1.74 billion people have anemia symptoms and 32 million have thalassemia. Read more about anemia causes, symptoms, types, diagnosis, and treatment | Meri Sehat.

Anemia

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Ismail Munir

Overview

Red blood cells (RBC) are disc-shaped cells that carry oxygen to the organs and tissues of the body. Anemia occurs when the number of healthy red blood cells in the body is low.

Anemia is a major health concern that affects 1.74 billion people around the world.<a href="#accordion">[1]</a>&nbsp;In addition, 41.7% to 77.0% of Pakistani women of reproductive age are affected with anemia.<a href="http://#accordion">[2]</a>&nbsp;According to the World Health Organization (WHO), the prevalence of global anemia in 2019 was 29.9% in women of reproductive age, which equals half a billion women aged between 15 and 49 years.<a href="#accordion">[3]</a>&nbsp;While the global prevalence of anemia in pregnant women has decreased over the years, it remains stagnant in women of reproductive age.

Anemia often presents with symptoms of being tired and weak. The reason is that anemia occurs when the body does not have adequate healthy red blood cells. There are different types of anemias, e.g. iron-deficiency anemia, aplastic anemia, sickle cell anemia, and pernicious anemia.&nbsp; 
&nbsp;

<h5 dir="ltr">Iron Deficiency Anemia&nbsp;</h5>

<a href="https://merisehat.pk/disease/iron-deficiency-anemia-64">Iron</a><a href="http://merisehat.pk/disease/iron-deficiency-anemia-64"> deficiency anemia</a> is the most common type of anemia that occurs when the blood does not have enough oxygen to produce healthy red blood cells and hemoglobin. Haemoglobin is the protein in red blood cells that binds to oxygen in the lungs and carries it to the body&rsquo;s organs and tissues. The WHO states that 30% of the world&rsquo;s population is affected by this common and widespread nutritional disorder.<a href="#accordion">[3]</a>&nbsp;Red blood cells carry oxygen to the body&rsquo;s tissues and remove carbon dioxide. Decreased number of red blood cells manifests as tiredness and shortness of breath.&nbsp;

<h5 dir="ltr"> 
Vitamin Deficiency/ Pernicious Anemia&nbsp;</h5>

Vitamin deficiency anemia occurs when there are below-normal levels of folate or vitamin B12.&nbsp;Pernicious anemia is characterized by vitamin B12 deficiency caused by autoantibodies that interfere with the absorption of vitamin B12. This type of anemia occurs when the body cannot absorb vitamin B12. Typically, pernicious anemia is an autoimmune condition that runs in families.&nbsp;

Vitamin B12 is an essential vitamin to make red blood cells and to make the nervous system work properly; its deficiency is often due to dietary inadequacies.&nbsp;

At times, vitamin B12 deficiency can also mimic pernicious anemia, as both occur when there is reduced vitamin B12 available for the creation of red blood cells.&nbsp; 
&nbsp;

<h4>Hemolytic Anemia&nbsp;</h4>

Hemolytic anemia occurs when the red blood cells are destroyed faster than the body can replace them. It can be triggered by autoimmune activity and inherited conditions such as sickle cell disease or <a href="https://merisehat.pk/disease/thalassemia-major-and-minor">thalassemia</a>.&nbsp; 
&nbsp;

<h5>Aplastic Anemia&nbsp;</h5>

Aplastic anemia is described as a blood disorder in which the bone marrow does not make enough healthy red blood cells. For this reason, it is also sometimes referred to as bone marrow failure. According to the Aplastic Anemia and MDS International Foundation, even though the condition is rare, each year 600 to 900 people in the United States are diagnosed with aplastic anemia.<a href="#accordion">[4]</a>&nbsp;

The disorder is commonly reported in adults between the ages of 20 and 25 and affects both males and females. However, it is also seen in people aged 60 and above.&nbsp; 
&nbsp;

<h5>Sickle Cell Anemia&nbsp;</h5>

Sickle cell anemia is an inherited blood disorder characterized by a deficiency of healthy red blood cells and painful episodes of sickle cell crisis, a major symptom of sickle cell anemia. Sickle cell crisis includes periodic episodes of extreme pain, which develops when the sickle-shaped red blood cells block the flow of blood through the tiny blood vessels in the chest, abdomen, and joints. The pain may last for a few hours to a few days and varies in intensity.&nbsp;

The disorder occurs when there is a mutation in the gene that tells the body to make hemoglobin. The body produces a defective form of hemoglobin, called hemoglobin S, because of the mutation. And causes the red blood cells to sickle or develop the shape of a crescent. Sickle cells are stiff and sticky. These sickle cells cause pain and increase the risk of infection because they tend to block the flow of blood in the vessels of the limbs and organs. The life span of sickle cells is also shorter than normal red blood cells, which leads to an overall shortage of red blood cells, and thus, anemia.&nbsp; 
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<h5>Anemia Due To Chronic Disease&nbsp;</h5>

Anemia due to inflammation and chronic disease is described as the second most common type of anemia, secondary to iron-deficiency anemia. However, because of underreported cases, the exact incidence of the disease is not known. This type of anemia is more common in people with long-term medical conditions that affect the body&rsquo;s ability to produce healthy red blood cells. For example, autoimmune and inflammatory diseases, kidney disease, infections, and cancer. In most cases, the autoimmune disorder prevents the body from effectively using iron for making new red blood cells. This is the case even when there are normal levels of iron stores in the body. 
&nbsp;

Signs And Symptoms

The signs and symptoms of anemia are associated with a lack of oxygen in the body&rsquo;s organs and tissues. If you have anemia, you may experience the following symptoms:&nbsp;

<ul>
	<li>Fatigue&nbsp;</li>
	<li>Weakness&nbsp;</li>
	<li>Lightheadedness and dizziness, especially when standing up or active&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/migraines-73">Headache</a>&nbsp;</li>
	<li>Shortness of breath&nbsp;</li>
	<li>Pale skin, gums, and nails&nbsp;</li>
	<li>Irregular or very fast heartbeat&nbsp;</li>
	<li>Cold hands and feet&nbsp;</li>
	<li>Fainting feeling&nbsp;</li>
	<li>Brittle nails&nbsp;</li>
	<li>Inflamed tongue&nbsp;</li>
	<li>Cracks around the mouth&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/jaundice-65">Jaundice</a>&nbsp;</li>
	<li>Heart murmur&nbsp;</li>
	<li>Enlarged lymph nodes, spleen, or liver&nbsp;</li>
	<li>Difficulty concentrating&nbsp;</li>
	<li>Unusual cravings such as wanting to eat dirt, clay, or ice&nbsp;</li>
</ul>

&nbsp;

Signs and symptoms specific to the different types of anemia are listed below and may also include the general symptoms detailed earlier:

<ul>
	<li>Iron Deficiency Anemia: Fatigue, shortness of breath, and chest pain.&nbsp;</li>
	<li>Vitamin Deficiency Anemia: Numbness and tingling in the hands and feet, muscle weakness, smooth and thick red tongue, problems with reflexes, depression, trouble with memory, and confusion. Digestive symptoms may include bloating, gas, <a href="https://merisehat.pk/disease/heart-burn-58">heartburn</a>, <a href="https://merisehat.pk/disease/constipation">constipation</a>, nausea, and vomiting.&nbsp;</li>
	<li>Haemolytic Anemia: Jaundice, enlarged spleen, chills, back and upper abdominal pain.&nbsp;</li>
	<li>Aplastic Anemia: Low white blood cell count, easy bruising, bleeding, skin rashes, and nausea. 
	&nbsp;</li>
</ul>

<h4>"Head on over to our <a href="https://www.merisehat.pk/page/sehat-scan/" target="_blank">sehat scan</a> to see whether your anemia is raising your heart rate!" </h4>

Causes

When the production of red blood cells is lower than normal, the red blood cells in the circulation are less. This leads to anemia.

&nbsp;

Acquired factors of anemia include:&nbsp;

<ul>
	<li>Inadequate intake of nutrients for production of red blood cells, for example, iron, vitamin B12 and folate.&nbsp;</li>
	<li>Kidney diseases&nbsp;</li>
	<li>Cancers (leukemia, lymphoma, and multiple myeloma)</li>
	<li>Autoimmune diseases, for example, lupus and rheumatoid arthritis</li>
	<li><a href="https://merisehat.pk/disease/aids">HIV</a> and <a href="https://merisehat.pk/disease/tuberculosis">tuberculosis</a>&nbsp;</li>
	<li><a href="https://merisehat.pk/disease/hyperthyroidism">Hypothyroidism</a>&nbsp;</li>
	<li>Inflammatory bowel disease</li>
	<li>Aplastic anemia&nbsp;</li>
	<li>Certain medications, for example, chemotherapy and radiotherapy for cancer</li>
	<li>Toxins, such as lead</li>
</ul>

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Diagnosis

While there are various ways to diagnose anemia, the most common way is with a complete blood count (CBC). A CBC is an indication of overall health and helps check for underlying conditions, for example, leukemia or kidney disease. If the RBC, haemoglobin and hematocrit levels fall below the normal range, the diagnosis is likely of some form of anemia.&nbsp;

<ul>
	<li>Hematocrit levels that compare RBCs and the total volume of blood.&nbsp;</li>
	<li>Haemoglobin levels</li>
	<li>RBC count&nbsp; 
	&nbsp;</li>
</ul>

Treatment

Treatments for anemia aim to increase the number of RBCs which, as a result, increases the amount of oxygen in the blood. Below are treatments for the different types of anemia:

<ul>
	<li>Iron Deficiency Anemia: Iron supplements and dietary changes&nbsp;</li>
	<li>Vitamin Deficiency Anemia: Dietary supplements and vitamin B12</li>
	<li><a href="https://merisehat.pk/disease/thalassemia-major-and-minor">Thalassemia</a>: Folic acid supplements, iron chelation, blood transfusions, and bone marrow transplants.&nbsp;</li>
	<li>Anemia Because Of Chronic Illness: Treatment focuses on resolving underlying health conditions.&nbsp;</li>
	<li>Aplastic Anemia: Blood transfusions or bone marrow transplants&nbsp;</li>
	<li>Sickle Cell Anemia: Oxygen therapy, intravenous fluids, pain relief medications</li>
	<li>Haemolytic Anemia: Treatment for infections and immunosuppressant drugs. 
	&nbsp;</li>
</ul>

The following factors increase the risk of developing anemia:&nbsp;

<ul>
	<li>Premature birth</li>
	<li>Age between 6 months and 2 years&nbsp;</li>
	<li>Menstruation&nbsp;</li>
	<li>Pregnancy&nbsp;</li>
	<li>Diet low in vitamins, minerals, and iron&nbsp;</li>
	<li>Regular use of medications that inflame the stomach lining, for example, ibuprofen</li>
	<li>Family history of anemia&nbsp;</li>
	<li>Intestinal disorders that affect the absorption of nutrients, for example, Crohn&rsquo;s disease</li>
	<li>Loss of blood because of surgery or trauma&nbsp;</li>
	<li>Chronic illnesses, for example, <a href="https://merisehat.pk/disease/aids">AIDS</a> liver disease, heart failure, <a href="https://merisehat.pk/disease/rheumatoid-arthritis">rheumatoid arthritis</a>, cancer, kidney disease and <a href="https://merisehat.pk/disease/diabetes-type-1-and-2">diabetes</a>.&nbsp;</li>
</ul>

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Key Points

<ul>
	<li>Anemia develops when the red blood cell count and hemoglobin are below the normal range.&nbsp;</li>
	<li>The function of the red blood cells is to carry oxygen to the body&rsquo;s organs and tissues.</li>
	<li>Anemia is a major health concern that affects 41.7% to 77.0% of Pakistani women of reproductive age.&nbsp;</li>
	<li>Treatment of anemia varies depending on the type of anemia&nbsp;and aims to increase the number of RBCs, which as a result increases the amount of oxygen in the blood. 
	&nbsp;</li>
</ul>

[1] Gardner, W. and Kassebaum, N., 2020. Global, regional, and national prevalence of anemia and its causes in 204 countries and territories, 1990–2019. Current Developments in Nutrition, 4(Supplement_2), pp.830-830.