The Complete Guide to Understanding, Preventing & Treating Anemia
Anemia is the most common blood disorder in the world, affecting at least 1.62 billion people globally and 3 million people in the United States. Although there are many different forms of anemia, the symptoms they share are often similar. These symptoms can be mild, moderate, or severe, but it is important to recognize the early warning signs of anemia to pursue the most effective treatment strategy.
This guide will answer questions about what anemia is, its various types, symptoms of anemia, how anemia is diagnosed, and how to treat this common blood condition. With a better understanding of this information, individuals with anemia or at risk of developing anemia can improve communications with their physicians and find relief.
What is Anemia?
Although anemia is a very common condition, many people still lack understanding of what the disorder really is and why it occurs in the body. This section will give an overview of the blood disorder and define some important terms to become familiar with.
Anemia is a condition that involves a lack of red blood cells in the body or red blood cells that are not functioning properly. It can also occur in individuals that have low concentration of hemoglobin in their blood. Red blood cells are essential for delivering a very specific protein, called hemoglobin, throughout the body.
Without this protein, the body’s various parts do not receive the oxygen they need to thrive. This often results in feelings of tiredness, fatigue, and a variety of other symptoms. Anemia is often considered to be a symptom of a disease rather than a disease itself because it typically develops due to blood loss or suboptimal levels blood cell production and destruction.
All About Blood Cells
An extensive background in medicine and anatomy is not required to understand what anemia is; however, there are a few key terms to know. To start, it’s important to know what the three main types of blood cells are and what their functions are in the body.
Blood cells are the solid parts of blood that coexist with the liquid part, which is called plasma and transports nutrients, hormones, proteins, and waste as needed. There are three types of blood cells: red blood cells, white blood cells, and platelets. All blood cells are produced in the bone marrow, and new blood cells are constantly being produced to replace ones that are destroyed or that have died.
Red Blood Cells
It is the job of the red blood cells to carry hemoglobin throughout the body, which is a protein rich in iron that attaches to oxygen in the body’s lungs. The goal of this process is to carry iron to the various tissues of the body. Not only do red blood cells carry hemoglobin, but they also transport carbon dioxide that is produced as waste to the lungs. From there, carbon dioxide is exhaled through the mouth and nose.
Red blood cells are disc-shaped and have slight indentations in their center. Healthy red blood cells typically live for about 120 days.
White Blood Cells
White blood cells have a very important job as well, as they are responsible for sustaining the immune system and fighting off infection in the body. The body has a natural instinct to produce more white blood cells when it is becoming sick to overcome that illness and restore optimal health.
The five types of white blood cells in the human body are neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Each of these has a different function in the immune system and looks differently when viewed under a microscope. Certain types of white blood cells occur more frequently than others and live longer than other types.
The third type of blood cells in the body is the platelets. These are blood cells that promote blood clotting, which is important for skin cuts and abrasions. Platelets work by gathering at the site of an injury and forming a natural barrier to seal the skin closed again. From that point, certain proteins work with the platelets to stop the bleeding. Healthy platelets typically live for about six days.
Causes of Anemia
There is no one singular cause of anemia, as many people develop this condition for various reasons. However, patients and their medical professionals can benefit from getting to the root cause of the anemia and understanding what led to its development.
Some forms of anemia are genetically passed down from one generation to the next, while others are acquired due to lifestyle choices, health complications, and environmental factors. In some individuals, the cause of anemia cannot be determined, but it still can be diagnosed and treated in an effective way.
Common Causes and Examples
This section of the guide will address the three most common reasons that anemia occurs in the body. It will also provide examples of how these causes present themselves through specific diseases and conditions.
Not Producing Enough Red Blood Cells
One of the most common reasons that people develop anemia is that their bodies are producing too few red blood cells. Though meals and supplementation, the body uses iron, folate, vitamin B12, protein, and other nutrients to make red blood cells. Smaller amounts of vitamin C, copper, and riboflavin are also needed to aid red blood cell production.
It is also essential to get enough of a hormone known as erythropoietin, as this hormone also helps control red blood cell production. Erythropoietin is produced in the kidneys and assists with wound healing, heart health, brain development, and other important functions in the body too. Overall, it is important to maintain balanced hormones for a wide variety of bodily functions.
The condition of not being able to produce enough red blood cells can be genetically influenced or acquired due to health conditions that are not passed down through families. Potential inherited causes include Shwachman-Diamond Syndrome, Diamond-Blackfan Anemia, Amegakaryocytic Thrombocytopenia, Fanconi Anemia, and Dyskeratosis Congenita.
More commonly, an individual’s body will not produce enough red blood cells if it is suffering from an iron deficiency or folate deficiency. This is most often due to poor nutrition. Certain types of environmental toxins, such as pesticides, can influence the body’s production of red blood cells, as well as viral infections and autoimmune disorders.
Leukemia, lymphoma, and other cancers can cause this to happen, and also the radiation and chemotherapy treatments used for cancer patients. Cancers can actually take up space in the bone marrow and leave less room for bone marrow production to occur. Women who are pregnant may not be able to produce enough red blood cells to meet the increased demand while carrying a child. Also, certain antibiotic medications and prescriptions for rheumatoid arthritis can inhibit the body’s natural ability to produce red blood cells.
Destroying an Excess of Red Blood Cells
It is also possible to develop anemia if one’s body is destroying too many existing red blood cells that are essential to optimal functioning. As previously mentioned, healthy red blood cells die after about 120 days and after going through a natural process to benefit the body. At that point, cells in the liver, spleen, and bone marrow kill off the red blood cells because they aren’t needed anymore.
But certain medical conditions and hereditary factors can cause the body to destroy red blood cells before they can complete the full 120-day cycle. This sends the bone marrow into “overdrive” to start producing more red blood cells at a faster rate. The phenomenon of having red blood cells destroyed faster than bone marrow can produce new ones is called hemolytic anemia. This is a rare condition compared to the types of anemia caused by not producing enough red blood cells or losing too many red blood cells through bleeding.
Individuals who have inherited conditions like sickle cell anemia, thalassemias, or a pyruvate kinase deficiency may experience abrupt red blood cell destruction. This is also a common result in patients with hereditary spherocytosis and elliptocytosis, as well as those with a diagnosis of glucose-6-phosphate dehydrogenase deficiency. Hemolytic anemia can be a result of a red blood cell disorder or a side effect of another disease that is killing off red blood cells before they are ready to die.
Or alternatively, individuals who have a severe infection, such as malaria, may find that their red blood cells are being destroyed faster than the bone marrow can make new ones. This creates a deficiency of red blood cells in the body that leads to anemia. Red blood cells can be physically damaged due to injury as well after suffering from a trauma. Immune hemolytic anemia is a condition in which the body’s immune system kills off its own red blood cells. This is a disease that destroys red blood cells before their natural lifespan because the immune system malfunctions and creates destructive antibodies.
Losing Too Many Red Blood Cells
Finally, losing too many red blood cells can result in anemia as well. Although there are other rare ways that people develop anemia, these three ways are the most common. Blood cells are most commonly lost when the body loses a substantial amount of blood. This blood can come from a major injury or a frequent, recurring condition.
Not only does the body lose red blood cells with blood flow, but also iron. A lack of iron in the body is a very common cause of anemia. This is because iron is required to make enough red blood cells to keep the body sustainable, and even the few red blood cells that are made will have lower than healthy hemoglobin levels.
There are many very common and chronic causes of losing red blood cells in daily life. This includes heavy menstrual periods and heavy nosebleeds that occur on a regular basis. If an individual has bleeding in the stomach lining, urinary tract, or digestive tract, this can also lead to red blood cell loss. Chronic blood losses like these often lead to low iron levels, which worsens conditions of anemia. Certain types of cancers that affect the digestive and excretory systems may lead to red blood cell loss through excess blood as well.
Meanwhile, other types of traumatic experiences can bring about excess blood flow without warning. Examples include bleeding during surgery, a blood vessel bursting, and childbirth.
Symptoms of Anemia
Anemia affects different people in different ways, but there are many shared symptoms among anemia sufferers. These symptoms can be mild, moderate, or severe, and the severity often is determined by how quickly the condition develops. However, the symptoms of anemia can mirror the symptoms of other medical conditions. This is why proper diagnosis by a medical professional is essential so that the cause of the symptoms can be determined and targeted effectively.
This section of the guide will describe the most common symptoms experienced by anemia sufferers, as well as ways to diagnose and treat this condition.
Common Symptoms and Examples
Regardless of the type of anemia diagnosed, there are common symptoms that many people with this condition suffer from. In the beginning and in cases of very mild anemia, many people feel no symptoms at all and have no idea that their bodies do not have a healthy number of red blood cells. Some of the earliest warning signs that an individual may have are tiredness, weakness, and fatigue. These symptoms can occur in people with anemia regardless of how much sleep or exercise they have been getting. It is also possible for the skin to turn pale or yellowish in color when the condition of anemia Is present.
If left untreated, the symptoms of anemia may get worse and feelings of fatigue may turn into dizziness, changes in breathing, and irregular heartbeat rhythms. Anemia sufferers may feel faint, become short of breath, and get cramps when they exercise. They also may sweat more than usual and feel excessively thirsty even when staying properly hydrated.
Very severe and prolonged anemia that is not treated can lead to brain damage and heart damage. This occurs because red blood cells are needed to carry blood throughout the body, and a lack of them puts excessive strain on the body’s various systems. Heart murmurs and heart failure can result from this common blood condition if it is not controlled and reversed in a timely manner.
All of the above are considered to be symptoms of anemia, which are all physical feelings that individuals experience. But there are also visible signs of anemia that can be scientifically measured, such as abnormal heart beat and low hemoglobin levels.
Many people are unaware of the various ways that anemia is diagnosed by medical professionals. The first time that many people learn they are anemic is when trying to donate blood for a charitable cause and being told that they cannot donate because of low iron levels. Patients who seek medical treatment for another seemingly unrelated condition may be diagnosed with anemia because their doctors suspect the condition based upon a description of the symptoms.
The first step to diagnosing anemia is to review the patient’s medical history and inquire about the length and severity of symptoms being felt. Patients will also be asked about their family history to determine if genetics plays a role in the condition being experienced. At that point, a physical exam will be conducted to check the heartbeat, breathing, abdomen, and skin. Neurological tests, a pelvic exam, or a rectal exam may be conducted as well to check for possible health issues.
There are various tests that can be administered to check for anemia and determine which type of anemia a patient is suffering from. The sections that follow will highlight a few of the many tests that can be used to make an anemia diagnosis.
Complete Blood Count Tests
A complete blood count, also known as a CBC, is commonly used as the first test to determine the number of red blood cells, white blood cells, and platelets in the blood. If the number of red blood cells is lower than normal, then the patient may be anemic. Furthermore, the size and shape of those cells may indicate the cause of anemia. A WBC differential test compares the percentages of each type of white blood cell in the blood, and a hemoglobin test is a good test for iron deficiency anemia.
Other complete blood count tests measure how much space red blood cells occupy in the blood, their average size, and how much oxygen-carrying hemoglobin is inside each red blood cell. If a CBC doesn’t give an accurate picture of what is going on in a patient’s blood, then additional blood tests and bone marrow tests may be necessary as well.
Other Types of Blood Tests
A blood smear, for example, helps determine if abnormal blood cells are the cause of anemia, while a Coombs test indicates the presence of hemolytic anemia. Several blood tests check iron levels because iron is part of hemoglobin, and low levels of it are linked to iron deficiency anemia. Iron levels are measured by tests for serum iron, total iron-binding capacity, unsaturated iron-binding capacity, transferrin saturation, and serum ferritin.
Testing the Bone Marrow
Finally, the bone marrow can be tested to ensure that is capacity of making healthy red blood cells. Physicians collect samples of bone marrow to determine if aplastic anemia is present.
Treatments for anemia vary based on the type of blood disorder diagnosis and the severity of the condition. But fortunately, anemia is a treatable condition that can be monitored and corrected in most patients.
It is important for anemia patients to understand what to expect once they begin receiving treatment so that they can monitor their symptoms and report any adverse reactions. Individuals with anemia should expect to see their red blood cell counts and hemoglobin levels increase with treatment in order to restore the blood’s ability to carry oxygen. They should also expect to notice their symptoms subside.
In patients with iron deficiency anemia, iron supplements like Fergon can reverse the effects of anemia. But in very severe cases, blood transfusions may be necessary. However, a larger goal is to treat the condition that is causing one’s anemia so that it doesn’t return in the future.
An accurate diagnosis of anemia requires the expertise and resources of a trained medical professional. Many different medical professionals are trained to treat anemia, starting with one’s primary care provider. Internists, pediatricians, and nurse practitioners are all skilled in administering anemia tests and recommending a treatment plan.
But depending on a patient’s specific symptoms, a specialist may be called in for additional support. This could include a hematologist, who specializes in blood disorders, or a registered dietitian, who is an expert in healthy nutrition. Gastroenterologists, OBGYNs, cardiologists, and neurologists may be consulted if the symptoms of anemia affect certain parts of the body.
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