Anemia is a medical condition in which the number of red blood cells in the blood decreases which impairs the oxygen supply to body’s parts. The red blood cell or RBCs are cells which imparts red color to the blood as they contain a red pigment known as hemoglobin. The anemic person experiences fatigue, drowsiness and much more. There are many forms of anemia.
Sometimes anemia is seen as symptom and not a disease as it can be manifestation of various underlying diseases and once the disease is treated the anemia goes away.
For men anemia is generally defined as hemoglobin levels less than 13.5 grams per 100 ml of blood and for female this value is 12.0 grams. In the United State about 2% to 10% of people have anemia.
Symptoms of Anemia
The signs and symptoms of anemia are as follows
- Fatigue and weakness
- Pale or yellowish skin
- Shortness of breath
- Hair loss
- Difficulty in breathing
- Chest pain
There can be other signs and symptoms associated with the underlying cause
Causes of Anemia
As already mentioned anemia occurs due to the deficiency of the RBCs and that occurs due to three basic reasons
- When your body is not making enough red blood cells
- When your body is losing the blood causing a deficiency of red blood cells
- When your body is destroying the red blood cells
Conditions affecting the production of red blood cells: Red blood cells are produced in the bone marrow and requires iron, vitamin and other components for the formation of hemoglobin
- Iron deficiency anemia: This is the most common type of iron deficiency anemia and occurs when the iron storage pools of the body vanish. This type of anemia can be seen in people having strict vegetarian diet, pregnant women without any iron supplements or women having heavy menstrual bleeding.
- Vitamin deficiency: vitamin B12 and folate are also required for the production of hemoglobin. Deficiency of these vitamins can lead to abnormal RBCs production which lacks hemoglobin.
- Anemia of chronic disease: Systemic diseases such as cancer, SLE, rheumatoid arthritis, Crohn’s disease or any other inflammatory disorders are associated with some factors which suppress the bone marrow ability to produce RBCs.
- Thalassemia: This is an inherited disease where production of RBCs occurs with abnormal hemoglobin which can’t transport oxygen efficiently
- Aplastic anemia: Here the bone marrow is defective and doesn’t produce cells. The defect can be in the bone marrow itself or any other factors which destroy the bone marrow.
Conditions causing loss of blood
- Injury or trauma: they can cause bleeding and results in loss of blood as well as RBCs.
- Heavy menstrual bleeding: Female having periods can suffer from anemia as they lose blood easily every month.
- Rectal bleeding: chronic rectal bleeding can slowly lead to anemia
Destruction of Red blood cells
- Hemolytic anemia: there is destruction of normal red blood cells which can be due to various causes like toxin, inherited conditions or infections
- Sickle cell anemia: It is an inherited genetic disorder in which abnormal type of hemoglobin is formed leading to abnormal sickle like shape of RBCs. These RBCs die early and the production cannot cope with the loss, thus anemia occurs.
Diagnosis of Anemia
Your doctor will use your medical history, conduct a physical examination and order some tests to know the cause of anemia
Blood tests: a small sample of blood is taken to
- Count the number of all types of cells in per unit blood (CBC or complete blood count)
- Calculate the hematocrit value which tells the proportion of RBCs with respect to the blood.
- Microscopy: Red blood cells are examined under microscope to look for any abnormalities in shape or size which is quite useful to know the cause of the anemia.
These tests will only reveal that the presence of anemia. So, other tests are still required to know the cause of anemia like
- Finding levels of plasma transferrin, ferritin, bilirubin
- Kidney and Liver function test
- Bone marrow biopsy.
Treatment of Anemia
The treatment of anemia depends upon the underlying cause as
Iron supplements: if anemia is found to be mild and iron deficiency is found then your doctor can prescribe iron supplements. The cause of iron deficiency is necessary to determine.
Vitamin supplements: for vitamin deficient anemia, vitamins supplements like Vit B12, folic acid is given.
Transfusions: for conditions like acute blood loss, thalassemia, sickle cell anemia blood transfusion is required.
Bone marrow transplantation: For conditions where the bone marrow is not producing normal number and quality of RBCs, then stem cell transplantation can be carried out.
Erythropoietin: It is a hormone normally produced by the kidney which stimulates the formation of RBCs. The synthetic preparations of this hormone can be injected to increase RBCs production.
Treating the underlying cause: For conditions such as infection or any other systemic inflammatory disease, the above treatment option can be used to fasten the recovery but treating the underlying cause is more important.
Complications of Anemia
If the anemia is not treated it would become severe and following complications may arise
- Angina or severe chest pain leading to heart attack
- Fainting or passing out
- Arrythmia or abnormal beating of heart
- Anemia. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/anemia/
- Your guide to anemia. National Heart, Lung, and Blood Institute.
- Marx JA, et al., eds. Anemia, polycythemia and white blood cell disorders. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier http://www.clinicalkey.com