially going unnoticed.

Common symptoms of anemia include:

• Pallor or pale skin
• Increased heart rate
• Shortness of breath
• Fatigue or easy tiredness
• Dizziness or lightheadedness, especially when standing
• Headaches
• Irritability
• Irregular menstrual cycles
• Delayed or absent menstruation
• Sore or swollen tongue
• Jaundice (yellowing of skin, eyes, and mouth)
• Enlarged spleen or liver
• Impaired wound healing

Can anemia symptoms mimic other health conditions?

Indeed, anemia symptoms can often resemble those of other blood disorders or health problems. This similarity underscores the importance of seeking professional medical advice for an accurate diagnosis, as anemia is frequently a symptom associated with other underlying conditions.

Diagnostic Approaches for Anemia

Healthcare providers typically suspect anemia based on a combination of symptoms, medical history, and physical examination findings. However, confirming the diagnosis and determining the specific type of anemia requires laboratory testing.

The primary diagnostic tests for anemia include:

• Complete blood count (CBC) to assess hemoglobin levels and red blood cell count
• Peripheral blood smear to examine red blood cell morphology
• Iron studies to evaluate iron status and storage
• Vitamin B12 and folate levels
• Reticulocyte count to assess bone marrow response

In some cases, additional tests may be necessary:

• Bone marrow aspiration or biopsy to evaluate blood cell production
• Hemoglobin electrophoresis to diagnose hemoglobinopathies
• Genetic testing for inherited anemias

How does a bone marrow biopsy aid in anemia diagnosis?

A bone marrow biopsy provides valuable information about blood cell production. By examining a small sample of bone marrow, typically taken from the hip bone, healthcare providers can assess the number, size, and maturity of blood cells. This procedure is particularly useful in diagnosing conditions like aplastic anemia or identifying abnormal cells that may be contributing to anemia.

Treatment Strategies for Anemia

The treatment approach for anemia varies depending on the underlying cause, severity of symptoms, and overall health of the patient. The primary goal is to increase the oxygen-carrying capacity of the blood and address any underlying conditions contributing to the anemia.

Common treatment options include:

1. Addressing underlying causes
2. Vitamin and mineral supplementation
3. Dietary modifications
4. Medications
5. Blood transfusions
6. Bone marrow transplantation
7. Surgical interventions (e.g., splenectomy for certain hemolytic anemias)
8. Antibiotic therapy for infection-related anemia

How effective are iron supplements in treating iron-deficiency anemia?

Iron supplements are highly effective in treating iron-deficiency anemia when taken as prescribed. Oral iron supplements can significantly improve hemoglobin levels within 2-3 weeks of starting treatment. However, it’s crucial to continue supplementation for several months to replenish iron stores fully. In cases of severe iron deficiency or absorption issues, intravenous iron therapy may be recommended for more rapid improvement.

Potential Complications of Untreated Anemia

Left untreated, anemia can lead to various complications affecting multiple organ systems. The severity of these complications often correlates with the degree and duration of anemia.

Potential complications include:

• Cardiovascular problems (e.g., heart failure, arrhythmias)
• Cognitive impairment and decreased mental function
• Increased susceptibility to infections
• Pregnancy complications (e.g., preterm birth, low birth weight)
• Growth and developmental delays in children
• Reduced quality of life and decreased physical performance

Can severe anemia lead to heart problems?

Yes, severe anemia can significantly impact cardiovascular health. When the body lacks sufficient red blood cells to carry oxygen, the heart compensates by pumping faster and harder to deliver oxygen to tissues. This increased workload can lead to an enlarged heart (cardiomegaly), heart murmurs, and in severe cases, heart failure. Prompt treatment of anemia is crucial to prevent these potentially serious cardiac complications.

Preventing Anemia: Strategies for Optimal Health

While not all types of anemia are preventable, many cases can be avoided or managed through lifestyle modifications and proactive health measures.

Key strategies for preventing anemia include:

• Consuming a balanced diet rich in iron, vitamin B12, and folate
• Regular health check-ups and screening for at-risk individuals
• Managing chronic health conditions effectively
• Addressing sources of chronic blood loss
• Taking iron supplements when recommended by a healthcare provider
• Proper prenatal care during pregnancy

Which foods are particularly beneficial for preventing iron-deficiency anemia?

Several foods are excellent sources of iron and can help prevent iron-deficiency anemia:

• Lean red meat, poultry, and fish
• Beans and lentils
• Dark leafy greens (e.g., spinach, kale)
• Iron-fortified cereals and bread
• Dried fruits (e.g., raisins, apricots)
• Eggs

Consuming these foods alongside vitamin C-rich sources can enhance iron absorption. Additionally, avoiding tea and coffee with meals can prevent interference with iron uptake.

Living with Anemia: Management and Quality of Life

For individuals diagnosed with chronic forms of anemia, effective management is key to maintaining a good quality of life. This often involves a combination of medical treatment, lifestyle adjustments, and regular monitoring.

Strategies for living well with anemia include:

• Adhering to prescribed treatment plans
• Regular follow-up appointments with healthcare providers
• Maintaining a nutrient-rich diet
• Engaging in appropriate physical activity as recommended by a doctor
• Managing stress and prioritizing rest
• Joining support groups or seeking counseling if needed

How can individuals with anemia safely engage in physical activity?

While anemia can cause fatigue and reduced exercise tolerance, physical activity remains important for overall health. Individuals with anemia should:

1. Consult their healthcare provider before starting any new exercise regimen
2. Start with low-intensity activities and gradually increase as tolerated
3. Listen to their body and rest when feeling overly fatigued
4. Stay hydrated and avoid overexertion
5. Consider activities like walking, swimming, or gentle yoga
6. Monitor symptoms and report any unusual fatigue or shortness of breath to their doctor

With proper management and guidance, many individuals with anemia can maintain an active lifestyle while supporting their overall health and well-being.

Anemia Overview | Cedars-Sinai

Not what you’re looking for?

What is anemia?

Anemia is a common blood disorder. It occurs when you have fewer red blood cells than normal, or not enough hemoglobin in your blood. Hemoglobin is the iron-rich protein in red blood cells. It carries oxygen from your lungs to all parts of your body.

When you have anemia, your blood can’t carry enough oxygen to your body. Without enough oxygen, your body can’t work as well as it should.

There are several different types of anemia. Each has its own cause and treatment. They include:

• Iron-deficiency anemia
• Vitamin B12 deficiency anemia
• Anemia of folate deficiency
• Hemolytic anemia
• Sickle cell anemia
• Cooley’s anemia (beta thalassemia)
• Aplastic anemia
• Chronic anemia
• Kidney failure associated anemia

What causes anemia?

Anemia is often a symptom of
another disease. Anemia often occurs when you have:

• Too much blood loss
• Not enough red blood cells being made
• Too many red blood cells being destroyed
• More than one of these problems at the same time

Anemia may often be caused by several problems, including:

• Certain infections
• Certain diseases
• Certain medicines
• Poor nutrition
• Blood loss

Who is at risk for anemia?

Anyone can get anemia. But it is more common in women of childbearing age. It’s also more common during pregnancy, infancy, and in older adults. Risk factors include:

• A diet low in iron-rich foods
• Heavy menstrual periods
• Lifelong (chronic) diseases such as kidney disease, rheumatoid arthritis, HIV, Crohn’s disease, and heart, liver, or thyroid disease

What are the symptoms of anemia?

Most anemia symptoms occur because of less oxygen getting to the body’s cells and tissues (hypoxia). The hemoglobin in red blood cells carries oxygen. So having fewer red blood cells leads to hypoxia. If you have mild anemia, you may not have many symptoms.

Each person’s symptoms will vary. Symptoms may include:

• Being very pale
• Faster heart rate
• Having trouble catching your breath
• Lack of energy or tiring easily (fatigue)
• Feeling dizzy or faint, especially when standing
• Headache
• Being irritable
• Irregular menstruation cycles
• Delayed menstruation, or not having a period
• Sore or swollen tongue
• Yellowing of skin, eyes, and mouth (jaundice)
• Enlarged spleen or liver
• Not easy for wounds or tissue to heal

Anemia symptoms may look like other blood disorders or health problems. Anemia is often a symptom linked to another disease. So be sure your healthcare provider knows about symptoms you may have. Always see your provider for a diagnosis.

How is anemia diagnosed?

Your healthcare provider may think
you have anemia based on your symptoms, health history, and a physical exam. Anemia is
often confirmed using blood tests. These tests check your hemoglobin level and your red
blood cell count.

You may have additional tests such as:

• Other blood tests
• Bone marrow aspiration or biopsy. A
  small amount of bone marrow fluid (aspiration) or solid bone marrow tissue (called
  a core biopsy) is taken. The sample is often taken from the hip bones. It is checked
  for the number, size, and maturity of blood cells or abnormal cells.

How is anemia treated?

Treatment will depend on your symptoms, age, and general health. It
will also depend on how severe the condition is.

Treatment may include:

• Treating any underlying cause
• Vitamin and mineral supplements
• Change in diet
• Medicine
• Blood transfusion
• Bone marrow transplant
• Surgery to remove the spleen, if it is
  linked to hemolytic anemia
• Antibiotics if an infection is the
  cause

What are possible complications of anemia?

Mild anemia may cause no problems.
But if your body’s organs don’t get enough oxygen, you may have organ damage. The heart
can be damaged by the increased stress of pumping faster. It can also be damaged by
working too hard to carry oxygen to the body. In some cases, the underlying cause of the
anemia may be deadly.

Can anemia be prevented?

Preventing anemia includes eating a well-balanced diet with iron-rich foods. It also includes managing any lifelong (chronic) or underlying conditions that may be causing the anemia. For young women and women with heavy menstrual periods, using birth control medicines may help manage anemia.

Living with anemia

Some types of anemia can’t be cured, such as sickle cell anemia. Work with your healthcare provider to make a treatment plan that can reduce the effects of these diseases.

Key points about anemia

• Anemia is a common blood disorder. It happens when you have fewer red blood cells than normal.
• When you have anemia, your blood can’t carry enough oxygen to your body. Without enough oxygen, your body can’t work as well as it should.
• Anyone can get anemia. But it is more common in women of childbearing age.
• Preventing anemia includes eating a well-balanced diet with iron-rich foods.
• Some types of anemia can’t be cured, such as sickle cell anemia.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Not what you’re looking for?

Causes – Causes | American Geriatrics Society

In the United States, about one-third of all anemias among older adults are due to dietary deficiencies in iron, vitamin B12 and or folate (folic acid). About one-half of all anemias among older adults are due to chronic medical conditions, and about one-fifth of all anemias remain unexplained even with thorough evaluation. 

The three major reasons why anemia can happen are described below. In older people, anemia is often the result of more than one condition occurring at the same time. These conditions can include:

• Decreased red blood cell production caused by:
  • Problems with bone marrow function
  • Chronic diseases or inflammation, such as cancer or infections
  • Hormone problems
  • Kidney disease
  • Malnutrition and dietary deficiencies in iron, vitamin B12, or folic acid (folate)
  • Hereditary disorders
  • Medications
  • Alcohol dependency

• Loss of blood from:
  • stomach irritation from medications, alcohol, or an ulcer
  • polyps or tumors in the bowels
  • kidney stones or tumors
  • cancers
  • surgery 

• Increased destruction of red blood cells caused by:
  • Medications
  • A hereditary disorder
  • A disease of your immune system
  • Heart valve problems (which damage your red blood cells)
  • A tumor
  • Infections

Here are the most common causes of anemia in older adults.  

Iron-deficiency Anemia

A common cause of iron-deficiency anemia is chronic blood loss, usually from the gastrointestinal tract. This kind of “silent” internal bleeding can be caused by bleeding ulcers or polyps, cancer, or chronic irritation of the lining of the gastrointestinal tract. Often, this blood loss is invisible to the naked eye, and your healthcare provider may do a simple test, called a fecal occult blood test, to find it.

Anemia of Chronic Disease

Anemia of chronic disease can result from chronic inflammation caused by ongoing infections, tissue damage, various forms of arthritis, benign or malignant tumors, or a variety of chronic medical conditions. These conditions cause inflammation inside your body and prevent your bone marrow from working as well as it should.

Anemia of B12 and Folate Deficiencies

Vitamin B12 and folate (folic acid) are two vitamins important for red blood cell production. Vitamin B12 deficiency is more common with advancing age, particularly in women over the age of 60 and adults with autoimmune thyroid disease. Signs and symptoms include:

• General body weakness
• Pale skin
• Changes in the nervous system (some signs of this include a clumsy walk, or numbness and tingling in the arms and legs)
• Behavioral changes or confusion

Folate deficiency can result from poor nutrition, certain medications, or diseases affecting absorption from the gut.  

Hemolytic Anemia

Anemia caused by red blood cell destruction is called hemolytic anemia. Problems with your immune system are often to blame. Cancers, such as non-Hodgkin’s lymphoma or chronic lymphocytic leukemia, also destroy red blood cells. Hemolytic anemia can also be caused by medications or infections, or by an immune system disease like rheumatoid arthritis or lupus.

Last Updated July 2020

Anemia – Symptoms, Causes, Treatments

The symptoms of anemia are caused by an abnormally low number of red blood cells in the blood. Red blood cells contain the protein hemoglobin, which is vital to carrying oxygen to the body’s cells. Many symptoms of anemia are due to a general lack of oxygen that is available to the cells.

Your symptoms may also be caused by low blood pressure (hypotension), which is due to reduced blood volume. Blood volume will be low if anemia develops quickly, as in blood loss from hemorrhage.

Symptoms of anemia can be mild to severe and vary depending on the underlying cause.

Symptoms of mild to moderate anemia that develop slowly

When anemia is mild or develops slowly, symptoms may not be noticeable at first because the body may be able to adjust to a slow decline in red blood cells. Symptoms can also be mild or vague. Symptoms can include:

• Difficulties with memory and concentration

• Fatigue

• Feeling mildly light-headed

• Feeling unusually cold

• Low energy level

• Mild shortness of breath with exertion that goes away with rest

• Pale skin

• Sluggishness

• Tiring easily

Serious symptoms of severe or rapid-onset anemia that might indicate a life-threatening condition

When anemia is severe or develops quickly, symptoms are more serious because the body cannot adjust to the rapid decrease in blood pressure and the rapid decline in oxygen that is delivered to the cells. This can result in shock and death if not treated immediately.
Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

• Black, tarry stools (melena)

• Bluish coloration of the lips or fingernails

• Chest pain, chest tightness, chest pressure, and palpitations due to a lack of oxygen delivered to the heart

• Cold, clammy skin and extreme pallor (pale skin)

• Heavy, uncontrolled bleeding or hemorrhage

• Rapid heart rate (tachycardia)

• Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

• Vertigo (severe dizziness) and syncope (fainting) caused by a lack of oxygen in the brain

• Vomiting blood

When is a fall a symptom of an underlying problem?

Anemia and falls are very common and closely linked in older adults and the elderly. Anemia can cause dizziness, difficulty concentrating, confusion, and other problems that make it difficult to maintain balance during everyday activities. However, older adults and the elderly may become accustomed to these symptoms over time and not realize there is an underlying problem, even after falling.

In fact, falling may be the first sign that an older adult has anemia or another serious underlying medical condition. Falling can also cause injuries, such as a fractured hip, that can lead to bleeding and cause or worsen anemia.

Seek prompt medical care if you, or an older adult you know, have fallen, even if there appears to be no injuries. Prompt diagnosis and treatment of underlying anemia can reduce the risk of additional falls and injuries and other serious complications.

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.

Causes

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

Anemia // Middlesex Health

Overview

Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues. Having anemia, also referred to as low hemoglobin, can make you feel tired and weak.

There are many forms of anemia, each with its own cause. Anemia can be temporary or long term and can range from mild to severe. In most cases, anemia has more than one cause. See your doctor if you suspect that you have anemia. It can be a warning sign of serious illness.

Treatments for anemia, which depend on the cause, range from taking supplements to having medical procedures. You might be able to prevent some types of anemia by eating a healthy, varied diet.

Symptoms

Anemia signs and symptoms vary depending on the cause and severity of anemia. Depending on the causes of your anemia, you might have no symptoms.

Signs and symptoms, if they do occur, might include:

• Fatigue
• Weakness
• Pale or yellowish skin
• Irregular heartbeats
• Shortness of breath
• Dizziness or lightheadedness
• Chest pain
• Cold hands and feet
• Headaches

At first, anemia can be so mild that you don’t notice it. But symptoms worsen as anemia worsens.

When to see a doctor

Make an appointment with your doctor if you feel fatigued and you don’t know why.

Fatigue has many causes besides anemia, so don’t assume that if you’re tired you must be anemic. Some people learn that their hemoglobin is low, which indicates anemia, when they donate blood. If you’re told that you can’t donate because of low hemoglobin, make an appointment with your doctor.

Causes

Anemia can be due to a condition present at birth (congenital) or to a condition you develop (acquired). Anemia occurs when your blood doesn’t have enough red blood cells.

This can happen if:

• Your body doesn’t make enough red blood cells
• Bleeding causes you to lose red blood cells more quickly than they can be replaced
• Your body destroys red blood cells

What red blood cells do

Your body makes three types of blood cells — white blood cells to fight infection, platelets to help your blood clot, and red blood cells to carry oxygen from your lungs to the rest of your body and carbon dioxide from the body back to the lungs.

Red blood cells contain hemoglobin — an iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs to be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow — a spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, vitamin B-12, folate and other nutrients from the foods you eat.

Causes of anemia

Different types of anemia have different causes. They include:

• Iron deficiency anemia. This most common type of anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can’t produce enough hemoglobin for red blood cells.

  Without iron supplementation, this type of anemia occurs in many pregnant women. It’s also caused by blood loss, such as from heavy menstrual bleeding; an ulcer in the stomach or small bowel; cancer of the large bowel; and regular use of some pain relievers that are available without a prescription, especially aspirin, which can cause inflammation of the stomach lining resulting in blood loss. It’s important to determine the source of iron deficiency to prevent recurrence of the anemia.

• Vitamin deficiency anemia. Besides iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Some people who consume enough B-12 aren’t able to absorb the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.
• Anemia of inflammation. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn’s disease and other acute or chronic inflammatory diseases — can interfere with the production of red blood cells.
• Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn’t produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
• Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
• Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.
• Sickle cell anemia. This inherited and sometimes serious condition is a hemolytic anemia. It’s caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.

Risk factors

These factors place you at increased risk of anemia:

• A diet lacking in certain vitamins and minerals. A diet consistently low in iron, vitamin B-12, folate and copper increases your risk of anemia.
• Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in your small intestine — such as Crohn’s disease and celiac disease — puts you at risk of anemia.
• Menstruation. In general, women who haven’t had menopause have a greater risk of iron deficiency anemia than do men and postmenopausal women. Menstruation causes the loss of red blood cells.
• Pregnancy. Being pregnant and not taking a multivitamin with folic acid and iron, increases your risk of anemia.

• Chronic conditions. If you have cancer, kidney failure or another chronic condition, you could be at risk of anemia of chronic disease. These conditions can lead to a shortage of red blood cells.

  Slow, chronic blood loss from an ulcer or other source within your body can deplete your body’s store of iron, leading to iron deficiency anemia.

• Family history. If your family has a history of an inherited anemia, such as sickle cell anemia, you also might be at increased risk of the condition.
• Other factors. A history of certain infections, blood diseases and autoimmune disorders increases your risk of anemia. Alcoholism, exposure to toxic chemicals and the use of some medications can affect red blood cell production and lead to anemia.
• Age. People over age 65 are at increased risk of anemia.

Complications

Left untreated, anemia can cause many health problems, such as:

• Extreme fatigue. Severe anemia can make you so tired that you can’t complete everyday tasks.
• Pregnancy complications. Pregnant women with folate deficiency anemia can be more likely to have complications, such as premature birth.
• Heart problems. Anemia can lead to a rapid or irregular heartbeat (arrhythmia). When you’re anemic your heart pumps more blood to make up for the lack of oxygen in the blood. This can lead to an enlarged heart or heart failure.
• Death. Some inherited anemias, such as sickle cell anemia, can lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal. Among older people, anemia is associated with an increased risk of death.

Prevention

Many types of anemia can’t be prevented. But you can avoid iron deficiency anemia and vitamin deficiency anemias by eating a diet that includes a variety of vitamins and minerals, including:

• Iron. Iron-rich foods include beef and other meats, beans, lentils, iron-fortified cereals, dark green leafy vegetables and dried fruit.
• Folate. This nutrient, and its synthetic form folic acid, can be found in fruits and fruit juices, dark green leafy vegetables, green peas, kidney beans, peanuts, and enriched grain products, such as bread, cereal, pasta and rice.
• Vitamin B-12. Foods rich in vitamin B-12 include meat, dairy products, and fortified cereal and soy products.
• Vitamin C. Foods rich in vitamin C include citrus fruits and juices, peppers, broccoli, tomatoes, melons and strawberries. These also help increase iron absorption.

If you’re concerned about getting enough vitamins and minerals from food, ask your doctor whether a multivitamin might help.

Diagnosis

To diagnose anemia, your doctor is likely to ask you about your medical and family history, perform a physical exam, and run the following tests:

• Complete blood count (CBC). A CBC is used to count the number of blood cells in a sample of your blood. For anemia, your doctor will likely be interested in the levels of the red blood cells contained in your blood (hematocrit) and the hemoglobin in your blood.

  Normal adult hematocrit values vary among medical practices but are generally between 40% and 50% for men and 35% and 43% for women. Normal adult hemoglobin values are generally 13. 6 to 16.9 grams per deciliter for men and 11.9 to 14.8 grams per deciliter for women.

  Numbers might be lower for people who engage in intense physical activity, are pregnant or of older age. Smoking and being at high altitude might increase numbers.

• A test to determine the size and shape of your red blood cells. Some of your red blood cells might also be examined for unusual size, shape and color.

Additional diagnostic tests

If you receive a diagnosis of anemia, your doctor might order other tests to determine the cause. Occasionally, it can be necessary to study a sample of your bone marrow to diagnose anemia.

Treatment

Anemia treatment depends on the cause.

• Iron deficiency anemia. Treatment for this form of anemia usually involves taking iron supplements and changing your diet. For some people, this might involve receiving iron through a vein.

  If the cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and the bleeding stopped. This might involve surgery.

• Vitamin deficiency anemias. Treatment for folic acid and vitamin C deficiency involves dietary supplements and increasing these nutrients in your diet.

  If your digestive system has trouble absorbing vitamin B-12 from the food you eat, you might need vitamin B-12 shots. At first, you might have the shots every other day. Eventually, you’ll need shots just once a month, possibly for life, depending on your situation.

• Anemia of chronic disease. There’s no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. If symptoms become severe, a blood transfusion or injections of a synthetic hormone normally produced by your kidneys (erythropoietin) might help stimulate red blood cell production and ease fatigue.
• Aplastic anemia. Treatment for this anemia can include blood transfusions to boost levels of red blood cells. You might need a bone marrow transplant if your bone marrow can’t make healthy blood cells.
• Anemias associated with bone marrow disease. Treatment of these various diseases can include medication, chemotherapy or bone marrow transplantation.
• Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating infections and taking drugs that suppress your immune system, which could be attacking your red blood cells. Severe hemolytic anemia generally needs ongoing treatment.
• Sickle cell anemia. Treatment might include oxygen, pain relievers, and oral and intravenous fluids to reduce pain and prevent complications. Doctors might also recommend blood transfusions, folic acid supplements and antibiotics. A cancer drug called hydroxyurea (Droxia, Hydrea, Siklos) also is used to treat sickle cell anemia.
• Thalassemia. Most forms of thalassemia are mild and require no treatment. More-severe forms of thalassemia generally require blood transfusions, folic acid supplements, medication, removal of the spleen, or a blood and bone marrow stem cell transplant.

Preparing for an appointment

Make an appointment with your primary care doctor if you have prolonged fatigue or other signs or symptoms that worry you. He or she may refer you to a doctor who specializes in treating blood disorders (hematologist), the heart (cardiologist) or the digestive system (gastroenterologist).

Here’s some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

• Your symptoms and when they began
• Key personal information, including major stresses, implanted medical devices, exposure to toxins or chemicals, and recent life changes
• All medications, vitamins and other supplements you take, including the doses
• Questions to ask your doctor

For anemia, basic questions to ask your doctor include:

• What’s the most likely cause of my symptoms?
• Are there other possible causes?
• Do I need tests?
• Is my anemia likely temporary or long lasting?
• What treatments are available, and which do you recommend?
• What side effects can I expect from treatment?
• I have other health conditions. How can I best manage them together?
• Do I need to restrict my diet?
• Do I need to add foods to my diet? How often do I need to eat these foods?
• Do you have brochures or other printed materials I can take? What websites do you recommend?

What to expect from your doctor

Your doctor is likely to ask you questions, such as:

• Do your symptoms come and go or are they constant?
• How severe are your symptoms?
• Does anything seem to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Are you a vegetarian?
• How many servings of fruits and vegetables do you usually eat in a day?
• Do you drink alcohol? If so, how often, and how many drinks do you usually have?
• Are you a smoker?
• Have you recently donated blood more than once?

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Causes of Anemia

Anemia is a blood disorder characterized by an inadequate level of hemoglobin in the blood.

Image Credit: MarySan / Shutterstock.com

Hemoglobin is needed to transport oxygen around the body. Moreover, hemoglobin is a protein that enables red blood cells (RBCs) to carry oxygen from the lungs to tissues and other organs in the body and also facilitates the transportation of carbon dioxide to the lungs from other parts of the body so that it can be expelled.

Mechanisms of anemia

There are several types of anemia; whereas some only cause mild health problems, others are much more serious. Whichever type of anemia a person has, the condition is caused by one of the following:

• The body fails to produce adequate levels of hemoglobin
• Hemoglobin is produced but fails to function properly
• The body does not produce adequate levels of RBCs
• RBCs are broken down too quickly in the body

Iron-deficiency anemia

Hemoglobin and RBCs are made by the bone marrow, which requires iron for their production. If there is an inadequate amount of iron available, the bone marrow cannot make hemoglobin for RBCs.

Thus, the most common cause of anemia is low iron. Some of the reasons why iron levels might be reduced include blood loss, a diet lacking in iron, and pregnancy.

Blood loss

When a person loses blood as a result of surgery, injury, or a blood clotting disorder, such as hemophilia or intestinal bleeding caused by an ulcer or cancer, anemia may develop. The use of blood thinners such as aspirin or heparin can also lead to anemia.

Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) can also lead to stomach ulcers and chronic intestinal bleeding. For women, menstruation is another risk factor for blood loss.

A diet lacking in iron

For the body to produce adequate levels of hemoglobin, the diet needs to be rich in iron. Some good sources of dietary iron include whole wheat bread, kidney beans, tofu, tuna, eggs, shrimps, turkey, brown rice, and lamb.

Pregnancy

An unborn baby is reliant on the mother for iron; therefore, the level of iron the body needs to increase during pregnancy to accommodate for this demand. As a result, many pregnant women will take a vitamin supplement that contains iron to decrease their risk of developing anemia.

Explaining AnemiaPlay

Vitamin deficiency Anemia

Aside from iron, the body also requires vitamin B12 and folate to produce RBCs and hemoglobin. A diet low in these nutrients can decrease the body’s ability to produce healthy RBCs that have a sufficient amount of hemoglobin. In the majority of cases, people with vitamin B12 or folate deficiency have RBCs that are large, underdeveloped, and fail to function properly. This is also referred to as megaloblastic anemia.

Foods that are a good source of B12 include meat, fish, and dairy products; therefore, a diet that includes these food products can typically ensure adequate B12 levels. People with a poor overall diet or those following a vegan diet may be at risk of vitamin B12 deficiency anemia.

Examples of foods that are good sources of folate are broccoli, asparagus, chickpeas, and brown rice. A folate deficiency may develop if these foods are not eaten regularly.

Pernicious anemia

Some individuals who consume adequate levels of B12 are still unable to process the vitamin due to an autoimmune condition called pernicious anemia.

In this condition, the body’s immune system attacks cells in the stomach that produce a protein called intrinsic factor. Intrinsic factor combines with vitamin B12 to form a complex that is then absorbed by the gut.

The lack of intrinsic factor in pernicious anemia prevents this absorption of vitamin B12. Pernicious anemia is the most common cause of vitamin B12 deficiency in the United Kingdom.

Gastrointestinal issues and anemia

Certain stomach and bowel conditions, such as Crohn’s disease, or gastrointestinal surgeries, such as gastrectomy, can affect the body’s ability to absorb sufficient amounts of vitamin B12. Anemia caused by Crohn’s disease or other chronic conditions such as kidney disease or cancer is referred to as anemia of chronic disease.

Medications and anemia

Some medications can affect the absorption of B12. Proton pump inhibitors (PPIs), for example, inhibit the production of acid in the stomach. Without this acid, vitamin B12 cannot be released from food in the stomach.

Image Credit: Double Brain / Shutterstock.com

Other causes of folate deficiency anemia

Malabsorption

Certain health conditions can affect the body’s ability to absorb folate properly. An example of such a condition is celiac disease.

Excessive urination

Excessive urination can lead to too much folate being expelled from the body. Examples of problems that can lead to excessive urination include acute liver damage and congestive heart failure.

Medication

Certain medications decrease folate levels or affect the body’s ability to absorb it. For example, certain types of anticonvulsants used to treat epilepsy can cause this effect.

Need for excess folate

In some circumstances, the body requires more folate than it usually would, which can lead to folate deficiency anemia if this excess need is not met. Examples of these conditions include pregnancy, certain blood disorders, cancer, as well as diseases that cause inflammation.

Aplastic anemia

Aplastic anemia is a condition that decreases the amount of RBCs because the bone marrow has become damaged and is thus incapable of making adequate amounts of new RBCs. This type of anemia be caused by a viral infection, the use of certain medications such as cancer drugs or antibiotics, and exposure to certain toxic substances. Leukemia and autoimmune diseases also affect the bone marrow’s ability to make red blood cells.

Hemolytic anemia

Hemolytic anemia is a condition where RBCs do not last as long as they usually would, which is about 120 days. The bone marrow does not produce enough RBCs at a fast enough rate to replace the ones being destroyed.

Factors that can lead to RBC destruction include autoimmune disorders, genetic conditions such as sickle cell anemia and thalassemia, glucose-6-phosphate dehydrogenase (G6PD) deficiency, blood clots, infection, and exposure to certain medications, chemicals, or toxins.

References

Further Reading

Anemia Information | Mount Sinai

Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-107.

CDC Recommendations to prevent and control iron deficiency in the United States. Centers for Disease Control and Prevention. MMWR Recomm Rep. 1998;47:1-29.

Elia M. Oral or parenteral therapy for B12 deficiency. Lancet. 1998;352:1721-22.

Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011.

Hayden SJ, Albert TJ, Watkins TR, Swenson ER. Anemia in critical illness: insights into etiology, consequence, and management. Am J Respir Crit Care Med. 2012;185(10):1049-57.

JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.

Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-9.

Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-53.

Lu K, Cheng MC, Ge X, et al. A retrospective review of acupuncture use for the treatment of pain in sickle cell disease patients: descriptive analysis from a single institution. Clin J Pain. 2014;30(9):825-30.

McClung JP, Karl JP, Cable SJ, Williams KW, Nindl BC, Young AJ, Lieberman HR. Randomized, double-blind, placebo-controlled trial of iron supplementation in female soldiers during military training: effects on iron status, physical performance, and mood. Am J Clin Nutr. 2009 Jul;90(1):124-31.

McCullough PA, Barnard D, Clare R, et al. Anemia and associated clinical outcomes in patients with heart failure due to reduced left ventricular systolic function. Clin Cardiol. 2013;36(10):611-20.

Mozaffari-Khosravi H, Noori-Shadkam M, Fatehi F, Naghiaee Y. Once weekly low-dose iron supplementation effectively improved iron status in adolescent girls. Biol Trace Elem Res. 2009 Aug 4. [Epub ahead of print]

O’Meara E, Rouleau JL, White M, et al. Heart failure with anemia: novel findings on the roles of renal disease, interleukins, and specific left ventricular remodeling processes. Circ Heart Fail. 2014;7(5):773-81.

Peña-Rosas JP, Viteri FE. Effects and safety of preventive oral iron or iron+folic acid supplementation for women during pregnancy. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD004736.

Prakash D. Anemia in the ICU. Critical Care Clinics. Philadelphia, PA: Elsevier Saunders. 2012;28(3).

Ranucci M, Di Dedda U, Castelvecchio S, Menicanti L, Frigiola A, Pelissero G. Impact of preoperative anemia on outcome in adult cardiac surgery: a propensity-matched analysis. Ann Thorac Surg. 2012;94(4):1134-41.

Rizack T, Rosene-Montella K. Special Hematologic Issues in the Pregnant Patient. Hematology/Oncology Clinics of North America. Philadelphia, PA: Elsevier Saunders. 2012;26(2).

Selmi C, Leung PS, Fischer L, German B, Yang CY, Kenny TP, Cysewski GR, Gershwin ME. The effects of Spirulina on anemia and immune function in senior citizens. Cell Mol Immunol. 2011 May;8(3):248-54.

Ullman D. The Consumer’s Guide to Homeopathy. New York, NY: Penguin Putnam;1995:181.

Watanabe F. Vitamin B12 sources and bioavailability. Exp Biol Med (Maywood). 2007 Nov;232(10):1266-74. Review.

Winther SA, Finer N, Sharma AM, Torp-Pedersen C, Andersson C. Association of anemia with the risk of cardiovascular adverse events in overweight/obese patients. Int J Obes (Lond). 2014; 38(3):432-7.

90,000 Anemia: Causes, Symptoms, Diagnosis and Treatment

Anemia is a pathological condition of the body characterized by a decrease in the number of red blood cells and hemoglobin in a blood unit. More often, anemia is a symptom of any disease. People of different ages and gender face this condition.

Anemia is defined as a decrease in hemoglobin to below 110 g / l – in children 6 months – 6 years old, below 120 g / l – in children 6-14 years old, below 120 – in adult women, below 130 – in adult men.

Causes of morbidity

One of the most common causes of anemia is a lack of folic acid, iron or vitamin B12. Also, anemia develops due to heavy bleeding during menstruation or against the background of certain cancers. Often, anemia is manifested due to the lack of substances that are responsible for the production of hemoglobin, as well as disruptions in the formation of red blood cells. Inherited diseases and exposure to toxic substances can also cause the development of anemia.

Depending on the causes of the onset of the disease, it is customary to divide all anemias into three types:

• post-hemorrhagic,
• hemolytic,
• associated with impaired blood formation (deficient and hypoplastic).

Post-hemorrhagic anemias are associated with acute or chronic blood loss (bleeding, injury).

Hemolytic – develop due to increased destruction of red blood cells.

Deficiency anemias are caused by a lack of vitamins, iron or other trace elements that are necessary for blood formation.

Hypoplastic anemia is the most severe type of anemia and is associated with impaired blood formation in the bone marrow.

Symptoms

Anemia is manifested by dizziness, tinnitus, flashing of flies before the eyes, shortness of breath, palpitations. Dry skin, pallor are noted, ulcerations and cracks appear in the corners of the mouth.

Typical manifestations are fragility and stratification of nails, their transverse striation. The nails become flat, sometimes taking a concave spoon-like shape.

Some patients note a burning sensation of the tongue. Perhaps a perversion of taste in the form of an indomitable desire to eat chalk, toothpaste, ash and the like, as well as an addiction to certain odors (acetone, gasoline).

In the early stages, anemia may not have pronounced manifestations; in this case, the diagnosis is made after special diagnostic measures.

Diagnostics

Blood tests, including blood counts, are required to make a diagnosis.A family history of the disease should also be compiled. When there are only mild manifestations of anemia, a radioactive chromium test can be done to determine the life span of blood cells, which is shortened by illness.

Other specific tests may be needed to check for abnormalities in the red blood cell membrane, enzymes, or hemoglobin. Sometimes a bone marrow sample may be taken to determine the cause that may cause hemolytic anemia.

Treatment

A mild stage of anemia often does not require medication. It is recommended to consume more foods that contain iron, proteins and other vitamins and minerals, more often to be in the fresh air.

Drug therapy is prescribed by a doctor only when the type of anemia, cause and severity are clear. Not infrequently, anemia does not require medical correction, especially when the cause, against the background of which anemia appeared, is eliminated.

If, nevertheless, the disease requires drug treatment, then the doctor prescribes drugs that will allow the bone marrow to quickly replenish the deficiency of red blood cells and hemoglobin in the blood.

In more severe cases, when iron preparations do not give a positive result, a hematologist may prescribe glucocorticoid hormones, erythropoietins, anabolic steroids, chemotherapeutic agents and other drugs that are treated in a hospital. Any type of drug therapy should be combined with a healthy diet and lifestyle. The patient needs to give up smoking, alcohol intake.

90,000 B12-deficiency anemia – causes, symptoms, diagnosis and treatment

IMPORTANT!

The information in this section cannot be used for self-diagnosis and self-medication.In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct treatment, you should contact your doctor.

B12-deficiency anemia: causes, symptoms, diagnosis and treatment.

Definition

B12-deficiency anemia (pernicious anemia) is a disease characterized by a violation of hematopoiesis caused by a deficiency of vitamin B12 (cobalamin, cyanocobalamin).In the blood, the number of red blood cells decreases and the level of hemoglobin falls. In addition, vitamin B12 deficiency causes gastrointestinal tract damage and neurological disorders.

Causes of B12-deficiency anemia

Vitamin B12 is not synthesized in the body, its reserves are replenished only through food. Cobalamin is present in sufficient quantities in animal products: liver, eggs, milk, meat. Cobalamin is absorbed in the intestine in the presence of a specific enzyme – Castle’s internal factor (produced by cells of the gastric mucosa).Thus, the vitamin B12 supplied with food binds to this enzyme in the stomach, and the formed complex interacts with the receptors of the cells of the ileal mucosa, as a result of which cobalamin enters the bloodstream, while the intrinsic Castle factor remains in the intestine. Once in the blood, vitamin B12 binds to a transport protein – transcobalamin, which delivers it to the bone marrow, where it is involved in the process of hematopoiesis, and to the liver, where it is deposited.

Insufficient intake of vitamin B12 in the body is the main cause of the development of B12-deficiency anemia.

The risk group includes strict vegetarians, pregnant and lactating women, children 4-6 months of life when breastfed by a vegetarian mother, as well as hungry people.

The second reason is a violation of the absorption of vitamin B12 due to a decrease in the acidity of gastric juice. Low acidity is typical for people who have undergone gastric resection, for patients with atrophic gastritis (often found in people of the older age group), lesions of the gastric mucosa with burns with chemicals, stomach cancer.

Prolonged uncontrolled intake of drugs that reduce the secretion of hydrochloric acid also leads to impaired absorption of cobalamin.

The autoimmune nature of B12-deficiency anemia is also possible, when the body produces antibodies whose activity is directed against stomach cells or Castle’s intrinsic factor.

Severe diseases of the pancreas often cause the development of B12-deficiency anemia. This is due to a violation of the secretion of pancreatic juice, transport and release of vitamin B12 in the intestine.

With intestinal diseases or the removal of some of its parts, the absorption of nutrients, including vitamin B12, is disrupted, and the so-called malabsorption syndrome develops – insufficient absorption. It is most often observed in inflammatory bowel diseases, for example, Crohn’s disease, ileitis (chronic inflammation of the ileum), amyloidosis (a pathological process in which amyloid is deposited in the intestinal tissues – a protein that is not found in a healthy body), lymphoma (malignant lymphoid intestinal tissue).

A rather rare reason for the development of B12-deficiency anemia is the competitive consumption of vitamin B12 by microorganisms and helminths parasitizing in the small intestine, for example, when the tapeworms are infested with Diphyllobothrium latum .

There are a number of hereditary pathologies (hereditary transcobalamin deficiency, Imerslund-Gresbeck syndrome, etc.), in which there are disorders in the absorption and transport of vitamin B12.

Classification of B12-deficiency anemia

B12-deficiency anemia is divided into congenital (hereditary) and acquired.

Among acquired anemias, the primary form is distinguished, due to the presence of antibodies to the internal Castle factor, and the secondary, associated with one or more risk factors for the development of B12 deficiency (for example, the presence of congenital hemolytic anemia, a strict vegan diet, etc.). Autoimmune vitamin B12 deficiency often complicates the course of autoimmune thyroiditis and type 1 diabetes mellitus. Hereditary forms of cobalamin deficiency have been described in children with congenital genetic defects leading to impaired transport of vitamin B12.

Symptoms of B12-deficiency anemia

The reserves of vitamin B12 in the liver are quite large, and with the complete exclusion of the intake of vitamin from the outside, their depletion occurs only after 2-3 years.

Anemia develops gradually and can be latent for a long time, being determined only by changes in blood tests.

With the development of the clinical picture of B12-deficiency anemia, damage to the hematopoietic system, gastrointestinal tract and nervous system is observed.

Anemia of any etiology, including that caused by cobalamin deficiency, is characterized by the appearance of an anemic syndrome. This syndrome develops with a decrease in the amount of hemoglobin and red blood cells in the blood.

There is a violation of oxygen delivery to organs and tissues, which leads to the development of the following symptoms:

• pallor, with B12-deficiency anemia, sometimes with an icteric tinge due to the destruction of large erythrocytes;

90,015 general weakness;

• increased fatigue;

90,015 shortness of breath;

90,015 heart palpitations;

90,015 dizziness;

90,015 tinnitus;

• children are characterized by developmental delays.

The listed symptoms can manifest when anemia has already acquired a severe stage – this is due to the very slow development of the disease and successful compensation by the body.

The defeat of the gastrointestinal tract in B12-deficiency anemia is manifested by impaired appetite, loss of body weight, decreased gastric secretion and the development of atrophic gastritis. One of the nonspecific symptoms of B12-deficiency anemia is a “lacquered” tongue – due to atrophy of the papillae of the tongue, its relief disappears, and seizures in the corners of the mouth (angular stomatitis) may also appear.Patients complain of tingling and burning of the tongue.

With B12-deficiency anemia, a specific lesion of the peripheral nervous system occurs – a violation of the formation of myelin (a special sheath of nerve cells that serves to protect and accelerate the conduction of a nerve impulse). In this regard, degeneration of the posterior and lateral columns of the spinal cord develops – funicular myelosis and symmetrical neuropathy of the lower extremities. First, various sensory disturbances, or paresthesias, appear.Then there is a loss of vibration and positional sensitivity, the coordination of movements is disturbed (ataxia).

This condition can progress to the development of spastic seizures, paresis and paralysis, fecal and urinary incontinence. In rare cases, memory loss and dementia may develop.

Main symptoms of vitamin B12 deficiency

For young children, B12 deficiency threatens with a lag in psychomotor development, a predisposition to infectious diseases, and various disorders in the work of the gastrointestinal tract.

Diagnosis of B12-deficiency anemia

To diagnose B12-deficiency anemia, before starting treatment, the doctor draws up a plan for the necessary laboratory and instrumental examinations. The following studies can be included in it:

• puncture, or trepanobiopsy, with the study of red bone marrow is the gold standard for diagnosing B12-deficiency anemia. Carrying out this study allows you to exclude other dangerous conditions leading to similar changes in the blood count;
• the level of vitamin B12 in the blood;

Anemia – Dictionary of Pathology – MyPathologyReport.ru

What does anemia mean?

Anemia means a decreased amount of hemoglobin in the blood. This may be due to a decrease in the number of red blood cells (red blood cells) in the blood or a decrease in the amount of hemoglobin in each red blood cell. Because the body uses oxygen to produce energy, a person with anemia has less oxygen in their blood, which can make them tired or short of breath.

Hemosiderin and red blood cells

Blood contains many different types of cells.These cells include immune cells and red blood cells (erythrocytes). Red blood cells are responsible for carrying oxygen from the lungs to the rest of the body and for carrying carbon dioxide back to the lungs. They trap oxygen and carbon dioxide using a special protein called hemoglobin.

Red blood cells form in a part of the bone called the bone marrow. When young red blood cells mature in the bone marrow, they produce hemoglobin. Your body needs iron to make hemoglobin for red blood cells.At the end of this process, red blood cells enter the bloodstream. Normal, healthy red blood cells circulate in the bloodstream for about 120 days before they are removed and their iron is recycled to form new red blood cells.

Extra iron is stored in a specialized protein called ferritin. The amount of ferritin will change as the amount of iron in your body changes. For example, a person with low levels of iron in their body will have low levels of ferritin in their blood.

What causes anemia?

Anemia can be caused by anything that lowers the number of red blood cells in the blood or the amount of hemoglobin in each red blood cell. In some situations, a person may have several reasons for the development of anemia.

Causes of anemia are often divided into three groups:

1. Conditions under which insufficient red blood cells are produced.
2. Conditions under which red blood cells do not mature normally.
3. Conditions in which red blood cells are cleared from the bloodstream faster than usual (less than 120 days).

Other useful links

Government of Quebec – Iron rich foods

90,000 We fight anemia – we keep the body in good shape!

Constant fatigue, memory problems, hair loss and brittle nails, dizziness, heart pain, sleep problems, high blood pressure, fainting …
All this can be symptoms of a bunch of various diseases – chronic fatigue syndrome, neurosis, hypertension, coronary heart disease.
A may be signs of one disease –
anemia.

What is hemoglobin and why is normal hemoglobin so important?

It is a complex iron-containing protein found in erythrocytes – red blood cells. Its main function is to carry oxygen produced by the lungs to all tissues and cells of our body. By the blood flow, erythrocytes containing hemoglobin molecules with bound oxygen are delivered to organs and tissues, where the latter is released.Thus, if the number of red blood cells decreases or the amount of hemoglobin they contain decreases, then the body feels a lack of oxygen. It is no secret that in the human body, all reactions take place in the presence of oxygen, therefore, without it, the body, in fact, begins to gradually die.

So, hemoglobin consists of protein and iron, which we get from food. As you might guess, this is often not enough, and even those people who eat a nutritious and balanced diet cannot guarantee themselves protection against anemia.The fact is that most of the population (50%) suffers from various diseases of the gastrointestinal tract – various gastritis, cholecystitis, pancreatitis and other diseases. They lead to a decrease in the production of intestinal juices, respectively, food is not broken down enough and the body does not receive the required amount of nutrients, trace elements and vitamins. Thus, you can eat meat in kilograms and still suffer from anemia. Other causes that indirectly lead to anemia are kidney disease, diabetes mellitus, hernia of the esophagus, decreased thyroid function, chronic intoxication with alcoholism, drug addiction, tuberculosis, etc.In addition, in some people, anemia can be caused by a vitamin deficiency.
B ₁₂ and folate, which are also important for the production of red blood cells. In some cases, anemia is caused by a lack of all of the above elements at once.

Who is most at risk for anemia?

There is a widespread belief that anemia is directly related to excessive thinness. Nevertheless, there is no direct connection between these two phenomena – often even a very fat person can suffer from anemia.However, some risk groups do exist. First of all, these are women – simply by virtue of their physiology. Heavy menstrual bleeding can lead to exhaustion. So, during menstruation, about 100 milligrams of iron is excreted from the body. Men with gastric ulcer or duodenal ulcer, erosive gastritis, gastroduodenitis, hemorrhoids, pulmonary bleeding, etc. are also at risk.

Signs of anemia

Common symptoms for almost all forms of anemia are:

• pallor of the skin and mucous membranes;
• shortness of breath, palpitations, dizziness;

90,015 headaches, tinnitus;

• discomfort in the region of the heart;
• severe general weakness, rapid fatigability, increased irritability.

What do you need to eat in order not to get anemic?

Anemia is a disease that can develop for various reasons. Sometimes a lot of blood loss can lead to anemia, sometimes an unbalanced diet. In most cases, anemia is a consequence of a deficiency in the body of iron, proteins, B vitamins, folic acid, ascorbic acid, copper, cobalt and other essential trace elements. It is obvious that improper diet can cause anemia.However, in the treatment of the disease, nutritional correction does not have an independent meaning and can be considered only as an auxiliary component.

The simplest and most common foods containing iron can help a person. Iron in foods is usually divided into two types (depending on the type of compound it enters into): inorganic (found in plant foods) and heme (found in animal foods). Heme iron is absorbed much better than inorganic iron.Therefore, for the prevention of iron deficiency anemia, it is imperative to eat daily

meat (beef, pork, poultry), fish and liver.

Iron is also contained in cereals (for example, in buckwheat), fruits, vegetables, berries, but only 5-7% of iron is absorbed from plant products (although their use can also contribute well to the process of hematopoiesis). Most iron and its salts
contained in potatoes, pumpkin, rutabaga, onions, garlic, lettuce, dill, buckwheat, gooseberries, strawberries and grapes.

Paying attention to your diet, try to avoid foods that contain compounds that interfere with the absorption of iron in the human body. Experts refer to such compounds as oxalates, which are found in chocolate, beets and sorrel; phosphates (soups in bags, cheeses), as well as caffeine (coca-cola, coffee) and tannins, which are found in large quantities in tea.

It is imperative to remember that in order to satisfy the body’s need for iron, in addition to certain foods, substances are needed to help assimilate this element.Without them, iron is very poorly absorbed, and eating foods saturated with iron will not bring the desired result. Iron’s best “friend” is vitamin C or ascorbic acid. It is very important not only for hematopoiesis, but also for the normal functioning of many body systems, has a beneficial effect on the functions of the central nervous system, stimulates the activity of the endocrine glands, contributing to the absorption of iron and normal hematopoiesis.

Quite large doses of vitamin C are beneficial for heavy smokers, women who use contraceptive pills, the elderly, and athletes.It should be noted that vitamin C is also a powerful antioxidant.

For high-quality absorption of iron, 75 mg of vitamin C must be consumed daily.
Such an amount of this vitamin is contained in a teacup of each of the following foods: broccoli, Brussels sprouts, cauliflower; cranberry, orange, grapefruit
lemon or pineapple juice; papaya (in pieces), fresh strawberries, cantaloupe and kiwi .
Also, a large amount of vitamin C is contained in rose hips, black currants, mountain ash, sea buckthorn, red pepper, horseradish, parsley, green onions, dill and red cabbage.

Also useful are products containing B vitamins, which take an active part in hematopoiesis. Often, the root cause of anemia is
vitamin B deficiency in the body ₁₂ . In addition to participating in blood formation, it affects the course of many processes in the human body. If the body lacks vitamin B ₁₂ ,
it also leads to vitamin B deficiency ₁ (even when there is enough of it in the diet).This, in turn, leads to a disorder not only of the nervous system, but also of the endocrine glands, the brain, polyneuritis, and indigestion.

To prevent deficiency of such an important vitamin and anemia caused by its deficiency, it is necessary to include in the diet dairy products and eggs, seafood: seaweed, squid, shrimp, etc .; potatoes, white cabbage, eggplant, zucchini, melons, pumpkin, lettuce, green onions, spinach, corn, sprouted wheat, garlic, rose hips, sea buckthorn, blackberries, strawberries, viburnum, cranberries, hawthorn, gooseberries, lemons, oranges, apricots, pears and cherries.

Folic acid (vitamin B ₉ ) – another element necessary for the construction of hemoglobin. Together with vitamin B ₁₂ folic acid is necessary for cell division, which is especially important for tissues that are actively dividing and differentiating, stimulates plastic and regenerative processes in all organs and tissues. Also, folic acid is necessary for the assimilation of sugar and amino acids and the formation of nucleic acids (RNA and DNA), which are involved in the transmission of hereditary traits.Besides,
it provides healthy looking skin, improves appetite.

Folic acid comes primarily from 93,003 fresh fruits and dark green leafy vegetables (spinach, lettuce, asparagus).

It is also found in 90,003 carrots, yeast, liver, egg yolk, cheese, melons, apricots, pumpkin, avocado, beans, whole wheat flour and dark rye flour.
In the daily diet for the treatment of anemia, these products must be present – of course, not all at once, but the maximum possible set of them.However, we must not forget that folic acid can be completely neutralized during heat treatment (cooking) of products containing it, as well as while taking these products and estrogens.

Methods for treating iron deficiency anemia during pregnancy

A condition when there are not enough red blood cells in the blood, or when red blood cells do not carry enough hemoglobin to deliver oxygen to the tissues, is called anemia. Usually, the concentration of hemoglobin in the mother’s blood decreases during pregnancy, which improves blood flow around the uterus and blood flow to the baby.This is sometimes called physiological anemia and does not require treatment. However, true anemia can be mild, moderate, or severe and can cause weakness, fatigue, and dizziness. Severe anemia puts women at risk for heart failure; it is very common in low-income countries. Anemia can be caused by many causes, including iron, folate, or vitamin B deficiency ₁₂ . They are essential for the formation of red blood cells and come with a good diet.However, iron deficiency is the most common cause of anemia during pregnancy. Iron can be taken orally (orally), by injection into a muscle (intramuscularly), or by injection into a vein (intravenous). Blood transfusion or the use of red blood cell stimulants (erythropoietin) are also possible treatments.

In preparing this review, we found 23 trials involving 3198 pregnant women. Many of these trials were conducted in low-income countries; many different treatment options have been explored.Oral iron supplements have been shown to reduce the incidence of anemia, but they are known to sometimes cause constipation and nausea. Despite the fact that intramuscular and intravenous routes of administration provided higher levels of red blood cells and iron stores than the oral route, clinical outcomes (such as preeclampsia, preterm labor, postpartum hemorrhage) were not evaluated, and there were insufficient data on adverse effects. Intravenous administration of the drug can cause venous thrombosis (blockage of blood flow in the veins), and intramuscular administration can cause significant pain and discoloration at the injection site.It remained unclear if women and children were healthier after iron supplementation for mild to moderate anemia during pregnancy. There were no studies on blood transfusion.

Overall, there was insufficient evidence to support when and how anemia in pregnancy should be treated.

Anemia in cats – types, symptoms, causes, treatment. Hemolytic anemia in cats

Anemia in cats is a pathological condition characterized by a decrease in the number of circulating red blood cells (red blood cells), hemoglobin, or both.Anemia is not a disease as such, but is a consequence of other pathological processes or diseases.

Contents

1. Relationship of anemia with a lack of oxygen in the tissues
2. Types of anemias
3. Symptoms
4. Diagnosis
5. Iron deficiency anemia in cats
6. Treatment
7. Prognosis

tissues

Hemoglobin contained in erythrocytes supplies oxygen to the cells and tissues of the whole body and the symptoms characteristic of anemia are caused precisely with a lack of oxygen.Red blood cells, or red blood cells, are produced in the bone marrow and released into the bloodstream, where they circulate for about two months. As we age, red blood cells are removed from the bloodstream and their components are recycled. The number of red blood cells may decrease due to decreased production or increased loss of red blood cells.

Types of anemias

There are three types of anemias:

• Posthemorrhagic anemia – associated with bleeding of various etiologies.Its causes can be: trauma or damage to blood vessels or internal organs; severe parasitic infestations (for example, fleas, ticks, hookworms, etc.), tumors of the intestines, kidneys, bladder; diseases that can disrupt blood clotting, as well as poisoning with anticoagulant substances.
• Hemolytic anemia – caused by the destruction and decay of red blood cells. Causes may include autoimmune hemolytic anemia, feline leukemia virus, blood parasitic infestations (eg, hemobartonellosis), chemicals or toxins, or neoplasia (cancer).
• Non-regenerative anemia. It is caused by bone marrow suppression, which can be caused by any severe or chronic illness, very poor or severely unbalanced diet, autoimmune anemia, feline leukemia virus, chemicals or toxins, neoplasia (cancer). This type of anemia can develop with chronic renal failure, due to impaired endocrine function in the kidneys and, accordingly, a decrease in the production of erythropoietin.

Symptoms

The most common and easily noticeable symptoms for the owners are the pallor of the visible mucous membranes, the depressed state of the animal (lethargy, refusal to eat, lethargy, etc.).and if we are talking about hemolytic anemia, the urine may turn red (to brown).

Diagnostics

The presence of anemia is confirmed by a general clinical blood test, and the most informative part of it is the hematocrit (the volume of red blood cells in the blood). In healthy cats, it is 25-45%. If its value is below 25%, then we are talking about the fact that the cat has been diagnosed with anemia. It is also very important to know if the bone marrow is producing an increased number of new red blood cells in response to the lost ones.If this is so, then there will be a large number of young, immature erythrocytes (reticulocytes) in the blood, that is, this anemia is regenerative and is accompanied by the normal synthesis of young cells replacing the lost erythrocytes.

Bone marrow biopsy or aspirate is performed if it is suspected that the bone marrow does not respond with an adequate response (synthesis of new red blood cells) to the anemic condition. A bone marrow sample is taken with a special needle and analyzed, providing valuable information about its condition and sometimes showing the cause of the anemia.

Blood chemistry and urinalysis are other important tests for cats with anemia. These tests allow you to assess the function of internal organs and electrolyte metabolism.

Examination of feces for parasites is important to identify the presence of parasites in the intestines that could cause chronic blood loss. Hemoparasitic diseases are established by examining a blood smear.

Finally, an anemic cat should be tested for feline leukemia virus and haemoplasmosis pathogens because they are important and common causes of anemia.

Iron deficiency anemia in cats

This type of anemia is very common in humans, more often in women. However, it is rare in cats and can develop secondary in severe chronic blood loss or in cats that are fed a very unbalanced diet.

Treatment

If the development of anemia has reached a critical level, then the cat will need a blood transfusion (blood transfusion). Before a transfusion, blood samples from the donor and recipient are checked for compatibility.The main purpose of blood transfusion is to stabilize the cat’s condition, to buy time for the main diagnosis. Once the true cause is established, targeted treatment for feline anemia is initiated.

Forecast

The forecast of anemia mainly depends on the root cause, the severity of the underlying disease, as well as on the general condition of the body and the age of the animal. An important factor is the early diagnosis of anemia, quick correct diagnosis and immediate initiation of adequate treatment.

Most likely, cats that are anemic due to toxins, cancer or autoimmune diseases, chronic viral infections, severe trauma, chronic renal failure will have a cautious or poor prognosis.

The article was prepared by A.M. Kuznetsova,

by veterinary therapist “MEDVET”
and prevention

With anemia, the amount of oxygen-carrying red blood cells or erythrocytes, as well as hemoglobin, the main protein inside red blood cells, is reduced in the blood.

Almost a quarter of the world’s population is affected by anemia. In most cases, a moderate form is observed, which complicates a person’s life with constant weakness and fatigue. However, there are cases when anemia can seriously threaten health and even life.

In this article we will understand what can cause anemia and what factors can be controlled.

Content

Constant fatigue – a reason to see a doctor

General signs of anemia are sometimes mistaken for a normal condition and attributed to fatigue, in fact, these are signals that you need to see a doctor:

• Fatigue,
• Weakness,
• Pale or yellowish skin,
• Irregular heartbeat,
• Shortness of breath,
• Dizziness or lightheadedness,
• Chest pain,
• Cold hands and feet,
• Headaches.

Should you take iron for these symptoms?

Alarming symptoms – a reason to see a doctor, but the diagnosis is made only on the basis of a blood test that determines the number of red blood cells and the degree of their saturation with hemoglobin. Also, the doctor may be interested in the level of free iron in the blood, transferrin proteins and ferritin. This is how the most common type of anemia, iron deficiency, is diagnosed.

But it is important to understand that fatigue can be a symptom of another disease, and anemia can be not only iron deficiency, there are other types of this disease.The doctor will determine the type of anemia and the causes of the disease.

What causes red blood cells to stop forming?

• Diet lacking vitamin B12, iron and folate;
• Insufficient stimulation of red blood cell production by the hormone erythropoietin, which is produced by the kidneys;
• Hypothyroidism;
• Aplastic anemia is an autoimmune disease in which the bone marrow stops producing enough blood cells.

Iron deficiency is the cause of nearly half of all anemia and is usually diet related. However, sometimes enough blood cells are produced, but they are destroyed faster than they are produced.

Why do not erythrocytes have time to renew?

This usually occurs due to bleeding, for example, with lesions of the gastrointestinal tract, trauma, heavy menstruation. More complex causes may include destruction of red blood cells from bone marrow damage, autoimmune diseases, genetic defects, liver or spleen problems, and certain medications.

In these cases, doctors focus on solving the underlying problem and select treatment that helps not to aggravate it. Such diagnoses are made as a result of a complex comprehensive examination.

Can anemia be inherited?

Some types of anemia are caused by genetic disorders:

• Deficiency of glucose-6-phosphate dehydrogenase (G6PD) – this defect occurs in 8% of people in the world, but the proportion of people susceptible to the disease varies greatly among different populations – more often G6PD deficiency occurs in the Middle East , Asia and Latin America.
• Thalassemia is a common genetic disorder in which damaged hemoglobin is produced in blood cells. More than 56,000 babies are born with this disease every year in the world. Some types of illness may never show up, but there is a possibility of developing serious anemia and life threatening. If both parents are carriers of thalassemia, then the probability of the disease in the child is 25%.
• Sickle cell anemia. In this disease, erythrocytes contain an abnormal form of hemoglobin – less soluble hemoglobin S.This type of hemoglobin crystallizes inside the red blood cells and they deform into a sickle shape. Inelastic red blood cells have difficulty passing through the smallest vessels, so blood flow is blocked and tissues are less supplied with oxygen. People from Africa, the Middle East and India are more likely to suffer from this disease.
• Defects of the erythrocyte cell membrane. The most common disease in this group is hereditary spherocytosis, which is manifested by anemia, jaundice and enlargement of the spleen.In the United States and Northern Europe, up to 1 in 2,000 people have this disease. In order for hereditary spherocytosis to manifest in a child, both parents must be carriers of the disease.

Genetic test Atlas will help to identify hereditary diseases associated with the exchange of iron in the blood and to predict the inheritance of the disease in family planning.

How is anemia treated?

Anemias caused by chronic or hereditary diseases require more complex treatment than iron deficiency disease.

For example, iron intake is not recommended in thalassemia and should be monitored even at the dietary level. In severe cases, for some types of anemia, removal of the spleen, bone marrow transplant, and blood transfusion may be recommended. Therefore, if you have a family history of anemia, it is important to consult with a geneticist in order to understand what form of the disease it is, to control your lifestyle and to properly plan a family.

Fortunately, most cases are related to iron deficiency or vitamin deficiency anemia and are treated with iron supplements, vitamins and lifestyle adjustments.

It is important to understand that if the problem already exists, then it is impossible to cure it exclusively with a diet: iron or folic acid preparations are necessary to restore the normal level of red blood cells and hemoglobin in the blood.

What to do to reduce the risk of anemia?

Many types of anemia cannot be prevented. But you can reduce the risk of iron and vitamin deficiency anemia by eating a diet that includes the essential vitamins and minerals:

• Iron. Iron-rich foods include beef and other meats, beans, lentils, iron-fortified cereals, dark green leafy vegetables, and dried fruits.
• Folic acid. Found in fruits and fruit juices, dark green leafy vegetables, green peas, beans, peanuts, and fortified grain products such as breads, cereals, pasta and rice.
• Vitamin B12 . Foods rich in vitamin B12 include meats, dairy products, and fortified cereals.
• Vitamin C. Foods rich in vitamin C – citrus fruits, peppers, broccoli, tomatoes, melons and strawberries.

• WHO, Global anemia prevalence and number of individuals affected, 2008
• Rebecca J Stoltzfus, Iron deficiency: global prevalence and consequences, 2003
• P. Vivax, G6PD Global Prevalence, 2018
• Bernadette Modell, Matthew Darlisonahttps, Global epidemiology of haemoglobin disorders and derived service indicators, 2008
• P Bolton-Maggs, Hereditary spherocytosis; new guidelines, 2003
• Irene Roberts, Mariane de Montalembert, Sickle cell disease as a paradigm of immigration hematology: new challenges for hematologists in Europe, 2007
• UCSF Benioff Children’s Hospital Oakland, Living with Thalassemia

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