What is Anemia
In anemia, the level of haemoglobin in the blood is below the normal range. Haemoglobin is the iron-containing molecule in red blood cells that carries oxygen around the body. So in anemia, less oxygen is delivered to the tissues.
Iron Deficiency Anemia
Iron is needed to make haemoglobin. A shortage of iron is the most common cause of anemia, known as iron-deficiency anemia. This may be due to blood loss, either sudden – when a stomach ulcer bursts, for example – or over time, such as when a woman has heavy periods. After blood loss the body needs more iron in order to make more haemoglobin and blood cells. A lack of iron may also be due to a dietary deficiency.
Pregnancy is a time when the body may become lacking in iron such that anemia develops.
As well as iron, vitamins B12 and folic acid are also needed to make properly functioning red blood cells, and anemia may be caused by a shortage of these nutrients. Sometimes, especially as people get older, they become less able to take vitamin B12 into the body from the food they eat and so they become anemic.
This can also happen because of an autoimmune disease that damages the stomach, and then the problem is called pernicious anemia.
Red blood cells are made in bone marrow, so if this is damaged and can’t function properly a shortage of good red blood cells results. This is the case in a rare form of anemia called aplastic anemia, and with leukemia.
In some conditions, red blood cells mature and are destroyed by the body too quickly. This type of anaemia is called haemolytic anemia and is often caused by an inherited condition, such as sickle cell anemia. Blood cells may be destroyed by mechanical devices implanted in the body such as heart valves.
People with chronic diseases may also suffer from anemia, such as:
Some people with anemia don’t have any symptoms for months. When symptoms do appear, common ones include
- Dizzy spells
- Feeling faint
As the anemia becomes more severe symptoms appear:
- Shortness of breath,
- Sore mouth and gums, and
- Brittle nails may cause problems.
People may look pale and find that others around them notice they’re looking peaky.
Anemia Risk Factors
Anyone can suffer from anemia. Most often it affects women of childbearing age, men and women over 75, growing children and teenagers. Usually it’s because their diet doesn’t contain enough iron, vitamin B12 and folic acid.
Pregnant women must watch out for anemia and vegetarians must ensure they get enough iron from food other than meat.
Anaemia also becomes more common with age because the stomach becomes less efficient at producing a special chemical called ‘Intrinsic factor’ which is needed to transport vitamin B12 into the body.
Anemia in Children
Anemia is uncommon in newborn babies but may result from haemorrhage (including from the placenta), transfusion between twins in the womb and breakdown of blood in rhesus disease, and other blood group incompatibilities between mother and foetus.
After the newborn period, the most common cause of anemia in children is iron deficiency caused by an inadequate diet. Iron deficiency is more common in premature babies, deprived populations or developing countries. It’s also important to look out for it in teenage girls who’ve started their periods.
Anemia from blood loss is less common but may occur from repeated blood sampling in sick babies, or from parasitic infections such as hookworm.
Symptoms of Anemia in Children
Children with anemia, like adults, may appear pale, tired and short of breath. Another sign of iron deficiency in children is pica – the inappropriate eating of non-food material such as soil or chalk. Iron deficiency may also affect brain development and lead to behavioral and intellectual problems (which are reversible with treatment).
Other symptoms may reflect the causes of anemia and include, for example, jaundice, weight loss or sickle cell crises.
What’s the treatment?
Treatment depends on the cause of the anemia, so this should be explored first. Reversible causes should be treated. If the anaemia is due to a lack of iron, eating iron-rich food may be all that’s needed.
Foods that are rich in essential nutrients include:
- Iron – red meat, liver, green vegetables, eggs, dried apricots, sardines, spinach, fortified breakfast cereals, wholemeal bread
- Vitamin B12 – meat, poultry, fish, eggs, milk, cheese, fortified breakfast cereals
- Folic acid – wheatgerm, broccoli, green cabbage, pulses, nuts, yeast extract
- It’s also important to have plenty of vitamin C because it helps the body to absorb iron from the diet. Sometimes it’s advisable to take iron supplements to speed up the process but always get medical advice first for children. Never give children adult iron tablets unless your doctor tells you to. Some people need folic acid supplements.
In older people or those with pernicious anaemia, vitamin B12 tablets are not effective because the body cannot absorb the vitamin through the gut. So it must be given as a regular injection into the muscles once every few months.
When the anemia is more severe, a blood transfusion is often necessary.
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