What are the potential life-threatening types of anemia? How can anemia impact your health? Learn about the symptoms, causes, and serious forms of anemia that require immediate medical attention.

The Perilous Consequences of Anemia

Anemia is a widespread health condition that occurs when the body lacks enough healthy red blood cells to effectively transport oxygen throughout the body. While some forms of anemia are relatively mild, certain types can have severe, and even life-threatening, consequences if left untreated.

Aplastic Anemia: When the Bone Marrow Fails

Aplastic anemia is a potentially fatal form of the disorder, occurring when the bone marrow becomes damaged and fails to produce sufficient new blood cells. This can happen suddenly or gradually over time, and is often linked to factors such as cancer treatments, exposure to toxic chemicals, pregnancy, autoimmune disorders, or viral infections. In some cases, the cause remains unknown, referred to as idiopathic aplastic anemia.

Paroxysmal Nocturnal Hemoglobinuria: A Rare, Genetic Threat

Paroxysmal nocturnal hemoglobinuria is a rare, life-threatening genetic condition that causes blood clots, destroys blood cells, and impairs bone marrow function. It is often diagnosed in individuals in their 30s or 40s and is closely related to aplastic anemia, frequently arising after treatment for the condition.

Myelodysplastic Syndromes: Abnormal Blood Cell Production

Myelodysplastic syndromes are a group of conditions that cause the blood-making cells in the bone marrow to become abnormal. This leads to the production of defective blood cells that die earlier and are more prone to destruction by the immune system. Myelodysplastic syndromes are considered a type of cancer and may progress to acute myeloid leukemia.

Hemolytic Anemia: Rapid Red Blood Cell Destruction

Hemolytic anemia occurs when red blood cells are destroyed faster than the body can replace them. This can be a temporary or chronic condition, and can be inherited or acquired due to factors such as infections, certain medications, blood cancers, autoimmune disorders, or a severe reaction to a blood transfusion.

Sickle Cell Disease: A Genetic Threat to Oxygen Delivery

Sickle cell disease is an inherited form of anemia that causes red blood cells to become deformed, rigid, and sticky. This leads to blockages in small blood vessels, depriving tissues of oxygen and causing severe pain, swelling, and frequent infections. It is more common in people of African descent.

Severe Thalassemia: Inadequate Hemoglobin Production

Thalassemia is an inherited condition in which the body does not produce enough hemoglobin, the crucial protein in red blood cells. Severe forms of thalassemia, where individuals inherit two copies of the gene that causes the condition, can be life-threatening as red blood cells do not function properly and die off more quickly.

Recognizing the Symptoms of Anemia

Common symptoms of anemia include fatigue, cold hands and feet, dizziness, headaches, lightheadedness, irregular heartbeats, chest pain, pale or yellowish skin, shortness of breath, weakness, and a whooshing or pounding sound in the ears. Individuals may also experience symptoms specific to the underlying condition causing the anemia.

Causes of Anemia: Genetics, Bleeding, and Destruction

Anemia can occur when the body does not make enough blood cells, destroys red blood cells, or produces malformed red blood cells. Genetic conditions, severe bleeding, and various acquired factors can all contribute to the development of anemia.

Seeking Prompt Medical Attention

Given the potentially life-threatening nature of certain forms of anemia, it is crucial to seek immediate medical attention if experiencing symptoms. Early diagnosis and appropriate treatment can be the difference between a manageable condition and a severe, or even fatal, outcome.

Conclusion

Anemia is a complex and diverse health condition that, in its most severe forms, can have devastating consequences. By understanding the types of anemia that pose the greatest risks, recognizing the warning signs, and seeking prompt medical care, individuals can take proactive steps to protect their health and well-being.

Yes It Can, and Here’s What You Need to Know

Some types of anemia, including aplastic anemia and severe thalassemia, can potentially be life threatening. Treatment depends on the underlying cause.

Anemia is a condition where you don’t have enough healthy red blood cells, to carry oxygen throughout your body. Anemia can be temporary or long term (chronic). In many cases, it’s mild, but anemia can also be serious and life-threatening.

Anemia can happen because:

• 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.

Red blood cells carry oxygen throughout your body. When you don’t have enough red blood cells, your organs don’t get enough oxygen and can’t work properly. This can have severe consequences.

Types of anemia that can potentially be life-threatening include:

Aplastic anemia

Aplastic anemia is when your bone marrow becomes damaged, and your body therefore stops producing new blood cells. It can be sudden or get worse over time.

Common causes of aplastic anemia include

• cancer treatment
• exposure to toxic chemicals
• pregnancy
• autoimmune disorders
• viral infections

It can also have no known cause, which is referred to as idiopathic aplastic anemia.

Paroxysmal nocturnal hemoglobinuria

Paroxysmal nocturnal hemoglobinuria is a rare, life-threatening disease. It causes blood clots, destroys blood cells, and impairs bone marrow function. It’s a genetic condition, usually diagnosed in people who are in their 30s or 40s.

Paroxysmal nocturnal hemoglobinuria is related to aplastic anemia. It often starts as aplastic anemia or arises after treatment for the condition.

Myelodysplastic syndromes

Myelodysplastic syndromes are a group of conditions that cause the blood-making cells in your bone marrow to become abnormal. Your bone marrow then doesn’t make enough cells, and the cells it does make are generally defective. These cells die earlier and are more likely to be destroyed by your immune system.

Myelodysplastic syndromes are considered a type of cancer. They may turn into acute myeloid leukemia, a type of blood cancer.

Hemolytic anemia

Hemolytic anemia is when your red blood cells are destroyed faster than your body can make them. It can be temporary or chronic.

Hemolytic anemia can also be inherited, which means it’s passed down through your genes, or acquired.

Potential causes of acquired hemolytic anemia include:

• infection
• certain medications, such as penicillin
• blood cancers
• autoimmune disorders
• an overactive spleen
• some tumors
• severe reaction to a blood transfusion

Sickle cell disease

Sickle cell disease is an inherited type of anemia. It causes your red blood cells to be deformed — they become sickle-shaped, rigid, and sticky. This causes them to get stuck in small blood vessels, which blocks blood flow throughout your body, depriving tissue of oxygen. It’s more common in people of African descent.

Sickle cell disease causes very painful episodes, swelling, and frequent infections.

Severe thalassemia

Thalassemia is an inherited condition in which your body doesn’t make enough hemoglobin. This is a protein that’s a crucial part of red blood cells. Without enough hemoglobin, your red blood cells don’t work properly and die more quickly than healthy cells.

Thalassemia can be mild or severe. It becomes severe if you inherit two copies of the gene that causes it.

Malarial anemia

Malarial anemia is a main symptom of severe malaria. Many factors contribute to its development, including:

• nutritional deficiencies
• bone marrow problems
• the malaria parasite entering red blood cells

Fanconi anemia

Fanconi anemia (FA) is a genetic condition that impairs bone marrow and causes you to have a lower than normal amount of all types of blood cells.

It often also causes physical abnormalities, such as malformed thumbs or forearms, skeletal abnormalities, a malformed or missing kidney, gastrointestinal abnormalities, infertility, and vision and hearing problems.

Fanconi anemia can also cause an increased risk of leukemia, as well as head, neck, skin, reproductive, and gastrointestinal cancers.

Common symptoms of anemia include:

• fatigue
• cold hands and feet
• dizziness
• headache
• lightheadedness
• irregular heartbeat
• chest pain
• pale or yellowish skin
• shortness of breath
• weakness
• whooshing sound or pounding in your ears

You may also have symptoms specific to the condition underlying anemia.

Anemia happens when your body doesn’t make enough blood cells, your body destroys your red blood cells, or the red blood cells it does make are malformed.

Different causes of these conditions include:

Genetics

These are conditions that cause anemia and are inherited, which means they are passed down through one or both parents through your genes.

• sickle cell
• thalassemia
• some hemolytic anemias
• Fanconi anemia
• paroxysmal nocturnal hemoglobinuria

Bleeding

Severe bleeding can cause sudden, short-term anemia. For example, this might happen after a traumatic injury where you lose a lot of blood.

Cancer

Cancers of the blood, lymphatic system, and bone marrow can cause anemia. Examples include:

• aplastic anemia
• some hemolytic anemias
• myelodysplastic syndromes

Diseases

Acquired diseases, including malaria, can cause anemia. Other infections can cause aplastic anemia or hemolytic anemia. Autoimmune diseases are also a potential cause of anemia, as they may cause your body to attack red blood cells.

First, your doctor will take your family and medical history. Then they will do a physical exam to look for symptoms of anemia. After that, your doctor will draw blood for several tests. The most common are:

• complete blood count to count the number of red blood cells and the amount of hemoglobin in your blood
• tests to look at the size and shape of your red blood cells

Once you’re diagnosed with anemia, your doctor may do more testing to see if they can find the underlying cause of anemia. For example, they might do a bone marrow test to see how well your body makes red blood cells, look for internal bleeding, or scan for tumors.

Treating severe anemia takes more than just diet and lifestyle changes, although eating a healthy diet with lots of iron can help keep you healthy.

Sometimes, treating anemia requires treating the underlying cause. Examples include:

• chemotherapy for myelodysplastic syndrome
• eculizumab (Soliris) for paroxysmal nocturnal hemoglobinuria, which keeps your body from destroying red blood cells
• immunosuppressants for some types of aplastic anemia and hemolytic anemias

In all types of anemia, blood transfusions can help replace your lost or defective red blood cells and reduce symptoms. However, it usually does not address the underlying cause.

A bone marrow transplant, also known as a stem cell transplant, is an option if you can’t make healthy red blood cells. In this procedure, your bone marrow is replaced with donor marrow that can make healthy cells.

This is the only cure for some type of anemia, such as paroxysmal nocturnal hemoglobinuria.

Anemia in general causes 1.7 deaths per 100,000 people in the United States annually. It is usually treatable if caught quickly, although some types are chronic, which means they need continual treatment.

The outlook for people with serious anemia will depend on the cause:

• Aplastic anemia. People who are younger than 40 years old with severe aplastic anemia are usually treated with a bone marrow transplant. This can cure aplastic anemia. People over 40 years old, or for whom there’s not a good bone marrow match, are usually treated with medications. These can reduce symptoms but aren’t a cure. Up to 50 percent of patients treated with drug therapy have their aplastic anemia return, or develop another, related blood disorder.
• Paroxysmal nocturnal hemoglobinuria. The median survival time after diagnosis of PNH is 10 years. However, new treatments can help people with this condition live to a normal life expectancy.
• Myelodysplastic syndromes. Without treatment, the median survival time for myelodysplastic syndromes range from less than a year to approximately 12 years, depending on factors such as number of chromosome abnormalities and level of red blood cells. However, treatment is often successful, especially for certain types of this condition.
• Hemolytic anemias. The outlook for hemolytic anemias depends on the underlying cause. Hemolytic anemia itself is rarely fatal, especially if treated early and properly, but the underlying conditions can be.
• Sickle cell disease. Sickle cell disease decreases life expectancy, although people with this condition are now living into their 50s and beyond, due to new treatments.
• Severe thalassemia. Severe thalassemia can cause death due to heart complications before age 30. Treatment with regular blood transfusions and therapy to remove excess iron from your blood can help the prognosis.
• Malarial anemia. If diagnosed and treated quickly, malaria is usually curable. However, severe malaria, which is what causes anemia, is a medical emergency. The mortality rate for severe malaria varies widely, from 1.3 to more than 50 percent, depending on factors such as age, location, other presenting conditions, and overall health.
• Fanconi anemia. A bone marrow transplant can cure severe FA. However, you would still have an increased risk of squamous cell carcinoma. Your prognosis also depends on your specific genetic abnormality that led to FA.

Iron deficiency anaemia – Illnesses & conditions

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   About iron deficiency anaemia
   
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   Causes of iron deficiency anaemia
   
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   Diagnosing iron deficiency anaemia
   
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   Treating iron deficiency anaemia
   
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   Complications of iron deficiency anaemia
   

About iron deficiency anaemia

Iron deficiency anaemia is a condition where a lack of iron in the body leads to a reduction in the number of red blood cells.

Iron is used to produce red blood cells, which help store and carry oxygen in the blood. If you have fewer red blood cells than is normal, your organs and tissues won’t get as much oxygen as they usually would.

There are several different types of anaemia, and each one has a different cause. Iron deficiency anaemia is the most common type.

Other types of anaemia can be caused by a lack of vitamin B12 or folate in the body – read more about vitamin B12 and folate deficiency anaemia.

Symptoms of iron deficiency anaemia

Many people with iron deficiency anaemia only have a few symptoms. The severity of the symptoms largely depends on how quickly anaemia develops.

You may notice symptoms immediately, or they may develop gradually if your anaemia is caused by a long-term problem, such as a stomach ulcer.

The most common symptoms include:

• tiredness and lack of energy (lethargy)
• shortness of breath
• noticeable heartbeats (heart palpitations)
• a pale complexion

Less common symptoms include:

• headache 
• hearing sounds that come from inside the body, rather than from an outside source (tinnitus)
• an altered sense of taste
• feeling itchy
• a sore or abnormally smooth tongue
• hair loss
• a desire to eat non-food items, such as ice, paper or clay (pica)
• difficulty swallowing (dysphagia)
• painful open sores (ulcers) on the corners of your mouth
• spoon-shaped nails

When to see your GP

See your GP if you experience symptoms of iron deficiency anaemia. They should be able to diagnose the condition using a simple blood test.

Read more about diagnosing iron deficiency anaemia

What causes iron deficiency anaemia?

There are many things that can lead to a lack of iron in the body. In men and post-menopausal women, the most common cause is bleeding in the stomach and intestines.

This can be caused by a stomach ulcer, stomach cancer, bowel cancer, or by taking non-steroidal anti-inflammatory drugs (NSAIDs).

In women of reproductive age, heavy periods and pregnancy are the most common causes of iron deficiency anaemia as your body needs extra iron for your baby during pregnancy.

Unless you’re pregnant, it’s rare for iron deficiency anaemia to be caused just by a lack of iron in your diet. However, if you do lack dietary iron, it may mean you’re more likely to develop anaemia than if you have one of the problems mentioned above.

Read more about the causes of iron deficiency anaemia

How iron deficiency anaemia is treated

Treatment for iron deficiency anaemia involves taking iron supplements to boost the low levels of iron in your body. This is usually effective, and the condition rarely causes long-term problems.

You’ll need to be monitored every few months to check the treatment is working and your iron levels have returned to normal.

The underlying cause will need to be treated so you don’t get anaemia again. Increasing the amount of iron in your diet may also be recommended.

Good sources of iron include:

• dark-green leafy vegetables, such as watercress and curly kale
• iron-fortified cereals or bread
• brown rice 
• pulses and beans
• nuts and seeds
• meat, fish and tofu
• eggs
• dried fruit, such as dried apricots, prunes and raisins

Read more about treating iron deficiency anaemia

Further problems

If iron deficiency anaemia is left untreated, it can make you more susceptible to illness and infection, as a lack of iron affects the body’s natural defence system (the immune system).

Severe iron deficiency anaemia may increase your risk of developing complications that affect the heart or lungs, such as an abnormally fast heartbeat (tachycardia) or heart failure, where your heart is unable to pump enough blood around your body at the right pressure.

Pregnant women with severe or untreated anaemia also have a higher risk of complications before and after birth.

Read more about the complications of iron deficiency anaemia

Causes of iron deficiency anaemia

Iron deficiency anaemia occurs when the body doesn’t have enough iron, leading to the decreased production of red blood cells. Red blood cells carry oxygen around the body.

A lack of iron can be caused by several factors. Some of the most common causes of iron deficiency anaemia are outlined below.

Monthly periods

In women of reproductive age, periods are the most common cause of iron deficiency anaemia.

Usually, only women with heavy periods develop iron deficiency anaemia. If you have heavy bleeding over several consecutive menstrual cycles, it’s known as menorrhagia.

Pregnancy

It’s also very common for women to develop iron deficiency during pregnancy.

This is because your body needs extra iron to ensure your baby has a sufficient blood supply and receives necessary oxygen and nutrients.  

Some pregnant women require an iron supplement, while others may need to increase the amount of iron in their diet.

Read more about vitamins and minerals in pregnancy

Gastrointestinal blood loss

The gastrointestinal tract is the part of the body responsible for digesting food. It contains the stomach and intestines.

Bleeding in the gastrointestinal tract is the most common cause of iron deficiency anaemia in men, as well as women who’ve experienced the menopause (when monthly periods stop).

Most people with gastrointestinal bleeding don’t notice any obvious blood in their stools and don’t experience any changes in their bowel habits.

Some causes of gastrointestinal bleeding are described below.

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause bleeding in the stomach. Ibuprofen and aspirin are two commonly prescribed NSAIDs.

If your GP thinks your medication is causing gastrointestinal bleeding, they can prescribe a less harmful medicine. However, don’t stop taking a medicine you’ve been prescribed unless your GP advises you to.

Stomach ulcers

The acid in your stomach, which helps your body digest food, can sometimes eat into your stomach lining. When this happens, the acid forms an open sore (an ulcer). This is also known as a stomach ulcer or a peptic ulcer.

Stomach ulcers can cause the stomach lining to bleed, which can lead to anaemia. In some cases, the bleeding can cause you to vomit blood or pass blood in your stools. However, if the ulcer bleeds slowly, you may not have any symptoms.

Gastrointestinal cancer

In a few cases, gastrointestinal bleeding can be caused by cancer, usually stomach cancer or bowel cancer.

When trying to establish the cause of anaemia, your GP will check for possible signs of cancer.

If your GP suspects cancer, you’ll be referred to a gastroenterologist (a specialist in treating digestive conditions) for a more thorough examination. This means that if cancer is found, it can be treated as quickly as possible.

If you’re 60 years old or over and have iron deficiency anaemia, your GP should refer you to a specialist to rule out bowel cancer. Your  appointment with the specialist should be within two weeks of your GP referring you.

Angiodysplasia

Gastrointestinal bleeding can also be caused by a condition called angiodysplasia. This is the result of abnormal, fragile superficial blood vessels in the gastrointestinal tract, which can cause bleeding.

Chronic kidney disease

People with chronic kidney disease (CKD) often develop iron deficiency anaemia.

Most people with CKD who have iron deficiency anaemia will be given iron supplement injections, although daily tablets may be tried first.

You can read more about treating anaemia in people with CKD on the National Institute for Health and Care Excellence (NICE) website.

Other causes

Other conditions or actions that cause blood loss and may lead to iron deficiency anaemia include:

• inflammatory bowel disease – a condition that causes redness and swelling (inflammation) in the digestive system, such as Crohn’s disease and ulcerative colitis 
• oesophagitis – inflammation of the gullet (oesophagus) caused by stomach acid leaking through it
• schistosomiasis – an infection caused by parasites, mainly found in sub-Saharan Africa
• blood donation – donating a large amount of blood may lead to anaemia
• trauma – a serious accident, such as a car crash, may cause you to lose a large amount of blood 
• nosebleeds – having regular nosebleeds may lead to anaemia, although this is rare
• haematuria (blood in your urine) – but this rarely causes anaemia and may be a symptom of another condition

Malabsorption

Malabsorption is when your body can’t absorb iron from food, and is another possible cause of iron deficiency anaemia.

This may happen if you have coeliac disease, a common digestive condition where a person has an adverse reaction to gluten, or surgery to remove all or part of your stomach (gastrectomy).

Lack of iron in your diet

Unless you’re pregnant, it’s rare for iron deficiency anaemia to be caused solely by a lack of iron in your diet.

However, a lack of dietary iron can increase your risk of developing anaemia if you also have any of the conditions mentioned above.

Some studies suggest vegetarians or vegans are more at risk of iron deficiency anaemia because of the lack of meat in their diet.

If you are vegetarian or vegan, it is possible to gain enough iron by eating other types of food, such as:

• beans
• nuts
• dried fruit, such as dried apricots
• wholegrains, such as brown rice
• fortified breakfast cereals
• soybean flour
• most dark-green leafy vegetables, such as watercress and curly kale

If you’re pregnant, you may need to increase the amount of iron-rich food you consume during pregnancy to help prevent iron deficiency anaemia.

Read more about vegetarian and vegan diets

Diagnosing iron deficiency anaemia

See your GP if you experience symptoms of iron deficiency anaemia, such as tiredness, shortness of breath and heart palpitations.

A simple blood test can usually confirm the diagnosis.

Your GP may also carry out a physical examination and ask you a number of questions to help determine the cause of your anaemia.

Blood test

To diagnose iron deficiency anaemia, a blood sample is taken from a vein in your arm and a full blood count is made. This means all the different types of blood cells in the sample will be measured.

If you have anaemia:

• your levels of haemoglobin – a substance that transports oxygen – will be lower than normal
• you’ll have fewer red blood cells, which contain haemoglobin, than normal
• your red blood cells may be smaller and paler than usual

Your GP may also test for a substance called ferritin, a protein that stores iron. If your ferritin levels are low, it means there isn’t much iron stored in your body and you may have iron deficiency anaemia.

Read more about blood tests 

Vitamin B12 and folate deficiency

If your GP thinks your anaemia may be the result of a vitamin B12 and folate deficiency, the levels of these substances may be tested. Folate works with vitamin B12 to help your body produce red blood cells.

Vitamin B12 and folate deficiency anaemia is more common in people who are over the age of 75.

Finding the cause

To determine the underlying cause of your anaemia, your GP may ask questions about your lifestyle and medical history. For example, they may ask you about:

• your diet – to see what you typically eat and whether this includes any iron-rich foods
• any medicines you take – to see if you’ve been regularly taking a type of medicine that can cause bleeding from the stomach and intestines (gastrointestinal bleeding), such as ibuprofen or aspirin
• your menstrual pattern – if you’re a woman, your GP may ask if you’ve been experiencing particularly heavy periods
• your family history – you’ll be asked if your immediate family has anaemia or a history of gastrointestinal bleeding or blood disorders

Iron deficiency anaemia is common during pregnancy. If you’re pregnant, your GP will usually only look for an alternative cause if a blood test has identified a particularly low haemoglobin level, or if your symptoms or medical history suggest your anaemia may be caused by something else.

Physical examination

A physical examination will usually only be needed if the cause of your iron anaemia deficiency hasn’t been identified by examining your medical history and asking you about your symptoms.

In such cases, your GP may:

• examine your stomach (abdomen) to check for any physical signs of gastrointestinal bleeding
• look for signs of heart failure, such as swollen ankles – heart failure can have some similar symptoms to iron deficiency anaemia

Two other possible types of physical examination you may have are explained below.

Rectal examination

A rectal examination is usually only needed if you’re bleeding from your bottom. It’s a common procedure that can help your GP find out if there’s something in your gastrointestinal tract that’s causing bleeding.

Your GP will insert a lubricated gloved finger into your bottom to feel for any abnormalities.

A rectal examination isn’t something to be embarrassed about, as it’s a procedure your GP will be used to doing. It shouldn’t cause significant pain, but it may cause some slight discomfort – this will only last for a minute.

Pelvic examination

Women may have a pelvic examination if their GP thinks heavy menstrual bleeding (menorrhagia) may be the cause of their anaemia.

During a pelvic examination, your GP will examine your vulva and labia (external sex organs) for signs of bleeding or infection.

They may also examine you internally. This will involve your GP inserting lubricated gloved fingers into your vagina to feel whether your womb (uterus) is tender or enlarged.

A pelvic examination won’t be carried out without your consent (permission), and you can choose to have someone with you.

Referral to a specialist

In some cases, your GP may refer you to a gastroenterologist, a specialist in treating digestive conditions. They’ll carry out a more thorough examination.

For example, you may be referred to a gastroenterologist if your GP can’t identify a cause and you have a particularly low haemoglobin level, or if your GP thinks there’s a possibility your symptoms could be caused by stomach cancer or bowel cancer, although this is unlikely.

If you’re a woman with heavy periods, you may be referred to a gynaecologist if you don’t respond to treatment with iron supplements.

Treating iron deficiency anaemia

Treatment for iron deficiency anaemia usually involves taking iron supplements and changing your diet to increase your iron levels, as well as treating the underlying cause.

Iron supplements

Your GP will prescribe an iron supplement to restore the iron missing from your body. The most commonly prescribed supplement is ferrous sulphate, which is taken as a tablet, usually twice a day.

Some people can experience side effects when taking iron supplements, including:

• abdominal (tummy) pain
• constipation or diarrhoea
• heartburn
• feeling sick
• black stools (faeces)

These side effects should settle down over time. However, your GP may recommend taking the tablets with food or shortly after eating if you have troublesome side effects.

Your GP may also advise you to only take one or two tablets a day, instead of three, if you’re finding side effects difficult to cope with.

If you can’t take ferrous sulphate because you get severe side effects, you may be prescribed a different iron supplement called ferrous gluconate.

This supplement should cause fewer side effects because it contains a less concentrated dose of iron. However, it may take longer for the iron levels in your body to be restored.

In a few cases – for example, if you have chronic kidney disease (CKD) – iron injections may be recommended instead of tablets.

As with all medications, it’s important to store iron supplements out of the reach of children. An overdose of iron supplements in a young child can be fatal.

Dietary advice

If a lack of iron in your diet is thought to be contributing to your iron deficiency anaemia, your GP will tell you how to up your intake.

Iron-rich foods include:

• dark-green leafy vegetables, such as watercress and curly kale
• iron-fortified cereals or bread
• brown rice 
• pulses and beans 
• nuts and seeds
• white and red meat 
• fish 
• tofu
• eggs 
• dried fruit, such as dried apricots, prunes and raisins

Your diet should include foods from all the major food groups to ensure it’s healthy and balanced. In particular, food and drink containing vitamin C are important as vitamin C helps your body absorb iron.

However, consuming large amounts of some foods and drinks, as well as certain medicines, may make it harder for your body to absorb iron. These include:

• tea and coffee
• calcium – found in dairy products, such as milk 
• antacids and proton pump inhibitors (PPIs) – medications used to relieve indigestion
• wholegrain cereals – although wholegrains are a good source of iron themselves, they contain phytic acid, which can stop your body absorbing iron from other foods and pills

You may be referred to a nutrition specialist called a dietitian if you’re finding it difficult to include iron in your diet. They’ll be able to give you detailed, personalised advice about how you can improve your diet.

Treating the underlying cause

Your GP will also need to ensure the underlying cause of your anaemia is treated so it doesn’t happen again.

For example, if non-steroidal anti-inflammatory drugs (NSAIDs) are causing bleeding in your stomach, your GP may prescribe a different medicine to help minimise the risk of stomach bleeding.

Heavy periods can be treated with medication or – in particularly severe cases – surgery.

Monitoring

Your GP will ask you to return two to four weeks after you’ve started taking iron supplements to check how well you’ve responded to the treatment. You’ll have a blood test to check your haemoglobin levels.

If your blood test results show an improvement, you’ll be asked to continue taking iron supplements and return in two to four months for another blood test.

Once your haemoglobin levels and red blood cells are normal, your GP will usually recommend continuing to take iron supplements for three months to help build up the iron levels in your body.

After this, you should be able to stop taking the supplements, depending on the cause of your iron deficiency anaemia. Your condition will be monitored every three months over the course of a year, and again a year later.

Continuing treatment

Sometimes after a person’s iron levels have been replenished, they start to fall again.

This could happen if you don’t get enough iron in your diet, you’re pregnant, or you have consistently heavy periods.

In such cases, you may be prescribed an ongoing iron supplement to help stop your anaemia returning. This will usually be a tablet, which you’ll have to take once a day. 

If treatment is ineffective

If your iron levels don’t improve, your GP will ask how regularly you’ve been taking your iron supplements.

Some people are put off taking the medication because of the side effects. However, your condition won’t improve if you don’t take the supplements.

If you’ve been taking the supplements as prescribed and your iron levels still haven’t improved, your GP may refer you to a specialist for an assessment.

Complications of iron deficiency anaemia

Iron deficiency anaemia rarely causes serious or long-term complications, although some people with the condition find it affects their daily life.

Some common complications are outlined below.

Tiredness

Iron deficiency anaemia can make you feel tired and lacking in energy (lethargic). This may result in you being less productive at work, and you may find it difficult to stay awake or not feel able to exercise regularly.

Increased risk of infections

Research has shown iron deficiency anaemia can affect your immune system – the body’s natural defence system. This increases your vulnerability to infection.

Heart and lung problems

Adults with severe anaemia may be at risk of developing complications that affect their heart or lungs.

For example, you may develop tachycardia, which is an abnormally fast heartbeat, or heart failure, where the heart fails to pump enough blood around your body at the right pressure.

Pregnancy complications

Pregnant women with severe anaemia have an increased risk of developing complications, particularly during and after birth.

They may also develop postnatal depression, which some women experience after having a baby.

Research suggests babies born to mothers who have untreated anaemia are more likely to:

• be born prematurely – before the 37th week of pregnancy
• have a low birth weight
• have problems with iron levels themselves
• do less well in mental ability tests

Restless legs syndrome

Some cases of restless legs syndrome are thought to be caused by iron deficiency anaemia. Doctors often refer to this as secondary restless legs syndrome.

Restless legs syndrome is a common condition that affects the nervous system, and causes an overwhelming, irresistible urge to move the legs. It also causes an unpleasant feeling in the feet, calves and thighs.

Restless legs syndrome caused by iron deficiency anaemia can usually be treated with iron supplements.

Heading “Health”: how to recognize anemia

May 21, 2015

What is anemia?

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

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

How can I find out if I have anemia?
Of great importance in the diagnosis of anemia is a laboratory blood test – determining the concentration of hemoglobin, the number of red blood cells, their size and saturation with hemoglobin.

Accurate identification of the type and cause of anemia is the basis for choosing the right treatment. The relative ease of diagnosing anemia often leads to the unreasonable use of “antianemic” drugs without clarifying the cause and mechanism of anemia.

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

How else can anemia manifest itself?
Other symptoms of anemia, primarily due to a lack of iron in the body are:

– Brittle nails

Iron is a very important element that ensures the normal functioning of various tissues of the human body. If, for any reason, the body’s iron supply decreases, then this circumstance immediately manifests itself as increased fragility of the nails.

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

– Unusual desire to eat chalk, clay, toothpaste, raw pasta?

With a decrease in iron stores in the human body, the normal functioning of special proteins is disturbed, which leads to a change in the taste perception of food and the appearance of unusual food cravings.

– Starting to like the smell of oil paint, nail polish remover, petrol and kerosene?

Special sensory receptor cells are required for the mechanism of odor perception. The work of these receptors largely depends on the content of iron in the human body. Even with a slight decrease in the iron reserve, the work of the receptors changes significantly.

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

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

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

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

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

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

What foods have the most iron?

Foods such as meat, green apples and pomegranates contain more iron than others.
Be healthy!

Anemia. Disease or symptom?

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Anemia. Disease or symptom?

Anemia is a general term for a body condition in which the levels of red blood cells and hemoglobin are reduced in the blood. As a result, the amount of oxygen carried by red blood cells, and then entering the organs and tissues, decreases – the patient feels tired, weak. Anemia can be long or temporary, asymptomatic or with severe clinical manifestations. However, for recovery, it is not enough to eliminate the symptoms: you need to establish the cause of this condition.

Anemia occurs when red blood cells and the hemoglobin contained in them are not produced in sufficient quantities by the body or these elements are destroyed very quickly. In addition, hemoglobin and red blood cell levels may decrease due to bleeding, when blood cells are lost faster than they are replaced.

Types of anemia
• Anemia caused by bleeding (posthemorrhagic anemia). Among the causes of blood loss are injuries, surgical operations, bleeding from the gastrointestinal tract, from the urinary and genital tract.
• Iron deficiency, folate deficiency, B12 deficiency anemia. To produce healthy red blood cells, the body needs enough iron, folic acid, and vitamin B12. If these elements are insufficiently supplied with food or they are not absorbed, this leads to a decrease in the production of red blood cells.
• Anemia of chronic disease. It occurs due to a decrease in the formation of red blood cells due to the stimulation of cellular immunity and an increase in the production of anti-inflammatory substances. It develops in chronic infections (viral, bacterial, fungal, parasitic), oncological and oncohematological diseases, autoimmune pathologies (rheumatoid arthritis, systemic lupus erythematosus, vasculitis, sarcoidosis), chronic renal or heart failure.
• Aplastic anemia. Occurs when there is insufficient production of red blood cells in the bone marrow. May be a hereditary disease. Among the causes of acquired aplastic anemia are infections and viruses (hepatitis, retroviruses, HIV, Epstein-Barr virus, herpes, etc.), drugs (cytostatics, sulfonamides, chloroquine, etc.), autoimmune diseases (systemic lupus erythematosus) and exposure to chemicals (benzene, herbicides, insecticides, etc.).
• Secondary (symptomatic) anemia associated with diseases of the bone marrow. Diseases such as leukemia and myelofibrosis can suppress the production of red blood cells and other blood cells in the bone marrow.
• Hemolytic anemia. This group of diseases develops when red blood cells are destroyed faster than the bone marrow can replace them. Hemolytic anemia can be acquired (after transplantation; due to lymphocytic leukemia, lymphomas, immunodeficiencies, infectious diseases; due to the influence of chemical, narcotic, poisonous substances, etc.) or inherited (sickle cell anemia, thalassemia, etc.).

Risk factors
Anemia is more likely to occur if the following factors are present:
• An unbalanced diet, a diet with insufficient amounts of nutrients – iron, folic acid, vitamins C and B12.
• Diseases of the gastrointestinal tract. Slow chronic blood loss from stomach ulcers or tumors, intestinal tumors, etc. can deplete iron stores in the body. Some pathologies (Crohn’s disease, celiac disease, etc.) prevent the absorption of nutrients in the small intestine.
• Menses. Women before menopause have a greater risk of developing iron deficiency anemia than postmenopausal women.
• Pregnancy. The need for iron, folic acid increases.
• Chronic diseases. Diseases such as cancer, kidney failure, diabetes, HIV/AIDS and others increase the risk of anemia.
• Family history. If close relatives have had hereditary anemia (for example, sickle cell), the risk of the disease increases.
• Toxic substances. Due to alcohol, certain drugs and drugs, chemicals, the amount of red blood cell production may decrease.
• Old age. People over 65 have an increased risk of developing anemia.

Symptoms
Anemia manifests itself in different ways, depending on the cause. Sometimes patients do not experience any deterioration in well-being. Among the signs of anemia:
• Fatigue, weakness, dizziness.
• Problems with concentration.
• Pale skin.
• Rapid, irregular heartbeat, chest pain, shortness of breath. High or low pressure.
• Cold hands and feet.
• Headaches.
• Brittle nails.
• Glossitis (inflammation of the tongue).
As the disease progresses, the symptoms of anemia may increase.

Which doctor to contact
As practice shows, with a decrease in hemoglobin, patients very often start taking iron supplements or vitamins without a specialist’s recommendation. It is clear that such “therapy” does not always help. Treatment should be aimed at eliminating the cause of the disease, which is why diagnosing the disease and determining treatment tactics is the task of doctors.
Changes in blood counts, constant causeless fatigue and weakness can be symptoms of many diseases. However, in such a situation, it is worth visiting a hematologist to rule out serious pathologies of the hematopoietic organs.
LISOD hematologists are specialists with extensive experience in diagnosing and treating diseases of the blood and blood-forming organs. Each clinical case is reviewed by a team of hematologists led by an Israeli oncohematologist, President of the Israeli Society of Hematology and Transfusiology, Professor Moshe Mittelman. The hospital has every opportunity to determine the exact cause of anemia – all types of examinations are carried out. If necessary, specialists from other specialties are involved in the diagnostic process – endoscopists, radiologists, clinical oncologists, etc. Everything is done in order to quickly establish the correct diagnosis and help the patient become healthy again.

Sign up for a consultation with a hematologist:
0-800-500-110 — free of charge within Ukraine;
+ 38-044-277-8-277 — daily from 8.00 to 20.00.

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