Anemia

What is anemia?

Anemia occurs when red blood cells are deficient or when these cells do not function properly. Red blood cells transport oxygen throughout the body, which is essential for powering cells and providing energy. When red blood cells are not functioning adequately, the body does not receive sufficient power to function optimally. While certain types of anemia may be temporary and mild, others can persist throughout one's lifetime. If left untreated, anemia can pose life-threatening risks.

What are the types of anemia?

1. Iron-deficiency anemia:

Iron deficiency anemia occurs when the body lacks sufficient iron, making it the most prevalent form of anemia, responsible for an estimated 50 percent of all cases. Various factors can contribute to reduced iron levels, including

• blood loss
• inadequate dietary iron intake
• conditions that hinder iron absorption, such as inflammatory bowel disease (IBD) or prior gastric bypass surgery.

While individuals with mild or moderate iron-deficiency anemia may not exhibit symptoms, severe cases can manifest as fatigue, shortness of breath, or chest pain. Left untreated, severe iron deficiency anemia can lead to potentially serious complications.

2. Vitamin-deficiency anemia

Vitamin deficiency anemia, on the other hand, results from lower-than-normal levels of folate or vitamin B12 in the body. This type of anemia is typically caused by inadequate dietary intake of these nutrients. In addition to general anemia symptoms, signs of anemia due to low folate levels may include mouth and tongue soreness or changes in skin, hair, or nails. Pernicious anemia, a specific type caused by low vitamin B12 levels, often results from a deficiency in intrinsic factor, a protein produced in the stomach that aids in vitamin B12 absorption. Symptoms specific to vitamin B12 deficiency may include numbness or tingling in the extremities, muscle weakness, or digestive issues.

3. Haemolytic anemia

Haemolytic anemia occurs when red blood cells are destroyed faster than the body can replace them. This condition has numerous causes, including:

• autoimmune activity
• inherited disorders like sickle cell disease
• physical damage to red blood cells
• medication side effects, infections
• toxin exposure.

Symptoms may include jaundice, an enlarged spleen, or abdominal pain.

4. Aplastic anemia

Aplastic anemia arises when the bone marrow fails to produce enough red blood cells, often due to damage to stem cells in the bone marrow. Common causes include:

• autoimmune activity
• certain medications
• toxin exposure
• genetic factors.

Aplastic anemia affects red blood cell production, white blood cells, and platelets, leading to increased infection risk, bruising, or bleeding.

5. Anemia of inflammation or chronic disease

Anemia of inflammation or chronic disease stems from underlying health conditions that cause inflammation within the body. This inflammation alters normal bodily functions, reducing iron levels despite adequate iron stores, decreasing erythropoietin production, impairing bone marrow response to erythropoietin, and shortening red blood cell lifespan. Conditions contributing to anemia of inflammation or chronic disease include:

• Cancer
• autoimmune disorders
• chronic kidney disease
• infections
• inflammatory bowel disease (IBD)\

How does anemia affect the body?

When an individual develops anemia, they exhibit symptoms such as fatigue or constantly feeling cold, indicating a low red blood cell count. The impact of anemia varies across different demographics:

1. Newborns: Some newborns are born with low red blood cell counts, with severe cases potentially necessitating blood transfusions, although most infants do not require medical intervention for anemia.

2. Infants: Upon transitioning to solid foods, infants may receive less iron than needed, as iron from solid foods is less readily absorbed than breast milk or formula. Anaemic infants may exhibit lethargy.

3. Children: During rapid growth stages from birth to age 2, children require increased iron intake. Anemia in children may lead to delayed motor skill development and learning difficulties.

4. Pregnant Women: Pregnant women may develop iron-deficiency anemia, which can heighten the risk of complications such as premature birth or delivering low birth weight babies.

5. Women: Women experiencing heavy menstrual bleeding or conditions like uterine fibroids are at risk of blood loss and subsequent anemia.

6. Individuals Over 65: Older individuals are prone to iron-poor diets and chronic illnesses, increasing their vulnerability to anemia. Anemia in this demographic may result in heart conditions, mobility issues, confusion, or depression.

7. Individuals with Chronic Conditions: Certain chronic conditions like autoimmune diseases or cancer elevate the risk of anemia, known as anemia of chronic disease.

What are the causes of anemia?

Anemia arises when the blood lacks sufficient hemoglobin or red blood cells, which can occur due to various reasons:

• Insufficient production of hemoglobin or red blood cells by the body.
• Rapid loss of red blood cells and hemoglobin through bleeding surpasses the replacement rate.
• Destruction of red blood cells and their hemoglobin content by the body.

The Role of Red Blood Cells:

The body manufactures three types of blood cells: white blood cells combat infection, platelets assist in blood clotting, and red blood cells transport oxygen throughout the body.

Red blood cells contain hemoglobin, an iron-rich protein that imparts blood its characteristic red hue. Hemoglobin facilitates oxygen carriage from the lungs to all body tissues and transports carbon dioxide from various body parts back to the lungs for exhalation.

Red blood cells and hemoglobin are produced within the spongy bone marrow in many large bones. Adequate intake of iron, vitamin B-12, folate, and other nutrients from the diet is necessary for their synthesis.

Causes of Anemia:

Anemia manifests in various forms, each with distinct aetiologies:

1. Iron deficiency anemia results from insufficient iron levels, hindering hemoglobin production in the bone marrow. Causes include inadequate dietary intake, blood loss (often due to heavy menstruation, ulcers, cancer, or aspirin use), and pregnancy.

2. Vitamin deficiency anemia arises when the body lacks folate and vitamin B-12, essential for red blood cell synthesis. Inadequate dietary intake or malabsorption issues can lead to this type of anemia, pernicious anemia.

3. Anemia of inflammation stems from chronic diseases causing persistent inflammation, hindering red blood cell production. Examples include cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, and Crohn's disease.

4. Aplastic anemia, a rare yet severe condition, occurs when the bone marrow fails to generate sufficient new blood cells. Causes include infections, certain medications, autoimmune disorders, and exposure to toxic substances.

5. Anaemias associated with bone marrow disorders, such as leukaemia and myelofibrosis, disrupted blood cell production, ranging from mild to life-threatening outcomes.

6. Haemolytic anaemias occur when red blood cells are destroyed at a rate surpassing bone marrow's replacement capacity. Some forms are hereditary, while others result from certain blood diseases or inherited conditions like sickle cell anemia, characterized by abnormal hemoglobin leading to premature red blood cell death.

What are the risk factors of anemia?

Several factors can heighten the risk of developing anemia:

• Inadequate intake of essential vitamins and minerals in the diet, such as iron, vitamin B-12, and folate, raises the likelihood of anemia.
• Gastrointestinal disorders affecting nutrient absorption in the small intestine, such as Crohn's disease and celiac disease, elevate the risk of anemia.
• Menstrual periods characterized by heavy bleeding can predispose individuals to anemia due to the loss of red blood cells.
• Pregnancy without the supplementation of a multivitamin containing folic acid and iron increases the vulnerability to anemia.
• Chronic health conditions like cancer, kidney failure, and diabetes are associated with an increased risk of anemia of chronic disease stemming from a diminished red blood cell count.
• Persistent, gradual blood loss from ulcers or other internal sources can deplete the body's iron stores, leading to iron deficiency anemia.
• A family history of inherited anaemias, such as sickle cell anemia, heightens the risk of developing these genetic conditions.
• Additional factors contributing to anemia risk include a history of certain infections, blood disorders, and autoimmune disorders, as well as excessive alcohol consumption, exposure to toxic substances, and the use of certain medications that can disrupt red blood cell production.
• Advanced age, particularly individuals 65 and older, increases susceptibility to anemia.

What are the symptoms of anemia?

The symptoms of anemia can vary depending on its underlying cause and severity. While anemia may initially present with mild or no symptoms, it typically becomes more pronounced as the condition progresses.

In cases where anemia is secondary to another medical condition, the symptoms of the underlying disease may overshadow those of anemia, potentially leading to a delayed diagnosis. However, certain types of anemia exhibit specific symptoms indicative of their underlying causes.

Common symptoms associated with anemia include:

1. Fatigue.

2. Weakness.

3. Shortness of breath.

4. Pallor or a yellowish hue to the skin may be more noticeable in individuals with lighter skin tones.

5. Irregular heartbeat.

6. Dizziness or light-headedness.

7. Chest pain.

8. Cold extremities, such as hands and feet.

9. Headaches.

When to see a doctor

Schedule a consultation with your healthcare provider if you experience fatigue or shortness of breath without an apparent cause.

Reduced levels of hemoglobin, the protein responsible for oxygen transport in red blood cells, serve as a primary indicator of anemia. Individuals may discover low hemoglobin levels during blood donation screenings. If you're deferred from donating blood due to low hemoglobin, arranging a medical assessment is advisable.