Anemia

anemia summary

Anemia is a disease that affects the quality and quantity of red blood cells (or erythrocytes) in the blood It can occur due to several factors.
One of the types of anemia is that characterized by the absence of nutrients that are used in the production of elements in red blood cells, such as  iron (iron deficiency anemia), vitamin B12 or folic acid  (pernicious or megaloblastic anemia). Another factor is excessive blood loss, as in hemorrhages. Certain infectious and autoimmune diseases, as well as toxic substances, can cause destruction of red blood cells, leading to hemolytic anemia.

Genetic defects are also the cause of anemia such as sickle cell anemia, in which red blood cells are abnormally shaped (like a sickle). Enzymatic diseases, such as glucose-6-phosphate dehydrogenase deficiency, defects in erythrocyte membranes, thalassemias (deficiencies that lead to reduced synthesis of hemoglobin globins), also cause anemia.

People with poor nutrition are at risk of developing anemia due to lack of nutrients. Pregnant women need more vitamins and minerals. People with constant blood loss also enter the risk group.

Genetic defects are also the cause of anemia such as sickle cell anemia, in which red blood cells are abnormally shaped (like a sickle). Enzymatic diseases, such as glucose-6-phosphate dehydrogenase deficiency, defects in erythrocyte membranes, thalassemias (deficiencies that lead to reduced synthesis of hemoglobin globins), also cause anemia.

People with poor nutrition are at risk of developing anemia due to lack of nutrients. Pregnant women need more vitamins and minerals. People with constant blood loss also enter the risk group.

The symptoms of this disease are characterized by fatigue, pale skin, headaches, vertigo, palpitations, splenomegaly, jaundice, etc. The diagnosis is usually made with laboratory blood tests, with the dosage of vitamins, red blood cells and other elements.
When left untreated, anemia can lead to neurological complications and also kidney failure, in the case of hemolytic anemia. Treatments vary according to the type of anemia. Intake of nutrients (iron, folic acid, vitamin B12), discontinuing the use of agents that may cause hemolysis, or therapy with immunoglobulins in the case of autoimmune disease is usually recommended. It is always important to maintain a balanced diet, with adequate intake of vitamins and minerals to avoid deficiency anemia.

Definition

Anemia is a condition that affects the quality or number of red blood cells. These are blood cells that bring oxygen from the lungs to different tissues and organs, such as the brain. Anemia can be temporary or extend over a long period of time, it can have moderate or severe symptoms1.

In reality, there are several types of anemia, as the causes are diverse. It can occur due to a lack of precursor elements of red blood cells at the time of their manufacture (erythropoiesis):   iron , vitamin B12 or even folic acid . Another cause can be a great loss of blood in case of heavy menstruation or ulcers, for example. Pregnant women often develop anemia as a result of their need for iron. See causes of anemia section .
Different treatments can be used, such as supplementation with iron, vitamin B12 or folic acid .🇧🇷 Depending on the type and severity of anemia, you may need some blood transfusions. Anemia treatments are explained in the Anemia treatment section .

Epidemiology

– Anemia is especially common in the elderly. In the United States, about 17% of people age 65 and older have anemia2.

Causes

As we saw in the definition of anemia section, there are several causes, therefore several types of anemia.

– Pernicious or megaloblastic anemia: This type of anemia is very common. It is caused by a deficiency in vitamin B12 or folic acid , due to poor absorption of this element in the gastric region, in case of gastritis, for example.

– Iron deficiency anemia (iron deficiency): the disease is caused by a lack of iron , in case of excessive losses (heavy menstruation, gastric bleeding, in the case of a gastric ulcer) or nutritional deficiencies, malabsorption, increased need in case of pregnancy. It is the most frequent anemia.

– Hemolytic anemia: This type of anemia occurs due to a lack of red blood cells if production is insufficient or the destruction is too massive. This is the case with certain infectious, autoimmune or toxic diseases. We can cite malignant lymphopathies, certain medications, viral diseases, or even unknown.

– Anemia of the Newborn: The newborn may suffer from anemia if a placental deficiency occurs or if there is an Rh incompatibility problem between the mother and the baby.

– Anemia of chronic diseases. Some illnesses such as cancer, AIDS or Crohn’s disease can affect the production of red blood cells.

– Other forms of anaemia, such as thalassemia. There are many forms of anemia with low frequency.

Groups of risk

People at risk are the following:

– people suffering from malnutrition (iron deficiency due to lack of intake or deficiency of some hemoglobin precursor element: vitamin B12 or folic acid);

– elderly people who eat insufficiently (lack of intake of iron and hemoglobin precursors);

– children, due to an increased need for iron during growth.

– people with thalassemia, a genetic disease that causes a manufacturing defect in haemoglobin;

– a person with sickle cell disease (sickle cell anaemia), hereditary disease that alters the synthesis of haemoglobin;

– people with gastritis (vitamin B12 malabsorption);

– people with gastric ulcers (blood loss);

– people with lymphoma (destruction of blood cells)

– people with infectious diseases (such as malaria, due to the destruction of red blood cells during malarial attacks);

– women with heavy or abnormally long menstrual periods (bleeding);

– women using IUDs (risk of bleeding);

– pregnant women (increased need for iron);

– pregnant women with Rh incompatibility between mother and child;

– breastfeeding women (increased need for iron);

– people undergoing chemotherapy (due to cancer);

– people taking anticoagulants (risk of bleeding);

Symptoms

Anemia symptoms are better manageable in case of chronic anemia as the body has time to adapt to the lack of oxygen. This is not the case when acute anemia occurs, where the drastic drop in red blood cells is much less tolerated. You should know that with anemia (generally), early in the illness the symptoms are usually moderate (mild) and often go unnoticed[efn_notMayo Clinic Newsletter, Mayo Clinic Health Letter, page 1, June 2022 issue speaking specifically about anemia[/efn_note].

The general symptoms for the different types of anemia are:

  • Tiredness
  • Pallor of the skin and mucous membranes. We can see pallor, for example, in the nail bed, in the palm of the hand, inside the eyelids or on the lips.
  • Palpitations (mainly tachycardia)
  • Shortness of breathe
  • Disturbances in thermoregulation (dyspnoea on exertion)
  • cognitive disorders
  • hair loss
  • brittle nails
  • Canker sores

The characteristic symptoms of different types of anemia are listed below:

– Pernicious or megaloblastic anemia: This type of anemia is generally well tolerated, given its progressive onset. Vitamin B12 is also involved in nerve transmission, its lack can cause nervous disorders.

– Iron deficiency anemia (martial deficiency anemia): In general, the symptoms of this type of anemia are identical to the general symptoms.

– Hemolytic anemia: In addition to the general symptoms, it is possible to identify splenomegaly or jaundice.

– Anemia of the newborn The characteristic signs of anemia of the newborn are pallor, difficulty taking a bottle (due to suffocation) and a heart murmur.

Diagnosis

The diagnosis of anemia begins with anamnesis (medical history). The doctor collecting data from the patient about the characteristic symptoms of the disease, such as: paleness, mainly of the mucous membranes. A background check is also conducted. The doctor then checks for possible causes of anemia, such as use of an IUD (risk of bleeding), pregnancy (increased need for iron), taking certain medications (blood thinners that increase the risk of bleeding), heredity ( hereditary anaemia, such as thalassemia and sickle cell anaemia), or the presence of an infectious disease (malaria, HIV).

Diagnosis differs due to the diversity of types of anemia

– Pernicious or megaloblastic anemia: two tests allow the diagnosis of this type of anemia:
>the Schilling Test, in case of malabsorption
> blood levels of vitamin B12 and folic acid.

– Iron-deficiency anemia: blood measurements show a decrease in the hemoglobin level, the volume of red blood cells, as well as the iron level.

– Hemolytic anemia: to rule out this type of anemia, there are blood tests that show a high number of reticulocytes (young red blood cells).

– Anemia of the newborn In order to prevent anemia of the newborn, a screening is carried out on the mother (prenatal test). In the newborn, anemia is confirmed by a blood test (red blood cell numbering, blood group test).

Doctors sometimes do a scanner (for example, CT scan) to identify possible serious illnesses, particularly bleeding from internal organs.

Complications

In general, anemia is reversible, thanks to existing treatments. In contrast, in anemia in newborns, fetal death is common.

Various complications of anemia can occur, such as breathing or heart problems. Thus, anemia can cause dyspnoea (=difficulty breathing), tachycardia (=fast heart rate) and palpitations.

In severe acute anemia, the patient may faint, lose consciousness. This is a medical emergency. This is possible when anemia is not treated or there is poor adherence to treatment. In fact, due to side effects, mainly gastric effects in cases of iron supplementation, the patient often stops the medication on their own, sometimes slightly resuming their illness. A state of shock may also occur. In extreme cases (delayed diagnosis), the patient may die.

According to studies performed with anemia, it appears that dementia can occur. We still don’t know very well the relationship between dementia and anemia. Is anemia the cause or even a marker of an already advanced disease? In fact, during anemia, tissues are less oxygenated, as blood deficient in hemoglobin carries less oxygen. When the affected organ is the brain, the risk of dementia may logically appear.

In the case of pernicious anemia (lack of vitamin B12), neurological complications may appear, as vitamin B12 also acts on the nerves.

Kidney failure can occur in the case of hemolytic anemia.

When to consult?

Anemia requires medical consultation. If you are experiencing symptoms of anemia, consult your doctor because there are many causes of anemia and this can also be the sign of some serious illnesses.

The following symptoms should make you think of anemia:

Persistent fatigue, lack of energy, loss of enthusiasm, drowsiness, pale skin, rapid heartbeat, …

If you have these symptoms it is advisable to visit your doctor!

Self-medication is not recommended during anemia. For example, it is unnecessary to take iron supplements or vitamin supplements in cases where the person thinks he has anemia. In fact, there are many forms of anemia, many causes of this disease and that’s why it’s best to know the sources of the disease through medical diagnosis. Without consulting a doctor, you may have a serious illness and not seek adequate treatment in time.

There is also no need to take iron supplements if iron absorption is low, especially in cases of gastritis or when the cause of anemia is related to folic acid or vitamin B12, among others.

Thus, a medical diagnosis not only detects anemia and discovers the causes of this disease. With this diagnosis, the doctor will be able to prescribe the appropriate treatment.

Treatments

First of all, in case of anemia, it is necessary to treat the symptoms: stop bleeding (menstruations, ulcers). Then the causes of anemia will be treated: supplementation of folic acid, vitamin B12 or iron. Medications and care for anemia are as follows:

– Pernicious or megaloblastic anemia: In addition to treating the cause ( vitamin B12 malabsorption) , it will be necessary to supply the patient with this missing substance, in the form of tablets (by mouth) or parenterally (by injection).

– Iron-deficiency anemia: Treatment consists of providing iron orally. This treatment is initially done for six months.

– Hemolytic anemia: Given the number of causes of this type of anemia, it will be necessary to discover the origins. If the anemia is due to a medication, for example, the toxic medication needs to be stopped. Then, to overcome the deficiency in red blood cells, a transfusion may be performed.

– Anemia of the newborn Pregnant women are all diagnosed to avoid an Rh incompatibility. Women who present this incompatibility will receive an injection of Rhophylac®, a medicine that contains immunoglobins (lg).

natural treatment

Here are some interesting natural treatments as a complementary measure:

– nettle soup , cabbage soup

Anemia is often accompanied by fatigue, this symptom can be alleviated with natural herbal remedies such as: ginseng, Siberian ginseng, rhodiola (or golden root), schizandra. These are adaptogenic plants, which allow the body to reduce fatigue.

Another category includes plants that contain caffeine, a widely known stimulant. These plants are:  guarana , mate , black tea .

It is also interesting to use plants rich in vitamin C, such as acerola .

These plants can be found in the form of tea, capsules or in liquid form. The pharmacist can also prepare solutions based on standardized extracts from certain plants. It is common to prepare standardized extracts of guarana with ginseng.

No essential oils are used in cases of anemia, but some of them can help in case of fatigue during proven anemia. Orally, peppermint essential oil is a recognized tonic. However, it is important to be careful and never give it to a pregnant woman.

Of course, all these treatments must be carried out as complementary measures to the medication prescribed by your doctor in case of anemia. It is, above all, important to know the cause of the anemia, so that the prescribed treatment is appropriate. Always speak to a specialist (doctor, pharmacist).

Tips

In cases of iron supplementation, it is important to ensure good absorption of the substance. Iron is better absorbed when a person is fasting. However, iron can cause nausea and vomiting. Therefore, in this case it is preferable to take the iron-containing preparation together with a meal, even if the amount of iron absorbed is smaller. A little iron absorption is better than none at all.

– Iron , when given orally in tablet form, is better absorbed when taken with vitamin C. It is advisable to take this medicine with orange juice, for example.

– Homeopathic remedies such as Simifer can help improve iron absorption.

– Iron preparations can make stools darker. In this case, there is no cause for concern.

– Iron can cause gastrointestinal discomfort such as constipation, diarrhea, nausea, stomach pain. If discomfort appears, rather than stopping the medication and risking anemia complications (sickness, fainting, etc.), it is better to speak to your doctor who will find alternative treatments. There are several drug forms that contain iron, such as: tablet, syrup, drops or injection.

Food is an important source for iron, vitamin B12 and folic acid intake. Therefore, it is necessary to eat healthily.

Iron is particularly present in red meat. It is also found in poultry and seafood. This iron is much better absorbed than iron from vegetables, eggs or dairy products.

For vitamin B12, it can be found mainly in meats such as: liver, beef kidney, veal and sheep. It is also found in spirulina.

Folic acid can be found in fresh leafy vegetables such as spinach and watercress.

Certain categories of people are more likely to develop anemia (pregnant women, women with heavy menses). These people can reduce their risk of anemia by paying attention to their diet.

In cases of newborn anemia, it seems that children whose umbilical cord was clamped (clamped) too quickly (before 1 minute of life) may suffer from anemia. However, when the action is taken too late, there is a risk of jaundice. Thus, WHO recommends that cord clamping be performed between 1 and 3 minutes of life, to prevent anemia and to avoid jaundice.

Prevention

If anemia is caused by a deficiency in the constituent elements of red blood cells, it will be necessary to maintain a good supply of vitamin B12, folic acid and iron.

 If you are a vegetarian, consider taking dietary supplements (as a deficiency may occur).

  Vitamin C allows the stomach to be more acidic and improves the absorption of iron from food.

  Caffeine decreases iron absorption .

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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