Small size red blood cells: Microcytic Hypochromic Anemia – StatPearls
Microcytic Anemia: Symptoms, Types, and Treatment
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Microcytic anemia means that you have smaller red blood cells than typical — and fewer of them.
It can result from an iron deficiency or a health condition.
Microcytic anemia definition
Microcytosis is a term used to describe red blood cells that are smaller than normal. Anemia is when you have low numbers of properly functioning red blood cells in your body.
In microcytic anemias, your body has fewer red blood cells than normal. The red blood cells it does have are also too small. Several different types of anemias can be described as microcytic.
Microcytic anemias are caused by conditions that prevent your body from producing enough hemoglobin. Hemoglobin is a component of your blood. It helps transport oxygen to your tissues and gives your red blood cells their red color.
Iron deficiency causes most microcytic anemias. Your body needs iron to produce hemoglobin. But other conditions can cause microcytic anemias, too. To treat a microcytic anemia, your doctor will first diagnose the underlying cause.
You may not notice any symptoms of microcytic anemia at first.
Symptoms often appear at an advanced stage when the lack of normal red blood cells is affecting your tissues.
Common symptoms of microcytic anemias include:
- fatigue, weakness, and tiredness
- loss of stamina
- shortness of breath
- dizziness
- pale skin
If you experience any of these symptoms and they don’t resolve within two weeks, make an appointment to see your doctor.
You should make an appointment to see your doctor as soon as possible if you experience severe dizziness or shortness of breath.
Microcytic anemias can be further described according to the amount of hemoglobin in the red blood cells. They can be either hypochromic, normochromic, or hyperchromic:
1. Hypochromic microcytic anemias
Hypochromic means that the red blood cells have less hemoglobin than normal. Low levels of hemoglobin in your red blood cells leads to appear paler in color. In microcytic hypochromic anemia, your body has low levels of red blood cells that are both smaller and paler than normal.
Most microcytic anemias are hypochromic. Hypochromic microcytic anemias include:
Iron deficiency anemia: The most common cause of microcytic anemia is an iron deficiency in the blood. Iron deficiency anemia can be caused by:
- inadequate iron intake, usually as a result of your diet
- being unable to absorb iron due to conditions like celiac disease or Helicobacter pylori infection
- chronic blood loss due to frequent or heavy periods in women or by gastrointestinal (GI) bleeds from upper GI ulcers or inflammatory bowel disease
- pregnancy
Thalassemia: Thalassemia is a type of anemia that’s caused by an inherited abnormality. It involves mutations in the genes needed for normal hemoglobin production.
Sideroblastic anemia: Sideroblastic anemia can be inherited due to gene mutations (congenital). It can also be caused by a condition acquired later in life that impedes your body’s ability to integrate iron into one of the components needed to make hemoglobin.
This results in a buildup of iron in your red blood cells.
Congenital sideroblastic anemia is usually microcytic and hypochromic.
2. Normochromic microcytic anemias
Normochromic means that your red blood cells have a normal amount of hemoglobin, and the hue of red is not too pale or deep in color. An example of a normochromic microcytic anemia is:
Anemia of inflammation and chronic disease: Anemia due to these conditions is usually normochromic and normocytic (red blood cells are normal in size). Normochromic microcytic anemia may be seen in people with:
- infectious diseases, such as tuberculosis, HIV/AIDS, or endocarditis
- inflammatory diseases, such as rheumatoid arthritis, Crohn’s disease, or diabetes mellitus
- kidney disease
- cancer
These conditions can prevent red blood cells from functioning normally. This can lead to decreased iron absorption or utilization.
3. Hyperchromic microcytic anemias
Hyperchromic means that the red blood cells have more hemoglobin than normal.
High levels of hemoglobin in your red blood cells makes them a deeper hue of red than normal.
Congenital spherocytic anemia: Hyperchromic microcytic anemias are rare. They may be caused by a genetic condition known as congenital spherocytic anemia. This is also called hereditary spherocytosis.
In this disorder, the membrane of your red blood cells doesn’t form correctly. This causes them to be rigid and improperly spherical shaped. They are sent to be broken down and die in the spleen because they don’t travel in the blood cells properly.
4. Other causes of microcytic anemia
Other causes of microcytic anemia include:
- lead toxicity
- copper deficiency
- zinc excess, which causes copper deficiency
- alcohol use
- drug use
Microcytic anemias are often first spotted after your doctor has ordered a blood test known as a complete blood count (CBC) for another reason. If your CBC indicates that you have anemia, your doctor will order another test known as a peripheral blood smear.
This test can help spot early microcytic or macrocytic changes to your red blood cells. Hypochromia, normochromia, or hyperchromia can also be seen with the peripheral blood smear test.
Your primary care doctor may refer you to a hematologist. A hematologist is a specialist who works with blood disorders. They may be able to best diagnose and treat the specific type of microcytic anemia and identify its underlying cause.
Once a doctor has diagnosed you with microcytic anemia, they will run tests to determine the cause of the condition. They may run blood tests to check for celiac disease. They may test your blood and stool for H. pylori bacterial infection.
Your doctor might ask you about other symptoms you’ve experienced if they suspect that chronic blood loss is the cause of your microcytic anemia. They may refer you to a gastroenterologist if you have stomach or other abdominal pain. A gastroenterologist might run imaging tests to look for different conditions.
These tests include:
- abdominal ultrasound
- upper GI endoscopy (EGD)
- CT scan of the abdomen
For women with pelvic pain and heavy periods, a gynecologist may look for uterine fibroids or other conditions that could cause heavier flows.
Treatment for microcytic anemia focuses on treating the underlying cause of the condition.
Your doctor may recommend that you take iron and vitamin C supplements. The iron will help treat the anemia while the vitamin C will help increase your body’s ability to absorb the iron.
Your doctor will focus on diagnosing and treating the cause of the blood loss if acute or chronic blood loss is causing or contributing to microcytic anemia. Women with iron deficiency from severe periods may be prescribed hormonal therapy, such as birth control pills.
In cases of microcytic anemia so severe that you’re at risk for complications like cardiac failure, you may need to get a blood transfusion of donor red blood cells.
This can increase the number of healthy red blood cells that your organs need.
Treatment can be relatively straightforward if simple nutrient deficiencies are the cause of microcytic anemia. As long as the underlying cause of the anemia can be treated, the anemia itself can be treated and even cured.
In very severe cases, untreated microcytic anemia can become dangerous. It can cause tissue hypoxia. This is when the tissue is deprived of oxygen. It can cause complications including:
- low blood pressure, also called hypotension
- coronary artery problems
- pulmonary problems
- shock
These complications are more common in older adults who already have pulmonary or cardiovascular diseases.
The best way to prevent microcytic anemia is to get enough iron in your diet. Increasing your vitamin C intake can also help your body absorb more iron.
You can also consider taking a daily iron supplement. These are often recommended if you already have anemia.
You should always talk to your doctor before you start taking any supplements.
You can also try to get more nutrients through your food.
Foods rich in iron include:
- red meat like beef
- poultry
- dark leafy greens
- beans
- dried fruits like raisins and apricots
Foods rich in vitamin C include:
- citrus fruits, especially oranges and grapefruits
- kale
- red peppers
- Brussels sprouts
- strawberries
- broccoli
Microcytic Anemia: Symptoms, Types, and Treatment
We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.
Healthline only shows you brands and products that we stand behind.
Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:
- Evaluate ingredients and composition: Do they have the potential to cause harm?
- Fact-check all health claims: Do they align with the current body of scientific evidence?
- Assess the brand: Does it operate with integrity and adhere to industry best practices?
We do the research so you can find trusted products for your health and wellness.
Read more about our vetting process.
Was this helpful?
Microcytic anemia means that you have smaller red blood cells than typical — and fewer of them. It can result from an iron deficiency or a health condition.
Microcytic anemia definition
Microcytosis is a term used to describe red blood cells that are smaller than normal. Anemia is when you have low numbers of properly functioning red blood cells in your body.
In microcytic anemias, your body has fewer red blood cells than normal. The red blood cells it does have are also too small. Several different types of anemias can be described as microcytic.
Microcytic anemias are caused by conditions that prevent your body from producing enough hemoglobin. Hemoglobin is a component of your blood. It helps transport oxygen to your tissues and gives your red blood cells their red color.
Iron deficiency causes most microcytic anemias. Your body needs iron to produce hemoglobin. But other conditions can cause microcytic anemias, too.
To treat a microcytic anemia, your doctor will first diagnose the underlying cause.
You may not notice any symptoms of microcytic anemia at first. Symptoms often appear at an advanced stage when the lack of normal red blood cells is affecting your tissues.
Common symptoms of microcytic anemias include:
- fatigue, weakness, and tiredness
- loss of stamina
- shortness of breath
- dizziness
- pale skin
If you experience any of these symptoms and they don’t resolve within two weeks, make an appointment to see your doctor.
You should make an appointment to see your doctor as soon as possible if you experience severe dizziness or shortness of breath.
Microcytic anemias can be further described according to the amount of hemoglobin in the red blood cells. They can be either hypochromic, normochromic, or hyperchromic:
1. Hypochromic microcytic anemias
Hypochromic means that the red blood cells have less hemoglobin than normal.
Low levels of hemoglobin in your red blood cells leads to appear paler in color. In microcytic hypochromic anemia, your body has low levels of red blood cells that are both smaller and paler than normal.
Most microcytic anemias are hypochromic. Hypochromic microcytic anemias include:
Iron deficiency anemia: The most common cause of microcytic anemia is an iron deficiency in the blood. Iron deficiency anemia can be caused by:
- inadequate iron intake, usually as a result of your diet
- being unable to absorb iron due to conditions like celiac disease or Helicobacter pylori infection
- chronic blood loss due to frequent or heavy periods in women or by gastrointestinal (GI) bleeds from upper GI ulcers or inflammatory bowel disease
- pregnancy
Thalassemia: Thalassemia is a type of anemia that’s caused by an inherited abnormality. It involves mutations in the genes needed for normal hemoglobin production.
Sideroblastic anemia: Sideroblastic anemia can be inherited due to gene mutations (congenital). It can also be caused by a condition acquired later in life that impedes your body’s ability to integrate iron into one of the components needed to make hemoglobin. This results in a buildup of iron in your red blood cells.
Congenital sideroblastic anemia is usually microcytic and hypochromic.
2. Normochromic microcytic anemias
Normochromic means that your red blood cells have a normal amount of hemoglobin, and the hue of red is not too pale or deep in color. An example of a normochromic microcytic anemia is:
Anemia of inflammation and chronic disease: Anemia due to these conditions is usually normochromic and normocytic (red blood cells are normal in size). Normochromic microcytic anemia may be seen in people with:
- infectious diseases, such as tuberculosis, HIV/AIDS, or endocarditis
- inflammatory diseases, such as rheumatoid arthritis, Crohn’s disease, or diabetes mellitus
- kidney disease
- cancer
These conditions can prevent red blood cells from functioning normally.
This can lead to decreased iron absorption or utilization.
3. Hyperchromic microcytic anemias
Hyperchromic means that the red blood cells have more hemoglobin than normal. High levels of hemoglobin in your red blood cells makes them a deeper hue of red than normal.
Congenital spherocytic anemia: Hyperchromic microcytic anemias are rare. They may be caused by a genetic condition known as congenital spherocytic anemia. This is also called hereditary spherocytosis.
In this disorder, the membrane of your red blood cells doesn’t form correctly. This causes them to be rigid and improperly spherical shaped. They are sent to be broken down and die in the spleen because they don’t travel in the blood cells properly.
4. Other causes of microcytic anemia
Other causes of microcytic anemia include:
- lead toxicity
- copper deficiency
- zinc excess, which causes copper deficiency
- alcohol use
- drug use
Microcytic anemias are often first spotted after your doctor has ordered a blood test known as a complete blood count (CBC) for another reason.
If your CBC indicates that you have anemia, your doctor will order another test known as a peripheral blood smear.
This test can help spot early microcytic or macrocytic changes to your red blood cells. Hypochromia, normochromia, or hyperchromia can also be seen with the peripheral blood smear test.
Your primary care doctor may refer you to a hematologist. A hematologist is a specialist who works with blood disorders. They may be able to best diagnose and treat the specific type of microcytic anemia and identify its underlying cause.
Once a doctor has diagnosed you with microcytic anemia, they will run tests to determine the cause of the condition. They may run blood tests to check for celiac disease. They may test your blood and stool for H. pylori bacterial infection.
Your doctor might ask you about other symptoms you’ve experienced if they suspect that chronic blood loss is the cause of your microcytic anemia. They may refer you to a gastroenterologist if you have stomach or other abdominal pain.
A gastroenterologist might run imaging tests to look for different conditions. These tests include:
- abdominal ultrasound
- upper GI endoscopy (EGD)
- CT scan of the abdomen
For women with pelvic pain and heavy periods, a gynecologist may look for uterine fibroids or other conditions that could cause heavier flows.
Treatment for microcytic anemia focuses on treating the underlying cause of the condition.
Your doctor may recommend that you take iron and vitamin C supplements. The iron will help treat the anemia while the vitamin C will help increase your body’s ability to absorb the iron.
Your doctor will focus on diagnosing and treating the cause of the blood loss if acute or chronic blood loss is causing or contributing to microcytic anemia. Women with iron deficiency from severe periods may be prescribed hormonal therapy, such as birth control pills.
In cases of microcytic anemia so severe that you’re at risk for complications like cardiac failure, you may need to get a blood transfusion of donor red blood cells.
This can increase the number of healthy red blood cells that your organs need.
Treatment can be relatively straightforward if simple nutrient deficiencies are the cause of microcytic anemia. As long as the underlying cause of the anemia can be treated, the anemia itself can be treated and even cured.
In very severe cases, untreated microcytic anemia can become dangerous. It can cause tissue hypoxia. This is when the tissue is deprived of oxygen. It can cause complications including:
- low blood pressure, also called hypotension
- coronary artery problems
- pulmonary problems
- shock
These complications are more common in older adults who already have pulmonary or cardiovascular diseases.
The best way to prevent microcytic anemia is to get enough iron in your diet. Increasing your vitamin C intake can also help your body absorb more iron.
You can also consider taking a daily iron supplement. These are often recommended if you already have anemia.
You should always talk to your doctor before you start taking any supplements.
You can also try to get more nutrients through your food.
Foods rich in iron include:
- red meat like beef
- poultry
- dark leafy greens
- beans
- dried fruits like raisins and apricots
Foods rich in vitamin C include:
- citrus fruits, especially oranges and grapefruits
- kale
- red peppers
- Brussels sprouts
- strawberries
- broccoli
Erythrocyte indices – what is a color index
Erythrocytes
Erythrocytes (red blood cells) – blood cells that carry oxygen from the lungs to tissues and organs, and transport carbon dioxide back.
Normally, erythrocytes look like discs, concave on both sides. Due to this shape, they are more elastic and penetrate even the narrowest vessels.
Unlike most other cells, erythrocytes do not have a nucleus: 98% of their volume is occupied by hemoglobin is a protein that binds oxygen.
In one day, the red blood cells of an adult carry about 800 liters of oxygen and 200 liters of carbon dioxide.
In addition, these cells are involved in the transport of nutrients and help maintain acid-base balance.
In the form of a blood test, erythrocytes are designated by the Latin letters RBC – red blood cells (red blood cells).
What are erythrocyte indices
Red blood cell indices are indicators that measure the size of red blood cells and their hemoglobin content. Indices are considered fairly stable parameters, since they characterize not the number of erythrocytes, but their physiological properties.
Color value
Color indicator reflects the degree of saturation of the erythrocyte with hemoglobin: the more hemoglobin, the more red the erythrocyte will be.
Normal: 0.85 – 1.00. The indicator is measured in calculation units.
If the color index is above the norm, it is considered hyperchromic. The color index is below normal – hypochromic.
Main causes of hyperchromia
Pernicious anemia (megaloblastic, B12-deficient) is a pathology in which the maturation of red blood cells in the bone marrow is impaired due to poor absorption of vitamin B12.
Folate deficiency anemia is a disorder of hematopoiesis in the bone marrow associated with folic acid deficiency. The disease is often diagnosed together with iron deficiency anemia. It is especially dangerous for pregnant women, as it can lead to impaired development of the fetal nervous system.
Myelodysplastic syndrome is an oncological disease in which the normal maturation of all blood cells in the bone marrow is disturbed. Risk factors for the development of the disease: radiation therapy, chemotherapy, smoking, exposure to heavy metals (mercury, lead).
Main causes of hypochromia
Posthemorrhagic anemia is a condition associated with acute or chronic blood loss.
The main symptoms are: pallor, shortness of breath, darkening of the eyes, and in severe cases – lethargy, thready pulse, loss of consciousness.
Acute posthemorrhagic anemia is associated with rapid massive blood loss in trauma, surgery, gastric and duodenal ulcers, ectopic pregnancy. Chronic – due to frequent loss of a small amount of blood. This happens with gastrointestinal, nasal, uterine bleeding, as well as with diseases associated with impaired blood clotting.
Frequent nosebleeds can lead to chronic posthemorrhagic anemia
Iron deficiency anemia is a condition in which there is not enough iron in the body, which is necessary for the normal synthesis of hemoglobin. Most often, such anemia develops due to chronic blood loss or impaired iron intake. In addition, iron deficiency anemia occurs in people with increased iron consumption: women of reproductive age (due to monthly blood loss during menstruation), pregnant women, as well as children and adolescents (due to intensive body growth).
Anemia associated with lead toxicity is a condition commonly found in industrial workers. Lead is a heavy toxic metal. It blocks the enzymes necessary for the synthesis of hemoglobin. As a result, the hemoglobin content in the erythrocyte decreases.
Deviation towards hyperchromia (oversaturation with hemoglobin) is often combined with an increase in the size of red blood cells. This condition is called macrocytosis or megalocytosis. Conversely, with hypochromia (lack of hemoglobin), the size of red blood cells is usually lower: this is microcytosis.
Recently, instead of studying the color index, the determination of MCH is increasingly used – the average hemoglobin content in the erythrocyte.
Mean erythrocyte hemoglobin (MCH)
The mean concentration of hemoglobin in one erythrocyte (MCH) shows the mass of iron-containing protein in one red cell. Measured in picograms (pg): 1 pg is one trillionth of a gram.
The indicator depends on the gender and age of the patient. The highest values are observed in newborns under the age of 14 days. Then, as they grow older, MCH gradually decreases and equalizes with the norm for adults.
MCH norm for children under 18
Age of the child | MCH reference values, pg |
| 9 0098 1 day after birth | 27–33 |
2 to 13 days after birth | 27–33 |
14 to 23 days after birth | 27–33 |
24 to 30 days after birth | 27-33 |
1-3 months 9000 7 | 26.3–32.3 |
4–5 months | 25–29 |
6–7 months | 26–30 | 8-11 months | 25-31 |
12 months — 2 years | 22-32 |
2-3 years | 22. |
4-9 years | 22.7–32.7 |
10-14 | 25-35 |
15-18 | 26-34 |
15-18 | 27- 32 |
3-32.3MCH norm for women
Woman’s age | MCH reference values, pg 0098 18-44 | 27-34 |
45-64 | 27-34 | |
65 and over | 27-35 |
Male age | MCH reference values, pg 0098 18-44 | 27-34 |
45-64 | 27-35 | |
65 and over | 27-34 |
blood 140 ₽
blood 140 ₽
Age of the child | Reference MCHC values, g/l |
1 day – 1 month | 316–375 |
2-5 months | 306-324 |
6-7 months | 307-324 |
8 months – 1 year | 297-324 |
2 years | 307-344 |
3-9 years | 3 36–344 |
10–14 years | 336–354 |
15-18 | 300-380 |
In adults (men and women), normal MCHC values are independent of age and range from 300-380 g/l.
The reasons for the lower and higher MCHC index are the same as for the previous indicator, MCH.
Mean erythrocyte volume (MCV)
Erythrocyte index MCV (mean cell volume) characterizes the size of red blood cells contained in the blood. The indicator is measured in femtoliters (fl).
A femtoliter is a unit of volume equal to one cubic micrometer (one millionth of a metre).
If the erythrocytes are too large in size, then it is difficult for them to pass through the small capillaries. If they are too small, they cannot carry enough oxygen. In both cases, the risk of hypoxia, i.e. oxygen starvation of tissues, increases significantly.
MCV norm for children under 18
Child’s age | MCV reference values, fl |
1 day – 1 month | |
1 month | 84-96 |
2-3 months | 74-86 |
4-7 months | |
8 months – 1 year | 72-84 |
2-9 years | 77-83 | 10-14 years old | 81-87 |
15- 17 years old | 80–100 |
In adults (men and women), normal MCV values do not depend on age and are 80-100 fl.
Reducing the size of red blood cells is called microcytosis.
Main causes of microcytosis
Iron deficiency anemia is a condition in which there is not enough iron in the body, which is necessary for the normal synthesis of hemoglobin.
Hereditary anemias are hereditary diseases in which the synthesis of red blood cells is impaired, and their life span is significantly less than that of normal red blood cells.
Hemoglobinopathy is a congenital pathology in which the structure of the hemoglobin protein is disturbed and it can no longer transport oxygen normally from the lungs to the tissues.
Main causes of macrocytosis
Pernicious anemia (megaloblastic, B12-deficient) is a violation of the formation of red blood cells in the bone marrow, provoked by vitamin B12 deficiency.
Folate deficiency anemia is a violation of the synthesis of red blood cells associated with a lack of folic acid.
This condition can be caused by liver diseases (hepatitis, cirrhosis), oncological diseases, long-term use of drugs, such as anticonvulsants, cytostatics, certain antibiotics, etc.
RBC heterogeneity index by volume (RDW)
The RDW (red cell distribution width) index of erythrocyte heterogeneity by volume shows how erythrocytes differ from each other in size. The indicator is measured as a percentage.
In children under the age of 6 months, the normal value of RDW is 14.9-18.7%. In children older than 6 months, adolescents and adults – 11.6–14.8%.
A decrease in the RDW index has no clinical significance. And an increase, as a rule, is observed at iron deficiency anemia – a pathological condition in which the synthesis of red blood cells and hemoglobin is impaired due to a lack of iron in the body.
Erythrocyte indices: indications for testing
The study of erythrocyte indices is included in the general blood test, which is prescribed in a planned manner: during the annual preventive examination, as well as when anemia is suspected.
The test is repeated for patients who are being treated for anemia.
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Diagnosis of causes of anemia
If anemia is detected by the deviation of erythrocyte indices from the norm, it is necessary to establish the cause of its development. To do this, the therapist can prescribe additional tests or refer the patient to another doctor, for example hematologist – a specialist in the treatment of diseases of the blood and blood-forming organs.
Iron deficiency anemia
If iron deficiency anemia is suspected, it is advisable to investigate the indicators of iron metabolism: ferritin, transferrin, total serum iron-binding capacity (TIBC), serum iron level and transferrin iron saturation coefficient.
Ferritin
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Transferrin saturation coefficient
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Anemia of chronic disease
In order to diagnose anemia of chronic disease, it is common not only to perform a complete blood count and serum iron test, but also to measure the amount of ferritin, transferrin, and reticulocytes.
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Transferrin
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Serum iron
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Tests will help determine the severity of the general condition with anemia.
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Urinalysis
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Folate deficiency anemia
To diagnose folate deficiency anemia, in addition to a complete blood count with reticulocytes, a blood test for folate is prescribed to establish the fact of folate deficiency.
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B12 deficiency anemia
To make a diagnosis of “B12-deficiency anemia”, together with a general blood test, an analysis for vitamin B12 is prescribed, which allows to detect its deficiency in the blood serum.
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Anemia
Anemia is a pathological condition caused by a decrease in the number of red blood cells and / or a decrease in the concentration of hemoglobin in the red blood cells themselves.
Erythrocytes (red blood cells, red blood cells, RBC) – the most numerous population of blood cells. Red blood cells contain hemoglobin (Hb), which in the lungs attaches oxygen molecules and delivers them to tissues. In the opposite direction – from the tissues to the lungs – hemoglobin carries carbon dioxide molecules. In other words, hemoglobin provides the process of respiration. The erythrocyte has the shape of a disc, concave on both sides. Such a device significantly increases the surface area on which gas exchange occurs. Erythrocytes are small in size, which allows them to pass through the narrowest blood vessels (capillaries, arterioles, venules). One erythrocyte lives on average up to 120 days.
Low hemoglobin is one of the criteria that you need to pay attention to not only when diagnosing anemia itself, but also to assess their severity. A decrease in the amount of hemoglobin in erythrocytes occurs when there is insufficient supply of iron during the maturation of cells in the red bone marrow.
There are several classifications of anemia depending on the causes, on the mechanisms of development of anemia and on the severity of changes in blood parameters. They are necessary for the doctor to understand what the current condition is connected with. This helps to choose the best tactics for further examination, to conduct a differential diagnosis and prescribe an effective treatment.
Anemia is diagnosed and treated by general practitioners, general practitioners, and family physicians. In the case of a severe or malignant course of the disease, the intervention of a hematologist may be required, as well as a more detailed and specialized examination.
There are many reasons for the development of anemia. Anemia is often a complication of an underlying chronic disease.
Iron deficiency anemia develops either when there is insufficient intake of iron in the body, or when the body has an increased need for iron.
Both factors are often present to varying degrees.
The causes of insufficient iron intake can be diseases of the gastrointestinal tract, in which the processes of digestion and absorption of food are disturbed. The use of foods containing low amounts of iron or iron in a form that is difficult to digest (only a plant-based diet). Some foods (alcohol, milk, coffee) or drugs (antibacterials, antacids) interfere with the absorption of iron from food.
The body’s need for iron (“iron consumption”) increases significantly in children during periods of active growth, in women during pregnancy and lactation.
Anemia often complicates the course of diseases accompanied by prolonged blood loss (especially against the background of malabsorption of food):
- peptic ulcer of the stomach and duodenum;
- inflammatory bowel disease;
- uterine fibroids, endometriosis;
- malignant neoplasms;
- bleeding disorders;
- helminthic infestations.
The human body cannot synthesize iron! We get iron only from food.
What matters is not only the amount of iron in foods, but also its availability for absorption by the body. Animal products (beef, lamb, liver) contain heme iron. It is absorbed by the body most effectively. Plant foods (vegetables, fruits, cereals) contain non-heme iron. The human body does not absorb non-heme iron well.
The main reason for the development of iron deficiency anemia, according to experts from the World Health Organization (WHO), is an unhealthy (unbalanced) diet. If you do not eat meat products, then you must remember that iron is absorbed much worse from vegetable products. Plan your diet wisely to prevent iron deficiency.
Improve iron absorption:
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Another type of anemia is a disease caused by vitamin B12 deficiency.
B12 deficiency anemia develops due to a lack of cyanocobalamin.
Deficiency can be caused by:
- Insufficient intake of vitamin B12 from food (strict vegetarianism), since cyanocobalamin is found only in meat products, milk, eggs, fish and seafood.
- Violation of the secretion of the stomach “intrinsic factor Castle”;
- Malabsorption of vitamin B12 in the small intestine;
- Competitive consumption of vitamin B12;
- Increased consumption of vitamin B12;
- Decreased vitamin B12 stores;
- Violation of vitamin B12 transport;
- Absence or antibodies to transcobalamin.
Anemia symptoms:
- Paleness of the skin, cracks, “bites” in the corners of the mouth
- Brittle nails, thinning and striation of nails
- Hair loss, brittleness, structure disorder
- Increased fatigue, reduced performance
- Palpitations, dizziness, shortness of breath accompany even slight physical activity
Iron deficiency anemia is characteristic
- Taste perversion: addiction to inedible foods – raw meat, frozen semi-finished products; desire to eat inedible substances – chalk, earth, ice, clay.
- Perversion of smell: addiction to unpleasant odors, e.g. gasoline, acetone, paint, etc.
What tests can be done for those who suspect anemia? The most accessible and simplest is a complete blood count
- Complete blood count (without leukocyte formula and without ESR), venous blood.
If the analysis reveals changes in the number of erythrocytes, hemoglobin, hematocrit, erythrocyte indices (MCV, MCH, MCHC, RDW), then it is necessary to consult a doctor to prescribe further examination and treatment.
For reference:
Hematocrit (Ht) is an indicator that characterizes the number of cells per unit volume of whole blood. The value of hematocrit depends on the number and shape of red blood cells. A decrease in hematocrit also characterizes a decrease in the content of red blood cells in the blood.
MCV ( mean corpuscular volume) In the presence of long-term iron deficiency, maturing red blood cells become small, microcytes appear in the blood, and the MCV decreases.
If there is a deficiency of vitamins B12 and B9maturing cells become large, macrocytes appear in the blood, and this indicator increases. Both conditions negatively affect the main function of red blood cells – the transport of oxygen and carbon dioxide. In the case of macrocytic anemia, their ability to pass through small-diameter vessels is reduced, and their life span is reduced.
MCH ( mean corpuscular hemoglobin) – the average content of hemoglobin in the erythrocyte, reflects the same processes as the previous MCV indicator. With a prolonged iron deficiency, erythrocytes enter the bloodstream, which, in the process of growth and maturation, lacked this microelement, and they become not only small, but also insufficiently saturated with hemoglobin. MCH begins to decrease, a state of hypochromia develops. Erythrocytes become pale, their functioning worsens. Previously, to assess the state of hemoglobin saturation of erythrocytes, a color indicator was calculated, MCH is its modern, more accurate analogue and allows differentiating anemia into normochromic, hypochromic and hyperchromic.
In case of deficiency of vitamins B12 and B9the reverse situation occurs. Ripening erythrocytes are supersaturated with hemoglobin, this indicator begins to increase, a state of hyperchromia develops. Together, these two indicators will help the doctor only on the basis of the results of a general blood test to suggest the nature of anemia.
MCHC mean corpuscular hemoglobin concentration) Reflects the concentration of hemoglobin in the erythrocyte. It decreases with iron deficiency hypochromic anemia and diseases accompanied by impaired hemoglobin synthesis at any stage. Increases with hyperchromic B12 and B9deficiency anemia.
red blood cell distribution width This indicator depends on the average volume of the erythrocyte, therefore, with an increase or decrease in MCV, its increase is observed, which indicates in favor of the fact that there are cells of different volumes in the blood, for example, macrocytes and normocytes, or microcytes and normocytes.
For a comprehensive examination, when the cause of anemia is unknown, you can use the program Biochemical diagnosis of anemia, which includes parameters reflecting the metabolism and stock of iron in the body, the supply of vitamin B9(folic acid) and vitamin B12 (cyanocobalamin), as well as erythropoietin, a hormone that triggers erythropoiesis (the maturation of new red blood cells).
- Transferrin – carries out extracellular transport of iron to all cells of the human body.
- Soluble transferrin receptors (sTfR). One of the important diagnostic criteria, on the basis of which a true iron deficiency can be established. The entry of iron into the cell occurs after the interaction of the “iron-transferrin” complex with specific proteins – receptors on the cell membrane. The concentration of transferrin receptors depends on two factors – the amount of iron deposited in ferritin and the proliferative activity of the cell. The amount of soluble transferrin receptors is a sensitive indicator of both erythropoiesis activity and iron deficiency.
