How is anemia diagnosed. What are the different types of anemia. What treatments are available for various forms of anemia. How can one prepare for a medical appointment regarding anemia.

Diagnosing Anemia: A Comprehensive Approach

Anemia, a condition characterized by a lack of healthy red blood cells to carry adequate oxygen to body tissues, requires a thorough diagnostic process. Healthcare providers employ a combination of methods to accurately identify and classify anemia.

The Role of Medical History and Physical Examination

The diagnostic journey begins with a detailed medical and family history. Physicians inquire about symptoms, lifestyle factors, and any genetic predisposition to blood disorders. A physical examination follows, allowing doctors to observe physical signs of anemia, such as pale skin or rapid heartbeat.

Essential Blood Tests for Anemia Diagnosis

The cornerstone of anemia diagnosis is the Complete Blood Count (CBC). This comprehensive test provides crucial information about various blood components. For anemia, doctors focus on two key metrics:

• Hematocrit: The percentage of blood volume occupied by red blood cells
• Hemoglobin: The protein in red blood cells responsible for oxygen transport

Normal hematocrit ranges typically fall between 40% and 50% for men and 35% and 43% for women. Hemoglobin levels generally range from 13.6 to 16.9 grams per deciliter for men and 11.9 to 14.8 grams per deciliter for women. However, these values can vary based on factors such as age, pregnancy, physical activity levels, smoking habits, and altitude.

Microscopic Examination of Red Blood Cells

Beyond quantitative measures, doctors also assess the qualitative aspects of red blood cells. A microscopic examination reveals the size, shape, and color of these cells, providing valuable insights into the type and possible cause of anemia.

Advanced Diagnostic Techniques

In some cases, standard tests may not provide sufficient information. Additional diagnostic procedures may include:

1. Bone marrow biopsy: To evaluate the production of blood cells at their source
2. Genetic testing: To identify inherited forms of anemia
3. Iron studies: To assess iron levels and storage in the body
4. Vitamin B12 and folate tests: To check for deficiencies linked to certain types of anemia

Understanding the Various Types of Anemia

Anemia is not a single condition but a group of disorders with diverse causes and manifestations. Recognizing the different types is crucial for appropriate treatment and management.

Iron Deficiency Anemia: The Most Common Form

Iron deficiency anemia occurs when the body lacks sufficient iron to produce adequate hemoglobin. This type often results from blood loss, poor dietary iron intake, or impaired iron absorption.

Vitamin Deficiency Anemias: Beyond Iron

Deficiencies in vitamins such as B12 and folate can lead to anemia. These nutrients are essential for the production of healthy red blood cells.

Anemia of Chronic Disease: A Secondary Condition

Certain long-term medical conditions, such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, and other chronic inflammatory diseases, can interfere with red blood cell production, leading to anemia.

Aplastic Anemia: A Rare but Serious Condition

In aplastic anemia, the body stops producing enough new blood cells. This can result from various factors, including certain medications, radiation therapy, or autoimmune disorders.

Hemolytic Anemias: When Red Blood Cells Break Down

These types of anemia occur when red blood cells are destroyed faster than they can be replaced. Causes can be inherited (such as sickle cell anemia) or acquired (due to certain medications or infections).

Tailored Treatment Approaches for Different Anemia Types

The treatment of anemia varies significantly depending on its underlying cause. Healthcare providers develop personalized treatment plans to address the specific type and severity of anemia.

Addressing Iron Deficiency Anemia

Treatment for iron deficiency anemia typically involves:

• Oral iron supplements
• Dietary modifications to increase iron intake
• Intravenous iron therapy in severe cases or when oral supplements are ineffective
• Identifying and treating the source of blood loss, if applicable

Correcting Vitamin Deficiency Anemias

For anemias caused by vitamin deficiencies, treatment options include:

• Oral supplements of folic acid, vitamin B12, or vitamin C
• Dietary changes to increase intake of these vitamins
• Vitamin B12 injections for those with absorption issues

Managing Anemia of Chronic Disease

Treatment focuses on addressing the underlying condition. In severe cases, additional interventions may include:

• Blood transfusions to quickly increase red blood cell count
• Erythropoietin injections to stimulate red blood cell production

Treating Aplastic Anemia

Management of aplastic anemia may involve:

• Blood transfusions to maintain adequate red blood cell levels
• Immunosuppressive therapy to prevent the immune system from attacking bone marrow
• Bone marrow transplantation in severe cases

Addressing Hemolytic Anemias

Treatment approaches for hemolytic anemias include:

• Avoiding trigger medications
• Managing underlying infections
• Immunosuppressive therapy
• Specific treatments for inherited forms, such as sickle cell anemia or thalassemia

Innovative Therapies and Research in Anemia Treatment

The field of anemia treatment is constantly evolving, with new therapies and approaches being developed and tested. Understanding these advancements can provide hope and options for those affected by various forms of anemia.

Gene Therapy for Inherited Anemias

Researchers are exploring gene therapy as a potential cure for inherited forms of anemia, such as sickle cell disease and beta-thalassemia. These approaches aim to correct the genetic mutations responsible for these conditions.

Novel Iron Formulations

New iron formulations are being developed to improve absorption and reduce side effects associated with traditional iron supplements. These include iron-based nanoparticles and novel oral iron compounds.

Targeted Therapies for Anemia of Chronic Disease

Researchers are investigating drugs that target specific pathways involved in the development of anemia in chronic diseases. These include hepcidin antagonists and agents that modulate iron metabolism.

Advances in Bone Marrow Transplantation

Improvements in bone marrow transplantation techniques, including the use of cord blood and haploidentical donors, are expanding treatment options for severe aplastic anemia and other bone marrow disorders.

Lifestyle Modifications and Supportive Care in Anemia Management

While medical treatments are often necessary, lifestyle modifications and supportive care play a crucial role in managing anemia and improving quality of life for affected individuals.

Dietary Considerations

A balanced diet rich in iron, vitamins, and other essential nutrients can support red blood cell production. Key dietary recommendations include:

• Consuming iron-rich foods such as lean meats, leafy green vegetables, and fortified cereals
• Incorporating vitamin C-rich foods to enhance iron absorption
• Ensuring adequate intake of vitamin B12 and folate through diet or supplements

Exercise and Physical Activity

While anemia can cause fatigue, appropriate physical activity can help improve energy levels and overall well-being. It’s important to:

• Engage in moderate exercise as tolerated
• Avoid overexertion and listen to your body’s signals
• Consult with healthcare providers about safe exercise routines

Stress Management and Mental Health Support

Living with anemia can be challenging, both physically and emotionally. Implementing stress reduction techniques and seeking mental health support when needed can be beneficial. Consider:

• Practicing relaxation techniques such as meditation or yoga
• Joining support groups for individuals with anemia or related conditions
• Seeking counseling or therapy to address any emotional challenges

Navigating Healthcare: Preparing for Your Anemia-Related Appointment

Effective communication with healthcare providers is crucial for optimal anemia management. Preparing for medical appointments can help ensure that all concerns are addressed and that you receive the most appropriate care.

Documenting Symptoms and Concerns

Before your appointment, take time to document:

• A detailed list of symptoms, including onset and duration
• Any changes in energy levels, physical capabilities, or daily routines
• Specific questions or concerns you want to address during the appointment

Gathering Relevant Information

Compile important information to share with your healthcare provider, including:

• A complete list of current medications, supplements, and dosages
• Recent life changes or stressors that may impact your health
• Family history of anemia or related blood disorders
• Any recent medical procedures or diagnoses

Understanding Your Treatment Plan

During your appointment, ensure you fully understand the proposed treatment plan by:

• Asking for clarification on any medical terms or concepts you don’t understand
• Discussing potential side effects of recommended treatments
• Inquiring about alternative treatment options, if applicable
• Requesting written information or resources for further reading

The Future of Anemia Care: Emerging Technologies and Personalized Medicine

As medical science advances, the future of anemia care looks promising, with new technologies and approaches on the horizon that could revolutionize diagnosis, treatment, and management of this condition.

Artificial Intelligence in Anemia Diagnosis

Researchers are exploring the use of artificial intelligence (AI) algorithms to analyze blood test results and medical imaging, potentially improving the accuracy and speed of anemia diagnosis. These AI tools could help identify subtle patterns that might be missed by human observers, leading to earlier detection and more precise classification of anemia types.

Personalized Medicine Approaches

The field of personalized medicine holds great promise for anemia care. By analyzing an individual’s genetic profile, healthcare providers may be able to:

• Predict an individual’s risk of developing certain types of anemia
• Tailor treatment plans based on genetic markers of drug response
• Identify potential complications before they occur

Wearable Technology for Anemia Monitoring

Advances in wearable technology may soon allow for continuous, non-invasive monitoring of hemoglobin levels. This could provide real-time data to both patients and healthcare providers, enabling more responsive and personalized care.

Regenerative Medicine and Stem Cell Therapy

Ongoing research in regenerative medicine and stem cell therapy offers hope for new treatments for severe forms of anemia. These approaches aim to restore or enhance the body’s ability to produce healthy red blood cells, potentially offering long-term solutions for conditions like aplastic anemia.

As we continue to unravel the complexities of anemia, these advancements in diagnosis, treatment, and management offer hope for improved outcomes and quality of life for those affected by this common but often challenging condition. By staying informed about the latest developments and working closely with healthcare providers, individuals with anemia can look forward to a future with more effective, personalized, and less invasive care options.

Anemia – Diagnosis and treatment

Diagnosis

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

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

  Normal adult hematocrit values vary among medical practices but are generally between 40% and 50% for men and 35% and 43% for women. Normal adult hemoglobin values are generally 13.6 to 16.9 grams per deciliter for men and 11.9 to 14.8 grams per deciliter for women.

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

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

Additional diagnostic tests

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

Treatment

Anemia treatment depends on the cause.

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

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

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

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

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

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Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Preparing for your appointment

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

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

What you can do

Before your appointment, make a list of:

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

For anemia, basic questions to ask your doctor include:

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

What to expect from your doctor

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

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

Anemia care at Mayo Clinic

Sept. 08, 2021

Show references

1. Iron deficiency anemia. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia. Accessed May 29, 2021.
2. Anemia testing. Lab Tests Online. https://labtestsonline.org/anemia-testing. Accessed May 29, 2021.
3. Means RT, et al. Diagnostic approach to anemia in adults. https://www.uptodate.com/contents/search. Accessed May 29, 2021.
4. Anemia. American Society of Hematology. https://www.hematology.org/education/patients/anemia. Accessed May 29, 2021.
5. AskMayoExpert. Iron deficiency anemia. Mayo Clinic; 2021.
6. Morrow ES Jr. Allscripts EPSi. Mayo Clinic. April 19, 2021.
7. Your guide to anemia. National Heart, Lung, and Blood Institute. https://search.usa.gov/search?utf8=%E2%9C%93&affiliate=nhlbi_nhlbi_prod&query=your%20guide%20to%20anemia&commit=Search. Accessed May 29, 2021.
8. Nutritional anaemias: Tools for effective prevention and control. World Health Organization. https://www.who.int/publications/i/item/9789241513067?sequence=1&isAllowed=y. Accessed May 29, 2021.

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Associated Procedures

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Iron deficiency anemia – Diagnosis and treatment

Diagnosis

To diagnose iron deficiency anemia, your doctor may run tests to look for:

• Red blood cell size and color. With iron deficiency anemia, red blood cells are smaller and paler in color than normal.
• Hematocrit. This is the percentage of your blood volume made up by red blood cells. Normal levels are generally between 35. 5 and 44.9 percent for adult women and 38.3 to 48.6 percent for adult men. These values may change depending on your age.
• Hemoglobin. Lower than normal hemoglobin levels indicate anemia. The normal hemoglobin range is generally defined as 13.2 to 16.6 grams (g) of hemoglobin per deciliter (dL) of blood for men and 11.6 to 15. g/dL for women.
• Ferritin. This protein helps store iron in your body, and a low level of ferritin usually indicates a low level of stored iron.

Additional diagnostic tests

If your bloodwork indicates iron deficiency anemia, your doctor may order additional tests to identify an underlying cause, such as:

• Endoscopy. Doctors often check for bleeding from a hiatal hernia, an ulcer or the stomach with the aid of endoscopy. In this procedure, a thin, lighted tube equipped with a video camera is passed down your throat to your stomach. This allows your doctor to view the tube that runs from your mouth to your stomach (esophagus) and your stomach to look for sources of bleeding.
• Colonoscopy. To rule out lower intestinal sources of bleeding, your doctor may recommend a procedure called a colonoscopy. A thin, flexible tube equipped with a video camera is inserted into the rectum and guided to your colon. You’re usually sedated during this test. A colonoscopy allows your doctor to view inside some or all of your colon and rectum to look for internal bleeding.
• Ultrasound. Women may also have a pelvic ultrasound to look for the cause of excess menstrual bleeding, such as uterine fibroids.

Your doctor may order these or other tests after a trial period of treatment with iron supplementation.

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Treatment

To treat iron deficiency anemia, your doctor may recommend that you take iron supplements. Your doctor will also treat the underlying cause of your iron deficiency, if necessary.

Iron supplements

Your doctor may recommend over-the-counter iron tablets to replenish the iron stores in your body. Your doctor will let you know the correct dose for you. Iron is also available in liquid form for infants and children. To improve the chances that your body will absorb the iron in the tablets, you may be instructed to:

• Take iron tablets on an empty stomach. If possible, take your iron tablets when your stomach is empty. However, because iron tablets can upset your stomach, you may need to take your iron tablets with meals.
• Don’t take iron with antacids. Medications that immediately relieve heartburn symptoms can interfere with the absorption of iron. Take iron two hours before or four hours after you take antacids.
• Take iron tablets with vitamin C. Vitamin C improves the absorption of iron. Your doctor might recommend taking your iron tablets with a glass of orange juice or with a vitamin C supplement.

Iron supplements can cause constipation, so your doctor may also recommend a stool softener. Iron may turn your stools black, which is a harmless side effect.

Iron deficiency can’t be corrected overnight. You may need to take iron supplements for several months or longer to replenish your iron reserves. Generally, you’ll start to feel better after a week or so of treatment. Ask your doctor when to have your blood rechecked to measure your iron levels. To be sure that your iron reserves are replenished, you may need to take iron supplements for a year or more.

Treating underlying causes of iron deficiency

If iron supplements don’t increase your blood-iron levels, it’s likely the anemia is due to a source of bleeding or an iron-absorption problem that your doctor will need to investigate and treat. Depending on the cause, iron deficiency anemia treatment may involve:

• Medications, such as oral contraceptives to lighten heavy menstrual flow
• Antibiotics and other medications to treat peptic ulcers
• Surgery to remove a bleeding polyp, a tumor or a fibroid

If iron deficiency anemia is severe, you may need iron given intravenously or you may need blood transfusions to help replace iron and hemoglobin quickly.

Preparing for your appointment

Make an appointment with your doctor if you have any signs and symptoms that worry you. If you’re diagnosed with iron deficiency anemia, you may need tests to look for a source of blood loss, including tests to examine your gastrointestinal tract.

Here’s some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

• Write down any symptoms you’re experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including any major stresses or recent life changes.
• Make a list of all medications, vitamins or supplements you’re taking.
• Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. For iron deficiency anemia, some basic questions to ask your doctor include:

• What’s the most likely cause of my symptoms?
• Are there other possible causes for my symptoms?
• Is my condition likely temporary or long lasting?
• What treatment do you recommend?
• Are there any alternatives to the primary approach that you’re suggesting?
• I have another health condition. How can I best manage these conditions together?
• Are there any dietary restrictions that I need to follow?
• Are there any brochures or other printed material that I can take with me? What websites do you recommend?

In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to spend more time on. Your doctor may ask:

• When did you begin experiencing symptoms?
• How severe are your symptoms?
• Does anything seem to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
• Have you noticed unusual bleeding, such as heavy periods, bleeding from hemorrhoids or nosebleeds?
• Are you a vegetarian?
• Have you recently donated blood more than once?

Oct. 18, 2019

Craving and chewing ice: A sign of anemia?

Is constantly craving and chewing ice a sign of anemia?

Answer From Rajiv K. Pruthi, M.B.B.S.

Possibly. Doctors use the term “pica” to describe craving and chewing substances that have no nutritional value — such as ice, clay, soil or paper. Craving and chewing ice (pagophagia) is often associated with iron deficiency, with or without anemia, although the reason is unclear. At least one study indicates that ice chewing might increase alertness in people with iron deficiency anemia.

Less commonly, other nutritional problems may cause you to crave and chew ice. And in some individuals, pica is a sign of emotional problems, such as stress, obsessive-compulsive disorder or a developmental disorder.

A thorough medical evaluation can help determine if pica is due to an underlying medical condition. If the cause of pica is an emotional or developmental issue, cognitive behavioral therapy may be helpful.

With

Rajiv K. Pruthi, M.B.B.S.

• I have heavy periods. Should I take an iron pill?

Oct. 21, 2020

Show references

1. Kliegman RM, et al. Behavioral and psychiatric disorders. In: Nelson Textbook of Pediatrics. 20th ed. Philadelphia, Pa.: Elsevier; 2016. https://www.clinicalkey.com. Accessed Feb. 23, 2018.
2. Hunt MG, et al. Pagophagia improves neuropsychological processing speed in iron-deficiency anemia. Medical Hypotheses. 2014;83:473.
3. Powers JM, et al. Iron deficiency in infants and children <12 years: Screening, prevention, clinical manifestations, and diagnosis. https://www.uptodate.com/contents/search. Accessed Feb. 23, 2018.

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Sickle Cell Disease (Sickle Cell Anemia)

What Is Sickle Cell Disease?

Sickle cell disease (SCD) is the most common inherited blood disorder. That means it’s passed down through families. You’re born with SCD. It’s not something you catch or develop later in life.

Sickle cell disease is also known as:

• HbS disease
• Hemoglobin S Disease
• SCD
• Sickle cell disorders
• Sickling disorder due to hemoglobin S

The disease gets its name because when you have SCD, your red blood cells look like a sickle, which is a C-shaped farm tool.

Red blood cells contain a molecule called hemoglobin, which carries oxygen throughout the body. In a healthy person, hemoglobin is smooth, round, and flexible. That allows red blood cells to glide easily through your bloodstream. But if you have SCD, the hemoglobin’s shape is abnormal. That causes red blood cells to become rigid and curved. The odd-shaped cells block blood flow. It’s dangerous and can cause extreme pain, anemia, and other symptoms.

About 100,000 people in the United States have sickle cell disease. Most of them are African American.

Sickle Cell Disease Symptoms

Babies born with SCD usually show symptoms at around 5 months of age. Symptoms vary from person to person and change over time. Symptoms can include:

• Anemia. Sickle cells are more fragile than normal red blood cells and tend to die in 10-20 days. Normal cells live for about 120 days. This causes a shortage of red blood cells, known as anemia. There aren’t enough red blood cells to carry oxygen around the body, so it brings on fatigue.
• Pain crises. These bouts of pain are a major symptom of sickle cell disease. Sickle-shaped red blood cells block blood flow through tiny blood vessels, causing pain in your chest, abdomen, joints, and bones. The pain can vary in intensity and frequency, and sometimes you might need to go to the hospital.
• Swelling of hands and feet. When sickle-shaped red blood cells block blood flow to the hands and feet, this causes swelling.
• Frequent infections. Sickle cells sometimes damage your tissues, leading to ulcers. If they damage your spleen, you could get infections. Doctors sometimes give SCD patients vaccinations and antibiotics to prevent dangerous infections.
• Yellowing of skin and eyes. This can result from damaged sickle RBCs.
• Vision problems. Sickle cells can get stuck in the blood vessels that supply your eyes, causing damage to your retina as well as vision problems.
• Developmental delays. Children with SCD may grow at a slower rate than other children. Teenagers may reach puberty later than their friends.

Sickle Cell Disease Causes and Risk Factors

Sickle cell disease is caused by a problem in the hemoglobin-beta gene found on chromosome 11. The defect forms abnormal hemoglobin.

Both your parents need to pass the abnormal hemoglobin gene on to you in order for you to develop the disease. If both your parents carry the defective gene, you have a 1 in 4 chance of inheriting the disease and becoming sick with it.

If a child is born with one defective hemoglobin-beta gene, they may become a carrier of the disease. Carriers usually don’t develop SCD symptoms. But they can pass the disease on to their children if their partner also carries the sickle cell trait.

People of some ethnicities are more at risk for sickle cell disease than others.

In the United States, SCD affects African American people more than other races. One in 13 African American babies are born with sickle cell trait, and 1 in 365 Black children are born with sickle cell disease.

SCD also affects people from Hispanic, southern European, Middle Eastern, and Asian Indian backgrounds.

Types of Sickle Cell Disease

There are several forms of sickle cell disease. The type you or your child inherits depends on many things, including the specific type of abnormal hemoglobin you have.

Hemoglobin SS, also called sickle cell anemia, is usually the most severe type of this disorder.

Other common forms include:

• Hemoglobin SC (usually mild)
• Hemoglobin sickle beta thalassemia

Rare types are:

• Hemoglobin SD
• Hemoglobin SE
• Hemoglobin SO

Sickle Cell Disease Diagnosis

A blood test can check for the defective form of hemoglobin found in people with sickle cell disease. This test is available for newborns, older children, and adults. In the U.S., this test is a routine part of screening for newborn babies.

If you or your child has sickle cell disease, your doctor might suggest doing some extra tests.  The doctor may recommend a special ultrasound to find out your risk for stroke.  They may also refer you and your child to a genetic counselor (since you both carry the gene).

If you or your partner has sickle cell disease or sickle cell trait, a check of amniotic fluid can let you know if your unborn baby may have the disease. Talk to your doctor to find out more.

Sickle Cell Disease Treatments

Treatment for people with sickle cell disease usually involves:

• Avoiding pain crises 
• Relieving symptoms of the disease
• Preventing complications

Treatments include:

• Medications 
  • Daily hydroxyurea (Droxia, Hydrea, Siklos) can lower the number of times you have pain crises and might curb other complications like infections and anemia. This medication shouldn’t be taken if you’re pregnant.
  • Pain relievers can help when you are having a pain crisis.
  • Other drugs can reduce the frequency of pain crises, such as crizanlizumab (Adakveo) and L-glutamine oral powder (Endari). The latter is given by injection.
  • Voxelotor (Oxbryta) can help with anemia. 
• Blood transfusions
• Stem cell transplants might cure the disease for some children and teenagers.

Your Stem Cell Questions Answered

There’s a lot of fiction surrounding stem-cell facts. To separate one from the other, WebMD has consulted experts including Mahendra Rao, MD, PhD, director of the Center for Regenerative Medicine at the National Institutes of Health; Todd McDevitt, PhD, director of the Stem Cell Engineering Center at Georgia Tech; Mary Laughlin, MD, past president of the International Society for Cellular Therapy; and Joshua Hare, MD, director of the Interdisciplinary Stem Cell Institute at the University of Miami.

Here are the questions they answered:

• What are stem cells?
• What are embryonic stem cells?
• Why not just study adult stem cells?
• Why all the excitement about stem cells?
• Are there current stem cell treatments?
• Are stem cells safe?

Q: What are stem cells?

A: The term “stem cells” includes many different kinds of cells.

What they have in common is that they have the ability to make other types of cells. No other cell in the body can do that.

Some stem cells can renew themselves and become virtually any cell in the body. Those are called pluripotent stem cells. They include embryonic stem cells.

Other stem cells don’t have as much potential for self-renewal and can’t make as many types of cells.

The most basic kind of stem cells are the cells that make up an embryo soon after an egg is fertilized. These stem cells divide over and over, eventually making almost all the different cells in the body.

Adult stem cells, in contrast, are “fully differentiated.” That means they are what they are and do what they do. They can’t choose another career.

In many organs, however, adult stem cells linger throughout life. They are part of the body’s internal repair system. Researchers are still working to discover what adult stem cells from various parts of the body can and can’t do. Normally, these relatively rare cells act only on the organ or tissue type in which they are found.

Recently, researchers have learned to reprogram adult cells to become pluripotent cells. These cells, called induced pluripotent cells or iPSCs, have many of the same properties as embryonic stem cells. It’s not yet clear whether these cells might carry subtle DNA damage that limits their usefulness.

Q: What are embryonic stem cells?

A: Early in development, a fertilized egg becomes an embryo. The embryo is made up of stem cells that divide over and over again, until these stem cells develop into the cells and tissues that become a fetus.

During in-vitro fertilization, eggs taken from a woman’s body are fertilized with sperm cells. If not implanted in a woman’s womb, these embryos are discarded.

Researchers have learned to take embryonic stem cells from unused in-vitro fertilizations and, in laboratory culture, to get them to make more embryonic stem cells. Embryonic stem cells are not taken from fertilized eggs or embryos that have been in a woman’s womb.

While embryonic stem cells can become any kind of cell in the body, it’s unlikely they would be used directly as treatments. Because they have the ability to divide over and over again, they can become rapidly growing tumors. And because they are in such an early stage of development, they take a long time to become functional adult cells.

However, researchers are learning to coax embryonic stem cells to become more mature stem cells. One clinical trial, for example, matures embryonic stem cells into nerve stem cells. These nerve stem cells are being explored as a treatment for Lou Gehrig’s disease.

Q: Why not just study adult stem cells?

A: Adult stem cells have some advantages. When they come from your own body, your immune system will probably not try to reject them. And adult stem cells aren’t controversial.

But there are several main disadvantages to using adult stem cells:

• Adult stem cells aren’t able to form all types of cells, so their use may be limited.
• They are relatively rare among the body’s billions of cells, so they’re hard to find.
• They take a long time to grow.
• Adult stem cells donated by one person may be rejected by another person’s immune system.
• Adult stem cells can’t reveal to researchers the secrets of early human development.

Q: Why all the excitement about stem cells?

A: A relatively small number of stem cells taken from the body can be grown in the laboratory until they have created millions and millions of new stem cells. This makes it possible for researchers to explore cell-based therapies.

Cell-based therapies, collectively known as regenerative medicine, hold the promise of repairing or even replacing damaged or diseased organs.

Depending on which tissues they come from, stem cells have very different properties. Those from umbilical cord blood are quite different from those from fat, for example.

Q: Are there current stem cell treatments?

A: Yes. Stem cells from bone marrow have long been used to treat certain types of leukemia.

The bone marrow is a rich source of blood stem cells. These cells replace the white blood cells crucial to the immune system.

When used for leukemia, the goal is to to wipe out all of a person’s white blood cells with radiation and/or chemotherapy — and then to replace them with a bone marrow transplant from a matched donor. Stem cells from the donor marrow replace the diseased blood cells with healthy blood cells.

A stem cell product designed to avoid the need for a matched donor recently received limited approval in Canada. The product, Prochymal, appears to rescue bone marrow transplant patients who are rejecting their transplant.

In the U.S., the FDA has approved a product called Hemacord, which contains blood stem cells derived from cord blood. The product is approved for patients with diseases that affect their ability to make new blood cells, such as certain blood cancers and immune disorders.

Q: Are stem cell treatments safe?

A: That remains to be seen. Potential dangers include:

• As stem cells renew themselves and can become different kinds of cells, they might become cancer cells and form tumors.
• Stem cells grown in the laboratory, or adult cells reprogrammed to be stem cells, might have genetic damage.

There is also risk in some of the procedures used to get stem cells out of the body (such as from liposuction or spinal tap) or to deliver stem cells to the body (such as implanting them in the heart, brain, spinal cord, or other organs). That’s not so much about the stem cells, but because of the procedures themselves.

Researchers are studying all of that. Without carefully controlled clinical trials, there’s no way to know what might happen in the long term, or even in the short term. That’s why the FDA discourages the use of stem cells except in clinical trials or approved therapies.

If you are thinking about pursuing stem cell therapy, talk to your doctor first. In the U.S. and abroad, many clinics offer unproven stem cell treatments that have never been tested for safety or effectiveness.

Anemia – Hematology.org

Anemia is the most common blood disorder, and according to the National Heart, Lung, and Blood Institute, it affects more than 3 million Americans. 

The Role of Red Blood Cells in Anemia

Red blood cells carry hemoglobin, an iron-rich protein that attaches to oxygen in the lungs and carries it to tissues throughout the body. Anemia occurs when you do not have enough red blood cells or when your red blood cells do not function properly. It is diagnosed when a blood test shows a hemoglobin value of less than 13.5 gm/dl in a man or less than 12.0 gm/dl in a woman. Normal values for children vary with age.

When you have anemia, your body lacks oxygen, so you may experience one or more of the following symptoms:

• Weakness
• Shortness of breath
• Dizziness
• Fast or irregular heartbeat
• Pounding or “whooshing” in your ears
• Headache
• Cold hands or feet
• Pale or yellow skin
• Chest pain

Am I at Risk for Anemia?

Many people are at risk for anemia because of poor diet, intestinal disorders, chronic diseases, infections, and other conditions. Women who are menstruating or pregnant and people with chronic medical conditions are most at risk for this disease. The risk of anemia increases as people grow older.

If you have any of the following chronic conditions, you might be at greater risk for developing anemia:

• Rheumatoid arthritis or other autoimmune disease
• Kidney disease
• Cancer
• Liver disease
• Thyroid disease
• Inflammatory bowel disease (Crohn disease or ulcerative colitis)

The signs and symptoms of anemia can easily be overlooked. In fact, many people do not even realize that they have anemia until it is identified in a blood test.

Common Types of Anemia

Iron-deficiency anemia is the most common type of anemia. It happens when you do not have enough iron in your body. Iron deficiency is usually due to blood loss but may occasionally be due to poor absorption of iron. Pregnancy and childbirth consume a great deal of iron and thus can result in pregnancy-related anemia. People who have had gastric bypass surgery for weight loss or other reasons may also be iron deficient due to poor absorption.

Vitamin-deficiency anemia may result from low levels of vitamin B12 or folate (folic acid), usually due to poor dietary intake. Pernicious anemia is a condition in which vitamin B12 cannot be absorbed in the gastrointestinal tract.

Anemia and Pregnancy – Learn about the risk factors and symptoms of anemia during pregnancy.

Aplastic anemia  is a rare bone marrow failure disorder in which the bone marrow stops making enough blood cells (red blood cells, white blood cells, and platelets). This occurs as a result of destruction or deficiency of blood-forming stem cells in your bone marrow, in particular when the body’s own immune system attacks the stem cells. However, the few blood cells the marrow does make are normal. Viral infections, ionizing radiation, and exposure to toxic chemicals or drugs can also result in aplastic anemia.

Hemolytic anemia   occurs when red blood cells are broken up in the bloodstream or in the spleen. Hemolytic anemia may be due to mechanical causes (leaky heart valves or aneurysms), infections, autoimmune disorders, or congenital abnormalities in the red blood cell. Inherited abnormalities may affect the hemoglobin or the red blood cell structure or function. Examples of inherited hemolytic anemias include some types of thalassemia and low levels of enzymes such as glucose-6 phosphate dehydrogenase deficiency. The treatment will depend on the cause.

Sickle cell anemia is an inherited hemolytic anemia in which the hemoglobin protein is abnormal, causing the red blood cells to be rigid and clog the circulation because they are unable to flow through small blood vessels.

Anemia caused by other diseases   – Some diseases can affect the body’s ability to make red blood cells. For example, some patients with kidney disease develop anemia because the kidneys are not making enough of the hormone erythropoietin to signal the bone marrow to make new or more red blood cells. Chemotherapy used to treat various cancers often impairs the body’s ability to make new red blood cells, and anemia often results from this treatment.

How is Anemia Treated?

The treatment for anemia depends on what causes it.

Iron-deficiency anemia is almost always due to blood loss. If you have iron-deficiency anemia, your doctor may order tests to determine if you are losing blood from your stomach or bowels. Other nutritional anemias, such as folate or B-12 deficiency, may result from poor diet or from an inability to absorb vitamins in the gastrointestinal tract. Treatment varies from changing your diet to taking dietary supplements.

If your anemia is due to a chronic disease, treatment of the underlying disease will often improve the anemia. Under some circumstances, such as chronic kidney disease, your doctor may prescribe medication such as erythropoietin injections to stimulate your bone marrow to produce more red blood cells.

Aplastic anemia occurs if your bone marrow stops producing red blood cells. Aplastic anemia may be due to primary bone marrow failure, myelodysplasia (a condition in which the bone marrow produces abnormal red blood cells that do not mature properly), or occasionally as a side effect of some medications. If you appear to have a form of aplastic anemia, your doctor may refer you to a hematologist for a bone marrow biopsy to determine the cause of the anemia. Medications and blood transfusions may be used to treat aplastic anemia.

Hemolytic anemia occurs when red blood cells are destroyed in the blood stream. This may be due to mechanical factors (a leaky heart valve or aneurysm), infection, or an autoimmune disease. The cause can often be identified by special blood tests and by looking at the red blood cells under a microscope. The treatment will depend upon the cause and may include referral to a heart or vascular specialist, antibiotics, or drugs that suppress the immune system.

Talk with your doctor if you believe you may be at risk for anemia. Your doctor will determine your best course of treatment and, depending on your condition, may refer you to a hematologist, a doctor who specializes in blood disorders.

Is Anemia Preventable?

While many types of anemia cannot be prevented, eating healthy foods can help you avoid both iron-and vitamin-deficiency anemia. Foods to include in your diet include those with high levels of iron (beef, dark green leafy vegetables, dried fruits, and nuts), vitamin B-12 (meat and dairy), and folic acid (citrus juices, dark green leafy vegetables, legumes, and fortified cereals). A daily multivitamin will also help prevent nutritional anemias; however, older adults should not take iron supplements for iron-deficiency anemia unless instructed by their physicians.

Hereditary Spherocytosis: A Patient’s Journey

Where Can I Find More Information?

If you find that you are interested in learning more about blood diseases and disorders, here are a few other resources that may be of some help:

Results of Clinical Studies Published in 

Blood

Search Blood, the official journal of ASH, for the results of the latest blood research. While recent articles generally require a subscriber login, patients interested in viewing an access-controlled article in Blood may obtain a copy by e-mailing a request to the Blood Publishing Office.

Patient Groups

A list of Web links to patient groups and other organizations that provide information.

Anemia in the Elderly – American Family Physician

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Suman VJ,
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Prevalence of anemia in medical practice: community versus referral patients. Mayo Clin Proc.
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Anemia and hemoglobin levels in older persons: relationship with age, gender, and health status. J Am Geriatr Soc.
1992;40:489–96.

3. Daly MP.
Anemia in the elderly. Am Fam Physician.
1989;39:129–36.

4. Freedman ML, Sutin DG. Blood disorders and their management in old age. In: Brocklehurst’s Textbook of geriatric medicine and gerontology. 5th ed. New York, N.Y.: Churchill Livingstone, 1998:1247–88.

5. Joosten E,
Pelemans W,
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Prevalence and causes of anaemia in a geriatric hospitalized population. Gerontology.
1992;38:111–7.

6. Sheth TN,
Choudhry NK,
Bowes M,
Detsky AS.
The relation of conjunctival pallor to the presence of anemia. J Gen Intern Med.
1997;12:102–6.

7. Elis A,
Ravid M,
Manor Y,
Bental T,
Lishner M.
A clinical approach to ‘idiopathic’ normocytic-normochromic anemia? J Am Geriatr Soc.
1996;44:832–4.

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Safran C,
Marton KI,
Robinson SH.
Does the mean corpuscular volume help physicians evaluate hospitalized patients with anemia? J Gen Intern Med.
1990;5:187–91.

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The anemia of chronic disease. J Am Geriatr Soc.
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Sears DA.
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Weinberg ED,
Stuart-Macadam P.
The etiology of the anemia of chronic disease and infection. J Clin Epidemiol.
1994;47:23–33.

12. Walsh JR. Hematologic problems. In: Cassel CK, et al., eds. Geriatric medicine. New York, N.Y.: Springer,1997:627–36.

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Microcytic anemia. Am Fam Physician.
1997;55:2455–62.

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Singer J,
Levine M,
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et al.
Diagnosis of iron-deficiency anemia in the elderly. Am J Med.
1990;88:205–9.

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Oxman AD,
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Laboratory diagnosis of iron-deficiency anemia: an overview J Gen Intern Med.
1992;7:145–53 [published erratum appears in J Gen Intern Med 1992;7:423]

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Cook DJ,
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Recognizing and investigating iron-deficiency anemia in hospitalized elderly people. CMAJ.
1996;155:691–6.

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Carnes M.
Detecting iron deficiency in anemic patients with concomitant medical problems. J Gen Intern Med.
1998;13:455–61.

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Smith RE,
Power GC.
The role of endoscopy in the evaluation of iron deficiency anemia in patients over the age of 50. Am J Gastroenterol.
1994;89:1963–7.

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Cello JP.
Evaluation of the gastrointestinal tract in patients with iron-deficiency anemia. N Engl J Med.
1993;329:1691–5.

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Ghesquiere B,
Linthoudt H,
Krekelberghs F,
Dejaeger E,
Boonen S,

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Upper and lower gastrointestinal evaluation of elderly inpatients who are iron deficient. Am J Med.
1999;107:24–9.

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Bensen S,
Smith R.
Long-term follow-up of older patients with iron deficiency anemia after a negative GI evaluation. Am J Gastroenterol.
1996;91:885–9.

22. Balducci L, Saba HI. Hematologic diseases and disorders. In: Reuben DB, Yoshikawa TT, Besdine RW, eds. Geriatrics review syllabus: a core curriculum in geriatric medicine. 3d ed. New York, N.Y.: American Geriatrics Society, 1996:314–8.

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1998;46:1317–9.

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1994;96:239–46.

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1998;92:1191–8.

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1996;156:1097–100.

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1996;124:469–76.

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Macrocytic anemia. Am Fam Physician.
1996;53:155–62.

90,000 WHO | Micronutrient deficiency

Iron deficiency anemia

A few important facts

• It is estimated that in developing countries one in two pregnant women and about 40% of preschool children suffer from anemia.
• In many developing countries, iron deficiency anemia is exacerbated by helminth infections, malaria and other infectious diseases such as HIV and tuberculosis.
• Major health consequences include poor pregnancy outcomes, impaired physical and cognitive development, increased risk of morbidity in children and reduced working capacity for adults.Anemia is responsible for 20% of all maternal deaths.

Issue

Iron deficiency is the leading and most common nutritional disorder in the world. Iron deficiency, which affects many children and women in developing countries, is the only nutritional deficiency that is also significant in industrialized countries. Prevalence levels are staggering: 2 billion people, more than 30% of the world’s population, suffer from anemia, many from iron deficiency, which is exacerbated by infectious diseases in resource-poor areas.Malaria, HIV / AIDS, hookworm infection, schistosomiasis and other infections such as tuberculosis are particularly important contributing factors to the high prevalence of anemia in some areas.

Iron deficiency affects more people than any other health problem, a public health problem commensurate with the epidemic. Less noticeable in its manifestations than, for example, protein-energy malnutrition, iron deficiency leads to dire consequences – poor health, premature mortality and loss of earnings.

Iron deficiency and anemia reduce the productivity of individuals and entire populations, have serious economic consequences and create obstacles to national development. Overall, iron deficiency disproportionately affects the most vulnerable, the poorest and least educated people, and it is they who will benefit most from lower prevalence rates.

Answer: Offensive in three directions

Invisible but pervasive in many developing countries, the true consequences of iron deficiency and anemia are hidden behind statistics on overall mortality rates, maternal bleeding, poor school performance and disability.Iron deficiency anemia affects millions of people. The health consequences are hidden but destructive, subtly weakening the potential for the development of people, society and the national economy.

It doesn’t have to be. We know not only the reasons, but also the ways to solve this problem, inexpensive and effective. Given the close relationship between iron deficiency and anemia, they must be tackled simultaneously using a multifactorial and multisectoral approach.This approach also needs to be adjusted to suit local conditions, taking into account the specific etiology of the anemia and the affected populations.

Eliminating iron deficiency anemia requires the most determined efforts on the part of governments around the world and the international community. It’s time to act.

WHO

It shouldn’t be

WHO has developed a comprehensive health package for all aspects of iron deficiency and anemia.These measures are being implemented in countries with high levels of iron deficiency and anemia, malaria, helminthiasis and schistosomiasis.

Increased levels of iron intake. A variety of foods that include iron-rich foods, as well as improving iron absorption, food fortification, and iron supplements.

Fight against infections. Programs for immunization and malaria, hookworm disease and schistosomiasis.

Improved nutritional health. Prevention and control of other nutritional deficiencies, such as deficiencies in vitamin B12, folate and vitamin A.

Why is it necessary to end iron deficiency anemia?

This has significant advantages. Timely treatment can restore the health of individuals and increase national productivity levels by as much as 20%. To support countries in tackling anemia, WHO has developed guidelines on the prevention and control of iron deficiency and anemia, along with a tool to assess the magnitude of the problem and monitor interventions.

Iron deficiency anemia drains vitality and hinders development. We have both the means and the potential to make improvements on a large scale, and we must apply them vigorously.

90,000 Anemia – what is it? – Baltic Medical Center

Anemia (anemia) is a pathological condition characterized by a low level of red blood cells and / or hemoglobin in the blood, which impairs the transfer of oxygen to the tissues and causes hypoxia, i.e.e. oxygen starvation of tissues.

According to WHO, anemia is diagnosed at:

• hemoglobin concentration less than 130 g / l in men and women after menopause,

• hemoglobin concentration less than 120 g / l in women of childbearing age,

• hemoglobin concentration less than 110 g / l in pregnant women (in the first and third trimesters) or less than 105 g / l (in the second trimester).

The following degrees of severity of anemia are distinguished:

• light degree (I˚) – Hb 120–95 g / l,

• medium degree (II˚) – Hb 94-80 g / l,

• severe degree (III˚) – Hb 79-65 g / l,

• degree, life-threatening (IV˚) – Hb <65 g / l.

According to the WHO, about 1 987 300 000 people suffer from anemia.

90,016 • Iron deficiency occurs in 3,580,000,000 people.

• Anemia is more common among women than among men.

• Anemia – iron deficiency affects 25-40% of newborns and 25% of adolescents.

• Anemia occurs in 10% of women of childbearing age.

90,016 • About 11% or 3.4 million people in the United States are anemic.

• Iron deficiency is the most common anemia, followed by chronic disease anemia.

The following factors increase the risk of anemia:

• demographic (older age, adolescence, pregnancy)

• nutritional factors (consumption of foods low in iron, lack of vitamin C, excessive consumption of coffee / tea, wasting diet)

• social factors (poverty, alcohol consumption, diseases of the digestive tract, depression and other diseases)

Anemia is caused by one of three processes in the body:

• acute or chronic bleeding (over time, causes anemia of insufficient production).

• insufficient production of red blood cells in the bone marrow.

• increased destruction of erythrocytes (hemolysis).

Signs of anemia:

• general weakness

• lack of appetite

• hair loss

• lamination of nails

• tachycardia (rapid heart rate)

• shortness of breath

• edema (swelling of the legs, arms)

• angina pectoris (heart pain)

• disorders of the central nervous system (brain):

o irritability

o chronic fatigue

o violation of attention

o memory impairment

o dizziness

o lethargy

o apathy

o depression

• visual impairment (“flies” before the eyes), damage to muscles and bones:

o general muscle weakness

o rapid muscle fatigue

o twitching in muscles

o cramp

o intermittent claudication

o Poor bone healing (with fracture)

• digestive disorders:

o anorexia

o delay in height and weight (in children)

o pagophagia (eating ice)

o geophagy (eating the earth)

o bad breath

o dysphagia (difficulty in swallowing)

o atrophic glossitis (tongue lesions)

o malabsorption (violation of the processes of absorption of substances in the intestine)

o exudative enteropathy (intestinal damage)

• weakened immunity

• late puberty

• menstrual irregularities

Treatment of anemia:

• elimination of the cause, treatment of the primary disease

• preparations with iron content, better together with vitamin C

• preparations of the group of vitamin B and folic acid

• blood transfusion

• long-term treatment from 3 months.

Iron deficiency

Specialists a lot
talk about the lack of iron in the body and its consequences, tirelessly reminding
the importance of getting tested from time to time to check iron stores. V
recently, great importance has also been given to solar hormone or
vitamin D in maintaining health.

Anemia in itself
is not the main diagnosis.This is a harbinger of some other process in
an organism that causes, among other things, anemia, and therefore should not
remain without examination and treatment. Anemia is a change in the composition of the blood
which leads to a decrease in the number of red cells or contained in them
hemoglobin. When they decrease, there are not enough “transport units” for blood,
responsible for delivering sufficient oxygen wherever it is
necessary. Namely, the function of red cells or erythrocytes is
delivery of oxygen from the lungs to tissues throughout the body and carbon dioxide to
the opposite direction – from the tissues to the lungs for exhalation.In erythrocytes, which
this important role is assigned, oxygen is transported by hemoglobin, iron-containing
protein, which also gives the cell its characteristic red color.

IMPORTANT TO KNOW :

Most often anemia
is chronic. This means that the loss of red blood cells or
hemoglobin is moderate and can be partially compensated by the body,
therefore the consequences are not significant. Thus, iron deficiency
often overlooked at first.

HOW TO DEFINIT ANEMIA?

• To be done
blood test – a blood sample taken from a vein in a laboratory called a general
blood test. It provides information on the number of different blood cells and
hemoglobin, as well as other indicators that can help the doctor
determine the direction in which to look for the cause of anemia.

• There are also
the so-called methods of express diagnostics, in which a small amount
hemoglobin can be measured in less than one minute by applying a small
the amount of blood from a finger to a test strip using a special device,
which is now available in most family doctor practices.On practice
family doctors, iron deficiency anemia is the most common. It arises
when the body lacks the main source of hemoglobin – iron.
Iron deficiency anemia occurs either due to insufficient iron intake,
or in the event of complications.

SYMPTOMS
GLAND. IF YOU NOTICE ANY OF THEM, IT IS NECESSARY TO CONTACT
TO A DOCTOR TO FIND OUT THE CAUSE IN TIME

• long-term
fatigue;

• drowsiness;

• pallor;

• weakness;

• dizziness;

• suppressed
mood;

• brittle nails and
hair; 90 017 90 016 • are not uncommon in women
disorders of the menstrual cycle.

SHOULD BE OBSERVED!

Sorry, women
are more likely to suffer from iron deficiency anemia because it can be caused by
monthly menstruation, during which increased blood loss occurs,
which leads to the depletion of iron stores in the body. Women need to discuss
these questions with your gynecologist or family doctor! If natural
sources of iron – meat, especially beef or veal, liver, egg
yolk, apricots, pomegranates and pomegranate juice, legumes, spinach –
not enough, the doctor usually recommends iron supplements.Existing anemia
usually not compensated by diet and requires treatment. Treatment for anemia requires
patience and time, as on average it takes 4-6 months. Usually treatment
start with the so-called oral agents (tablets, capsules, syrups).
Intravenous iron is effective and requires 10 to 20 injections.
Prolonged, albeit moderate, fasting wreaks havoc on cells
organism, and they are not able to properly perform their functions.

ANEMIA REGULAR
OCCURS IF:

• increased
destruction of red blood cells;

• insufficient
production of red blood cells;

• loss occurs
blood.

Darth Family Physician
Mikelsone, Capital Clinic Riga and endocrinologist Gita Erta

Polyclinic :: news :: Event

The event will take place on November 26, 2020 at 12:00 Moscow time on the website https://medsanprosvet.ru (to participate, you must follow the link: https://medsanprosvet.ru/broadcast/ )

Annually, on November 26, the world celebrates International Day of Iron Deficiency *.Iron deficiency is the leading and most common nutritional disorder in the world. Iron deficiency, which affects many children and women in developing countries, is the only nutritional deficiency that is also significant in industrialized countries. Prevalence levels are staggering: 2 billion people, more than 30% of the world’s population, suffer from anemia, many from iron deficiency, which is exacerbated by infectious diseases in resource-poor areas.Malaria, HIV / AIDS, hookworm infection, schistosomiasis and other infections such as tuberculosis are particularly important contributing factors to the high prevalence of anemia in some areas.

Iron deficiency affects more people than any other health problem that is a public health problem commensurate with the epidemic. Less noticeable in its manifestations than, for example, protein-energy malnutrition, iron deficiency leads to dire consequences – poor health and premature mortality.

Iron deficiency and anemia reduce the productivity of individuals and entire populations, have serious economic consequences and impede national development.

Symptoms that may indicate signs of iron deficiency include:

• Feeling “overwhelmed”;
• Hair loss;
• Brittle nails;
• Pallor;
• Rapid bruising and hemorrhage;
• Decreased memory;
• Aspiration is little edible and inedible things;
• Restless Legs Syndrome;
• Cold intolerance;
• Shortness of breath;
• Susceptibility to infections;
• Headache;
• Decreased sexual function and many others.

In view of the nonspecific clinical picture in iron deficiency states, each of us is looking for help from specialists who, in our opinion, can help with the most pronounced symptom of possible iron deficiency anemia: with shortness of breath – from a cardiologist or cardiologist, with headache – from a neurologist or therapist, with digestive disorders – from a gastroenterologist or surgeon, etc.

On the International Day of Iron Deficiency, we invite you to join the project “Academy of Iron Deficiency Anemia”, which was organized by experts from the Federal State Budgetary Institution “NMITs TPM” of the Ministry of Health of Russia, with the support of the Russian Society for the Prevention of Noncommunicable Diseases and the National Society for the Advancement of Physicians named after V.I.S.P. Botkin.

The event will take place on November 26, 2020 at 12:00 Moscow time on the website https://medsanprosvet.ru (to participate, you must follow the link: https://medsanprosvet.ru/broadcast/ )

Participation is free.

90,000 Anemia in Children: Causes and Symptoms

Anemia occurs when the level of hemoglobin and / or red blood cells in the body decreases.Red blood cells are special blood cells that carry oxygen from the lungs to the tissues. Anemia in newborns and infants is common and also occurs in older children and adults. Infant anemia can develop for a number of reasons. In this article, you will learn about the causes of anemia, its signs and symptoms, and how to treat anemia in young children.

What is anemia

To understand what anemia is, you first need to understand how blood cells function.Blood consists of several types of cells, almost half of which are red blood cells (aka red blood cells). These cells contain a red pigmented protein called hemoglobin. The function of hemoglobin is to carry oxygen from the lungs to the tissues, and the carbon dioxide formed during metabolism from the tissues to the alveoli of the lungs.

Anemia develops when there is not enough hemoglobin in red blood cells or when there are not enough healthy red blood cells to transport oxygen through the body. Against the background of anemia, problems with cell function and growth may occur.

Anemia in newborns and infants

Some of the causes and risk factors for anemia in newborns and infants are:

• Not enough hemoglobin. This is often due to iron deficiency, which can occur when young children start drinking cow’s milk too early (cow’s milk contains very little iron and should not be given until one year old). Less commonly, the problem may be a lack of folic acid.

• Mom’s anemia during pregnancy – a huge percentage of women have iron deficiency anemia during pregnancy.This leads to the fact that the baby, being in the womb, does not receive the necessary amount of iron, thereby developing anemia.

• Prematurity is also a risk factor for the development of anemia, since it is in the late stages of pregnancy that there is an active transfer of iron from the mother to the fetus.

• Too many red blood cells are being destroyed. This can happen if the child has a medical condition such as hemolytic or sickle cell disease.The latter is more common in children of African descent.

• There is a low level of hemoglobin in erythrocytes. Inherited blood disorders such as thalassemia, often seen in people of Asian, African, Middle Eastern, Greek and Italian descent, can lead to insufficient hemoglobin levels or low red blood cell counts.

• Blood loss. This may be the result of trauma or a condition such as hemophilia in which the blood does not clot properly.

Signs and symptoms of anemia in young children

Common signs and symptoms of anemia include:

• Pallor of the skin and mucous membranes

• tearfulness and irritability

• weakness

• fast fatigue or unusual sleepiness

• yellowness of the skin and / or whites of the eyes (jaundice)

Signs of severe anemia include:

• dyspnea

• heart palpitations

• swelling of hands and feet

• headaches

• dizziness and fainting

Anemia in infants can be caused by iron deficiency.This type of anemia is typical for babies between the ages of 9 and 24 months. Here are the signs and symptoms of iron deficiency anemia:

• decreased appetite

• tearfulness and irritability

• restless state

• Difficulty holding attention

If you notice any of the above signs and symptoms in your child, or if you think your child is not getting enough iron from food, talk to your pediatrician.

How Anemia in Young Children is Treated

There are different types of anemia and they require different treatments. Therefore, you should not give your child vitamins, nutritional supplements, or any other over-the-counter medications without consulting a doctor.

To treat anemia in children, your doctor may prescribe medications or recommend dietary adjustments. If the anemia is caused by a lack of iron, your doctor may prescribe a liquid iron supplement.It is important to follow all your doctor’s instructions, including dosage recommendations. Your doctor may recommend periodic tests to check your iron levels.

If your child’s anemia is caused by a blood cell disorder, such as hemolytic anemia (also known as sickle cell anemia) or thalassemia, your doctor may recommend that you consult a hematologist – a doctor who specializes in
blood diseases.

If the baby is born prematurely or is very ill, blood transfusion may be indicated in some cases to treat anemia.

When talking to your pediatrician, be sure to mention any symptoms of anemia you have noticed in your child, and if anyone in the family has had anemia or blood problems.

Methods for preventing anemia in young children

Not all types of anemia are preventable, especially those caused by genetic diseases such as sickle cell disease or thalassemia. However, anemia due to iron deficiency or other nutritional deficiencies can be prevented with a balanced diet.Methods for preventing iron deficiency anemia in newborns and young children:

• Do not give your baby cow’s or goat’s milk until one year old.

• If the baby is breastfed, the pediatrician can prescribe an iron supplement from four months until the introduction of complementary foods with a high iron content (fortified cereals, meat puree).

• If your baby is bottle-fed, choose an iron-based formula.

• When your baby gets used to eating solid foods, include iron-rich foods such as red meat, egg yolks, potatoes, tomatoes, beans, dried fruits and dark leafy vegetables in the diet.

• Include foods rich in vitamin C in your diet as it helps the absorption of iron. These include citrus fruits, orange juice, bell peppers, tomatoes, spinach, and broccoli.

Conclusion

Most childhood anemia can be successfully treated with dietary adjustments or medication as recommended by your doctor.If the anemia is caused by a genetic disorder, your pediatrician may refer you to a specialist for advice.

If you are worried that your child may have anemia, or notice symptoms such as pallor and lethargy, consult your pediatrician. The iron level in the blood is checked with a simple blood test. Once diagnosed, the doctor will be able to recommend a course of treatment (if needed). The sooner you learn about possible violations, the sooner you can help your baby.

_{How This Article Was Written
The information in this article is based on expert advice from trusted medical and government sources such as the American Pediatric Association and the American College of Obstetricians and Gynecologists. A complete list of links to sources used to write this article can be found at the end of the article. The information on this page does not replace professional medical advice.Always see your doctor for diagnosis and treatment.}

“Iron” health: causes, danger, treatment of anemia

“Iron” health: causes, danger, treatment of anemia

In ancient times, this element of the periodic table was valued more than gold. Without it, vital processes in the body do not take place, and all living things are doomed to death. This is iron.

Why do we need iron?

Iron is an integral part of hemoglobin, participates in the formation of lymphocytes and erythrocytes, removes carbon dioxide during respiration and delivers oxygen to tissues.Also, iron is part of enzymes for immunity, helps the thyroid gland.

How do you know if you are missing hardware?

You are familiar with morning headache, increased fatigue, tearfulness, decreased mental performance and attention, frequent SARS. These are the most striking symptoms of a lack of iron in the body, even if the hemoglobin in the blood is within the normal range. A condition in which iron absorption is impaired and hemoglobin decreases is called iron deficiency anemia (IDA).

Why does anemia occur?

The most common causes:
– blood loss – pathological uterine, gastrointestinal, pulmonary and other bleeding;
– increased iron consumption – pregnancy, lactation, growth, puberty, chronic diseases, inflammatory processes;
– violation of iron absorption;
– unbalanced diet.

Why is anemia dangerous?

First of all, iron deficiency affects the immune system, the risk of viral infections increases.The cardiovascular and central nervous systems suffer, myocardial changes occur. Lack of iron complicates the course of pregnancy, negatively affects the development of the fetus and childbirth.

Treatment and prevention

It is impossible to cure anemia by diet alone without the use of iron supplements. The sequence of treatment consists of 2 stages:
1. Relief of anemia – taking iron supplements for at least 1 month.

2. Replenishment of iron reserves.It continues for another 2-3 months.

Normalization of hemoglobin level does not mean the end of treatment. The course lasts at least 3 – 4 months. Ferrotherapy must be combined with a diet rich in vitamins and protein.

How to take iron correctly

1. Ferrum-containing short-acting preparations are taken 15 – 20 minutes after meals
2. Iron preparations should not be taken with milk and fermented milk drinks – they contain calcium, which will inhibit the absorption of iron;
3. Tablets, dragees and capsules are not chewed and washed down with plenty of water, rosehip decoction or clarified juice without pulp.

what is it, causes, risk factors, treatment

Anemia is a shortage of red blood cells or the hemoglobin contained in them, due to which the supply of oxygen to the tissues of the body is impaired. The most common type of anemia is caused by a lack of iron in the body: iron deficiency anemia affects 1.5 to 2 billion people worldwide.

In this article, we will find out who is at risk of suffering from iron deficiency, what measures can be taken to avoid the disease, and how the state of the microbiome affects treatment.

Contents

How do you know if you lack hardware?

IDA can be manifested by signs common to all anemias, with which you must definitely consult a doctor:

• Extreme fatigue;
• Weakness;
• Pale skin;
• Chest pain;
• Rapid heartbeat or shortness of breath;
• Headache, dizziness or lightheadedness;
• Cold hands and feet.

However, iron deficiency also has specific symptoms:

• Inflammation or soreness of the tongue, stomatitis;
• Brittle nails and hair loss;
• Perverted taste – eg unusual cravings to taste ice, chalk, dirt or starch;
• Poor appetite, especially in infants and children.

For any symptoms, only a doctor can diagnose and prescribe treatment. In most cases, in order to understand that this is iron deficiency anemia, and not another disease, a blood test will be needed.

Reasons for IDA

During the waiting period, 2 problems come to the fore – insufficient iron intake and too rapid iron loss.

• Bleeding . May occur with heavy periods, stomach ulcers, colon polyps, or bowel cancer.
• Diet poor in iron and other substances . Vitamin C and beta-carotene allow for more efficient absorption of iron, and zinc helps to regulate iron metabolism in the body.
• Disorders of iron absorption. Celiac disease, Crohn’s disease and ulcerative colitis prevent iron from entering the bloodstream because the intestinal wall is constantly inflamed.
• Pregnancy. In most pregnant women, IDA appears as a result of increased blood volume, and the growing fetus consumes hemoglobin reserves from the mother’s body.

Who is most at risk of getting sick due to a lack of iron in the body?

• Women of childbearing age, especially with heavy menses;
• Pregnant, recently given birth and breastfeeding women;
• People who have had major surgery or physical injury;
• People with inflammatory bowel disease or celiac disease;
• Those who follow an unbalanced diet. This is especially true for vegetarians and vegans who do not eat meat, fish and poultry and do not add plant sources of iron to their diet.
• Infants and toddlers who drink more than 700 milliliters of cow’s milk every day. Cow’s milk is low in iron and may decrease the absorption of iron from other sources.

Diet to prevent iron deficiency

Recommendations for daily iron intake:

• For men of all ages and postmenopausal women – 8 mg / day;
• For women of childbearing age – 18 mg / day;
• The maximum amount of iron that can be tolerated by the body is 45 mg / day, if this dose is exceeded, serious gastrointestinal upset can occur.

The first recommendation for the prevention of IDA is to increase the consumption of meat, chicken, and eggs. These are foods rich in heme iron – the easiest to digest. It is not necessary to stock up on fatty beef: 100 grams of beef liver contains about 6.5 mg of iron, and 100 grams of shellfish can contain about 28 grams – even more than you need.

In addition to increasing your iron-rich foods, here are some tips to help improve your absorption of iron, even if you’re getting it exclusively from plant sources:

• Combine iron-rich foods with vitamin C: this is especially important for vegetarians who only get non-heme iron.Vitamin C prevents the formation of non-absorbable compounds and keeps iron in the form that is necessary for absorption by the cells of the lining of our intestines.
• Beta Carotene also helps make iron more readily available: Pumpkin, carrots, sweet potatoes, apricots and tomatoes are great additions to your daily menu.
• Take iron supplements and foods containing iron separately from calcium supplements and dairy products : Calcium interferes with the absorption of iron.Try iron supplements 2 hours before or after consuming any dairy or calcium supplement.
• Limit your intake of foods high in phytates: Grains, legumes, and nuts that have not been sprouted or fermented contain a compound called phytic acid that interferes with the absorption of iron.
• Limit your consumption of coffee and tea: coffee, even decaf and tea contain tannins that impair the absorption of iron.

It is important to know that an excess of iron also leads to serious health problems, so you should not try to eat too much iron-containing food or take supplements without a doctor’s recommendation.

How is anemia related to the microbiome?

Certain gut bacteria are able to convert non-heme iron into heme iron, which is more easily absorbed. The main food for such bacteria are fructo- and oligosaccharides, inulin and pectin, which can be found in the simplest foods: bananas, cabbage, onions, garlic, beets, apples, chicory.

Another way to increase the bioavailability of iron with the help of bacteria is to ferment vegetables. Studies have shown that eating fermented vegetables with food increases the bioavailability of iron even when phytates are present in the diet.

The use of probiotics in dietary supplements can also increase the absorption of iron.

But it is important to understand that probiotics are an adjunctive therapy and iron supplements are also needed in the presence of anemia.

There is another side to the interaction of the microbiome with iron – iron supplements and iron-fortified foods can alter the gut microbiome.Iron is important for both the host and intestinal microorganisms. Pathogenic strains grow especially well in iron-rich conditions due to their efficiency in iron processing. This is partly attributed to the increased symptoms of inflammatory bowel disease with oral iron intake. Therefore, in case of problems with the gastrointestinal tract, it is necessary to pay particular attention to the microbiome – this will reduce side effects and increase the effectiveness of treatment, which is necessary in any case.

Microbiota test Atlas helps to analyze the composition of the microbiome and assess its ability to break down different types of fiber and synthesize vitamins.

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