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Anaemia Medical Overview

Anaemia is a blood condition caused by a lack of normal, healthy red blood cells. The red blood cells are those cells in the bloodstream that pass on oxygen from the lungs to the healthy tissues and take carbon dioxide away from the tissues.

There are a number of types of anaemia, including iron deficiency anaemia, B12 or "pernicious" anaemia, folate deficiency anaemia, haemolytic anaemia, aplastic anaemia, megaloblastic anaemia, sickle cell anaemia and thalassemia. The two major causes of anaemia include iron deficiency anaemia and pernicious anaemia. In fact, anything that interferes with the making of blood cells or causes blood cells to be damaged more quickly (haemolytic anaemia and sickle cell anaemia) can cause anaemia to occur. Some types of anaemia result in the bone marrow not making many red blood cells, which lowers the red cell count.

Healthy red blood cells live as long as 120 days and then the body chews up those old red blood cells. There is a hormone known as erythropoietin that sends a signal to the bone marrow to make more red blood cells. Erythropoietin is made in the kidneys so you need healthy kidneys to prevent anaemia.

The causes of anaemia include taking certain medications, having genetic disorders which lead to anaemia, having a chronic disease, having kidney failure, eating a poor diet, having blood loss, being pregnant and having a damaged or overgrown bone marrow with other things, such as leukaemia or lymphoma. The immune system can result in a loss of red blood cells (haemolytic anaemia) and surgery to the stomach or intestines that causes absorption of nutrients to be diminished, such as iron, folic acid or vitamin B12 can affect the level of red blood cells.

Iron deficiency anaemia is the most common type of anaemia. It affects twenty percent of women, half of all pregnant women and three percent of men. It results in anaemia because you need iron to make red blood cells. Iron is the oxygen-carrying portion of the red blood cell. You get iron through a healthy diet and by recycling old red blood cells. The causes of iron deficiency anaemia include blood loss, poor iron absorption and too little of the nutrient in the body. In children, iron deficiency anaemia can be related to lead poisoning.

In iron deficiency anaemia, the anaemia develops gradually as fewer and fewer cells are made along with a gradual reduction in the cells that are too old. Women lose blood through menstruation and are therefore at higher than average risk for getting iron deficiency anaemia. Gastrointestinal bleeding is another cause of iron deficiency anaemia. This can be due to an ulcer of the stomach, oesophageal varices or long term use of nonsteroidal anti-inflammatory medications. Some cancers can contribute to anaemia as can celiac disease, Crohn's disease and gastric bypass surgery.

Those at high risk for iron deficiency anaemia are those that take nonsteroidal anti-inflammatory diseases for a long time or who are pregnant or breastfeeding. Seniors are at higher risk of developing iron deficiency anaemia as are women who are of childbearing age.

Symptoms of anaemia include brittle nails, poor appetite, tiredness, bluish colouration to the whites of the eyes, headache, pale skin, irritability, shortness of breath, sore tongue, and unusual food cravings.

Testing for iron deficiency anaemia includes doing a faecal occult stool test for blood, checking the anaemia, getting indices for the RBCs, checking a serum ferritin and doing a serum iron level.

Treatment of iron deficiency anaemia includes giving iron by mouth or injection, giving erythropoietin to stimulate red blood cell production and fixing the underlying problem causing the iron deficiency anaemia. It often takes up to six to twelve months to fix iron deficiency anaemia completely.

B12 deficiency anaemia is also called pernicious anaemia. The cause is a lack of intake of enough vitamin B12 due to stomach or intestinal problems. If your body is missing the intrinsic factor made in the stomach, you cannot absorb vitamin B12 very well. You can also get pernicious anaemia if you eat a vegetarian diet or have a bad diet while an infant. Poor nutrition during pregnancy can lead to problems with B12 anaemia. It is often seen in chronic alcoholism, Crohn's disease or other intestinal diseases.

Regardless of the type of anaemia you have, you can get the following symptoms: pain in the chest, fatigue, low energy, dizziness, headaches, difficulty concentrating and shortness of breath during exercise.

The treatment of anaemia depends on the type of anaemia you have. Fixing the underlying problem is the first choice and giving nutrients or erythropoietin to begin building red blood cells is a second good choice. In addition, severe anaemia can be treated with transfusions until the red blood cells can be produced in sufficient numbers.