Anaemia: Types , Symptoms, Diagnosis and Treatment

What is Anaemia? Learn about different types of anaemia, what may put you at risk and the various anaemia treatment options available.

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What is Anaemia?

Anaemia is a blood condition in which one has a deficiency of haemoglobin, the red pigment in red blood cells which carries oxygen in the blood.

This may be due to a reduction in the number of red blood cells caused by decreased production, blood loss, increased destruction or a combination of these factors. It may also be due to abnormally formed haemoglobin or abnormal red blood cells, which affect the stability of the cells, making them more prone to destruction.

Blood consists of three types of blood cells:
White blood cells are cells that fight infection
Platelets help the blood to clot
Red blood cells carry oxygen from the lungs in the blood to the vital organs and other tissues

Red blood cells contain haemoglobin, an iron-containing protein that gives blood its red colour.

In anaemia, the body produces fewer red blood cells, loses too many of them or these cells are destroyed more quickly than they can be replaced.

Types of Anaemia

These are some common types of anaemia:
Iron deficiency anaemia: the most common form of anaemia that is caused by a deficiency of iron in the body
Vitamin B12 and folate deficiency anaemia: also known as megaloblastic anaemia
Anaemia of chronic disease: this may be due to cancer, kidney failure, rheumatoid arthritis, Crohn's disease and other chronic inflammatory diseases which interfere with the production of red blood cell
Aplastic anaemia: a life-threatening type of anaemia caused by a decrease in the bone marrow's ability to produce red blood cells, white blood cells and platelets
Anaemia associated with bone marrow diseases, such as leukaemia
Haemolytic anaemia: this develops when red blood cells are excessively destroyed
Sickle cell anaemia: an inherited form of anaemia which is caused by a defective form of haemoglobin that forces red blood cells to assume an abnormal crescent (sickle)

Anaemia Symptoms

Anaemia in its early stages may not have any obvious symptoms except for fatigue. However, other associated symptoms that may develop include:
Pale skin
A fast or irregular heartbeat
Shortness of breath
Chest pain
Dizziness
Cognitive problems
Numbness or coldness in your extremities
Headache
Yellowing of the skin in anaemia due to increased red cell destruction

Anaemia Causes and Risk Factors

These factors include:
Poor diet consistently low in iron and vitamins such as folate which increase the risk of developing anaemia
Intestinal disorders that affect the absorption of nutrients in the small intestine, such as Crohn's disease and Celiac disease
Menstrual disorders with increased blood loss — women are at greater risk of iron deficiency anaemia because of blood loss during menstrual periods, especially for those with heavy periods
Pregnancy increases the risk of iron deficiency anaemia because of increased blood volume during pregnancy, as well as developmental demands from the growing foetus
Chronic conditions like cancer, kidney or liver failure and rheumatoid arthritis increase the risk of developing anaemia of chronic disease
Family history of inherited anaemia also increases the risk of developing anaemia

Diagnosis of Anaemia

Anaemia is diagnosed based on:
medical history
physical examination
blood tests such as peripheral smear and full blood count (FBC) and other blood indices
bone marrow biopsy to confirm the diagnosis in more difficult cases

Anaemia Treatment

Types of anaemia treatment depends on specific anaemia causes.
Iron deficiency anaemia is treated with iron supplements or with blood transfusion, in severe cases 
Vitamin deficiency anaemia such as Pernicious anaemia is treated with Vitamin B-12 injections and folic acid deficiency anaemia is treated with folic acid supplements
Anaemia of chronic disease has no specific treatment for anaemia symptoms alone, as iron supplements and vitamins are generally ineffective
Aplastic anaemia treatment may include blood transfusions to boost red blood cell count, or a bone marrow transplant
Haemolytic anaemia treatment includes taking drugs that suppress the immune system such as steroids or gamma globulin and the removal of an enlarged spleen, if necessary
Sickle cell anaemia treatment includes blood transfusions, folic acid supplements, antibiotics, bone marrow transplant and cancer drugs, such as hydroxyurea for adults

What You Can Do to Prevent Anaemia 

1. Avoid iron deficiency anaemia and vitamin deficiency anaemia by eating a healthy diet that includes foods rich in iron, folate and vitamin B-12.
The best sources of iron are:
  • beef and other red meats
  • beans
  • lentils
  • iron-fortified cereals
  • dark green leafy vegetables
  • dried fruit
  • nuts and seeds
Folate can be found in citrus juices and fruits, dark green leafy vegetables, legumes and fortified breakfast cereals, while Vitamin B-12 is found in meat and dairy products.

2. Take iron supplements for iron deficiency anaemia as recommended by your doctor. Vitamin C may be given together with iron tablets as it helps in its absorption.

3. Vegans can consume non-haem iron from sources such as green leafy vegetables and fruits, which are also rich in Vitamin C to maximise their iron absorption. They can also get alternative sources of iron from beans (eg, bean products such as soy beans, tempeh, lentils, tofu, chickpeas), whole-grains, nuts and seeds.

Even then, iron intake may not be enough especially for women, whose average recommended daily allowance (RDA) for iron is 19mg. Vegans should talk to their doctors about iron supplements if they suspect they may be lacking the nutrient.



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