Anaemia is a condition in which the number of red blood cells or the haemoglobin concentration within them is lower than normal. Haemoglobin is needed to carry oxygen and if you have too few or abnormal red blood cells, or not enough haemoglobin, there will be a decreased capacity of the blood to carry oxygen to the body’s tissues. This results in symptoms such as fatigue, weakness, dizziness and shortness of breath, among others. Anemia is reported as a low hemoglobin or hematocrit. Anaemia (or anemia) is the most common blood condition in the U.S. It affects almost 6% of the population. Women, young children, and people with long-term diseases are more likely to have anemia.
Causes of anaemia
- Dietary deficiency – Lack of iron, vitamin B12 or folic acid in the diet can cause low levels of haemoglobin leading to anemia.
- Malabsorption – Abnormalities reducing the body’s ability to absorb nutrients in diet, such as coeliac disease.
- Inherited disorders- Genetic abnormalities involving abnormal haemoglobin production, such as thalassemia or sickle cell disease; or abnormalities in the enzymes involved in haemoglobin production, such as porphyria.
- Autoimmune disorders – Red cell life span decreased due to increased clearance by immune system such as autoimmune haemolytic anaemia or thyroid disease.
- Kidney disease – Decreased erythropoietin production
- Chronic inflammatory diseases – Chronic inflammation such as seen in arthritis can result in reduced ability to utilize iron in the body.
- Bone marrow disorders – Decrease production of red cells resulting from a malfunctioning bone marrow, such as in blood cancer.
- Blood loss – Direct loss of blood such as in trauma, surgery, blood donation, menstrual periods, gastric ulcers, intestinal polyps
- Toxins or medications – Toxins such as alcohol can directly damage bone marrow; some medications can reduce bone marrow function.
- Periods of increased need – Pregnancy and conditions which require more oxygen for the body can lead to anemia.
- Heavy menstruation- Many women in the child-bearing age have low haemoglobin causing them to be anaemic.
- Mechanical destruction – Mechanical heart valves can damage red cells reducing their natural life span.
- Infections – Anaemia in infections are often due to several different mechanisms such as in malaria.
Symptoms of anaemia
Depending on the severity, the symptoms of anaemia may include:
- Pale skin
- Tiring easily
- Drop in blood pressure when standing from a sitting or lying position (orthostatic hypotension) – this may happen after acute blood loss, like a heavy period
- Frequent headaches
- Racing heart or palpitations
- Becoming irritated easily
- Concentration difficulties
- Cracked or reddened tongue
- Loss of appetite
- Strange food cravings
Types of anaemia
There are many forms of anemia, and each type has telltale symptoms. Some common types of anemia include:
- iron deficiency anemia
- vitamin B12 deficiency anemia
- aplastic anemia
- hemolytic anemia
There are also some types of anemia that can be inherited. These include:
- Sickle cell anemia: Sickle cell anemia changes your red blood cells’ shape, turning round flexible discs into stiff and sticky sickle cells that block blood flow.
- Fanconi anemia: Fanconi anemia is a rare blood disorder. Anemia is one sign of Fanconi anemia.
- Diamond-Blackfan anemia: This inherited disorder keeps your bone marrow from making enough red blood cells.
Groups of people more susceptible to anaemia
Certain people are at increased risk of anaemia, including:
- Menstruating women
- Pregnant and women
- Babies, especially if premature
- Children going through puberty
- People following a vegetarian or vegan diet
- People with cancer, stomach ulcers and some chronic diseases (particularly kidney disease & those on )
- People on fad diets
How to diagnose anaemia
- Complete blood count (CBC): Healthcare providers use this test to check on all of your blood cells, with a focus on your red blood cells. They count your red blood cells and evaluate your red blood cells’ size and shape. Healthcare providers may use this test to check on your vitamin B12 or B9 levels.
- Peripheral blood smear: Healthcare providers examine your red blood cells under a microscope.
Treatment for anaemia
There is a range of treatments for anemia. Each aims to increase a person’s RBC count, which increases the amount of oxygen in the blood.
The required treatment depends on the type of anemia a person has. Treatments for common forms of anemia include the following:
- Iron-deficiency anemia: Iron supplements and dietary changes can help, and a doctor will identify and address the cause of any excessive bleeding if present.
- Vitamin deficiency anemia: Treatments can include dietary supplements and vitamin B12 injections.
- Thalassemia: Treatments include folic acid supplements, iron chelation, and, for some people, blood transfusions and bone marrow transplants.
- Anemia due to chronic disease: The doctor will focus on managing the underlying condition.
- Aplastic anemia: Treatment for aplastic anemia involves blood transfusions or bone marrow transplants.
- Sickle cell anemia: Doctors treat this with oxygen therapy, pain relief medication, and intravenous fluids. They may also prescribe antibiotics, folic acid supplements, blood transfusions, and a cancer drug called hydroxyurea.
- Hemolytic anemia: The treatment plan may include immunosuppressant drugs, treatments for infections, and plasmapheresis, which filters the blood.