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Feeling anemic: Symptoms, Types, Causes, Risks, Treatment & Management

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Symptoms, Types, Causes, Risks, Treatment & Management



Overview

What is anemia?

Anemia happens when you do not have enough red blood cells. The cells travel with iron and hemoglobin, which is a protein that helps carry oxygen through the bloodstream to your organs all through the body. When someone develops anemia, they are said to be “anemic.” Being anemic might mean that you feel more tired or cold than you usually do, or if your skin seems too pale. This is due to your organs not receiving the oxygen they need to do their jobs. Some people find out they are low in iron when they go to donate blood.

Are there different kinds of anemia?

There are several different types of anemia, but each of them causes the number of red blood cells in circulation to drop. Red blood cell levels are low due to one of the following reasons:

  • Your body cannot make enough hemoglobin (low hemoglobin).
  • Your body makes hemoglobin, but the hemoglobin doesn’t work correctly.
  • Your body does not make enough red blood cells.
  • Your body breaks down red blood cells too quickly.

Some types of anemia that you may have heard of include iron-deficiency anemia and sickle cell anemia.

How common is anemia?

Anemia affects more than two billion people globally, which is more than 30% of the total population. It is especially common in countries with few resources, but it also affects many people in the industrialized world. Within the U.S., anemia is the most common blood condition. An estimated three million Americans have the disorder.

Who is most likely to develop anemia?

Anyone can develop anemia, although the following groups have a higher risk:

  • Women: Blood loss during monthly periods and childbirth can lead to anemia. This is especially true if you have heavy periods or a condition like fibroids.
  • Children, ages 1 to 2: The body needs more iron during growth spurts.
  • Infants: Infants may get less iron when they are weaned from breast milk or formula to solid food. Iron from solid food is not as easily taken up by the body.
  • People over 65: People over 65 are more likely to have iron-poor diets and certain chronic diseases.
  • People on blood thinners: These medications include drugs include aspirin, clopidogrel (Plavix®), warfarin (Coumadin®), heparin products, apixaban (Eliquis®), betrixaban (BevyxXa®), dabigatran (Pradaxa®), edoxaban (Savaysa®) and rivaroxaban (Xarelto®).

What are the signs and symptoms of anemia?

Several signs and symptoms occur in all types of anemia, such as fatigue, shortness of breath and feeling cold. Others include:

  • Dizziness or weakness.
  • Headache.
  • Sore tongue.
  • Pale skin, dry skin, or easily bruised skin.
  • Unintended movement in the lower leg (restless legs syndrome).
  • Fast heartbeat.

How does anemia affect the body?

Anemia can have other affects on your body in addition to feeling tired or cold. Other signs that you might be lacking in iron include having brittle or spoon-shaped nails and possible hair loss. You might find that your sense of taste has changed, or you might experience ringing in your ears.

Different types of anemia may lead to other serious problems. People with sickle cell anemia often have heart and lung complications.

If you have anemia that is not treated, it could lead to an arrhythmia (irregular heartbeat), an enlarged heart or heart failure. You are also at greater risk of getting infections and becoming depressed.

You might have heard that iron deficiency is linked to chewing ice, which does happen. Chewing ice is a sign of pica, a condition that includes eating things that are not really food, like chalk or dirt. So pica is also a sign of iron deficiency. It is often seen in children with anemia.

How else does anemia affect children?

It is important for children to have enough iron and other nutrients in their diets to prevent anemia and the related problems with lack of attention, delayed development of motor skills and problems with learning. In older children, you need to pay more attention to signs of anemia during growth spurts and menstrual cycles.

How does anemia affect older adults?

In older adults, anemia might have even more impact in causing confusion or depression. Weakness may make walking more difficult. Anemia may shorten your lifespan if you are older and it is not treated.

Can anemia affect my weight?

Having enough iron may also be a factor in weight issues. Studies have found overweight people might lose weight if they address low iron in the blood. You might experience unintentional weight loss along with anemia if you have other conditions, such as cancer. People who have had weight loss surgery might become anemic due to vitamin and mineral deficiencies.

How does anemia affect pregnancy?

Iron deficiency during pregnancy increases the chance of complications, such as premature birth. After the birth, studies have indicated that babies born to women with low iron levels have a higher risk of low birth weight and problems with their own iron levels.

If you are pregnant, you are more likely to develop iron-deficiency anemia. Your unborn baby relies on you for iron and other nutrients. Many women who are pregnant take iron pills to prevent anemia. To make sure that you have enough iron for you and your baby, eat well-balanced meals that include iron-rich foods and foods that provide B12 and B9 vitamins. Follow your healthcare provider’s instructions for taking vitamins and adding iron to your diet.

Finding out that you have anemia is just the beginning. Finding the cause of the anemia will lead you to the best treatment.



Symptoms and Causes

What causes anemia?

The most common cause of anemia is low levels of iron in the body. This type of anemia is called iron-deficiency anemia. Your body needs a certain amount of iron to make hemoglobin, the substance that moves oxygen throughout your body. However, iron-deficiency anemia is just one type. Other types are caused by:

  • Diets lacking in vitamin B12, or you can’t use or absorb Vitamin B12 (like pernicious anemia).
  • Diets lacking in folic acid, also called folate, or your body can’t use folic acid correctly (like folate-deficiency anemia).
  • Inherited blood disorders (like sickle cell anemia or thalassemia).
  • Conditions that cause red blood cells to break down too fast (like hemolytic anemia).
  • Chronic conditions causing your body to not have enough hormones to create red blood cells. These include hyperthyroidism, hypothyroidism, advanced kidney disease, lupus and other long-term diseases.
  • Blood loss related to other conditions such as ulcers, hemorrhoids or gastritis.

What causes iron-deficiency anemia?

You can get iron-deficiency anemia from:

  • Bleeding, either from losing a large amount of blood quickly (for instance, in a serious accident) or losing small amounts of blood over a long period of time. The body loses more iron with blood loss than it is able to replace with food. This can happen to women having heavy menstrual periods or in people who have inflammatory bowel disease.
  • Not getting enough iron in the diet.
  • Needing more iron than you did previously (for instance, during pregnancy or illness).

Some types of iron-deficiency anemia are called by other names related to the cause, such as anemia of chronic disease (also called anemia of inflammation) or acute blood loss anemia.

What causes types of anemia that aren’t iron-deficiency anemia?

Pernicious anemia

In a strict sense, pernicious anemia happens when a person lacks something called intrinsic factor, which lets them absorb vitamin B12. Without vitamin B12, the body cannot develop healthy red blood cells. Other types of anemia that involve lack of B vitamins, such as B9 (folic acid), are also often lumped in as pernicious anemia. This name may refer to other conditions, including folic acid deficiency anemia and Addison’s anemia, even though there is no intrinsic factor deficiency.

Hemolytic anemia

This type of anemia can be caused by inherited or acquired diseases that cause the body to make deformed red blood cells that die off too quickly. (An acquired disease is one that you didn’t have when you were born.) If it is not genetic, hemolytic anemia can be caused by harmful substances or reactions to certain drugs.

Sickle cell anemia

This genetic form of anemia happens because the shape of the red blood cells is faulty. They are sickle shaped, which means that they can clog the blood vessels and cause damage. The hemoglobin does not work correctly. This type of anemia is most often, but not always, found in African Americans.

Diamond-Blackfan anemia

This is a rare blood disorder that may be inherited or acquired. In this type of anemia, the bone marrow does not make enough red blood cells. Diamond-Blackfan anemia is diagnosed within the first year of life in nearly 90% of people who have it.

Aplastic anemia

This is a type of anemia in that is caused by damaged bone marrow which is unable to make enough red blood cells. It also may be congenital or acquired. Another name for aplastic anemia is bone marrow aplasia (failure). Some people might think of this condition as cancer, but it is not.

There is something referred to by some people as myelodysplastic anemia. However, myelodyplastic syndromes (MDS) refer to actual cancer and are a result of abnormal cells in the bone marrow.

Fanconi anemia

This type of anemia is also rare and it is genetic. It happens because the bone marrow does not make enough red blood cells. There are physical signs of this condition, such as abnormal bone structure and abnormal skin color. About 50% of people with this condition are diagnosed by the time that they turn 10 years old.

Mediterranean anemia

This condition is also known as Cooley’s anemia and actually refers to beta thalassemia major. Thalassemias are inherited conditions in which your body does not make the right amount of hemoglobin. In addition to not making enough of these cells, the red blood cells do not live as long as they would in someone without the condition.

Vegetarian or vegan anemia

This term refers to the idea that people who are vegetarians or vegans have a difficult time getting enough iron because they don’t eat meat, poultry or seafood. However, careful food planning makes this statement false. There are plenty of ways to get enough iron with a plant-based diet.

Your healthcare provider might also use terms for anemia that refer to the size of the red blood cells. These words include terms like macrocytic anemia (larger than normal cells) or microcytic anemia (smaller than normal cells).



Diagnosis and Tests

How is anemia diagnosed?

Your healthcare provider can perform blood tests to tell if you have anemia. The main test is a complete blood count test, also called the CBC. The CBC can tell you how many red blood cells you have, how big they are and what shape they are. Blood tests can also tell you if you are low in vitamins B12 and B9 and how much iron your body has stored.

The type and number of blood and other tests will depend on what type of anemia your provider thinks that you have.

  • Blood and urine tests can indicate if you have hemolytic anemia.
  • A colonoscopy or fecal occult blood tests of your stool may be suggested to find gastrointestinal bleeding.
  • Your provider might order a bone marrow biopsy (removal of bone marrow tissue) in certain rare cases.

The type of anemia and its cause will allow your healthcare provider to determine the right kind of treatment.



Management and Treatment

How is anemia treated?

First, your healthcare provider will find out if the anemia is being caused by a poor diet or a more serious health problem. Then, you can be treated for both the anemia and its cause. Iron-deficiency anemia is treated with:

  • Iron supplements taken by mouth.
  • Foods high in iron and foods that help your body absorb iron (like foods with Vitamin C).
  • Iron given through an intravenous (IV) infusion. (This is often a choice if you have chronic kidney disease, or CKD.)
  • Transfusions of red blood cells.

If your anemia is caused by internal bleeding, your provider may need to do surgery to stop it. Surgical repair has been used to cure anemia in people with the paraesophageal type of hiatal hernias, with or without ulcers (called Cameron’s ulcers).

Other types of anemia may require other types of treatment. For instance, genetic disorders (like beta thalassemia and sickle cell anemia) may require bone marrow transplant.

If CKD is causing your anemia, in addition to iron supplementation (through oral or IV means), treatment could also include injections of erythropoietin (EPO). EPO is a hormone that tells the bone marrow to make red blood cells.

Anemia is also linked to cancer in some cases — both in terms of anemia being a symptom and in terms of cancer treatment. Both radiation and chemotherapy can cause anemia. It might be necessary to stall further cancer treatment until the anemia is improved by iron, blood transfusions, getting necessary B vitamins and/or getting shots of drugs to stimulate your body to produce EPO.

Is anemia fatal?

Although most types of anemia can be treated, anemia can still be fatal. According to the Centers for Disease Control and Prevention, there were 1.7 deaths per 100,000 due to anemia in the U.S. in 2017.



Prevention

How can I prevent anemia?

Some kinds of anemia, such as those that are inherited, cannot be prevented. However, you can prevent anemia caused by iron deficiency, vitamin B12 deficiency and vitamin B9 deficiency by eating well. This includes eating a diet with enough foods that provide iron and these vitamins, along with vitamin C food sources to help with the absorption. Make sure that you drink enough water. Some studies have indicated that this will help keep hemoglobin levels up.

How do I manage anemia?

While some types of anemia are short-term and mild, others can last throughout a lifetime. There are several ways to help manage anemia, including:

  • Following a healthy diet.
  • Drinking enough water to stay hydrated.
  • Exercising regularly. However, if you have been weak, you should begin exercising cautiously. Check with your healthcare provider about ways to exercise safely.
  • Avoiding exposure to chemicals that set off anemia.
  • Washing your hands often to avoid infection.
  • Taking good care of your teeth and going to the dentist regularly.
  • Talking to your doctor about any changing symptoms.
  • Keeping track of your symptoms by writing them down.

Which foods should I eat, and which foods should I avoid, if I have anemia?

With anemia, making good food choices is important. Eating junk food means you are getting calories without nutrients. You also have to consider other medical conditions that you have when you make your food choices.

Some things have been shown to impair iron absorption. You should not take calcium and iron supplements at the same time. In addition, you may want to avoid or limit these items:

  • Tannin-containing items like coffee, tea and some spices.
  • Milk.
  • Egg whites.
  • Fiber. (You will not want to eliminate all fiber, though, because taking iron supplements could cause constipation.)
  • Soy protein.

In general, you should eat iron-rich foods and foods that provide vitamins B12, B9 and C. This means that you can enjoy plenty of good food that is for you, whether you eat meat or not. You can get iron from plant sources like lentils, spinach and pistachios. You can get iron from protein sources like lean beef and turkey. Whole grains and dark leafy vegetables are good sources of B vitamins. Some foods are even fortified with iron.

Citrus fruits, berries and other vitamin C-containing foods like peppers and tomatoes improve iron consumption. It is a good idea to get advice from your healthcare provider or perhaps from a registered dietitian about the best ways to eat when you have anemia. Also, make sure that grapefruit does not interfere with any of your medications.

It’s important to be educated on what you can do to take the best care of yourself that you can. It is also important that you and your healthcare provider make decisions together about what works best for you. Take the opportunity to ask for a referral to a registered dietitian if you want help setting a diet to help with iron intake. Make sure you ask all the questions that you have so you can be confident in moving forward.



Resources

Are there resources for people with anemia?

Depending on what kind of anemia you have or are interested in learning more about, you might find the following resources to be helpful.

Iron Deficiency Anemia | Michigan Medicine

Topic Overview

What is iron deficiency anemia?

Iron deficiency anemia means that your body doesn’t have enough iron to make red blood cells.

Iron is important because it helps you get enough oxygen throughout your body. Your body uses iron to make hemoglobin. Hemoglobin is a part of your red blood cells. Hemoglobin carries oxygen through your body. If you do not have enough iron, your body makes fewer and smaller red blood cells. Then your body has less hemoglobin, and you cannot get enough oxygen.

Iron deficiency is the most common cause of anemia.

What causes iron deficiency anemia?

Iron deficiency anemia is caused by low levels of iron in the body. You might have low iron levels because you:

  • Have heavy menstrual bleeding.
  • Are not getting enough iron in food. This can happen in people who need a lot of iron, such as small children, teens, and pregnant women.
  • Have bleeding inside your body. This bleeding may be caused by problems such as ulcers, hemorrhoids, or cancer. This bleeding can also happen with regular aspirin use. Bleeding inside the body is the most common cause of iron deficiency anemia in men and in women after menopause.
  • Cannot absorb iron well in your body. This problem may occur if you have celiac disease or if you have had part of your stomach or small intestine removed.

What are the symptoms?

You may not notice the symptoms of anemia, because it develops slowly and the symptoms may be mild. In fact, you may not notice them until your anemia gets worse. As anemia gets worse, you may:

  • Feel weak and tire out more easily.
  • Feel dizzy.
  • Be grumpy or cranky.
  • Have headaches.
  • Look very pale.
  • Feel short of breath.
  • Have trouble concentrating.

Babies and small children who have anemia may:

  • Be fussy.
  • Have a short attention span.
  • Grow more slowly than normal.
  • Develop skills, such as walking and talking, later than normal.

Anemia in children must be treated so that mental and behavior problems do not last long.

How is iron deficiency anemia diagnosed?

If you think you have anemia, see your doctor. Your doctor will do a physical exam and ask you questions about your medical history and your symptoms. Your doctor will take some of your blood to run tests. These tests may include a complete blood count to look at your red blood cells and an iron test that shows how much iron is in your blood.

Your doctor may also do tests to find out what is causing your anemia.

How is it treated?

Your doctor will probably have you take iron supplement pills and eat foods rich in iron to treat your anemia. Most people begin to feel better after a few days of taking iron pills. But do not stop taking the pills even if you feel better. You will need to keep taking the pills for several months to build up the iron in your body.

If your doctor finds an exact cause of your anemia, such as a bleeding ulcer, your doctor will also treat that problem.

If you think you have anemia, do not try to treat yourself. Do not take iron pills on your own without seeing your doctor first. If you take iron pills without talking with your doctor first, the pills may cause you to have too much iron in your blood, or even iron poisoning. Your low iron level may be caused by a serious problem, such as a bleeding ulcer or colon cancer. These other problems need different treatment than iron pills.

You can get the most benefit from iron pills if you take them with vitamin C or drink orange juice. Do not take your iron pills with milk, caffeine, foods with high fiber, or antacids.

Can you prevent iron deficiency anemia?

You can prevent anemia by eating foods that contain iron every day. Iron-rich foods include meats, vegetables, and whole grains such as iron-fortified cereals.

You can prevent anemia in babies and children by following recommendations for feeding infants and making sure babies and children get enough iron.

If you are pregnant, you can prevent anemia by taking prenatal vitamins. Your doctor will give you prenatal vitamins that include iron. Your doctor will also test your blood to see if you are anemic. If you are anemic, you will take a higher-dose iron pill.

Symptoms

Mild iron deficiency anemia may not cause noticeable symptoms. If anemia is severe, symptoms may include:

  • Weakness, fatigue, or lack of stamina.
  • Shortness of breath during exercise.
  • Headache.
  • Trouble concentrating.
  • Irritability.
  • Dizziness.
  • Pale skin.
  • Craving substances that are not food (pica). In particular, a craving for ice can be a sign of iron deficiency anemia.

Other signs may include:

  • Rapid heartbeat.
  • Brittle fingernails and toenails.
  • Cracked lips.
  • Smooth, sore tongue.
  • Muscle pain during exercise.
  • Trouble swallowing.

Babies and small children with iron deficiency anemia may not grow as expected and may have delays in skills such as walking and talking. Children may be irritable and have a short attention span. These problems usually go away when the deficiency is treated. If it is not treated, mental and behavior problems may be permanent.

Exams and Tests

If your doctor suspects iron deficiency anemia, he or she will do a physical exam and ask about your symptoms and your medical history. Your doctor will want to know about:

  • Any medicines that you are taking.
  • Your eating habits.
  • Any current or past conditions or diseases that you or a close family member has had.
  • Your history of pregnancy, menstruation, or other sources of bleeding.

Your doctor will recommend tests to check for low iron levels and anemia. Possible tests include:

  • A complete blood count (CBC), to look at the shape, color, number, and size of your blood cells.
  • Iron tests, which measure the amount of iron in your blood, to help determine the type and severity of anemia.
  • Reticulocyte count, to help determine the cause of anemia. Reticulocytes are immature red blood cells produced by bone marrow and released into the bloodstream. Levels of reticulocytes are lower in iron deficiency anemia.
  • A ferritin level test, which reflects how much iron may be stored in the body. Abnormally low ferritin levels may point to iron deficiency anemia. This is one of the first tests to be abnormal when you have iron deficiency.

If your doctor suspects that bleeding in your stomach or intestines is causing your anemia, you will have tests to determine the cause of the bleeding. These may include:

  • A fecal occult blood test (FOBT), which looks for blood in stool samples.
  • A colonoscopy. This test inspects the entire large intestine (colon) using a long, flexible, lighted viewing scope to look for polyps or other sources of bleeding.
  • An upper gastrointestinal (GI) endoscopy. This test, which uses a thin, flexible, lighted viewing instrument, can help identify stomach ulcers or other causes of irritation or bleeding.
  • Video capsule endoscopy. For this test, you swallow a capsule that contains a tiny camera. As the capsule travels through your system, the camera takes pictures of your small intestine that can show where bleeding is occurring.
  • X-ray tests such as an upper GI series or barium enema.

If blood tests don’t find the problem, you may need a test called a bone marrow aspiration. Bone marrow aspiration removes a small amount of bone marrow fluid through a needle inserted into the bone. Because iron is stored in the bone marrow, this test can provide a good idea of how much iron is in the body. But bone marrow aspirations are not done very often.

Treatment Overview

Treatment for iron deficiency anemia focuses on increasing your iron stores so they reach normal levels and identifying and controlling any conditions that caused the anemia. If your anemia is caused by:

  • A disease or condition, such as bleeding in your stomach, your doctor will take steps to correct the problem.
  • Not having enough iron in your diet or not being able to absorb iron, your doctor will work with you to develop a plan to increase your iron levels.

Taking iron supplement pills and getting enough iron in your food will correct most cases of iron deficiency anemia. You usually take iron pills 1 to 3 times a day. To get the most benefit from the pills, take them with vitamin C (ascorbic acid) pills or orange juice. Vitamin C helps your body absorb more iron.

Most people start to feel better within a few days of beginning treatment. Even though you feel better, you will need to keep taking the pills for several months to build up your iron stores. Sometimes it takes up to 6 months of treatment with iron supplements before iron levels return to normal.

You may need to get iron through an IV if you have problems with the iron pills or if your body doesn’t absorb enough iron from food or iron pills.

If your anemia is severe, your doctor may give you a blood transfusion to correct your anemia quickly and then have you start on iron supplement pills and a diet high in iron.

To watch your condition, your doctor will use blood tests, such as:

  • A complete blood count (CBC), to look at the shape, color, number, and size of your blood cells.
  • Iron tests, which measure the amount of iron in your blood.
  • A reticulocyte count, to see how well treatment is working. Reticulocytes are immature red blood cells produced by the bone marrow and released into the bloodstream. When reticulocyte counts increase, it usually means that iron replacement treatment is effective.
  • A ferritin level test, which reflects how much iron may be stored in the body.

Usually, people can eliminate iron deficiency anemia by taking iron as pills and adding iron in their diet. If your anemia is not corrected with these treatments, your doctor might do more testing to look for other causes of your anemia, such as new bleeding or difficulty absorbing iron from pills. These tests may be the same as those initially used to diagnose your anemia.

What to think about

If you suspect you have iron deficiency anemia, do not take iron pills without consulting your doctor. Taking iron pills could delay the diagnosis of a serious problem such as colorectal cancer or a bleeding ulcer.

If the anemia is not due to iron deficiency, taking iron pills will not relieve the anemia and could cause poisoning (iron toxicity). It could also cause an iron overload condition called hemochromatosis, especially in people who have a genetic tendency toward storing too much iron in their bodies.

In some people, iron pills cause stomach discomfort, nausea, diarrhea, constipation, and black stool. Iron is best absorbed if taken on an empty stomach. But if you are having stomach problems, you may need to take the pills with food. Do not take iron pills with milk, caffeinated drinks, or antacids. If the side effects of your iron pills make you feel too sick, talk to your doctor. He or she may know of another type of iron pill you can take.

If you get iron through an IV, there is a risk of an allergic reaction.

Home Treatment

If you have iron deficiency anemia, talk with your doctor about taking iron supplement pills and getting enough iron in your food each day. Iron-rich foods include meats, vegetables, and whole grains such as iron-fortified cereals.

To get the most benefit from your iron pills and the iron content of your food:

  • Take vitamin C (ascorbic acid) or drink orange juice with your pills.
  • Steam vegetables to help them retain their iron content.

Do not take your iron pills:

  • Within 2 hours of taking antacids or tetracycline (an antibiotic).
  • With certain foods, chemicals, and nutrients. These include:
    • Tea, coffee, chocolate, and other food or beverages high in caffeine.
    • Milk and other calcium-rich foods or supplements.
    • High-fiber foods, such as bran, whole grains, nuts, and raw green vegetables.

In some people, iron supplements can cause stomach discomfort, nausea, diarrhea, constipation, and black stool. Iron is best absorbed if taken on an empty stomach. But if you are having stomach problems, you may need to take the pills with food. If the side effects of your iron pills make you feel too sick, talk to your doctor. He or she may know of another type of iron pill you can take.

If you think you have anemia, do not take iron pills without talking with your doctor. If the iron loss is from intestinal bleeding, taking iron pills may delay the diagnosis of a serious problem such as a bleeding ulcer or colon cancer. If the anemia is not due to iron deficiency, taking iron pills will not relieve the anemia and may cause poisoning (iron toxicity) or iron overload (hemochromatosis).

Keep iron tablets out of the reach of small children. Iron poisoning can be very dangerous.

Preventing iron deficiency

You can prevent anemia in babies and children by following recommendations for feeding infants and by making sure babies and children get enough iron.

If you are pregnant, your doctor will test your iron level at your first prenatal visit, and he or she will give you prenatal vitamins that include iron (30 mg a day). If you are anemic, your doctor will give you a higher-dose pill to take.

References

Other Works Consulted

  • American Academy of Pediatrics (2010). Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics, 126(5): 1040–1050. Available online: http://pediatrics.aappublications.org/cgi/content/full/126/5/1040.
  • Hillman RS, et al. (2011). Iron-deficiency anemia. In RS Hillman et al., eds., Hematology in Clinical Practice, 5th ed., pp. 53–64. New York: McGraw-Hill.
  • Paulman P (2015). Iron deficiency. In ET Bope et al., eds., Conn’s Current Therapy 2015, pp. 857–859. Philadelphia: Saunders.
  • U.S. Preventive Services Task Force (2006). Screening and supplementation for iron deficiency anemia. Available online: http://www.uspreventiveservicestaskforce.org/uspstf/uspsiron.htm.

Credits

Current as of:
September 23, 2020

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD – Internal Medicine
Adam Husney MD – Family Medicine
Martin J. Gabica MD – Family Medicine
Kathleen Romito MD – Family Medicine
Caroline S. Rhoads MD – Internal Medicine

Current as of: September 23, 2020

Author:
Healthwise Staff

Medical Review:E. Gregory Thompson MD – Internal Medicine & Adam Husney MD – Family Medicine & Martin J. Gabica MD – Family Medicine & Kathleen Romito MD – Family Medicine & Caroline S. Rhoads MD – Internal Medicine

Anemia: Causes, Symptoms, Diagnosis, Treatments

What Is Anemia?

 

Anemia is defined as a low number of red blood cells. In a routine blood test, anemia is reported as a low hemoglobin or hematocrit. Hemoglobin is the main protein in your red blood cells. It carries oxygen, and delivers it throughout your body. If you have anemia, your hemoglobin level will be low too. If it is low enough, your tissues or organs may not get enough oxygen. Symptoms of anemia — like fatigue or shortness of breath — happen because your organs aren’t getting what they need to work the way they should.

Anemia is the most common blood condition in the U.S. It affects almost 6% of the population. Women, young children, and people with long-term diseases are more likely to have anemia. Important things to remember are:

  • Certain forms of anemia are passed down through your genes, and infants may have it from birth.
  • Women are at risk of iron-deficiency anemia because of blood loss from their periods and higher blood supply demands during pregnancy.
  • Older adults have a greater risk of anemia because they are more likely to have kidney disease or other chronic medical conditions.

There are many types of anemia. All have different causes and treatments. Some forms — like the mild anemia that happens during pregnancy — aren’t a major concern. But some types of anemia maymay reflect a serious underlying medical condition

Anemia Symptoms

The signs of anemia can be so mild that you might not even notice them. At a certain point, as your blood cells decrease, symptoms often develop. Depending on the cause of the anemia, symptoms may include:

  • Dizziness, lightheadness, or feeling like you are about to pass out
  • Fast or unusual heartbeat
  • Headache
  • Pain, including in your bones, chest, belly, and joints
  • Problems with growth, for children and teens
  • Shortness of breath
  • Skin that’s pale or yellow
  • Cold hands and feet
  • Tiredness or weakness

Anemia Types and Causes

There are more than 400 types of anemia, and they’re divided into three groups:

  • Anemia caused by blood loss
  • Anemia caused by decreased or faulty red blood cell production
  • Anemia caused by destruction of red blood cells

Anemia Caused by Blood Loss

You can lose red blood cells through bleeding. This can happen slowly over a long period of time, and you might not notice. Causes can include:

  • Gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of your stomach), and cancer
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, which can cause ulcers and gastritis
  • A woman’s period, especially if you have a heavy menstruation (or heavy period). This can be associated with fibroids.
  • Post-trauma or post-surgery as well.

Anemia Caused by Decreased or Faulty Red Blood Cell Production

With this type of anemia, your body may not create enough blood cells, or they may not work the way they should. This can happen because there’s something wrong with your red blood cells or because you don’t have enough minerals and vitamins for your red blood cells to form normally. Conditions associated with these causes of anemia include:

Bone marrow and stem cell problems may keep your body from producing enough red blood cells. Some of the stem cells in the marrow that’s in the center of your bones will develop into red blood cells. If there aren’t enough stem cells, if they don’t work right, or if they’re replaced by other cells such as cancer cells, you might get anemia. Anemia caused by bone marrow or stem cell problems includes:

  • Aplastic anemia happens when you don’t have enough stem cells or have none at all. You might get aplastic anemia because of your genes or because your bone marrow was injured by medications, radiation, chemotherapy, or infection. Other malignancies that commonly effect the bone marrow include multiple myeloma or leukemia. Sometimes, there’s no clear cause of aplastic anemia.
  • Lead poisoning. Lead is toxic to your bone marrow, causing you to have fewer red blood cells. Lead poisoning can happen when adults come into contact with lead at work, for example, or if children eat chips of lead paint. You can also get it if your food comes into contact with some types of pottery that aren’t glazed right.
  • Thalassemia happens with a problem with hemoglobin formation (4 chains aren’t correctly formed). You make really small red blood cells-though you can make enough of them to be asymptomatic, or it can be severe.It’s passed down in your genes and usually affects people of Mediterranean, African, Middle Eastern, and Southeast Asian descent. This condition can range from mild to life-threatening; the most severe form is called Cooley’s anemia.

Iron-deficiency anemia happens because you don’t have enough of the mineral iron in your body. Your bone marrow needs iron to make hemoglobin, the part of the red blood cell that takes oxygen to your organs. Iron-deficiency anemia can be caused by:

  • A diet without enough iron, especially in infants, children, teens, vegans, and vegetarians
  • Certain drugs, foods, and caffeinated drinks
  • Digestive conditions such as Crohn’s disease, or if you’ve had part of your stomach or small intestine removed
  • Donating blood often
  • Endurance training
  • Pregnancy and breastfeeding using up iron in your body
  • Your period
  • A common cause is chronic slow bleed, usually from a Gastrointestinal source.

Sickle cell anemia is a disorder that, in the U.S., affects mainly African Americans and Hispanic Americans. Your red blood cells, which are usually round, become crescent-shaped because of a problem in your genes. Anemia results when the red blood cells break down quickly, so oxygen doesn’t get to your organs. The crescent-shaped red blood cells can also get stuck in tiny blood vessels and cause pain.

Vitamin-deficiency anemia can happen when you aren’t getting enough vitamin B12 and folate. You need these two vitamins to make red blood cells. This kind of anemia can be caused by:

  • Dietary deficiency: If you eat little or no meat, you might not get enough vitamin B12. If you overcook vegetables or don’t eat enough of them, you might not get enough folate.
  • Megaloblastic anemia: When you don’t get enough vitamin B12, folate, or both
  • Pernicious anemia: When your body doesn’t absorb enough vitamin B12

Other causes of vitamin deficiency include medications, alcohol abuse, and intestinal diseases such as tropical sprue.

Anemia associated with other chronic conditions usually happens when your body doesn’t have enough hormones to make red blood cells. Conditions that cause this type of anemia include:

Anemia Caused by Destruction of Red Blood Cells

When red blood cells are fragile and can’t handle the stress of traveling through your body, they may burst, causing what’s called hemolytic anemia. You might have this condition at birth, or it could come later. Sometimes, the causes of hemolytic anemia are unclear, but they can include:

  • An attack by your immune system, as with lupus. This can happen to anyone, even a baby still in the womb or a newborn. That’s called hemolytic disease of the newborn.
  • Conditions that can be passed down through your genes, such as sickle cell anemia, thalassemia, and thrombotic thrombocytopenic purpura (TTP)
  • Enlarged spleen. This can, in rare cases, trap red blood cells and destroy them too early.
  • Something that puts strain on your body, such as infections, drugs, snake or spider venom, or certain foods
  • Toxins from advanced liver or kidney disease
  • Vascular grafts, prosthetic heart valves, tumors, severe burns, being around certain chemicals, severe hypertension, and clotting disorders

Anemia Diagnosis

A complete blood count (CBC) test will measure your red blood cells, hemoglobin, and other parts of your blood. Your doctor will ask about your family history and your medical history after the CBC. They’ll probably do some tests, including:

  • Blood smear or differential to count your white blood cells, check the shape of your red blood cells, and look for unusual cells
  • Reticulocyte count to check for immature red blood cells

Anemia Treatment

Your treatment will depend on your type of anemia. There are lot of causes, so there are also many treatments available.

  • If you have aplastic anemia, you might need medication, blood transfusions (in which you get blood from another person), or a bone marrow transplant (in which you get a donor’s stem cells).
  • If you have hemolytic anemia, you might need medication that will hold back your immune system. Your primary care doctor may refer you to a doctor who specializes in vascular problems.
  • If it’s caused by blood loss, you might have surgery to find and fix the bleeding. If you have iron-deficiency anemia, you’ll probably need to take iron supplements and change your diet.
  • Sickle cell anemia treatment includes painkillers, folic acid supplements, intermittent antibiotics or oxygen therapy. A drug. called hydroxyurea (Droxia, Hydrea, Siklos) is often prescribed to decrease sickle cell pain crises (complicated mechanism). The medication called voxelator (Oxbryta) whichcan help your red blood cells keep their proper shape. Crizanlizumab-tmca (Adakveo) can keep the blood cells from sticking together and blocking vessels. L-glutamine oral powder (Endari) can cut down on your trips to the hospital for pain and also guard against a condition called acute chest syndrome. 
  • If you have a vitamin B12 or folate deficiency, you will be prescribed supplements..
  • Thalassemia doesn’t usually need treatment, but if your case is severe, you might have blood transfusions, a bone marrow transplant, or surgery.

Iron deficiency anaemia – NHS

Iron deficiency anaemia is caused by lack of iron, often because of blood loss or pregnancy. It’s treated with iron tablets prescribed by a GP and by eating iron-rich foods.

Check if you have iron deficiency anaemia

Symptoms can include:

  • tiredness and lack of energy
  • shortness of breath
  • noticeable heartbeats (heart palpitations)
  • pale skin

Less common symptoms of iron deficiency anaemia

Less common symptoms of iron deficiency anaemia (that are not usually connected to pregnancy) include:

  • headaches
  • hearing ringing, buzzing or hissing noises inside your head (tinnitus)
  • food tasting strange
  • feeling itchy
  • a sore tongue
  • hair loss – you notice more hair coming out when brushing or washing it
  • wanting to eat non-food items, such as paper or ice (pica)
  • finding it hard to swallow (dysphagia)
  • painful open sores (ulcers) in the corners of your mouth
  • spoon-shaped nails
  • restless legs syndrome

Non-urgent advice: See a GP if you have symptoms of iron deficiency anaemia

A simple blood test will confirm if you’re anaemic.

Information:

Coronavirus (COVID-19) update: how to contact a GP

It’s still important to get help from a GP if you need it. To contact your GP surgery:

  • visit their website
  • use the NHS App
  • call them

Find out about using the NHS during COVID-19

What happens at your appointment

The GP will ask you about your lifestyle and medical history.

If the reason for the anaemia is not clear, they might order some tests to find out what might be causing the symptoms.

They might also refer you to a specialist for further checks.

Blood tests for iron deficiency anaemia

The GP will usually order a full blood count (FBC) test. This will find out if the number of red blood cells you have (your red blood cell count) is normal.

You do not need to do anything to prepare for this test.

Iron deficiency anaemia is the most common type of anaemia. There are other types, like vitamin B12 and folate anaemia, that the blood test will also check for.

Treatment for iron deficiency anaemia

Once the reason you have anaemia has been found (for example, an ulcer or heavy periods) the GP will recommend treatment.

If the blood test shows your red blood cell count is low, you’ll be prescribed iron tablets to replace the iron that’s missing from your body.

The prescribed tablets are stronger than the supplements you can buy in pharmacies and supermarkets.

You’ll need to take them for about 6 months. Drinking orange juice after you’ve taken a tablet may help your body absorb the iron.

Follow the GP’s advice about how to take iron tablets.

Some people get side effects when taking iron tablets like:

  • constipation or diarrhoea
  • tummy pain
  • heartburn
  • feeling sick
  • black poo

Try taking the tablets with or soon after food to reduce the chance of side effects.

It’s important to keep taking the tablets, even if you get side effects.

Your GP may carry out repeat blood tests over the next few months to check that your iron level is getting back to normal.

Important

Keep iron supplement tablets out of the reach of children. An overdose of iron in a young child can be fatal.

Things you can do yourself

If your diet is partly causing your iron deficiency anaemia, your GP will tell you what foods are rich in iron so you can eat more of them.

Eat and drink more:

  • dark-green leafy vegetables like watercress and curly kale
  • cereals and bread with extra iron in them (fortified)
  • meat
  • dried fruit like apricots, prunes and raisins
  • pulses (beans, peas and lentils)

Eat and drink less:

  • tea
  • coffee
  • milk and dairy
  • foods with high levels of phytic acid, such as wholegrain cereals, which can stop your body absorbing iron from other foods and pills

Large amounts of these foods and drinks make it harder for your body to absorb iron.

You might be referred to a specialist dietitian if you’re finding it hard to include iron in your diet.

Causes of iron deficiency anaemia

In pregnancy, iron deficiency anaemia is most often caused by a lack of iron in your diet.

Heavy periods and pregnancy are very common causes of iron deficiency anaemia. Heavy periods can be treated with medicine.

For men and for women whose periods have stopped, bleeding in the stomach and intestines is the most common cause of iron deficiency anaemia. This can be caused by:

Any other conditions or actions that cause blood loss could also lead to iron deficiency anaemia.

If iron deficiency anaemia is not treated

Untreated iron deficiency anaemia:

  • can make you more at risk of illness and infection – a lack of iron affects the immune system
  • may increase your risk of developing complications that affect the heart or lungs – such as an abnormally fast heartbeat (tachycardia) or heart failure
  • in pregnancy, can cause a greater risk of complications before and after birth

Page last reviewed: 29 January 2021
Next review due: 29 January 2024

Anemia (for Parents) – Nemours KidsHealth

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What You Need to Know about Anemia and Your Period

Anemia is a common health condition characterized by low red blood cell count that affects more than 3 million Americans. Having an insufficient amount of red blood cells can be problematic because the body’s cells are unable to get enough oxygen, leading to fatigue and other symptoms.

Anemia comes in many forms, with many caused by blood loss or iron deficiency. In general, many women experience anemia because of heavy menstrual periods that cause their iron levels to fall. Overall, women are at higher risk of anemia than men. Specific high risk groups include the elderly, Hispanic women, women of color, people with chronic illness, and women of childbearing age. Here we’ll get into the specifics of anemia and the ways in which menstruation can affect and contribute to anemia.

Anemia due to blood loss

Women who suffer from heavy menstrual periods are more prone to forms of anemia where red blood cells are lost to bleeding, which makes sense when you think about it. Women with anemia due to blood loss may be left feeling tired, weak, and possibly even out of breath. One sign that your period is abnormally heavy is if you’re going through a tampon or pad every hour for at least a few hours in a row. Other signs include passing large blood clots and bleeding for more than seven days in a row. If you’re experiencing any of these situations, you should speak with your doctor about getting tested for anemia.

Iron-deficiency anemia

Iron-deficiency anemia comes about when the body is low on iron. Not having enough iron in the body is problematic because it’s needed to produce hemoglobin for red blood cells. While this form of anemia can arise from a number of factors, including diet, menstruation is a common contributor. Women of childbearing age are at a higher risk for this form of anemia due to blood loss during menstruation and the increased demands on blood supply during pregnancy. People suffering from iron-deficiency anemia may experience strange cravings, such as for paper, dirt, or ice.

What are some symptoms of anemia?

Some common symptoms of anemia include lethargy, dizziness, pale skin, abnormally rapid heartbeat, shortness of breath, irritability, trouble with concentration, sexual dysfunction, and insomnia. Though these symptoms will vary depending on the form of anemia, its severity, and the cause. It’s important to speak with your doctor if you’re experiencing a combination of these symptoms, especially if you’re also suffering from a very heavy menstrual period. Your physician will be able to carry out further testing to determine if you are suffering from anemia. These tests are likely to include a physical exam, medical history, and blood work that assesses your levels of red and white blood cells, hemoglobin, and platelets.

Should I be worried about anemia?
Whether you should worry about anemia depends on the situation. Anemia that develops during pregnancy affects up to 40% of pregnant women and is often seen as normal. For women who are considering becoming pregnant, doctors will usually recommend supplements including iron and folate. And anemias due to blood loss and iron-deficiency can usually be treated with iron supplements and even dietary adjustments. However, some forms of anemia can be much harder to treat and require procedures such as blood transfusions and bone marrow transplants.

If you have any concerns about anemia and want to speak with a knowledgeable physician, call Arizona OB/GYN Affiliates (AOA) at 602-343-6174 or visit www.aoafamily.com.

Anemia | Cancer.Net

Anemia is when your body’s level of red blood cells goes below normal. When you do not have enough red blood cells, your body parts do not get enough oxygen. As a result, they cannot work the way they should and cause problems.

You can develop anemia if your body does not make enough red blood cells or destroys them. You can also develop anemia if you lose too much blood from your bloodstream.

Anemia is a common side effect of cancer and cancer treatment. This is especially true for people receiving chemotherapy.

What are the signs and symptoms of anemia?

Many people with anemia feel fatigue or muscle weakness. These symptoms can make it harder to cope with other physical and emotional effects of cancer treatment.

Symptoms of anemia may also include:

  • Rapid or irregular heart beat

  • Occasional chest pain

  • Trouble breathing or shortness of breath

  • Dizziness or fainting

  • Pale or lighter than normal color of the skin, nail beds, lips, gums, or tongue

  • Headaches

  • Trouble concentrating

  • Insomnia

  • Becoming tired more easily

  • Trouble staying warm

  • Bleeding problems

Talk with your health care team about any symptoms you experience. This includes any new symptoms or a change in symptoms. Managing anemia and other cancer side effects is an important part of your medical care and treatment. This type of care is called palliative care or supportive care.

What are the causes of anemia?

Red blood cells are made in the bone marrow. Bone marrow is the soft, spongy tissue found inside your larger bones. A hormone from the kidneys, called erythropoietin, tells your body when to make more red blood cells. Damage to either the bone marrow or the kidneys can cause anemia. Anemia can be caused by cancer, cancer side effects, or cancer treatment. It can also be caused by factors unrelated to cancer.

Common causes of anemia in people with cancer include:

Chemotherapy. Chemotherapy can damages bone marrow. This damage usually does not last and anemia often improves a few months after chemotherapy ends. Also, chemotherapy with platinum-based drugs may harm the kidneys. These drugs include cisplatin (Platinol) and carboplatin (Paraplatin).

Radiation therapy. Radiation therapy to large areas of the body can damage bone marrow. So can radiation therapy to bones in the pelvis, legs, chest, or abdomen.

Certain types of cancer. Leukemia, lymphoma, and multiple myeloma damage bone marrow. Also, cancer that spreads to the bone or bone marrow may crowd out healthy red blood cells.

Nausea, vomiting, and loss of appetite. Nausea and vomiting and loss of appetite may cause you to lose nutrients. Your body needs nutrients to make red blood cells. These includes iron, vitamin B12, and folic acid.

Too much blood loss. You can lose red blood cells faster than your body can make them. This may happen after surgery or if a tumor causes bleeding inside your body.

How is anemia diagnosed?

Doctors use a blood test called a complete blood count (CBC) to diagnose anemia. The test results include your number of red blood cells.

There are several ways to check your red blood cell count, including measuring hemoglobon and hematocrit. Hemoglobin is the iron-rich protein in red blood cells that carries oxygen. Hematocrit is the percentage of blood that is made up of red blood cells.

People with specific types of cancer or who are receiving certain cancer treatments may have regular CBC tests to monitor their health. In addition to anemia, a CBC looks for other blood-related problems. If the test shows that you have anemia, you may need other tests to find the cause.

How is anemia treated?

Doctors treat anemia based on the cause and symptoms. Here are some examples.

Blood transfusion. If anemia is causing symptoms or problems, you may need a red blood cell transfusion. During the transfusion, healthy red blood cells from a donor go into your body through a needle into a vein.

Medication. If chemotherapy causes anemia, your doctor may prescribe medications called erythropoiesis-stimulating agents (ESAs). ESAs are forms of erythropoietin made in the laboratory. They work by telling your bone marrow to make more red blood cells.

ESAs include epoetin alfa (Epogen, Procrit, Retacrit) and darbepoetin work equally well for treating anemia from chemotherapy. They also have similar risks. Epoetin and darbepoetin are injected in the body at regular intervals. They can take several weeks to start working.

The American Society of Clinical Oncology (ASCO) and the American Society of Hematology (ASH) provide these recommendations for using epoetin and darbepoetin:

  • When ESAs may be given. You may get ESAs to treat anemia if you are receiving chemotherapy as a treatment to manage cancer symptoms. This is called palliative treatment. You may also get ESAs if you have low-risk myelodysplastic syndrome (MDS) even when you are not receiving chemotherapy. MDS is a bone marrow disorder that can cause anemia.

  • When ESAs should not be given. ESAs are not recommended if you are not receiving chemotherapy or if you are receiving chemotherapy to cure cancer. You should also not receive ESAs if your hemoglobin level is 10 grams per deciliter (g/dL) or higher.

  • How ESAs are given. You should get ESAs at the lowest dose possible. The goal is to raise your hemoglobin level just enough for your to avoid a blood transfusion. Your doctor may lower the dose when that level is reached. They may also lower the dose if your hemoglobin level rises more than 1 g/dL within 2 weeks.

    If your hemoglobin level does not rise after 6 to 8 weeks, ESA treatment is not working. Your doctor should stop the treatment.

  • Risks of ESAs. ESAs have serious health risks. This includes an increased risk of death and blood clots. Talk with your doctor about the possible risks and benefits of using ESAs. Together, you should compare them with the risks and benefits of a red blood cell transfusion. You and your doctor should be very cautious about using ESAs if you have a high risk of blood clots.

    Risk factors for developing a blood clot from ESAs include:

    • A previous blood clot

    • Recent major surgery

    • Long periods of bed rest or limited activity, such as being in the hospital

    • Some types of chemotherapy and hormone therapy

    • Some types of treatment for multiple myeloma, especially thalidomide (Thalomid) or similar drugs

This information is based on ASCO and ASH recommendations about treatment of anemia with ESAs. Please note that this link takes you to another ASCO website.

Vitamin or mineral supplements. If a lack of nutrients causes anemia, your doctor may prescribe supplements. These include iron, folic acid, or vitamin B12. These supplements are usually pills taken by mouth. Occasionally, you may get a vitamin B12 injection. These injections may help your body better absorb the vitamin.

Also consider eating foods high in iron or folic acid. Foods high in iron include:

Foods high in folic acid include:

Questions to ask the health care team

  • Does my cancer or cancer treatment put me at risk for developing anemia?

  • Will you test my blood to look for signs of anemia? If so, how often will I need to have this test?

  • What signs or problems of anemia should I watch for? Which ones should I tell you about right away?

  • What is causing my anemia?

  • How can my anemia be treated?

  • Who can help me understand my nutritional needs?

Related Resources


ASCO Answers Fact Sheet: Anemia (PDF)

When to Call the Doctor During Cancer Treatment

More Information

National Cancer Institute: Anemia and Cancer Treatment

90,000 How to cope with anemia: causes, symptoms, degrees, treatment

Since iron is so difficult to assimilate, our body had to learn to treat it with care and economize in every possible way. Most of the iron from erythrocytes that have outlived their own (and they live for a maximum of one and a half to two months) is used again. Thus, the amount of iron in the body is a very stable value. However, then why does iron deficiency anemia occur so often? The answer is simple – either because of the loss of iron, or because of the increased need for it.

Women are more likely to suffer from anemia. Perhaps you have already understood why: after all, the female body loses a small amount of blood every month. And along with it – a little of the valuable iron contained in the hemoglobin of erythrocytes. Its amount is small, but you already know that iron losses are difficult to replenish with food, and especially if they are of a regular nature. However, in the same way, any bleeding leads to anemia: whether it be an injury or chronic blood loss as a result of a stomach ulcer or a tumor in the intestine.This is why chronic anemia is of concern in older patients, who have a particularly high risk of tumors.

Another risk category for anemia is children. At certain stages of development, it is observed in almost every child: this occurs during the so-called “growth spurt”, when the child is growing rapidly and has an increased need for iron. For similar reasons, pregnant women also need more iron.

However, the risk of developing anemia due to malnutrition is also not to be discounted.True, it is often associated not only with a lack of iron, but also with a lack of vitamin B in food 12 . In this case, anemia is called B 12 -deficient and occurs due to a violation of the formation of red blood cells (this vitamin is involved in this process). Vitamin B 12 is rich in animal food: meat, milk, fish and eggs. Because of this, vegans are usually advised to drink special dietary supplements to avoid deficiency.

In addition to the reasons listed above, anemia can be a consequence of chronic kidney disease (it is in the kidneys that erythropoietin is formed – a hormone that stimulates the formation of red blood cells), any chronic infections and inflammations, hereditary causes and side effects of a number of drugs.However, the main factor leading to anemia is iron deficiency.

90,000 Daytime sleepiness: causes and treatment

Hypersomnia is not an independent disease, but a symptom that accompanies various diseases and conditions.

Daytime sleepiness is usually considered a sign of lack of sleep or some kind of disturbance in normal sleep, but researchers have concluded that latent depression, somatic pathology and obesity can be the cause of such sleepiness much more often.People suffering from irresistible daytime sleepiness should first of all be screened for depression and diabetes, thyroid and nervous system disorders, regardless of the presence or absence of specific symptoms of sleep disturbance.

There are many reasons why a person can feel sleepy during the day:

– poor quality night sleep,

– hypodynamia (sedentary lifestyle) due to poorly ventilated premises, as well as due to sedentary work that is not associated with physical activity,

– idiopathic hypersomnia,

– syndrome of limb movements during sleep,

– delayed sleep phase syndrome,

– overeating, especially with a lot of high-calorie foods,

– consuming a large amount of chocolate, coffee, various energy drinks and even strong tea,

– vitamin deficiency,

– sometimes the desire to sleep is due to a lack of sunlight,

– fast change of time zones, especially immediately after the flight,

– bad habits,

– Iron-deficiency anemia,

– obesity,

– taking sedatives (sedatives), antihistamines and other medications,

– overdose of a number of stimulants of the nervous system,

– infectious diseases, especially in the convalescent stage,

– low blood pressure,

– latent asthenic-neurotic and depressive states,

– atherosclerosis of the coronary arteries or cerebral vessels,

– intoxication,

– diseases of the nervous system,

– narcolepsy,

– low or high blood glucose level,

– endocrine disorders,

-somatic diseases,

– organic diseases and brain injuries,

– the most common and dangerous cause of severe daytime sleepiness is obstructive sleep apnea syndrome,

– and others.

A distinction should be made between psychophysiological hypersomnia. It is observed in practically healthy people with insufficient night sleep or under stress.

Chronic snoring (Daytime sleepiness occurs because snoring can cause frequent micro-awakenings in the brain. This leads to disturbed sleep patterns and fragmentation. The body and brain do not rest at night.)

The most common and dangerous cause of severe daytime weakness and drowsiness is obstructive sleep apnea syndrome.This disease is characterized by severe daytime sleepiness, accompanied by fatigue, lethargy, weakness, as well as neurological disorders caused by a violation of the structure of night sleep.

Diabetes mellitus is a disease of the endocrine system with a decrease in the production of the hormone insulin by the pancreas or an insensitivity of body tissues to insulin. Insulin is a conductor of glucose into cells, which is their main source of energy. In diabetes mellitus, there is an imbalance between the intake of glucose and its utilization by the body.Drowsiness can be a sign of both an excess of glucose in the body and a lack of it. And the progression of drowsiness may indicate a formidable complication of diabetes – coma. In addition to drowsiness, diabetes mellitus is characterized by symptoms such as thirst, weakness, an increase in the amount of urine, itching of the skin, and dizziness. Everyone should know their blood sugar level, for this you need to pass a simple test in your clinic or any diagnostic center.

Hypothyroidism is a syndrome caused by decreased thyroid function.Often this disease is disguised as other diseases. Most often, primary hypothyroidism appears as a result of autoimmune thyroiditis or as a result of treatment of thyrotoxicosis. It is also possible to develop hypothyroidism as a side effect of amiodarone therapy in the treatment of cardiac arrhythmias and cytokines in the treatment of infectious hepatitis. Symptoms of this disease, in addition to drowsiness, are considered rapid fatigue, dry skin, slow speech, swelling of the face and hands, constipation, chilliness, memory loss, depressive conditions, menstrual irregularities in women and infertility.

But, the causes of daytime sleepiness are often associated with the diet of the foods used. Even with a good night’s sleep, when a person gets enough sleep, he may experience severe daytime sleepiness. The secret lies in the composition of the food that people eat during the day. After a fatty meal, it starts to fall asleep, and a meal rich in carbohydrates, on the contrary, increases concentration and performance. The protein content had no effect on sleepiness.

Brain trauma can also cause drowsiness.Headaches, dizziness, bruising under the eyes, and an episode of prior traumatic brain injury should alert the patient.

In most cases, excessive daytime sleepiness is a common symptom of narcolepsy. This is a rare form of sleep disturbance in which a person suddenly falls asleep and then wakes up as if nothing had happened. The symptoms of this pathology can appear all at once or develop gradually over the years. The sleep of such people is no different from the usual, with the only difference that a sick person cannot predict where, when and how long he will fall asleep next time.

The neurologists of the Dixion Clinic will help to identify the cause of the sleep disturbance.

Gastroscopy and Helicobacter test in Klimovsk

The procedure is used for a detailed examination of the walls of the stomach, esophagus and upper gastrointestinal tract. Most often
used for suspected tumor and inflammatory processes, possible bleeding, ulcers and erosion.

Also carried out in the event of pain of a different nature in the esophagus, stomach, duodenal
intestines.Allows you to determine the nature of pain, timely detect the pathological process.

In the center of Tomograd-Klimovsk, modern ultra-thin
video endoscopes with virtual chromoscopy
(i-scan) and image enlargement (zoom 2x), allowing you to accurately and most delicately perform the study
stomach, esophagus and duodenum.

With symptoms such as: nausea, vomiting, heartburn, pain, a feeling of heaviness in the abdomen, anemia, severe
weight loss, lack of appetite, food failure, gastroscopy is mandatory.

For gastroscopy, a special flexible probe with a camera is inserted into the esophagus through the oral opening.
captures the image on its way and transmits it to the monitor. Due to this, the doctor during the procedure can
to investigate and assess the condition of the mucous membranes of the gastrointestinal tract in real time.

The procedure is very informative and at the same time it is carried out quickly, that is, it allows you to obtain the most accurate data in
short term

If necessary, the examination is supplemented with a biopsy.Such a combined study option is considered one
of the most effective methods for diagnosing tumor processes in the initial stages, when the symptoms are still
absent.

Endoscopy with biopsy is indicated in the following cases:

  • polyps and tumors of the mucous membrane of the stomach, esophagus and duodenum;
  • inflammation of the gastric mucosa of the esophagus and duodenum;
  • peptic ulcer and erosive process of the gastric mucosa of the esophagus and duodenum;
  • Crohn’s disease;
  • acute and chronic gastritis;
  • Helicobacter pylori infection.

Also, the study is used for the early diagnosis of precancerous conditions and tumor processes.

Transnasal gastroscopy, which is performed through the nose, is much easier to tolerate,
than the traditional oral route, because the intranasal route of administration does not induce a gag reflex. This
the method is mainly used in elderly patients with a complex of concomitant diseases. Patients can
speak if necessary during the procedure.

Processing of endoscopes after each patient is carried out in an automatic
sterilization washing machine (Yu.Korea), which completely excludes the possibility of infection. All tools to
endoscopes are also sterilized.

90,000 Symptoms of chronic fatigue syndrome. Advice from a DOCTOR of the Medical Center MedFarm Ussuriysk

«Back

18.10.2019 00:00

There are many advantages to the modern lifestyle. Even in comparison with the lives of our parents, our life is much more interesting, varied and easier. Our homes and offices are equipped with all the necessary equipment, which does a lot of work for us, many have their own transport.

However, in spite of this, we more and more often experience fatigue and the feeling that we are not doing anything. Sometimes the consequence of such problems is chronic fatigue syndrome, which is not a disease, but is no longer considered a healthy condition. Most often, chronic fatigue syndrome appears in an active modern person.

The symptoms of chronic fatigue syndrome are:

• Pain in joints and muscles, fear, depression, anxiety, weakening of concentration, fever.

• Sometimes this syndrome manifests itself as an exacerbation of chronic diseases for no reason.

• Chronic fatigue syndrome can also be suspected by frequent headaches, bowel dysfunctions, irritability, decreased or increased appetite, frequent mood swings, muscle cramps, sleep disturbances, sore throat, upper respiratory tract infections, temporary memory impairment, severe weakness.

• Healthy Living draws your attention to the fact that the symptoms of chronic fatigue syndrome are similar to those of influenza and other viral infections, as well as mental illness, which often complicates diagnosis.

• But the main symptom of this syndrome is a constant feeling of fatigue, which does not go away even after sleeping and a few days off.

• Chronic fatigue syndrome affects women three times more often than men.

• For obvious reasons, it is characteristic of active people who are building their own destiny. These are most often students and people under 45 years old.

• It has been noticed that the appearance of this syndrome is also facilitated by the time of the year when the daylight hours are short.

• In addition, office workers are 10 times more likely to experience chronic fatigue syndrome than manual or even hard workers.

70% of patients with signs of chronic fatigue have chronic diseases such as diabetes, pulmonary diseases, anemia, which leads to an even greater loss of strength.

Causes of chronic fatigue syndrome. Although the exact causes of chronic fatigue syndrome have not been established, it is clear what causes them in our lifestyle with constant stress, poor ecology, inactivity, oxygen starvation. These factors lead to weight gain, deterioration of the nervous system and the body as a whole.

One of the side factors in the appearance of fatigue is the modern image of a successful person who must use every minute to improve his life and strive upward.

If you feel constant fatigue, you should go to the clinic for a full examination.

Some serious diseases in the initial stage can lead to fatigue: endocrine, immune, oncological, cerebral, mental, diseases of the nervous system, internal organs, AIDS.Fatigue can be a consequence of past illnesses, post-infectious and post-traumatic syndromes.

Danger of chronic fatigue syndrome. Although chronic fatigue syndrome does not lead to death, it interferes with a good quality of life, reduces working capacity, and leads to serious disorders of the immune system.

Often a person, having reached the limits of fatigue, falls into bed, believing that he has a cold. And this helps him to rest, recover, gain strength.However, if you do not change your lifestyle and do not treat chronic fatigue syndrome, then chronic fatigue will return again, especially after illness and stress.

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Features of high and low blood pressure

Blood pressure is the rate of blood flow through large arteries in the human body, measured in mm Hg.

It is divided into two types: diastolic (upper) and systolic (lower).Based on the upper indicator, the pressure of the relaxed arteries is determined, and the first criterion depends on the heart rate. When calculated from the indicator of systolic blood pressure, the distolic one, the pulse pressure is obtained. In adolescents, blood pressure should be about 110 * 70, in adults under 60 years of age 125 * 85, in the elderly 135 * 90 mm Hg. Art.

Within one day, the human body can experience sudden changes in pressure, which affects its overall well-being. With an increase in the indicator for every 10 mm Hg.Art. the risk of heart and vascular diseases increases.

Signs and consequences of increased blood pressure

Not every person knows his individual pressure when he feels normal. But what are the consequences of an increase in blood pressure? In medical practice, the pathology associated with high blood pressure is called hypertension. This disease does not manifest itself in people of different ages in the same way.

Specialists of the Carnelian Medical Center in Novosibirsk noted the main symptoms of high blood pressure:

  • Regular cold sensation in the lower extremities.Edema associated with heart and kidney failure may occur;
  • excessive heartbeat;
  • frequent headaches;
  • pain in the heart region;
  • dizziness when turning or bending over the head;
  • stable high blood pressure, which can remain unchanged during emotional changes.

The risk of high blood pressure may appear in elderly patients. Pathology can be inherited or with head injury.Other risk factors are harmful working conditions and alcohol dependence, lack of sleep, intense physical activity, stress, symptomatic hypertension, thyroid and heart disorders, obesity, smoking, vegetative-vascular dystonia, etc.

Signs and consequences of a decrease in blood pressure

According to the specialists of MC Serdolik, the manifestation of a low blood pressure is typical for young women in the age category up to 40 years.

Symptoms of the manifestation of disorders include:

  • insufficient blood circulation, leading to the appearance of throbbing pain in the temporal region of the head;
  • sudden mood swings;
  • constant apathy, lethargy, tired feeling.The body is unable to recover from a sound, good rest and sleep.

Low blood pressure can manifest itself for various reasons: as a result of previous infections, underweight, anemia, unfavorable working conditions, changing climatic conditions or seasonality. Also, pressure can change as a result of a lack of vitamins, speaks of anemia, preinfarction, weight deficiency, cardiosclerosis, VSD, renal failure, low hemoglobin, circulatory disorders, etc.

With a slight change in blood pressure, people live a full life. To avoid health problems, experts recommend exercise, adhere to a healthy lifestyle and proper nutrition, often walk in the fresh air, give up alcohol and take vitamins and fruits. Also, a person should avoid stress and take care of his health, constantly monitor his pressure and keep it normal. Measurements need to be done several times a week, beforehand you cannot take alcoholic drinks and coffee, play sports, smoke, swim in hot water.

90,000 Gastroesophageal reflux with esophagitis – the causes of the onset of the disease, the first symptoms, methods of prevention and treatment of the disease from the doctors YugMed

The term “reflux” refers to the reflux of stomach contents into the esophagus. This phenomenon (the constant return of part of the eaten food) can cause inflammation of the esophageal mucosa – reflux esophagitis. The main symptom is persistent heartburn.

In the first three months of a child’s life, gastroesophageal reflux is characteristic and physiological.Young children have anatomical and physiological features that predispose to its development. These are underdevelopment of the distal esophagus, low acidity of gastric juice, an insignificant volume and a spherical shape of the stomach, and its delayed emptying.

Pathological gastroesophageal reflux in young children is characterized by frequent regurgitation and vomiting, accompanied by insufficient weight gain, anemia, and impaired general condition.

There are several reasons for this ailment: an increase in intragastric pressure, a decrease in the ability of the stomach to hold the contents, and the esophagus – to quickly evacuate the “lost” food back into the stomach. Normally, all bile should be secreted into the duodenum. However, with reflux, some of the bile that enters the stomach causes inflammation in the stomach. The child may say that he just has a stomach ache, sometimes you may notice belching or bad breath. Some children are constantly hungry or have no appetite altogether.

Anti-reflux mode

Due to the fact that gastroesophageal refluxes are often the cause of diseases of the esophagus and other organs, one of the ways to treat such diseases is lifestyle changes aimed at reducing gastroesophageal refluxes.

Anti-reflux mode includes:

  • In the presence of excess body weight – its reduction.
  • Lack of physical activity associated with bending, swinging the press, lifting weights and other exercises that increase intra-abdominal pressure.
  • Exclusion or limitation of the consumption of foods with an acid-stimulating effect, in particular citrus, chocolate, baked goods, fresh white bread, black bread, broths, spices, mushrooms, fried and fatty foods, radishes, radishes.
  • Refusal from carbonated drinks, coffee, strong tea, cold and hot food, overeating.
  • Sleeping on a bed with the head end raised 15 cm.
  • Sleep not earlier than two hours after eating.

More about pediatric gastroenterology at the YugMed clinic

90,000 Iron deficiency ›Feeling tired – is it normal?

We all get tired from time to time, but if you feel exhausted every day, you may be overworked.What is the difference between tiredness and overwork?

To understand why you are feeling tired, you first need to think about your lifestyle, everyday stressors and stress. Such factors may include:

  • Lack of physical activity 1.2.3
  • Lack of sleep 4
  • Excessive physical activity 5
  • Excessive caffeine use 5 or excessive alcohol use 7
  • Illnesses such as colds or flu 5

If you experience fatigue from any of these reasons, it is likely that the feeling will go away over time and you will feel better after exercising, resting, or getting enough sleep. 5

However, if you feel exhausted, and this feeling continues day after day, you may not just be tired, but overworked. In the event of overwork, you may experience physical and mental fatigue and lack of energy for several days each week, even without any particularly tiring physical activity. 8 If this happens, you may become very tired during the most common daily activities – when you put on clothes or go shopping, and you may often not have the energy to spend time with family and friends.When describing overwork, people say they feel “lethargic,” “drained,” or “irritable.”

If you would like to check if your level of fatigue is normal or if you are experiencing fatigue, you can take our Fatigue Test and get an estimate of your fatigue level.

Overwork is a common problem; often it is about him that people complain first of all when visiting a doctor. 9 This is not an easy symptom as it can be caused by many comorbidities, including the following:

  • Iron deficiency and iron deficiency anemia 10
  • Anemia due to other causes, including low levels of vitamin B12 or folate 11
  • Hormonal disorders such as hypothyroidism and diabetes 12
  • Chronic fatigue syndrome, also called myalgic encephalomyelitis (ME) 2
  • Depression 2.13 and sleep disorders 4
  • Iron overload, also called hemochromatosis, 14 in which an excessive amount of iron in the body can lead to its accumulation in organs. 15

Since fatigue can have so many different reasons, it is very important to consult with your doctor and discuss your well-being in more detail. Your doctor will be able to better diagnose overwork and discuss possible treatment options with you.

If overwork is associated with iron deficiency or iron deficiency anemia, your well-being will improve after an increase in iron intake – as a result of a change in diet or (if necessary) treatment with iron preparations.This is why it is so important to discuss this issue with your doctor and monitor for other symptoms of possible iron deficiency.

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