Blood is made up of plasma, red and white blood cells, and platelets. When there are less than normal red blood cells in the blood, the condition is described as anemia. Hemoglobin, a protein that is present in the red blood cells, carries oxygen to different parts of the body. Anemic people do not have enough hemoglobin in their blood, either due to poor nutrition, loss of blood, and chronic diseases like cancer or as a result of hereditary diseases like sickle cell anemia and thalassemia. Since iron is vital for the production of red blood cells in the bone marrow and so is erythroprotein, a chemical made in the kidneys, a deficiency of iron, folate, and vitamin B12 in the diet can lead to anemia over time. It is thus important that anemic people eat a balanced diet, along with the required supplements. Further, anemia during pregnancy is fairly common among women in developing countries.
Apart from the anemia caused by iron, folate, and vitamin B12 deficiency, there are several other types of anemia such as hemolytic anemia, megaloblastic anemia, aplastic anemia, pernicious anemia, sickle cell anemia, and thalassemia. Anemia could also be the result of chronic diseases like kidney disease, liver cirrhosis, rheumatoid arthritis, cancer or diseases of the bone marrow, as mentioned earlier. Hemolytic anemia is a condition in which there are fewer red blood cells because these cells get destroyed too early in their lifecycle (the normal lifespan is 120 days) and the bone marrow is unable to speed up production to replace the destroyed cells. In people with megaloblastic anemia, the red blood cells are larger than normal and are hence destroyed easily. Aplastic anemia is seen in pregnant women and in people who suffer from autoimmune diseases.
A complete blood cell count is one of the first anemia tests ordered when a doctor finds a patient with symptoms of anemia such as pale skin, fatigue, and nosebleeds. This test gives information about red blood cell count, hemoglobin content in the blood and amount of hemoglobin in each cell, average size of the red blood cells, white blood cell count, and platelet count. Of these, the first three are vital for the diagnosis of anemia. Bone marrow tests may be conducted in cases wherein the results of the complete blood cell count test shows an abnormal number of red blood cells. In some cases with jaundice or an enlarged spleen along with anemia, a blood smear may be requested.
Anemia causes are usually classified as those caused by blood loss, reduced production of blood cells, or rapid destruction of red blood cells. Apart from injuries, loss of blood could be caused by gastrointestinal disorders like ulcers and colitis or as a result of cancer. Causes of anemia in women include heavy menstrual flow and childbirth, apart from poor nutrition. Causes of anemia in men could range from alcoholism, chronic kidney or liver diseases, and even exposure to toxic chemicals. Aplastic anemia caused by toxic chemicals is reversible by simply avoiding such exposure. Deficiency of vitamin B12 or the inability to absorb the vitamin from the food consumed is one of the reasons for pernicious anemia in both men and women. Anemia causes in children may be hereditary, such as in the case of sickle cell anemia and thalassemia, both being blood disorders that are inherited from an infected parent. Folic acid deficiency is often related to megaloblastic anemia. In the developing world, poor nutrition is one of the major causes of anemia.
Fatigue, breathlessness, and light headedness are anemia symptoms that patients often report to medical professionals. Examining physicians may observe pale skin, a rapid heart rate, and shortness of breath in patients, some of whom might even complain of chest pain. Episodes of dizziness and fainting may follow headaches, and patients with circulation problems often have cold hands and feet as well as tingling in the hands and feet. Pernicious anemia symptoms could include neurological problems such as slow reflexes, disorientation, and a smooth tongue that is red in color rather than a healthy pink.
Establishing the cause of anemia plays a vital role in the effective anemia treatment. Dietary changes to increase the levels of iron and vitamins B12 in the body are the first line of treatment suggested for anemia caused by the deficiency of iron or vitamin 12. Hormones to treat menstrual problems in women and medication for chronic infections and thyroid problems are also prescribed. Cobalamin therapy may be started in case of severe vitamin B12 deficiency. Iron supplements may have side effects like constipation or diarrhea. Blood transfusions are common for patients with thalassemia and sickle cell anemia as well as for those who have lost a lot of blood during a surgery or due to an injury caused by an accident. A blood and bone marrow stem cell transplant may be necessary when bone marrow disease is the reason behind the lower production of red blood cells and the resultant anemic condition.