Anemia

What is anemia?

Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal. The normal level of hemoglobin is generally different in males and females. For men, anemia is typically defined as hemoglobin level of less than 13.5 gram/100ml and in women as hemoglobin of less than 12.0 gram/100ml. These definitions may vary slightly depending on the source and the laboratory reference used.

What causes anemia?

Any process that can disrupt the normal life span of a red blood cell may cause anemia. Normal life span of a red blood cell is typically around 120 days. Red blood cells are made in the bone marrow.

Anemia is caused essentially through two basic pathways. Anemia is either caused:

by a decrease in production of red blood cell or hemoglobin, or

by a loss or destruction of blood.


Can anemia be hereditary?

Yes, anemia may be genetic. Hereditary disorders can shorten the life-span of the red blood cell and lead to anemia (for example, sickle cell anemia). Hereditary disorders can also cause anemia by impairing the production of hemoglobin (for example, alpha thalassemia and beta thalassemia).

Depending on the degree of the genetic abnormality, hereditary anemias may cause mild, moderate, or severe anemia. In fact, some may be too severe to be compatible with life and may result in death of the fetus (unborn infant). On the other hand, some of these anemias are so mild that they are not noticeable and are incidentally revealed during a routine blood work.


What are the symptoms of anemia?

Some patients with anemia have no symptoms. Others with anemia may feel:

tired,

fatigue easily,

appear pale,

develop palpitations (feeling of heart racing), and
become short of breath.

Additional symptoms may include:

hair loss,

malaise (general sense of feeling unwell), and

worsening of heart problems.

Diagnosis of Anemia

Anemia is diagnosed from the patient's symptoms and by a blood test that measures the level of hemoglobin in the blood, as well as substances such as folic acid, bilirubin and vitamin B12. Additionally, the size of the red cells provide further clues to the type of anemia.
Other methods of diagnosis may include a bone marrow biopsy, which is the removal of bone marrow for further examination under a microscope.

Bone marrow biopsy is helpful in diagnosing vitamin B12 anemia. Some dietitians suggest that the doctor also check for levels of ferritin in the blood of premenopausal women. Ferritin is a protein that stores iron before the mineral circulates in the bloodstream.


Treatment of Anemia

Iron-deficiency anemia

Treatment will depend upon whether an individual is not getting enough iron in the diet (increase iron intake); not absorbing iron (surgery for celiac sprue, etc.); or losing small amounts over time due to anything from alcoholic gastritis to medication abuse to tumors. The doctor will often recommend iron-rich foods (such as liver, seafood, dried fruits, lima beans, whole grains, green leafy vegetables and blackstrap molasses) or iron pills. In the more severe cases of iron deficiency anemia caused by blood loss, surgery, blood transfusions or hormone injections may be recommended.

Vitamin B12 deficiency

Current treatment of vitamin B12 deficiency consists of a life-long regimen of monthly B-12 injections. Unfortunately, neither diet or iron pills will help, but if diagnosed early a full recovery is promising.

Folic acid deficiency

Treatment is frequently a dietary correction. Main sources of folic acid include meat, poultry, cheese, milk, eggs, liver, green leafy vegetables, raw fruits, lima and kidney beans, and yeast. Folic acid tablets cure the anemia quickly. If intestinal disorders impede folic acid absorption, a supplement may be needed for a time. In rare instances, injections of folic acid are necessary.

Overall treatment considerations

Other therapies for anemia may include oxygen, fluids, fresh frozen plasma, platelet replacement and vasopressors (medication to elevate blood pressure). This will depend upon the underlying cause of the anemia.


Prevention of Anemia

Consumption of a healthy diet including iron-containing foods and those with B-complex vitamins is essential to developing and maintaining a satisfactory blood count.