Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is a main part of
red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low,
the cells in your body will not get enough oxygen. Symptoms of anemia - like fatigue occur because organs aren't getting what they need to function properly.
Anemia can be detected by a simple blood test called a complete blood cell count (CBC).
Anemia is the most common blood condition in the U.S. It affects about 3.5 million Americans. Women and people with chronicdiseases
are at increased risk of anemia. Important factors to remember are:
Certain forms of anemia are hereditary and infants may be affected from the time of birth
Women in the childbearing years are particularly susceptible to iron-deficiency anemia because of the blood loss from menstruation
Older adults also may have a greater risk of developing anemia because of poor diet and other medical conditions.
There are many types of anemia. All are very different in their causes and treatments.
Iron-deficiency anemia, the most common type, is very treatable with diet changes and iron supplements. Some forms of anemia like the anemia that develops during pregnancy are even considered normal. However, some types of anemia may present
lifelong health problems.
What Causes Anemia
There are more than 400 types of anemia, which are divided into three groups:
Anemia caused by blood loss
Anemia caused by decreased or faulty red blood cell production
Anemia caused by destruction of red blood cells
Red blood cells can be lost through bleeding, which can occur slowly over a long period of time, and can often go undetected.
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), and cancer
Use of nonsteroidal anti-inflammatory drugs (NSAIDs) such asaspirinor ibuprofen, which can cause ulcers and gastritis
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. In either case, anemia can result. 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
Bone marrow and stem cell problems
Other health condition
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. The crescent-shaped red blood can cells also get stuck in tiny blood vessels, causing pain.
The treatment of the anemia varies greatly and very much depends on the particular cause. Vitamin supplements such as folic acid or vitamin B12 given orally will replace most specific deficiencies.
Mild to moderate iron-deficiency anemia is treated by oral iron supplementation with ferrous sulfate, ferrous fumarate, or ferrous gluconate. When taking iron supplements, stomach upset and/or darkening of the feces are commonly experienced. The stomach upset can be alleviated by taking the iron with food; however, this decreases the amount of iron absorbed. Vitamin C aids in the body's ability to absorb iron, so taking oral iron supplements with orange juice is of benefit.
In cases where oral iron has either proven ineffective, would be too slow (for example, pre-operatively) or where absorption is impeded (for example in cases of inflammation), parenteral iron can be used. The body can absorb up to 6 mg iron daily from the gastrointestinal tract. In many cases the patient has a deficit of over 1,000 mg of iron which would require several months to replace. This can be given concurrently with erythropoietin to ensure sufficient iron for increased rates of erythropoiesis.
Blood transfusions in those without symptoms is not recommended until the hemoglobin is below 60 to 80 g/L (6 to 8 g/dL). In those with coronary artery disease who are not actively bleeding transfusions are only recommended when the hemoglobin is below 70 to 80g/L (7 to 8 g/dL). Transfusing earlier does not improve survival.
Transfusions otherwise should only be undertaken in cases of cardiovascular instability.
The motive for the administration of an erythropoiesis-stimulating agent (ESA) is to maintain hemoglobin at the lowest level that both minimizes transfusions and meets the individual person’s needs. They should not be used for mild or moderate anemia. They are not recommended in people with chronic kidney disease unless hemoglobin levels are less than 10 g/dL or they have symptoms of anemia. Their use should be along with parenteral iron.
A moderate degree of iron-deficiency anemia affected approximately 610 million people worldwide or 8.8% of the population. It is slightly more common in female (9.9%) than males (7.8%). Mild iron deficiency anemia affects another 375 million.
Evidence of anemia goes back more than 4000 years.