How are the different types of anemia? What are the causes of anemia? What are the symptoms and complications of anemia? How to diagnose, prevent, treat anemia?
Such questions will be the subject of our article which aims to save lives; because many people die under the ignorance of anemia.
According to the World Health Organization, 25% of the world’s population suffers from anemia. Half of these cases are attributable to a nutritional deficiency of iron. Women who have heavy menstrual periods, preschoolers, and pregnant women are most at risk for anemia.
Anemia is manifested by a decrease in the quality or quantity of red blood cells. Anemia is due to a lack or dysfunction of red blood cells, resulting in a decrease in the flow of oxygen to the body’s organs.
Possible symptoms include fatigue, pale skin, shortness of breath, dizziness, vertigo, and rapid heartbeat.
I – Description of Anemia
Anemia is a disorder characterized by an abnormally low number of healthy red blood cells in the blood. There are several types of anemias. The most common is iron deficiency anemia related to iron deficiency.
One of the Causes of Anemia Is the Iron Deficiency Anemia
Iron deficiency anemia (caused by iron deficiency) is the most common type of anemia. It is very common among children and women of all ages – especially women who are still menstruating. It is estimated that at least one-fifth of women in North America suffer from iron deficiency. It can also affect men significantly when it is caused by polyps or cancers of the colon or other gastrointestinal malignancies (cancers). Iron deficiency anemia is often one of the first precursors to the presence of gastrointestinal cancer.
Anemia Caused by Vitamin Deficiency
This type of anemia produces deformed and very large red blood cells (macrocytic anemia). The most common are those caused by vitamin B12 or vitamin B9 (folic acid) deficiency. The first may occur because of insufficient dietary intake of this vitamin, poor intestinal absorption, or a condition called pernicious anemia. For more details, see our B12 deficiency Anemia file.
Sickle Cell Anemia
Sickle-cell anemia (sickle-shaped red blood cells) is another well-known form of anemia. Many millions of people around the world suffer from it. It is a hereditary condition, passed from parents to their children through defective genes. The people most often affected have ancestors from Africa, the Middle East, Mediterranean countries or India. Every year in the United States, 1 out of every 12 African American babies is born with the genetic potential to transmit sickle cell anemia. It is estimated that in the African-American population, one in 400 births will produce a newborn with Sickle Cell Anemia.
Aplastic anemia is a rare disorder that occurs when the bone marrow no longer produces any of the blood cells. This type of anemia is very serious, but also rare, fortunately. The incidence of this disorder is 2 to 12 new cases per million people per year. Adults and children can be affected by this form of anemia.
Inflammatory anemia is a mild form of anemia affecting people with illnesses lasting for more than 1 to 2 months. The diseases concerned include tuberculosis, HIV, cancer, kidney and liver diseases, and rheumatological disorders.
Pernicious anemia is a more common form of anemia in the elderly and is caused by a dietary vitamin B12 deficiency or poor absorption of this vitamin by the intestines. This condition is also frequently encountered in alcoholics.
Anemia Caused by a Chronic Disease
Many chronic diseases (and sometimes their treatments) can reduce the amount of circulating red blood cells in the blood. This is the case of cancer, Crohn’s disease and inflammatory diseases such as rheumatoid arthritis. Renal failure can also cause anemia because the kidneys secrete erythropoietin, the hormone that stimulates the production of red blood cells. However, they retain their normal size and appearance (normocytic anemia).
For example, severe blood loss after a serious accident, surgery, or delivery can quickly cause anemia. Some gastrointestinal problems (a peptic ulcer, intestinal polyps or colorectal cancer) can also lead to it, but this time causing a slight and constant loss of blood in the stool (sometimes invisible), over a long period.
This type of anemia is characterized by too rapid destruction of red blood cells. It may be due to a reaction of the immune system (autoimmune or allergic), to the presence of toxins in the blood, to infections (for example, malaria), or to be congenital (sickle cell anemia, thalassemia, etc.). The congenital form mainly affects individuals of African descent.
This term covers a group of very rare anemia in which red blood cells cannot fix iron in hemoglobin. This is an enzymatic problem of hereditary or acquired origin. The red blood cells are then smaller in size than normal.
*** Red Blood Cells
Red blood cells are cells that carry oxygen in the blood. Red blood cells carry oxygen throughout the body, so an insufficient number of red blood cells can have serious consequences.
The Life of a Red Blood Cell
Did you know? The kidneys secrete a hormone, erythropoietin, which controls bone marrow production of new red blood cells. These globules circulate in the blood for 120 days. Then, they are destroyed in the spleen. Every day, about 1% of red blood cells are renewed.
Red Blood Cells, Iron and Hemoglobin
Red blood cells are blood cells that consist mainly of hemoglobin. Hemoglobin is composed of a protein (globin) and a pigment (heme). It is the latter who gives the color red to the blood. It fixes the iron that carries oxygen from the lungs to the cells. Oxygen is necessary for the production of energy in cells and allows organs to perform their functions. The oxygen-linked pigment turns red-ruddy and circulates in the arteries. Hemoglobin also transports carbon dioxide (waste from the combustion of oxygen) from the cells to the lungs. It becomes purplish-red and circulates in the veins.
II – What Are the Causes of Anemia?
Anemia is not a disease in itself, but rather a condition attributable to other health problems. Anemia can be the consequence of three disorders:
1 – Blood Loss
In North America, blood loss is the most common cause of anemia. Many women have borderline anemia, in general, because their diets do not provide enough nutrients to replace the monthly menstrual bleeding. Gastrointestinal bleeding is another common cause of blood loss; these bleeds may be due to diseases such as ulcerative colitis, diverticulitis, and colon cancer. Certain medications such as acetylsalicylic acid * (ASA) and nonsteroidal anti-inflammatory drugs can also cause gastrointestinal bleeding.
The following conditions can also cause hemorrhaging:
– Gastric ulcers;
– Hookworms (hookworm).
2 – Inadequate Production of Healthy Red Blood Cells
The body needs iron to produce hemoglobin, the protein found in red cells that carries oxygen from the lungs to the rest of the body. Hemoglobin also gives its red color to the blood. Similarly, vitamin B12 and folic acid deficiencies are often observed.
Even though these deficiencies are rarer in North America, they still exist. People who need increased iron intake include infants, pregnant women, and teens who experience a growth spurt. Poor persistent bleeding can also lead to iron-deficiency anemia. Even a healthy person can lose a small amount of blood every day in his stool. A slightly larger blood loss can easily go unnoticed and cause anemia.
The cause of inflammatory anemia is not fully known. It is linked to a decrease in the production of red blood cells.
The lifespan of a red blood cell is only about four months, and red blood cells need to be replaced by new ones, which are produced in the bone marrow. You have aplastic anemia, if your bone marrow is destroyed or if it has suffered serious lesions and can no longer produce red blood cells. Some medications, as well as radiation, can destroy the bone marrow, but the most common cause is an autoimmune reaction. Such a reaction occurs when the cells that protect the body against the disease attack the person’s own tissues. In 50% of cases, the cause of the autoimmune reaction is unknown.
Other diseases can destroy bone marrow and cause aplastic anemia, including viral hepatitis and severe rheumatoid arthritis.
Fanconi’s disease is a rare hereditary aplasia, characterized by abnormalities of the bone marrow. Anemia is common in people with severe kidney problems because the kidneys secrete a hormone called erythropoietin, which causes the red blood cells to be produced by the bone marrow when the body needs it. In the case of kidney trouble, the kidneys cannot produce enough of this hormone so that the body is properly fed red blood cells, resulting in anemia.
3 – Rapid Destruction of Red Blood Cells
When healthy, the bone marrow produces a specific amount of red blood cells every month. If the destruction of red blood cells is faster than the rate of production, anemia sets in. The old red blood cells are mostly degraded by the spleen, the organ that filters the blood verifies that it is not infected, and eliminates the harmful substances. Some medical conditions cause an increase in the volume of the spleen. For example, liver disease or lupus are two possible causes of hypersplenism (increased spleen volume); malaria and tuberculosis are two others. When the spleen is larger than normal, it retains and destroys healthy red blood cells, causing anemia.
Sickle cell anemia and thalassemia are two inherited disorders characterized by an abnormal form of red blood cells. Sickle cell anemia is widespread among people of African American descent, while thalassemia is more common in families of Mediterranean origin. Sickle cell anemia occurs in a person who receives from his father and mother a copy of the gene coding for sickle-cell red blood cells, which results in the production of red blood cells that are grossly abnormal in shape. The spleen recognizes these red blood cells as abnormal, and it has to work harder and harder to remove these globules, which causes an increase in the volume of this organ. This anomaly causes anemia. Curiously, the sickle cell anemia gene confers at the same time a protective effect against the parasite that causes malaria.
Anemia can be caused by a combination of factors:
Anemia is widespread in people with cancer. In fact, about half of people with cancer develop anemia. The causes can be multiple and include bone marrow tumors, blood loss, dietary deficiency, chemotherapy and radiation that destroy the bone marrow where red blood cells are produced, or a combination of these factors.
In people with severe kidney disease, anemia is caused by the combination of decreased red blood cell production, reduced red blood cell lifespan, and blood loss associated with dialysis treatment.
III – Symptoms and Complications of Anemia
The symptoms of anemia vary according to their severity. For example, mild anemia, with a low hemoglobin level, gives little or no symptoms. This is particularly the case if it is slowly installed because the body has had time to get used to it.
(1) – If Anemia Worsens, Symptoms Appear:
– pallor, clearly visible inside the eyelids, at the level of the nails and the lips;
– shortness of breath on exertion and then on rest;
– persistent fatigue;
– dizziness, vertigo, weakness when getting up from a chair, feeling of turning head;
– headache ;
– difficulty concentrating, remembering, reading;
– lack of motivation, enthusiasm;
– decreased sexual desire (decreased libido);
– difficulties in carrying out one’s usual activities;
– physical, emotional, or psychological exhaustion.
Note: In front of one or more of these symptoms, it is necessary to consult a doctor.
(2) – If the Anemia Is Severe, Has Settled Quickly, or Lasts a Long Time, It Can Have Consequences:
– heart (worsening of heart disease, such as angina pectoris, heart failure);
– pulmonary (aggravation of respiratory insufficiency of COPD for example).
Note: The symptoms of anemia vary according to the importance of the decrease in the number of red blood cells in the blood.
Menstrual bleeding or iron deficiency tends to cause mild chronic anemia, the symptoms of which are fatigue, pallor, and weakness.
If anemia is caused by severe bleeding, such as severe gastrointestinal bleeding caused by an ulcer, you may feel dizzy and very weak, especially if you suddenly go into a standing position.
In case of severe anemia, the tissues and organs may be completely deprived of blood and oxygen. If so, the cells die quickly during a process called ischemia.
As we have explained, in sickle cell anemia red blood cells, which are normally rounded, look like sickles. Because of this abnormal form, the cells remain blocked in the small blood vessels and hinder the normal flow of blood. People with this condition may suffer from severe ischemia in the feet, which sometimes leads to amputation, or other organs, which causes pain. People with this form of anemia are at high risk of having a stroke because sickle cells can easily clump together and form a clot that blocks the flow of blood into the vessels of the brain.
In people with cancer, the most common symptoms of anemia are fatigue and shortness of breath. It can be difficult for these people to continue their activities and maintain their usual energy level, which can have very negative effects on activities of daily living.
IV – Diagnosis
Your doctor will take a blood sample and send it to the laboratory for hemoglobin levels in the blood. The result is expressed as the number of grams of hemoglobin per liter of blood. The number of white blood cells, platelets, and other blood elements will also be measured. The lab technologist will also examine the size and shape of the red blood cells.
The results of these tests inform the doctor about the number of different blood cells in the blood and their shape, which provides clues about the cause of anemia. For example, lower than normal numbers of white blood cells and red blood cells may be a sign of bone marrow involvement or spleen. The doctor then looks for other diseases, depending on the results of the first blood test.
V – Treatment, and Prevention of Anemia
Treatment depends on the underlying diagnosis. Iron-based dietary supplements can thus be used for iron deficiency, vitamin B dietary supplements for low vitamin levels, blood transfusions for blood loss, and blood-promoting drugs if the blood production in the body is reduced.
The choice of treatment for anemia is determined by the underlying disease that causes this anemia. Severe bleeding is usually treated with blood transfusions. If you have some form of severe chronic anemia, such as Fanconi’s disease or sickle cell anemia, you may also need to receive regular blood transfusions.
The life expectancy of people with sickle cell anemia has been greatly improved. In the past, young people often did not reach adulthood.
Iron supplements are given to treat iron-deficiency anemia.
It is often noted that infants with this form of anemia receive formula milk bottles. The infant’s body can absorb more iron in breast milk than in cow’s milk. Nursing mothers may take iron supplements. The latter is also useful for treating mild anemia caused by gastrointestinal bleeding or menstrual bleeding.
Vitamin B12, vitamin C and folic acid all play a crucial role in the production of red blood cells. The deficiency of any of these vitamins carries a risk of anemia. Beef and fish are good sources of vitamin B12. Vegetables do not contain this vitamin; a person who does not eat meat, fish, or dairy products needs a vitamin B12 supplement. Folic acid is present in spinach, green peas, oranges, and cantaloupes.
When anemia is caused by a reduction in the production of red blood cells, such as cancer or severe kidney disease, medications called epoetin alfa and darbepoetin alfa can be used. These drugs mimic the action of the natural hormone erythropoietin which results in increased production of red blood cells by the bone marrow.
If you experience any of the symptoms of anemia or are in any of the types of anemia listed in this article, please go to a nearby health center for follow-up. Anemia puts your health at risk but above all it is fatal. Thank you to take care of you, to make you consult by a general practitioner or specialized.
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Given that anemia could be a severe problem, I recommend reading the following book. This book contains everything a patient needs to know about the different forms of anemia, symptoms, treatment, and diet.
The Iron Disorders Institute Guide to Anemia