Anaemia

What is Anaemia?

This is when you have fewer red blood cells than normal, OR you have less haemoglobin than normal in each red blood cell. In either case, the amount of oxygen  that is carried around  in the blood is reduced.

Red Blood Cells

Blood is made up of  three types of blood cells: Red blood cells  which take oxygen around the body, White blood cells which are part of the immune system, and defend the body from  infection and  Platelets which help the blood to clot if we have a cut . These cells are contained in a fluid called plasma.

Red blood cells are made in the bone marrow, and millions are released into the bloodstream each day. A constant new supply of red blood cells is needed to replace old cells that break down. Red blood cells contain a chemical called haemoglobin. Haemoglobin binds to oxygen and takes oxygen from the lungs to all parts of the body.

To make red blood cells and haemoglobin constantly, you need a healthy bone marrow and nutrients such as iron and certain vitamins which we get from food.

Women in the childbearing years are particularly susceptible to iron-deficiency anemia because of the blood loss from menstruation and the increased blood supply demands during pregnancy.

Older adults also may have a greater risk of developing anemia because of poor diet and other medical conditions.

What are the Symptoms of Anaemia?

1.     Tiredness.

2.      Weakness and loss of energy.

3.     Feeling faint.

4.     Becoming easily breathless.

5.     Less common symptoms include.

6.     Headaches.

7.     Palpitations( thumping heart beats).

8.     Altered taste.

9.     Ringing in the ears (tinnitus).

10.   Pale skin.

11.   Difficulty concentrating

12.   Dizziness

13.   Leg cramps

14.   Insomnia

 Various other symptoms may develop, depending on the underlying cause of the anaemia.

What Causes Anemia?

There are many types of anemia, which are divided into three groups:

  1. Anemia caused by blood loss
  2. Anemia caused by decreased or faulty red blood cell production
  3. Anemia caused by destruction of red blood cells

Anemia Caused by Blood Loss

Red blood cells can be lost through bleeding, which can occur slowly over a long period of time, and can often go undetected. This kind of chronic bleeding commonly results from the following:

  • Gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of the stomach), cancer,use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen.
  • Menstruation and childbirth in women, especially if menstrual bleeding is excessive and if there are multiple pregnancies.

Anemia Caused by Decreased or Faulty Red Blood Cell Production

With this type of anemia, the body may produce too few blood cells or the blood cells may not function correctly.  Red blood cells may be faulty or decreased due to abnormal red blood cells or a lack of minerals and vitamins needed for red blood cells to work properly.Conditions associated with these causes of anemia include the following:

  • Sickle cell anemia
  • Iron-deficiency anemia
  • Vitamin deficiency
  • Bone marrow and stem cell problems eg Leukaemia

Sickle cell anemia is an inherited disorder. Red blood cells become crescent-shaped because of a genetic defect. They break down rapidly, so oxygen does not get to the body's organs, causing anemia.

Iron-deficiency anemia occurs because of a lack of the mineral iron in the body. Bone marrow in the center of the bone needs iron to make hemoglobin. Without adequate iron, the body cannot produce enough hemoglobin for red blood cells. The result is iron-deficiency anemia. This type of anemia can be caused by:

  • An iron-poor diet, especially in infants, children, and people on restricted diets e.g. vegetarians
  • The demands of pregnancy and breastfeeding that deplete a woman's iron stores
  • Heavy Menstruation
  • Endurance training
  • Poor absorption of iron may occur with some gut diseases - for example, chronic diarrhea disease.
  • Certain drugs, foods, and caffeinated drinks

Vitamin-deficiency anemia may occur when vitamin B12 and folate are deficient. These two vitamins are needed to make red blood cells. Conditions leading to anemia caused by vitamin deficiency include:

  • Megaloblastic anemia: Vitamin B12 or folate or both are deficient
  • Pernicious anemia: Poor vitamin B12 absorption caused by conditions such as Crohn's disease, an intestinal parasite infection, surgical removal of part of the stomach or intestine, or infection with HIV
  • Dietary deficiency: Eating little or no meat may cause a lack of vitamin B12, while overcooking or eating too few vegetables may cause a folate deficiency.
  • Other causes of vitamin deficiency: pregnancy, certain medications, alcohol abuse, intestinal diseases such as tropical sprue and celiac disease.

Bone marrow and stem cell problems may prevent the body from producing enough red blood cells. If stem cells are too few, defective, or replaced by other cells such as metastatic cancer cells, anemia may result. Anemia resulting from bone marrow or stem cell problems include: Aplastic anemia ,Thalassemia ,and Lead poisoning  which can occur in adults from work-related exposure and in children who eat paint chips, for example. Improperly glazed pottery can also taint food and liquids with lead.

Anemia associated with other conditions usually occur when there are too few hormones necessary for red blood cell production. Conditions causing this type of anemia includes advanced kidney disease,hypothyroidism ans old age.

Anemia Caused by Destruction of Red Blood Cells

When red blood cells are fragile and cannot withstand the normal stress of the circulatory system, they may rupture prematurely, causing hemolytic anemia.  Sometimes there is no known cause. Known causes of hemolytic anemia may includes  sickle cell anemia and thalassemia, infections, drugs, snake or certain foods. This can also be due to inappropriate attack by the immune system. This may also be found in prosthetic heart valves, severe burns, severe hypertension and exposure to certain chemicals.

 

How Do I Know if I Have Anemia?

To diagnose anaemia, your doctor will likely ask you about your medical history, perform a physical exam, and order blood tests.

The doctor will ask about your symptoms,family medical history, diet, medications you take, alcohol intake, and ethnic background. Your doctor will look for symptoms of anemia and other physical clues that might point to a cause.

Blood tests will confirm the diagnosis of anemia, and also help point to the underlying condition. Tests might include:

  1. Full blood count (FBC), which determines the number, size, volume, and hemoglobin content of red blood cells
  2. Blood iron profile.
  3. Levels of vitamin B12 and folate, vitamins.
  4. Special blood tests to detect rare causes of anemia, such as an immune attack on your red blood cells, red blood cell fragility, and defects of enzymes, hemoglobin, and clotting profile.
  5. Reticulocyte count, bilirubin, and other blood and urine tests to determine how quickly your blood cells are being made or if you have a hemolytic anemia.
  6.  Rarely your doctor may need to take a sample of bone marrow to determine the cause of your anemia.

 

How Can I Prevent Anemia?

1.     BALANCED DIET: You can help prevent iron-deficiency anemia by eating a well-balanced diet that includes good sources of iron, vitamin B12, and folate.

2.     If you are a vegetarian or vegan, talk to your doctor or a nutritionist about your diet and any possible need for supplements.

3.     Ask your doctor or nutritionist if you should take vitamin C. Vitamin C makes the stomach more acidic and can improve the absorption of iron in your diet.

4.     Decrease your consumption of caffeinated products and tea. These substances can decrease iron absorption.

5.     Select iron-fortified cereals and breads.

6.     Carefully follow safety guidelines if your occupation involves work with lead-containing materials such as batteries, petroleum, and paint.

What Are the Treatments for Anemia?

Your doctor will not treat your anemia until the underlying cause has been established. The treatment for one type of anemia may be both inappropriate and dangerous for another type of anemia.