Anemia Symptoms, Signs, Causes, Diagnosis, Diet, Treatment for Anemia

Anemia Symptoms, Signs, Causes, Diagnosis, Diet, Treatment for Anemia


What Is Anemia?


Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen. Symptoms of anemia -- like fatigue -- occur because organs aren't getting what they need to function properly. 
Anemia Symptoms, Signs, Causes, Diagnosis, Diet, Treatment for Anemia

Certain forms of anemia are hereditary and infants may be affected from the time of birth.

Women in the childbearing years are particularly susceptible to iron-deficiency anemia because of the blood loss from menstruation and the increased blood supply demands during pregnancy.

Older adults also may have a greater risk of developing anemia because of poor diet and other medical conditions.

There are many types of anemia. All are very different in their causes and treatments. Iron-deficiency anemia, the most common type, is very treatable with diet changes and iron supplements. Some forms of anemia -- like the anemia that develops during pregnancy -- are even considered normal. However, some types of anemia may present lifelong health problems.

When Anemia Begins


Anemia may begin to develop in the early stages of kidney disease, when you still have 20 percent to 50 percent of your normal kidney function. This partial loss of kidney function is often called chronic renal insufficiency. Anemia tends to worsen as kidney disease progresses. End-stage kidney failure, the point at which dialysis or kidney transplantation becomes necessary, doesn't occur until you have only about 10 percent of your kidney function remaining. Nearly everyone with end-stage kidney failure has anemia.

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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 Symptoms, Signs, Causes, Diagnosis, Diet, Treatment for Anemia

Anemia is caused essentially through two basic pathways. Anemia is caused by either:
  • A decrease in production of red blood cells or hemoglobin, or
  • An increase in loss or destruction of red blood cells.
A more common classification of anemia (low hemoglobin) is based on the Mean Corposcular Volume (MCV) which signifies the average volume of individual red blood cells.
  • If the MCV is low (less than 80), the anemia is categorized as microcytic anemia (low cell volume).
  • If the MCV is in the normal range (80-100), it is called a normocytic anemia (normal cell volume).
  • If the MCV is high, then it is called a macrocytic anemia (large cell volume).

Can inadequate iron cause anemia?


Absolutely! As a matter of fact, iron deficiency is a very common cause of anemia. This is because iron is major component of hemoglobin and essential for its proper function. Chronic blood loss due to any reason is the main cause of low iron level in the body as it depletes the body's iron stores to compensate for the ongoing loss of iron. Anemia that is due to low iron levels is called iron deficiency anemia.

Young women are likely to have low grade iron deficiency anemia because of the loss of blood each month through normal menstruation. This is generally without any major symptoms as the blood loss is relatively small and temporary.

Another common reason for iron deficiency anemia can be due to recurring or small ongoing bleeding, for instance from colon cancer or from stomach ulcers. Stomach ulcer bleeding may be induced by medications, even very common over-the-counter drugs such as aspirin and ibuprofen (Advil, Motrin). Slow and chronic oozing from these ulcers can lead to loss of iron. Gradually, this could result in anemia. In infants and young children, iron deficiency anemia is most often due to a diet lacking iron.

What are other causes of anemia?


Some of the most common causes include:

Vitamin B12 deficiency may cause pernicious anemia. This type of anemia could happen in people who are unable to absorb vitamin B12 from their intestines due to a number of reasons.
  • Strict vegetarians are at risk if they do not take adequate vitamin supplements.
  • Long-term alcoholics.
  • People who have abnormal structure or function of the stomach or intestines leading to impaired B12 absorption despite adequate intake.
This typically causes macrocytic (large blood cell volume) anemia. Vitamin B12, along with folate, is involved in making the heme molecule that is an integral part of hemoglobin. Folate deficiency can be the culprit of anemia as well. This may also be caused by inadequate absorption, under-consumption of green, leafy vegetables, and also long-term heavy alcohol use.

  • There can be rupture or destruction of red blood cells (hemolytic anemia) due to antibodies clinging to the surface of the red cells. Examples of hemolytic anemia include hemolytic disease of the newborn, medication induced hemolytic anemia, transfusion related hemolysis, and autoimmune hemolytic anemia.
  • A wide assortment of bone marrow diseases can cause anemia.
For example, cancers that spread (metastasize) to the bone marrow, or cancers of the bone marrow (such as leukemia or multiple myeloma) can cause the bone marrow to inadequately produce red blood cells, resulting in anemia.
Certain chemotherapy for cancers can also cause damage to the bone marrow and decrease red blood cell production, resulting in anemia.
Certain infections may involve the bone marrow and result in bone marrow impairment and anemia.
Finally, patients with kidney failure may lack the hormone necessary to stimulate normal red blood cell production by the bone marrow.
Chronic alcohol consumption may lead to anemia via different pathways and thus, anemia is commonly seen in alcoholics.
  • Another common cause of anemia is called anemia of chronic disease. This could typically occur in individuals with longstanding chronic diseases.
  • Some medications can cause anemia in a variety of ways.
  • Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) can cause anemia.
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What are the symptoms of anemia?


Anemia Symptoms, Signs, Causes, Diagnosis, Diet, Treatment for Anemia

Some patients with anemia have no symptoms. Others with anemia may feel:
  • Tired
  • Fatigue easily
  • Appear pale
  • Develop palpitations (feeling of heart racing)
  • Become short of breath
Additional symptoms may include:
  • Hair loss
  • Malaise (general sense of feeling unwell)
  • Worsening of heart problems
It is worth noting that if anemia is longstanding (chronic anemia), the body may adjust to low oxygen levels and the individual may not feel different unless the anemia becomes severe. On the other hand, if the anemia occurs rapidly (acute anemia), the patient may experience significant symptoms relatively quickly.

How is anemia diagnosed?


Anemia is usually detected, or at least confirmed, by a complete blood cell (CBC) count. A CBC test may be ordered by a physician as a part of routine general checkup and screening or based on clinical signs and symptoms that may suggest anemia or other blood abnormalities.

The evaluation will include tests for iron deficiency and blood loss in the stool to be certain there are no other reasons for the anemia.

Treatment for Anemia


The treatment of the anemia varies greatly. First, the underlying cause of the anemia should be identified and corrected. For example, anemia as a result of blood loss from a stomach ulcer should begin with medications to heal the ulcer. Likewise, surgery is often necessary to remove a colon cancer that is causing chronic blood loss and anemia.

Anemia Caused by Blood Loss 


If you suddenly lose a large volume of blood, you may be treated with fluids, a blood transfusion, oxygen, and possibly iron to help your body build new red blood cells. Chronic blood loss is treated by identifying the source of bleeding, stopping the bleeding, and, if necessary, providing treatment for iron-deficiency anemia.

Anemia Caused by Iron Deficiency


Without adequate iron, the body is unable to produce normal red blood cells. In young women, iron deficiency anemia can result from heavy menstrual bleeding. Non-menstruating women or men who develop iron deficiency need to have a colon exam (colonoscopy or barium enema) to help identify the source of chronic bleeding.

Sometimes iron supplements will also be needed to correct iron deficiency. In severe anemia, blood transfusions may be necessary. Vitamin B12 injections will be necessary for patients suffering from pernicious anemia or other causes of B12 deficiency.

In certain patients with bone marrow disease (or bone marrow damage from chemotherapy) or patients with kidney failure, epoetin alfa (Procrit, Epogen) may be used to stimulate bone marrow red blood cell production.

If a medication is thought to be the culprit, then it should be discontinued under the direction of the prescribing doctor.