Some important facts on anemia that you should know

What is anemia?   

The word anemia is derived from the ancient Greek word anaimia, which means lack of blood.

According to the World Health Organization (WHO), anemia is defined as hemoglobin (Hb) levels <12.0 g/dL in women and <13.0 g/dL in men. However, normal Hb distribution varies not only with sex but also with ethnicity and physiological status. Different places may adopt slightly different lower limits of normal Hb values according to ethnicity, gender, and age.

How common is anemia?

Anemia is a serious global public health problem that particularly affects young children, menstruating adolescent girls and women, and pregnant and postpartum women. WHO estimated that 40% of children 6–59 months of age, 37% of pregnant women, and 30% of women 15–49 years of age worldwide are anemic. According to WHO data (1993-2005), anemia affects 1.62 billion people, which corresponds to around 25% of the world population.

What are the symptoms of anemia?

Common symptoms include tiredness, weakness, and shortness of breath on exercise. One uncommon and rather strange symptom of iron-deficiency anemia is pica. Pica is an unusual craving for and ingestion of either edible or inedible substances, which includes ice cubes, clay, dried pasta, chalk, cigarette butts, hair, lead, and laundry starch.

 What are the causes of anemia?

Anemia has three main causes:

1. Inadequate Hb production: To make enough healthy Hb and red blood cells, your body needs iron, vitamin B12, folate, small amounts of other vitamins, minerals, and protein and inadequate amount of them in the diet would lead to poor Hb production. Certain chronic diseases can harm the body’s ability to make enough Hb. Some examples are cancer, rheumatoid arthritis, chronic inflammatory diseases, and kidney disease. Bone marrow diseases such as pure red cell aplasia, aplastic anemia and various types of blood cancers would affect red cell and Hb production.
2. High rates of red blood cell destruction: Sometimes your body destroys red blood cells before they reach the end of their natural lifespan of about 120 days. This process, called haemolysis, can be caused by acquired or inherited conditions. Red blood cells may be destroyed in such large numbers that the bone marrow cannot make enough new red blood cells to keep up. Some examples of acquired causes are certain diseases or infections such as lupus or hepatitis, which may cause your body to destroy too many red blood cells. Some examples of inherited causes are thalassaemia, sickle cell anemia, and glucose-6-phosphate dehydrogenase (G6PD) deficiency.
3. Blood loss: When you lose blood, you can lose a large number of red blood cells, and that can cause anemia. The loss of those red blood cells also leads to low levels of iron in your body. Without enough iron, your body will make fewer red blood cells than it needs, and the red blood cells it does make will have less haemoglobin than normal, leading to iron-deficiency anemia, which is the most common cause of anemia all over the world.

How to diagnose anemia?

Often, the first test is a complete blood count (CBC), which is a broad-scale test that provides a count of all red blood cells and the related red blood cell indices, white blood cells, and platelets in a sample of your blood. Depending on the results of the CBC and your clinical history and physical examination findings, your doctor may require you to have further tests like serum ferritin, Vitamin B12 and folate, and tests for haemolysis, in order to find out the type and cause of the anemia.

Anemia is not just a disease by itself, it may be a sign of a more sinister underlying disease. For example, the anemia may be caused by chronic blood loss due to bleeding from cancer of the large bowel. Therefore, it is of utmost importance to find out the underlying cause of the anemia.

How to treat anemia?

The treatment will depend on the type of anemia you have, its cause, and how severe it is. As anemia may be secondary to some underlying disease, finding out and treating the underlying disease should be done. For example, anemia due to nutrient deficiencies will be prescribed with their appropriate supplements such as iron, Vitamin B12 or folate.

People who have mild or moderate anemia with no symptoms, or people whose anemia is not getting worse, may not need treatment. Exceptions apply to those with nutritional anemias such as iron-deficiency anemia. In those cases, the low level of iron in the body may have other harmful effects besides anemia, and treatment is needed. Giving blood transfusion in raising the Hb level is the last resort but may be required if the anemia is severe.

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