What is Anaemia? Causes, Symptoms, and Treatments

Anaemia is defined as reduction in concentration of circulating hemoglobin. Anaemia develops when there is lack of oxygen due to a lack of healthy Red Blood Cells (RBCs).  Red blood cells contains haemoglobin, which is responsible for carrying oxygen in the blood. For production of red blood cells, the body needs iron, vitamin B12 and folic acid. If any one or more of these is deficient, anaemia will develop.

There are numerous forms of Anaemia, but iron deficiency Anaemia is the most common form of Anaemia.

Classification of Anaemia

Anaemia is classified on the basis of size of the red blood cells.

• In microcytic anaemia, the red blood cells size are smaller than normal.
• In normocytic anaemia, red blood cells are of normal size.
• In macrocytic anaemia, the red blood cells size are larger than normal.

Causes of Anaemia

There are a number of reason for each type of anaemia:

Microcytic Anaemia

• Iron deficiency.
• Inherited blood diseases (e.g. thalassaemia).
• Anaemia due to chronic disease.

Macrocytic Anaemia

• Lack of Vitamin B12 or folic acid: Inadequate intake in diet or not being absorbed (due to bowel disease).
• Chemotherapy drugs.
• Liver disease/long term heavy alcohol use.
• Diseases of the bone marrow.

Normocytic Anaemia

• Heavy Bleeding.
• Anaemia of chronic disease.
• Chronic renal failure.
• Endocrine disorders (e.g. low thyroid activity).

Diagnosis of Anaemia

The evaluation of anaemia begins with the doctor asking questions to ascertain the possible causes of the anaemia. This is usually followed by a careful general examination.

Symptoms of Anaemia

Symptoms of anaemia are usually vague and mild but may include:

• Fatigue.
• Muscle weakness.
• Headache.
• Poor concentration.
• Dizziness/fainting.
• Dyspnoea on exertion.
• Palpitations (abnormal heart beats).
• Iron deficiency causes: Poor iron intake, pregnancy, internal bleeding, heavy periods, use of anti-inflammatory or blood thinning medications.
• Folate deficiency causes: Inadequate diet, small bowel disease.
• B12 deficiency causes: previous bowel surgery, dietary factors.

Most cases of anaemia are usually mild, including those that occur as a result of chronic disease. Even mild anaemia can reduce oxygen transport in the blood, causing breathlessness, fatigue and a reduced physical capacity.

Megaloblastic anaemia (the red cells are megaloblastic i.e. large and abnormal) develops if vitamin B12 or folic acid are deficient.  In “pernicious” anaemia, there is insufficient absorption of vitamin B12 from the diet.

Haemolytic anaemia occurs as the result of an inherited or an acquired condition in which red blood cells are destroyed prematurely. Haemolysis is breakdown of  red blood cells, resulting in the release of haemoglobin into the plasma.

Tests

Complete Blood Count (CBC)

A Complete Blood Count (CBC) is a blood test that is used to assess your overall health performance include measuring the haemoglobin level, size of the red blood cells, and looking at the shape of characteristics of the blood cells as well as to diagnose a variety of illnesses, such as Anaemia, infection and leukaemia.

• Reticulocyte count
• Serum iron levels
• Ferritin test
• Vitamin B12 test
• Folic acid test
• Faecal occult blood test
• Bone marrow tests 

If clinician suspects there is trouble in formation of red blood cells, then a bone marrow biopsy test is performed.

Preventions of Anaemia by dietary habits

• Eat and drink vitamin C-rich foods  like citrus fruits, Strawberries, Black currents etc.
• Eat plenty of iron-rich foods like Green vegetables.
• Avoid drinking tea or coffee with food.

Treatment of Anaemia

Treatment should be according to any underlying cause of the anaemia (e.g. stopping any active bleeding). Dietary factors must also keep in mind, such as eating iron and vitamin C rich foods, and foods rich in folate and B12. In severe anaemia, blood transfusions may also required.

Erythropoietin causes the production of red blood cells. Injections of erythropoietin may be necessary in patients with chronic renal failure, as there is insufficiency of erythropoietin and hence develop anaemia.

Conclusion

Anaemia is a condition in which reduction in concentration of circulating hemoglobin occurs. There are many forms of Anaemia, Iron deficiency Anaemia is the most prevalent among different forms of Anaemia. It can develop as a result of a nutrient-deficient diet, Crohn’s illness or the use of certain drugs.

Treating the sign and symptoms of Anaemia at the earliest and taking proper treatment as recommended by your doctor cures Anaemia.

Author

Dr. Shalini Gupta 

(MD Pathology)