Know the Basics, Prevention and Treatment of Anemia

Prevention and Treatment of Anemia should know. Before that let’s know details about the anemia.

What is anemia?

The deficiency of red blood cells in the blood is known as Anemia.  Low oxygen-carrying capacity due to fewer red blood cells (RBCs) or dysfunctional RBCs in the blood is defined as Anemia.

This is a medical condition in which the number of red blood cells is decreased in blood.  Blood is comprised of cells (red blood cells, white blood cells, and platelets) 45% and plasma 55%.

Red blood cells mainly consist of hemoglobin.  Hemoglobin is an iron-containing protein that carries oxygen throughout the body to organs and tissues and transports back carbon dioxide to the lungs from organs and tissues.  The iron contained in hemoglobin gives red color to the blood.

The person who suffers from anemia is called anemic.  Because of decrement in the number of RBCs or hemoglobin, anemic will have a low amount of oxygen level in blood making them feel cold, painful, tired or fatigued and look pale.  Normal range of hemoglobin may vary for different age and sex as well as may vary from one medical practice to another.

Anemia hemoglobin level Normal range for men is 13.5 to 17.5 gm/dL whereas for women is 12.0 to 15.5 gm/dL.  So, hemoglobin lower than 13.5 gm/dL in men and lower than 12.0 gm/dL in women is regarded as Anemia.

Symptoms of Anemia

Because of the lowering of RBCs, organs and tissue will not get enough oxygen.  This will make me feel tired and weak.  In some conditions, anemic will also have a lower amount of iron in their blood, making them look pale.

These are the main symptoms of Anemia.  Symptoms are listed as below:

• Fatigue, weakness, and tiredness.
• Shortness of breath.
• Cold hand and feet.
• Paleness of skin.
• Headache and dizziness.
• Irregular heartbeat.

A person may have brittle nails or hair loss in some cases like in anemia of chronic disease and anemia of chronic kidney disease.

Causes of Anemia

To produce RBCs, our body needs iron, vitamin B12, folate, and nutrients.  Lacking any one of these can cause anemia.  The most common cause of anemia is the low level of iron in our body.  Sometimes, the term anemia is used for when our body has low iron.  Though there are so many different causes of anemia, we can categorize them into three.

1. Blood Loss.

When the body has heavy blood loss, it absorbs water from tissues to make blood vessels full.  By this reason, blood gets diluted lessening the number of RBCs in blood.  The heavy blood loss may be due to:

• Trauma or injury, childbirth, heavy menstruation, internal bleeding and surgery.
• The disease conditions like stomach ulcers, hemorrhoids, cancers, etc.
• Certain drugs like NSAIDs/anti-platelet agents.

2. Faster Destruction of RBCs.

Red blood cells (RBCs) are formed in the red bone marrow of bones and the stem cells in red bone marrow give rise to the blood.  These RBCs have 120 days of lifespan, so the body destroys them after their lifespan through the process called hemolysis.

In varied conditions, RBCs may have been destroyed earlier than their lifespan.  In such conditions, RBCs become less in the blood causing to have anemia.  The faster destruction of RBCs are due to:

• Inherited blood disorders like sickle cell disease, thalassemia, autoimmune hemolytic anemia.
• Infection caused by a weakened immune system.
• Bone marrow failure.
• Overactive spleen.
• Certain drugs.
• Treatment like chemotherapy, which can destroy bone marrow and RBCs.
• Mechanical heart valves that can damage RBCs.
• Severe reaction to blood transfusion.

3. Not Producing Enough RBCs.

The body forms the RBCs and destroys them too.  It is a continuous cycle.  The production and destruction of RBCs must get balanced in our body.  When the body cannot produce enough RBCs, we will suffer from anemia.  The diet, disease conditions, state of the body can cause to not produce enough RBCs.  Low production of RBCs due to:

• Deficiency of nutrients like iron, vitamin B12, folic acid can cause not to produce enough RBCs.
• Body cannot produce enough RBCs in diseases like Crohn’s disease, celiac disease, cancers, HIV/AIDS, kidney disease.
• In some anemia in pregnancy , body cannot produce enough RBCs.

Types of Anemia

There are different types of anemia.  Most common types of anemia are as follows:

• Iron Deficiency Anemia:  Anemia caused by a deficiency in iron whether it is due to blood loss, due to diet lacking iron or due to blood not absorbing iron.
• Vitamin Deficiency Anemia:  Anemia caused by a deficiency of vitamin B12 and folic acid whether it is due to not consuming enough vitamin B12 or due to the body not being able to absorb vitamins.  Vitamin B12 and folic acid both help in the production of RBCs.  Examples of vitamin deficiency anemia are Pernicious Anemia and Megaloblastic Anemia.  Due to a lack of substance in the stomach called intrinsic factor, body cannot absorb vitamin B12.  B12 is essential for the production of RBCs.  Anemia caused by vitamin B12 deficiency is Pernicious Anemia.  Due to lack of B12 and folate or both, body cannot form RBCs properly causing to have anemia called Megaloblastic Anemia.  The cells are larger than normal in size making it hard to exit to the bloodstream from bone marrow.  That’s why RBCs are less in Megaloblastic Anemia.
• Hemolytic anemia:  It is a condition in which red blood cells are destroyed earlier than their normal lifespan.  It is either inherited or acquired.  One of its examples is Sickle Cell Anemia.  In Sickle Cell Anemia, normally RBC is biconcave or disc-shaped, but in some cases, the body makes sickle shaped RBCs.  Such shaped cells can clog the blood vessels and damage the organ.  These sickle cells get destroyed in 10 to 20 days, earlier than normal lifespan causing to have sickle cell anemia.
• Hemorrhagic Anemia:  Blood loss internally or externally will make decrease in RBCs causing to have anemia.  Gunshot wound, stab wound, aortic aneurysms, peptic ulcer, etc. can cause to have hemorrhagic anemia.  This type of anemia can be treated by blood transfusing, giving fluid or getting the wound surgically fixed depending upon its severity.
• Aplastic Anemia:  This is a type of anemia caused by decreased ability of bone marrow to make RBCs, WBCs, and platelets.  It may be congenital or acquired.
• Thalassemia:  It is a congenital blood disorder in which the body makes fewer healthy RBCs and less hemoglobin.  It normally occurs in Mediterranean ancestry people.  Hemoglobin has two kinds of protein chains; alpha globin and beta-globin.  In thalassemia, body cannot make enough of either protein chain.  Due to genetic disorder, the process of protein chain gets altered.

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Risk Factors

Anybody can suffer from anemia at any age and some may have higher risk to have anemia.  There are varied risk factors that increase the chance of developing anemia.

• Menstruation.  In some case, female may have heavy menstrual bleeding leading to have anemia.
• Pregnancy.  During pregnancy, women need multivitamin, folic acid and iron regularly for normal development of fetus.  Otherwise, women may suffer from anemia.
• Lack of vitamins and minerals.  Diet consistently lacking iron and vitamin B12 can result in developing anemia.
• Intestinal diseases.  Certain diseases like Crohn’s disease and celiac disease cannot absorb the nutrients in intestine, putting at risk of anemia.
• Congenital blood disorder.  Congenital, inherited, or family history of blood disease such as sickle cell anemia and thalassemia are also risk factors.
• Chronic illnesses.  Chronic illnesses like HIV/AIDS, kidney disease, liver disease, diabetes, cancer, ulcer can also cause to have less RBCs.
• Heavy blood loss.  Blood loss during surgery or severe injury is also risk factor.
• Elderly people.  Elderly people over age 65 are at increased risk of anemia.

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Prevention and Treatment

Treatment for anemia is determined by the type as well as the cause of the anemia.

• Iron Deficiency Anemia:  This anemia is treated with iron supplements or even with blood transfusions if need be.  This type of anemia can be prevented by consuming foods that are rich in iron.  Iron-enriched foods are red meat, fish, shellfish, liver and other organ meat, legumes, dry fruits and nuts, beans and lentils, tofu, spinach, broccoli, beetroots, etc.  When you consume vitamin C, the iron absorption will be enhanced.
• Vitamin Deficiency Anemia:  Pernicious Anemia is treated with Vitamin B12 injections or oral supplements.  Megaloblastic Anemia caused by B12 deficiency is treated as in Pernicious anemia whereas folic acid deficiency anemia is treated with oral or intravenous folic acid supplements.  Such anemia can be prevented by consuming foods with B12 and folic acid.  Foods that are rich in B12 are animal liver and kidneys, eggs, tuna, salmon, sardines, trout, fortified cereal, milk and dairy products, etc.  Folic acid (folate) enriched foods are legumes, asparagus, eggs, leafy greens, beets, Brussels sprouts, broccoli, bananas, etc.
• Hemolytic anemia:  This type of anemia is treated with blood transfusions, corticosteroid medicines, gamma globulin, blood and marrow stem cell transplants, lifestyle changes and even removal of enlarged spleen in some cases.  Sickle Cell Anemia treatment includes blood transfusions, folic acid supplements, antibiotics, and even bone marrow transplant in severity and cancer drugs, such as hydroxyurea for adults.
• Hemorrhagic Anemia:  This type of anemia can be treated by blood transfusing, giving fluid or getting the wound surgically fixed depending upon its severity.
• Aplastic Anemia:  Depending upon its severity, the anemic should be treated with antibiotics, they should get a constant blood transfusion or even they should get bone marrow transplant.
• Thalassemia:  For severity, it is treated with blood transfusions, stem cell transplant, iron chelation, surgery or gene therapy.