Anemia
Pronounced: ah-KNEE-me-ah
Definition
Anemia is a disorder of the blood. It is the result of very low levels of red blood cells (RBC) and hemoglobin. Their main job is to carry oxygen from the lungs to the rest of the body. When RBC and hemoglobin levels are low the body does not get the right amount of oxygen. This causes fatigue, pale skin, irregular heartbeat, and other symptoms of anemia.
There are several specific types of anemia, including:
- Anemia of chronic disease —chronic diseases can slow the production of RBCs
- Aplastic anemia —bone marrow is not able to produce enough RBCs
- Iron-deficiency anemia —iron is a building block of hemoglobin
- Macrocytic B12 deficient anemia and pernicious anemia —B12 is a building block of RBCs
- Sickle cell anemia —RBC's have an abnormal shape that causes destruction of RBC's and low levels of hemoglobin
Red Blood Cells
Causes
The main causes of anemia are:
-
Blood loss, such as that caused by:
- Heavy menstrual periods
- Bleeding in the digestive tract
- Bleeding in the urinary tract
- Surgery
- Trauma
- Cancer
-
Abnormally low RBC production, due to:
- Kidney disease
- Cancer
- Infection
- Medication
- Radiation
- Pregnancy
- Lead intoxication
-
Abnormally high RBC destruction, caused by inherited disorders such as:
- Sickle cell anemia
- Thalassemia —difficulty in manufacturing hemoglobin
- Enzyme deficiencies
Risk Factors
The following factors may increase your risk of anemia:
- Women of childbearing age
- Pregnancy
- Older adults with other medical condition
- Infants younger than two years
- Poor diet low in iron, vitamins, and minerals
- Blood loss (eg, due to surgery or injury)
- Chronic or serious illness
- Chronic infections
- Family history of inherited anemia (eg, sickle cell anemia, thalassemia)
Symptoms
Symptoms of anemia may include:
- Tiredness
- Lethargy
- Feeling faint
- Paleness
- Shortness of breath
- Dizziness
- Headache
- Coldness in the hands and feet
- Pale skin
- Chest pain
- Rapid or irregular heartbeat
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Other tests may include:
- Complete Blood Count (CBC)—a test that measures levels of hemoglobin and RBCs
- Other blood tests
- Blood smear
- Stool sample
- Bone marrow aspiration or biopsy
Treatment
Talk with your doctor about the best plan for you. Options include:
Nutrition
Your doctor may suggest changes to your diet. The diet may include foods rich in iron, vitamin C, vitamin B12, and folate. Vitamins or iron supplements may be added.
Medications
To help treat your anemia or your symptoms your doctor may prescribe:
- Antibiotics
- Hormone treatment
- Epoetin
- Medications that act on the immune system
- Chelation therapy (for lead poisoning)
Blood Transfusions
A blood transfusion delivers blood cells from healthy donor blood.
Bone Marrow or Stem Cell Transplant
This procedure places healthy bone marrow or stem cell in the body. The goal is for the new tissue to produce healthy blood cells. This procedure carries risk. It is only done in severe cases of anemia.
Surgery
Critical bleeding may be treated with surgery. In cases of very high RBC destruction, your spleen may need to be surgically removed.
Prevention
Most inherited forms of anemia cannot be prevented. But the following steps may be taken to prevent certain types of anemia:
- Eat a diet rich in iron and vitamins
- Take iron or vitamin supplements, as recommended by your doctor
- Treat underlying causes of anemia
- Report signs and symptoms, especially chronic fatigue, to your doctor
RESOURCES:
Iron Disorders Institute
http://www.irondisorders.org
National Anemia Action Council
http://www.anemia.org
CANADIAN RESOURCES:
Anemia Institute
http://www.anemiainstitute.org
Chronic Disease Management, Government of British Columbia Ministry of Health
http://www.health.gov.bc.ca/cdm/
References:
Anemia. PatientUK website. Available at:
http://www.patient.co.uk/showdoc.asp?doc=23068888
.
Accessed June 25, 2007.
Anemia. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/anemia/anemia_whatis.html . Accessed June 25, 2007.
Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood . 2004;104:2263-2268.
Nissenson AR, Goodnough LT, Dubois RW. Anemia: not just an innocent bystander? Arch Intern Med . 2003;163:1400-1404.
Last reviewed September 2009 by Maria Adams, MS, MPH, RD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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