Anemias
Oxygen is distributed throughout the body by red blood cells, which contain an oxygen-carrying molecule called hemoglobin. Hemoglobin's ability to carry oxygen depends on iron. Red blood cells live for about 120 days. When they die, their iron is re-used to create new red blood cells. Anemia develops when heavy bleeding causes significant iron loss, if red blood cell production slows down, or if red blood cells are destroyed more rapidly than normal.
Poor diet can contribute to vitamin and iron deficiency anemias in which fewer red blood cells are produced. Hereditary disorders and certain diseases can cause increased blood cell destruction. However, excessive bleeding is the most common cause of anemia. Anemia can be mild, moderate, or severe enough to lead to life-threatening complications. More than 400 different types exist.
Iron deficiency anemia is the most common form of anemia. The deficiency occurs when the body loses more iron than it gets from food and other sources. The body tries to compensate for the iron deficiency by producing more red blood cells, which are characteristically small in size.
Folic acid deficiency anemia is the most common type of megaloblastic anemia (red blood cells are bigger than normal). It is caused by a deficiency of folic acid, a vitamin needed to produce normal cells. Although this condition usually results from a dietary deficiency, it is sometimes due to an inability to absorb enough folic acid from foods.
Less common is vitamin B12 deficiency anemia. This anemia develops when the body doesn't absorb enough vitamin B12 from foods. The most common form of B12 deficiency is pernicious anemia, which is caused by the body not absorbing vitamin B12 properly.
Some people are born with hemolytic anemia. An inherited form of hemolytic anemia is thalassemia. Thalassemia stems from the body's inability to manufacture enough normal hemoglobin. There are two categories of thalassemia. Alpha-thalassemias most commonly affect people of African ancestry; beta-thalassemias affect people of Mediterranean ancestry and Southeast Asians.
Sickle-cell anemia is hereditary. It affects people of African or Mediterranean ancestry. A child who inherits the sickle cell gene from each parent will have the disease. Sickle-cell anemia causes the body to produce defective hemoglobin, which forces red blood cells to assume an abnormal crescent shape. The blood cells do not work well and do not live as long as normal cells. The deformed cells can block narrow blood vessels, possibly causing a life-threatening condition called sickle cell crisis.
Aplastic anemia is characterized by decreased production of red and white blood cells and platelets (disc-shaped cells that allow the blood to clot). This disorder may be inherited or acquired due to recent severe illness; long-term exposure to industrial chemicals; or use of anticancer drugs and certain other medications.
Weakness, fatigue, and a run-down feeling are signs of mild anemia. Skin that is pasty or sallow or pale gums, nail beds, or eyelid lining are other signs of anemia. Someone who is weak, tires easily, is often out of breath, and feels faint or dizzy may be severely anemic.
Other symptoms of anemia are:
- Angina pectoris
- Cravings for ice, paint, or dirt
- Headache
- Inability to concentrate, memory loss
- Inflammation of the mouth (stomatitis) or tongue
- Insomnia
- Irregular heartbeat
- Loss of appetite
- Dry, brittle, or ridged nails
- Rapid breathing
- Sores in the mouth, throat, or rectum
- Sweating
- Hand and feet swelling
- Thirst
- Tinnitus
- Unexplained bleeding or bruising.
Personal and family health history may suggest certain anemias. Laboratory blood tests that measure the percentage of red blood cells or the amount of hemoglobin are used to confirm diagnosis and determine the type of anemia. X rays and examinations of bone marrow may also be used.
Anemia due to nutritional deficiencies can be treated with iron, folic acid, or other supplements or with injections of vitamin B12. Surgery may be necessary to treat anemia caused by excessive loss of blood. Transfusions may be used to increase red blood cells.
Although pernicious anemia is considered incurable, regular B12 shots will alleviate symptoms and reverse complications. Some symptoms will disappear almost as soon as treatment begins.
Treatment for aplastic anemia may involve blood transfusions or bone marrow transplant. If the condition is due to immunosuppressive drugs, symptoms may disappear once drugs are discontinued. This type of anemia rarely becomes severe. If it does, transfusions or hormone treatments to stimulate red blood cell production may be prescribed.
Although sickle cell anemia cannot be cured, effective treatments enable patients to enjoy more normal lives. Treatment involves regular eye examinations, immunizations for pneumonia and infectious diseases, and prompt treatment for sickle cell crises and infections of any kind.
People with mild thalassemia lead normal lives and do not require treatment. Those with severe thalassemia may require bone marrow transplantation.
Anyone with anemia caused by poor nutrition should modify the diet to include more vitamins, minerals, and iron. Vitamin C can stimulate iron absorption. The following foods are good sources of iron:
- Almonds
- Broccoli
- Dried beans
- Dried fruits
- Enriched breads and cereals
- Lean red meat
- Liver
- Potatoes
- Poultry
- Rice
- Shellfish
- Tomatoes.
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