Anemia is a common health problem seen more often in women than men. It is a frequent manifestation of a variety of underlying disease conditions. Essentially, anemia means presence of lower than normal amounts of red blood cells (RBCs) or hemoglobin (Hb) in the blood. Hemoglobin is the protein in red blood cells that carries oxygen throughout the body.
There are three main causes of anemia:
- Blood loss, either sudden or slow internal bleeding
- Low production of RBCs by the body
- High rate of RBCs being destroyed
Iron deficiency anemia is the most common cause of anemia. It may result from a diet low in iron, body’s inability to absorb iron or blood loss. Children and women of childbearing age are more susceptible. Blood loss from heavy bleeding during menstrual cycles in teens and young women is another common cause. In the elderly, iron deficiency anemia may be caused due to blood loss, such as gastrointestinal bleeding from colon cancer, alcohol use causing a gastric ulcer or a non-cancerous intestinal problem. Low levels of vitamin B-12 and folate, which is another B vitamin, are common causes of vitamin deficiency anemia. Those who are at highest risk for developing this condition are the elderly who do not have the ability to absorb nutrients effectively, substance abusers and alcoholics who may not eat a well-balanced diet and surgically treated patients who have had a part of their bowel removed.
A long-term or chronic illness can also cause anemia. People with inflammatory or autoimmune diseases, kidney disease, some cancers, disorders of the liver or thyroid and certain chronic infections are at highest risk. Parents with certain genes can pass on anemia diseases to their children. Many hereditary anemia types exist, but they generally fall into two categories. One is the hemolytic anemia in which the red blood cells are destroyed too quickly. Sickle cell disease and thalassemia fall into this group. The other is Inherited bone marrow failure syndromes (IBMFS) which are rare disorders in which the marrow does not produce enough RBCs. Specific conditions include aplastic anemia and Fanconi anemia. Some patients with IBMFS may eventually develop leukemia or another cancer.
Signs and symptoms vary depending on the cause of anemia. They may include fatigue, weakness, pale skin, dizziness, shortness of breath, chest pain, cold hands and feet, irregular heartbeats and headache.
Laboratory investigations often depend on the clinical suspicion of the cause of anemia. Spectrum of tests are available at Anand Diagnostic Laboratory and include complete blood counts, complete hemogram, hemoglobin electrophoresis, screening for Hereditary spherocytosis by flow cytometry, serum iron profile, Vitamin B12 and folate assays, bone marrow studies and various other tests that may indirectly cause anemia. Availability of state of the art instruments and interpretation of results by experienced hematopathologists help in giving precise values with low turnaround time.
When it comes to treatment of anemia, the one-size-fits all remedy does not apply as there are many types of anemia, and the doctor will create a personalized treatment plan with the specific anemia, symptoms and severity in mind.
Generally, deficiency anemia is treated with iron supplements, consuming iron rich food, folic acid supplements, injections for vitamin B-12. In hereditary anemia, the doctor will monitor blood counts and watch for problems with regular bone marrow and chromosome tests. Treatments include steroids, hormones, and drugs to stimulate blood cell production, or blood transfusions. Antibiotics to prevent or treat infections are used when necessary.
Early recognition, timely investigations and treatment will not only help in reducing the side effects and complications related to anemia but also improve the overall well-being and quality of life.