What is Anemia?

 

What is Anemia?

Anemia is a condition that develops when your blood produces a lower-than-normal amount of healthy red blood cells. If you have anemia, your body does not get enough oxygen-rich blood. The lack of oxygen can make you feel tired or weak. You may also have shortness of breath, dizziness, headaches, or an irregular heartbeat.

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.

Different types of anemia include:

·        Anemia due to vitamin B12 deficiency

·        Anemia due to folate (folic acid) deficiency

·        Anemia due to iron deficiency

·        Anemia of chronic disease

·        Hemolytic anemia

·        Idiopathic aplastic anemia

·        Megaloblastic anemia

·        Pernicious anemia

·        Sickle cell anemia

·        Thalassemia

Iron deficiency anemia is the most common type of anemia.

Causes

Although many parts of the body help make red blood cells, most of the work is done in the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form all blood cells.

Healthy red blood cells last between 90 and 120 days. Parts of your body then remove old blood cells. A hormone called erythropoietin (epo) made in your kidneys signals your bone marrow to make more red blood cells.

Hemoglobin is the oxygen-carrying protein inside red blood cells. It gives red blood cells their color. People with anemia do not have enough hemoglobin.

The body needs certain vitamins, minerals, and nutrients to make enough red blood cells. Iron, vitamin B12, and folic acid are three of the most important ones. The body may not have enough of these nutrients due to:

Changes in the lining of the stomach or intestines that affect how well nutrients are absorbed (for example, celiac disease)

Poor diet

Surgery that removes part of the stomach or intestines

Possible causes of anemia include:

Iron deficiency

Vitamin B12 deficiency

Folate deficiency

Certain medicines

Destruction of red blood cells earlier than normal (which may be caused by immune system problems)

Long-term (chronic) diseases such as chronic kidney disease, cancer, ulcerative colitis, or rheumatoid arthritis

Some forms of anemia, such as thalassemia or sickle cell anemia, which can be inherited

Pregnancy

Problems with bone marrow such as lymphoma, leukemia, myelodysplasia, multiple myeloma, or aplastic anemia

Slow blood loss (for example, from heavy menstrual periods or stomach ulcers)

Sudden heavy blood loss

Symptoms

You may have no symptoms if the anemia is mild or if the problem develops slowly. Symptoms that may occur first include:

·        Feeling weak or tired more often than usual, or with exercise

·        Headaches

·        Problems concentrating or thinking

·        Irritability

·        Loss of appetite

·        Numbness and tingling of hands and feet

If the anemia gets worse, symptoms may include:

·        Blue color to the whites of the eyes

·        Brittle nails

·        Desire to eat ice or other non-food things (pica syndrome)

·        Lightheadedness when you stand up

·        Pale skin color

·        Shortness of breath with mild activity or even at rest

·        Sore or inflamed tongue

·        Mouth ulcers

·        Abnormal or increased menstrual bleeding in females

·        Loss of sexual desire in men

Signs and Symptoms of Anemia

Depending on the type of anemia you have, you may experience a variety of symptoms, though there is some overlap in symptoms among the various types of anemia. The most common symptom of all anemias is weakness. Here are some other symptoms.

·        Iron-deficiency anemia symptoms may be mild, but as the condition advances, they can get worse and include

·        Extreme fatigue

·        Weakness

·        Pale skin

·        Chest pain, rapid heartbeat, or shortness of breath  

·         Headache, dizziness, or light-headedness

·        Cold hands and feet

·        An inflamed or sore tongue

·        Brittle nails

·        Odd cravings for ice, dirt, or starch

·        Loss of appetite, most often in babies and kids

Aplastic anemia symptoms may be severe from the start or gradually worsen over time. They include:

·         Bleeding or bruising easily

·         Heavy menstrual bleeding

·         Shortness of breath

·         Fatigue

·         Frequent infections

Sickle cell anemia symptoms can develop in some children earlier than others and typically start after the fifth or sixth month of life. Common signs and symptoms include:

·         Yellowish skin, known as jaundice

·         Yellowish whites of the eyes, known as icterus

·         Fatigue or fussiness

·         Painful swelling of the hands and feet

·         Frequent infections, especially pneumonia

·         Fatigue and weakness

·         Episodes of pain, called sickle cell crises, which occur when sickled red blood cells block blood flow to the limbs and organs

Pernicious anemia may show similar symptoms to other anemias. But because it is caused by lack of absorption of vitamin B12, and similar to inadequate B12 intake in the diet, a severe deficiency in B12 may cause:

·         Tingling and numbness in hands and feet

·         Muscle weakness

·         Loss of reflexes

·         Loss of balance

·         Trouble walking

·         Weakened bones, leading to hip fractures

·         Neurological problems, such as confusion, dementia, depression, and  memory loss

·         Nausea, vomiting,  heart burn, abdominal bloating and gas, constipation   or diarrhea, loss of appetite, and weight loss

·         Enlarged liver

·         Smooth, thick, red tongue

Infants who have B12 deficiency may show the following signs and symptoms: (14)

·         Poor reflexes or unusual movements like face tremors

·         Difficulty feeding due to tongue and throat problems

·         Irritability

·         Permanent growth problems if left untreated

Anemia of chronic disease may cause similar signs and symptoms to other anemias, such as fatigue, pale skin, light-headedness, shortness of breath, rapid heartbeat, irritability, and chest pain.

 

Anemia Treatment

Your treatment will depend on your type of anemia. 

• If you have aplastic anemia, you might need medication, blood transfusions (in which you get blood from another person), or a bone marrow transplant (in which you get a donor’s stem cells).
• If you have hemolytic anemia, you might need medication that will hold back your immune system. Your primary care doctor may refer you to a doctor who specializes in vascular problems.
• If it’s caused by blood loss, you might have surgery to find and fix the bleeding. If you have iron-deficiency anemia, you’ll probably need to take iron supplements and change your diet.

 

 

Dietary supplements

For some types of mild to moderate anemia, your doctor may recommend prescription supplements:

·         Iron supplements can increase the iron in your body. This may help treat iron-deficiency anemia. Iron supplements are generally not given to people who do not have iron-deficiency anemia because too much iron can damage your organs.

·         Vitamin B12 supplements or shots can help treat vitamin B12–deficiency anemia.

Procedures

Blood transfusion

A blood transfusion is a common, safe medical procedure in which healthy blood is given to you through an intravenous (IV) line that has been inserted in one of your blood vessels. Blood transfusions replace blood that is lost through surgery or injury, or they provide blood it if your body is not making it properly.

Most of the blood used for transfusions comes from whole blood donations given by volunteer blood donors. A person can also have their own blood collected and stored a few weeks before surgery in case it is needed.

After a doctor determines that you need a blood transfusion, he or she will test your blood to make sure that the blood you are given is a good match. Blood transfusions usually take 1 to 4 hours to complete. You will be monitored during and after the procedure.

Blood transfusions are usually very safe because donated blood is carefully tested, handled, and stored. However, there is a small chance that your body may have a mild to severe reaction to the donor blood. Other complications may include:

·         Fever

·         Heart or lung problems

·         All immunization (when the body’s natural defense system attacks donor blood cells)

·         Rare but serious reactions that occur when donated white blood cells attack your body’s healthy tissues

Some people have health problems from getting too much iron from frequent transfusions. There is also a very small chance of getting an infectious disease, such as hepatitis B or C or HIV, through a blood transfusion. For HIV, that chance is less than one in one million. Scientific research and careful medical controls make the supply of donated blood very safe.

Transfusions help people with serious anemia quickly increase the number of red blood cells in their blood. Your doctor may recommend this if you have serious complications of anemia.

Blood and bone marrow transplant

A bone (or blood) marrow transplant, also called a hematopoietic stem cell transplant, replaces faulty blood-forming stem cells with healthy cells.

Blood or bone marrow transplants are usually performed in a hospital. Often, you must stay in the hospital for one to two weeks before the transplant to prepare. You also will receive special medicines and possibly radiation to destroy your abnormal stem cells and to weaken your immune system so that it won’t reject the donor cells after the transplant.

On the day of the transplant, you will be awake and may get medicine to relax you during the procedure. The stem cells will be given to you through an IV (intravenous catheter). The stem cells will travel through your blood to your bone marrow, where they will begin making new healthy blood cells.

When the healthy stem cells come from you, the procedure is called an autologous transplant. When the stem cells come from another person, called a donor, it is an allogeneic transplant. For allogeneic transplants, your doctor will try to find a donor whose blood cells are the best match for you. Your doctor will consider using cells from your close family members, from people who are not related to you and who have registered with the National Marrow Donor Program, or from publicly stored umbilical cord blood.

Your doctor will keep watching your recovery, possibly for up to one year. After the transplant, your doctor will check your blood counts every day to see if new blood cells have started to grow in your bone marrow. The length of your recovery will depend on many factors. Before you leave the hospital, you will get detailed instructions on how to prevent infection and other complications.

Although blood or bone marrow transplant is an effective treatment for some conditions, the procedure can cause complications. The required medicines and radiation can cause side effects, including:

·         Nausea

·         Vomiting

·         Diarrhea

·         Tiredness

·         Mouth sores

·         Skin rashes

·         Hair loss

·         Liver damage

Blood and bone marrow transplants also can weaken your body’s natural defense against germs and sickness and raise your risk of infection. Some people may experience a serious complication called graft-versus-host disease if the donated stem cells attack the body. Other people may reject the donor stem cells after the transplant, which can be an extremely serious complication.