3.

ANEMIA
Anemia is a condition that develops when your blood lacks enough healthy red blood cells or
hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few
or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will
not get enough oxygen.
Important factors to remember are:
 Hereditary and infants may be affected from the time of birth.
 Older adults
 Women in the childbearing years are particularly susceptible to iron-deficiency anemia
because of the blood loss from menstruation and the increased blood supply demands
during pregnancy.
What Causes Anemia?
There are more than 400 types of anemia, which are divided into three groups:
 Anemia caused by blood loss
 Anemia caused by decreased or faulty red blood cell production
 Anemia caused by destruction of red blood cells
Anemia Caused by Blood Loss
Red blood cells can be lost through bleeding, which often can occur slowly over a long period of
time, and can go undetected. This kind of chronic bleeding commonly results from the following:
 Gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of the
stomach), and cancer
 Use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen,
which can cause ulcers and gastritis
 Menstruation and childbirth in women, especially if menstrual bleeding is excessive and
if there are multiple pregnancies
Anemia Caused by Decreased or Faulty Red Blood Cell Production
With this type of anemia, the body may produce too few blood cells or the blood cells may not
function correctly. Red blood cells may be faulty or decreased due to abnormal red blood cells or
a lack of minerals and vitamins needed for red blood cells to work properly.
Conditions associated with these causes of anemia include the following:
 Sickle cell anemia
 Iron-deficiency anemia
 Vitamin deficiency
 Bone marrow and stem cell problems
 Other health conditions
Anemia Caused by Destruction of Red Blood Cells
When red blood cells are fragile and cannot withstand the routine stress of the circulatory
system, they may rupture prematurely, causing hemolytic anemia. Hemolytic anemia can be
present at birth or develop later. Sometimes there is no known cause. Known causes of hemolytic
anemia may include:

 Inherited conditions, such as sickle cell anemia and thalassemia

 Stressors such as infections, drugs, snake or spider venom, or certain foods
 Toxins from advanced liver or kidney disease
 Inappropriate attack by the immune system (called hemolytic disease of
the newborn when it occurs in the fetus of a pregnant woman)
 Vascular grafts, prosthetic heart valves, tumors, severe burns, exposure to certain
chemicals, severe hypertension, and clotting disorders
 In rare cases, an enlarged spleen can trap red blood cells and destroy them before their
circulating time is up.

Symptoms
 Easy fatigue and loss of energy
 Unusually rapid heart beat, particularly with exercise
 Shortness of breath and headache, particularly with exercise
 Difficulty concentrating
 Dizziness
 Pale skin
 Leg cramps
 Insomnia
Diagnosis
 Complete blood count (CBC), which determines the number, size, volume, and
hemoglobin content of red blood cells
 Blood iron level and your serum ferritin level, the best indicators of your body's total iron
stores
 Levels of vitamin B12 and folate, vitamins necessary for red blood cell production
 Special blood tests to detect rare causes of anemia, such as an immune attack on your red
blood cells, red blood cell fragility, and defects of enzymes, hemoglobin, and clotting
 Reticulocyte count, bilirubin, and other blood and urine tests to determine how quickly
your blood cells are being made or if you have a hemolytic anemia, where your red blood
cells have a shortened life span.
Treatment

Anemia treatment depends on the cause.

 Iron deficiency anemia. Treatment for this form of anemia usually involves taking iron
supplements and making changes to your diet.

If the underlying cause of iron deficiency is loss of blood — other than from menstruation
— the source of the bleeding must be located and stopped. This may involve surgery.

 Vitamin deficiency anemias. Treatment for folic acid and B-12 deficiency involves
dietary supplements and increasing these nutrients in your diet.

If your digestive system has trouble absorbing vitamin B-12 from the food you eat, you
may need vitamin B-12 shots. At first, you may receive the shots every other day.
Eventually, you'll need shots just once a month, which may continue for life, depending on
your situation.

 Anemia of chronic disease. There's no specific treatment for this type of anemia. Doctors
focus on treating the underlying disease. If symptoms become severe, a blood transfusion
or injections of synthetic erythropoietin, a hormone normally produced by your kidneys,
may help stimulate red blood cell production and ease fatigue.

 Aplastic anemia. Treatment for this anemia may include blood transfusions to boost levels
of red blood cells. You may need a bone marrow transplant if your bone marrow is
diseased and can't make healthy blood cells.

 Anemias associated with bone marrow disease. Treatment of these various diseases can
include medication, chemotherapy or bone marrow transplantation.

 Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications,

treating related infections and taking drugs that suppress your immune system, which may
be attacking your red blood cells.

Depending on the severity of your anemia, a blood transfusion or plasmapheresis may be

necessary. Plasmapheresis is a type of blood-filtering procedure. In certain cases, removal
of the spleen can be helpful.

 Sickle cell anemia. Treatment for this anemia may include the administration of oxygen,
pain-relieving drugs, and oral and intravenous fluids to reduce pain and prevent
complications. Doctors also may recommend blood transfusions, folic acid supplements
and antibiotics.

A bone marrow transplant may be an effective treatment in some circumstances. A cancer

drug called hydroxyurea (Droxia, Hydrea) also is used to treat sickle cell anemia.
 Thalassemia. This anemia may be treated with blood transfusions, folic acid supplements,
medication, removal of the spleen (splenectomy), or a blood and bone marrow stem cell
transplant.