Anemia: Sign and symptoms, causes, treatment and prevention

LET US KNOW WHAT IS ANEMIA? 

Anemia is defined as a hematological disorder arising due to the decrease in the amount of red blood cells or erythrocytes.

RBCS or erythrocytes are responsible for carrying oxygen to the various parts of the body. The red colored pigment in RED blood cells is called Hemoglobin which acts as a carrier of Oxygen in the blood to supply throughout the body.

Decrease in the values of hemoglobin help to diagnose anaemia.  When a person becomes anaemic, his body receives less oxygen and thus the person experiences weakness and lethargy. The person who is anaemic gets off tired very soon than the healthier ones.

What is the role of hemoglobin in our blood? 

 Role of hemoglobin in the Red blood cells is significant and thus the maintenance of the normal level of hemoglobin levels in blood becomes the major requisite to correct anaemia.

What is the normal value range of hemoglobin in the blood for men and women? 

• In Men. the normal range of Hb is from 14 to 16 g/dL
• In Women the normal range of Hb is from 11 to 13g/dL

Most women are anemic as their Hb lies in the range of <11.  They may experience mild to moderate symptoms of anemia.  

The signs and symptoms of anemia may vary from mild to moderate to severe. The mild ones are better recovered by proper diet regimen and medications. The moderate anemia needs medical treatment and advice.

The anemia progressing to severe conditions requires immediate attention as the low hemoglobin may report as less as 2.0 gm/dl and then the oxygen perfusion in the tissues is not adequate to reach heart, brain and kidneys which may lead to more severe complications. Such cases require immediate blood transfusion.

What are the causes of Anemia? 

• Nutritional deficiencies: one of the most common causes of anemia is the deficiency of iron and vitamins such as folic acid vitamin B12 etc. in the body.
• Iron deficiency anemia, the most common form occurs due to the deficient levels of iron in blood. During menstruation and pregnancy the iron levels drop significantly and the females may develop the chances of becoming anemia.
• Due to the blood loss during menses/periods, especially in case of the heavy blood flow there are chances likely to develop anemia which in turn affects the general health of the women.
• Bleeding ulcers and the postpartum hemorrhage also add to the causes of anemia.
• Over the counter drugs: excess use of the over the counter drugs such as Aspirin or acetaminophen may lead to the development of the anemia due to its blood thinning property and damaging the gastric musical lining due to prolonged and unsupervised use.
• Hemolytic anemia and aplastic anemia: these are a sort of hereditary anemia exhibiting the inherited traits from the parents or family. The destruction of the red blood cells is the main cause here.
• Infection: the presence of infectious disease may cause the deficiency of hemoglobin leading to anemia through destruction of the Red blood cells. Such infections may be Malaria, tuberculosis, typhoid or hepatitis.
• Inflammatory conditions such as HIV/AIDS and cancer, kidney diseases, ulcerative colitis, Crohn’s disease and other immunodeficiency disorders may also develop risk of anemia in long term.
• BONE marrow disorders: inability of the bone marrow to produce the blood cells adequately due to some malignant conditions may result into the deficiency of the red blood cells contributing to anemia. 

What are the risk factors for anemia?

• Diet: an imbalanced diet, deficient in vitamins and minerals, mainly iron is one of the risk factor of anemia. There are different types based on the prevailing deficiency of vitamin such as vitamin B12 or folate deficiencies.

• Age: Adolescence / reproductive age

• According to World health Organization, It is estimated that One –third of all women of reproductive age are anemic.

• Pregnancy: the most commonly seen anemia is amongst the pregnant women. During pregnancy hemodilution occurs as a result of the increase in the plasma volume of the blood. Thus the overall decrease in the red blood cells and hemoglobin causes changes like anemia. It is termed as physiologic anemia.

•  Although it may disappear postpartum but the woman must intake plenty of food supplements of iron and folic acid and follow proper diet regimen so as to avoid any complications during pregnancy and after birth of the baby.

• Adolescent/ reproductive age: Here, menstruation becomes the foremost factor in causing anemia. The resulting blood loss during periods and the food fads during his period make the condition vulnerable. 

• The teenagers and the adolescents are moving nowadays to the fast or junk food and thus keep themselves away from the healthy food plates. The nutritional deficiencies adding up to the blood loss succumbs them to the anemic condition and debilitates their health.

• Family history of anemia

• The anemia types such as the hemolytic anemia such as Sickle cell anemia. Aplastic anemia are inherited types. The family history put on the risk of developing such anemia.

• Chronic Illnesses: Prolonged illness such as the inflammatory and bleeding disorders of GI tract and cancers, autoimmune disorders also pose a risk of developing anemia.

 

What are the signs and /symptoms of anemia? 

• Some people living with mild anemia hardly feel they are having any trouble, whereas people with distinctive low values of hemoglobin may experience a wide range of symptoms.
• Skin changes: Pale body, pale conjunctiva, lips, tongue, nail beds, pale skin.
• Weakness to extreme fatigue: Fatigue after playing or exercise
• Irregular heartbeats, chest pain, palpitations, shortness of breath on few distance walks
• Nerve disturbances: irritability, feeling coolness in the extremities, numbness and tingling of toes and fingers, headaches, dizziness or giddiness.
• Sleep disturbances: insomnia or sleeplessness, in some cases excess sleep due to fatigue.
• Food changes: anorexia, loss of weight due to anemia in some cases.

What are the complications of anemia? 

Mild anemia rarely creates any complications. But if it progresses then the person may be at the risk of suffering any serious complications:

The fatigue resulting from severe anemia makes a person lethargic and he/she starts to avoid many tasks of daily life. This can hamper their growth as an individual. The person may not feel it comfortable to complete the tasks that require physical effort as severe anemia leaves them easily tired on mild exertion.

Anemia in adolescents may develop issues related to self-perception due to the changes in their body image and personality. The pale skin and fatigued personality may contribute to develop inferiority complex and they may feel themselves low in groups, or ignored at times.

Anemia in pregnancy may cause ill effects on the developing fetus. Premature birth and low birth weight are the known risks associated to anemia in pregnancy. Especially when the pregnant woman is diagnosed with folic acid deficiency, there’s an alarming risk of developing neural tube defects in the fetus. The baby born with folate deficiency usually has less chances of survival.

Anemia in pregnancy and post pregnancy may pose a risk of hemorrhage. And in case hemorrhage occurs the woman’s body will not be able to suddenly compensate the blood loss in her body.

Anemia in infancy and teenage may hamper the growth and development of the child as these are often resulting due to the nutritional deficiencies such as iron and folic acid deficiency or the deficiency of other vitamins in the body.

The rarest yet fatal complication can be the death of the person as a result of cardiac insufficiency resulting from excess workload and pressure on the heart to meet the body requirements due to the lack of oxygen.

Some life threatening anemia such as sickle cell anemia, aplastic anemia are difficult to treat and they are often cited as severe anemia.

Severe anemia can lead to very serious complications if left untreated.

How is anemia diagnosed? 

Anemia can be diagnosed by:

• Family history of the patient: A thorough history may be helpful in ruling out the possibility of inherited anemia. Such as Thalassemia. Aplastic anemia or other hemolytic anemia.
• Physical assessment: a rough diagnosis can be made based on the physical assessment of the signs and the complaints of the patient.
• Medical tests: Complete blood count test is often recommended to reach to the diagnosis of anemia. The low hemoglobin levels, low red blood cell counts, decreased hematocrit values are suggestive of anemia.
• Blood smear or differential count, RBC morphology: the study of the size and shape of the red blood cells is also done microscopically to diagnose some of the hereditary anemia such as Sickle Cell anemia. RBCs may be hypochromic or hyper chromic or normochromic. They may be normocytic or microcytic or macrocytic. The significant changes in the size and shape of the red blood cells may help the physician to reach the accurate diagnosis about the type of anemia which makes it a bit easier to initiate the treatment plan of the condition.

How can we prevent anemia at home?  

Prevention of Anemia:

The prevention of anemia is related to the emphasis on diet and nutrition in a person’s life. The dietary management helps in preventing the anemia resulting from the nutritional deficiencies. Other hereditary anemia need definitive medical treatment plan and intervention to make the life of the person comfortable and convenient.

Dietary Management:

Healthy tips for anemia

• Intake of Plenty of fluids help maintains the fluid volume in the body. Water is the basic element of our diet and we should drink at least 10 to 12 glasses of water per day. Water is needed for the metabolism of the dietary nutrients we intake from the food.
  
  
• Eat iron rich food sources. Foods rich in iron are green leafy vegetables such as spinach, lettuce, dandelion, broccoli, cabbage, beans and peas etc., lentils, meat, dry fruits such as dates, raisins, etc. fruits like apple, pomegranates ,banana, mulberries, black grapes are also rich in iron.

• Along with iron sources, it is equally important to include food items rich in vitamin C because it is an essential vitamin for absorption of iron in the body.

• Vitamin C rich food sources are all types of citrus fruits such as lemon, oranges, sweet lime, kiwi, raspberries, strawberries, etc. Including curd and buttermilk in diet can also furnish the requirement of vitamin C.

• Ensure intake of folate sources in your diet. Folate rich food sources are: sea foods, fruit juices, vegetables such as kidney beans, broccoli and green leafy vegetables. Dried sunflower seeds, peanuts, almonds also contain folic acid.  In pregnancy folic acid tablets are given as a preventive measure to avoid neural tube defects.

• Vitamin B12 deficiency may also be one of the cause of anemia. To prevent anemia due to this deficiency, one must include Vitamin B12 in diet. The rich sources include fresh fruits and vegetables such as spinach, beet root, and broccoli. Legumes, meat, eggs, also contain good amount of vitamin B12. Fortified foods and soy products, tofu, milk, yoghurt etc. also are rich in Vitamin B12.

• Supplementary vitamins in the form of tablet, prescribed by an expert can also be a part of preventing anemia.

What is the treatment of anemia? 

• Treatment of anemia is a strategic approach depending upon its time and condition or severity of the patient.
• Depending on the type of anemia, once diagnosis is made sure, the doctor treats the patient accordingly.
• Most of the prevalent cases are seen in females around the globe, which are usually due to the nutritional deficits. Such mild to moderate cases are given supplementary iron and folate tablets as well as multivitamin therapy and some hematinic liquid syrups to increase the iron content of the blood. Thus helps in raising the hemoglobin level which in turn cures the anemic disorder.
• The severe cases are mostly related to genetic or hereditary anemia such as sickle cell anemia, aplastic anemia, etc. These are treated by blood transfusion or replacement of deficient blood by fresh one. It may include, plasma or packed blood cell.
• In aplastic anemia, the bone marrow cannot produce enough blood cells needed for the body. So the deficient red blood cells result in the lack of oxygen leading to anemia. The aplastic anemia needs bone marrow transplantation or stem cell therapy as it is necessary to rebuild the new bone marrow that would produce the blood cells in normal quantity. Immuno-suppressants, antibiotics and frequent blood transfusions are the line of treatment for patient suffering with aplastic anemia. Patients with aplastic anemia have weakened immune system and are often prone to infections due to the lack of platelets and other blood cells in the body. It includes a long term treatment which is planned by the physician as per the age and severity as well as the prognosis of the patient.

The final note: 

Anemia is often one of the most ignored disorder, especially by females, which makes them succumb to various infections and severe consequences later in their life. If proper checkup and management is done taking into consideration the diet and early treatment, it is possible to fight anemia even before it starts or creates complications in a person’s body.

Note: This blog post is for educational and informational purpose only. It is not a substitute to any medical advice, consultation or treatment. Seek medical help in any case.