Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues. Having anemia can make you feel tired and weak.
When someone develops anemia, they are said to be “anemic.” Being anemic might mean that you feel more tired or cold than you usually do, or if your skin seems too pale. This is due to your organs not receiving the oxygen they need to do their jobs. Some people find out they are low in iron when they go to donate blood.
There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe. It can be a warning sign of serious illness.
Types Of Anemia
Aplastic Anemia: This rare, life-threatening anemia occurs when your body doesn’t produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
Iron Deficiency Anemia: This most common type of anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can’t produce enough hemoglobin for red blood cells. Without iron supplementation, this type of anemia occurs in many pregnant women. It is also caused by blood loss, such as from heavy menstrual bleeding, an ulcer, cancer and regular use of some over-the-counter pain relievers, especially aspirin, which can cause inflammation of the stomach lining resulting in blood loss.
Sickle Cell Anemia: This inherited and sometimes serious condition is a hemolytic anemia. It’s caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.
Thalassemia: A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
Vitamin Deficiency Anemia: Besides iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Also, some people who consume enough B-12 aren’t able to absorb the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.
Causes Of Anemia
Causes of anemia are generally divided into those that decrease red blood cell production and those that increase red blood cell destruction.
Factors That Decrease Red Blood Cell Production
The things that typically decrease red blood cell production, causing anemia, include:
- inadequate stimulation of red blood cell production by the hormone erythropoietin, which is produced by the kidneys
- inadequate dietary intake of iron, vitamin B-12, or folate
Factors That Increase Red Blood Cell Destruction
On the other hand, any disorder that destroys red blood cells at a rate faster than they’re made can cause anemia. This typically occurs due to hemorrhaging, which can happen because of:
- gastrointestinal lesions
- excessive uterine bleeding
- cirrhosis, which involves scarring of the liver fibrosis (scar tissue) within the bone marrow
- hemolysis, a rupture of red blood cells that can occur with some medications or Rh incompatibility
- disorders of the liver and spleen genetic disorders such as: glucose-6-phosphate dehydrogenase (G6PD) deficiency, thalassemia, sickle cell anemia
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Overall, however, iron deficiency is the most common cause of anemia. It accounts for nearly half of all anemia cases, and is a major nutritional disorder worldwide.
Signs And Symptoms Of Anemia
People with anemia appear pale and may often complain of being cold. They may also experience:
- lightheadedness or dizziness, especially when active or standing up
- unusual cravings, such as wanting to eat ice, clay, or dirt
- trouble concentrating or tiredness
Some types of anemia can cause inflammation of the tongue, resulting in a smooth, glossy, red, and often painful tongue.
If anemia is severe, fainting may occur.
Other symptoms include:
- brittle nails
- shortness of breath
- chest pains
Blood oxygen levels can be so low that a person with severe anemia can have a heart attack.
If you get a physical exam and you have anemia, your results may show:
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- high or low blood pressure
- pale skin
- an increased heart rate
- a heart murmur
- enlarged lymph nodes
- an enlarged spleen or liver
- atrophic glossitis of tongue
People with signs or symptoms of anemia should seek medical attention, especially if fainting or chest pains occur.
Treatment Of Anemia
Anemia treatment depends on the cause.
Iron deficiency anemia. Treatment for this form of anemia usually involves taking iron supplements and changing your diet.If the cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and the bleeding stopped. This might involve surgery.
Vitamin deficiency anemias. Treatment for folic acid and vitamin C deficiency involves dietary supplements and increasing these nutrients in your diet.If your digestive system has trouble absorbing vitamin B-12 from the food you eat, you might need vitamin B-12 shots. At first, you might have the shots every other day. Eventually, you’ll need shots just once a month, possibly for life, depending on your situation.
Anemia of chronic disease. There’s no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. If symptoms become severe, a blood transfusion or injections of a synthetic hormone normally produced by your kidneys (erythropoietin) might help stimulate red blood cell production and ease fatigue.
Aplastic anemia. Treatment for this anemia can include blood transfusions to boost levels of red blood cells. You might need a bone marrow transplant if your bone marrow can’t make healthy blood cells. Anemias associated with bone marrow disease. Treatment of these various diseases can include medication, chemotherapy or bone marrow transplantation.
Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating infections and taking drugs that suppress your immune system, which could be attacking your red blood cells. Depending on the cause or your hemolytic anemia, you might be referred to a heart or vascular specialist.
Sickle cell anemia. Treatment might include oxygen, pain relievers, and oral and intravenous fluids to reduce pain and prevent complications. Doctors might also recommend blood transfusions, folic acid supplements and antibiotics. A cancer drug called hydroxyurea (Droxia, Hydrea, Siklos) also is used to treat sickle cell anemia.
Thalassemia. Most forms of thalassemia are mild and require no treatment. More severe forms of thalassemia generally require blood transfusions, folic acid supplements, medication, removal of the spleen, or a blood and bone marrow stem cell transplant.
Prevention Of Anemia.
Many types of anemia can’t be prevented. But you can avoid iron deficiency anemia and vitamin deficiency anemias by eating a diet that includes a variety of vitamins and minerals, including:
Iron. Iron-rich foods include beef and other meats, beans, lentils, iron-fortified cereals, dark green leafy vegetables, and dried fruit.
Folate. This nutrient, and its synthetic form folic acid, can be found in fruits and fruit juices, dark green leafy vegetables, green peas, kidney beans, peanuts, and enriched grain products, such as bread, cereal, pasta and rice.
Vitamin B-12. Foods rich in vitamin B-12 include meat, dairy products, and fortified cereal and soy products.
Vitamin C. Foods rich in vitamin C include citrus fruits and juices, peppers, broccoli, tomatoes, melons and strawberries. These also help increase iron absorption.
Complications Of Anemia
Left untreated, anemia can cause many health problems, such as:
- Severe fatigue. Severe anemia can make you so tired that you can’t complete everyday tasks.
- Pregnancy complications. Pregnant women with folate deficiency anemia may be more likely to have complications, such as premature birth.
- Heart problems. Anemia can lead to a rapid or irregular heartbeat (arrhythmia). When you’re anemic your heart must pump more blood to make up for the lack of oxygen in the blood. This can lead to an enlarged heart or heart failure.
- Death. Some inherited anemias, such as sickle cell anemia, can lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal.
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