Anemia

Anemia is the most prevalent blood disorder, affecting over 3 million people in the United States, according to the National Heart, Lung, and Blood Institute.

Red blood cells play a crucial role in delivering oxygen throughout the body. They contain hemoglobin, an iron-rich protein that binds to oxygen in the lungs and transports it to tissues. Anemia develops when there is a deficiency of red blood cells or when they do not function properly. It is diagnosed through a blood test showing hemoglobin levels below 13.5 gm/dl in men or below 12.0 gm/dl in women. Normal hemoglobin levels for children vary based on age.

When anemia is present, the body lacks adequate oxygen, which can lead to various symptoms:

• Weakness
• Shortness of breath
• Dizziness
• Fast or irregular heartbeat
• Pounding or "whooshing" in your ears
• Headache
• Cold hands or feet
• Pale or yellow skin
• Chest pain

Am I at Risk?

Many individuals are at risk for anemia due to factors such as an inadequate diet, digestive disorders, chronic illnesses, infections, and other medical conditions. Women who are pregnant or menstruating, as well as those with long-term health issues, are more likely to develop anemia. The risk also increases with age. Additionally, individuals who participate in intense physical activities like running or basketball may experience anemia due to the breakdown of red blood cells in the bloodstream.

Certain chronic conditions can further raise the risk of anemia, including:

• Rheumatoid arthritis or other autoimmune disorders
• Kidney disease
• Cancer
• Liver disease
• Thyroid disorders
• Inflammatory bowel diseases like Crohn’s disease or ulcerative colitis

Anemia symptoms can be subtle and often go unnoticed. Many individuals may not realize they have anemia until it is detected through a routine blood test.

Common Types of Anemia

Iron-deficiency anemia is the most prevalent type and occurs when the body lacks sufficient iron. This is often caused by blood loss but can also result from poor iron absorption. Pregnancy and childbirth increase the body's demand for iron, sometimes leading to anemia. Individuals who have undergone gastric bypass surgery may also develop iron deficiency due to decreased absorption.

Vitamin-deficiency anemia happens when the body lacks essential vitamins like B12 or folate (folic acid), typically due to inadequate dietary intake. In cases of pernicious anemia, vitamin B12 cannot be absorbed properly in the digestive system.

Aplastic anemia is a rare condition in which the body fails to produce enough red blood cells. It can be triggered by viral infections, exposure to harmful chemicals, medications, or autoimmune diseases. When the cause is unknown, it is referred to as idiopathic aplastic anemia.

Hemolytic anemia develops when red blood cells are destroyed in the bloodstream or spleen. This can result from mechanical issues like faulty heart valves or aneurysms, infections, autoimmune disorders, or inherited conditions affecting red blood cell function or structure. Some inherited hemolytic anemias include specific types of thalassemia and enzyme deficiencies like glucose-6-phosphate dehydrogenase deficiency. Treatment depends on the underlying cause.

Sickle cell anemia is a genetic form of hemolytic anemia in which an abnormal hemoglobin protein causes red blood cells to become rigid. This rigidity causes blockages in circulation due to the inability of the cells to move properly through small blood vessels.

Anemia linked to other diseases occurs when certain medical conditions interfere with red blood cell production. For example, kidney disease can lead to anemia if the kidneys do not produce enough erythropoietin, a hormone that signals the bone marrow to generate red blood cells. Similarly, chemotherapy treatments for cancer can impair the body’s ability to produce new red blood cells, often leading to anemia as a side effect.

How is Anemia Treated?

The approach to treating anemia depends on its underlying cause.

Iron deficiency anemia is typically linked to blood loss. If diagnosed with this condition, a doctor may conduct tests to check for internal bleeding in the stomach or intestines. Other nutritional deficiencies, such as folate or B-12 deficiency, can result from poor dietary habits or issues with vitamin absorption in the digestive system. Treatment options may include dietary changes or supplementation.

When anemia is associated with a chronic illness, managing the primary condition can often help improve red blood cell levels. In cases like chronic kidney disease, a doctor may recommend erythropoietin injections to encourage bone marrow to produce more red blood cells.

Aplastic anemia occurs when the bone marrow ceases to produce sufficient red blood cells. This condition may be caused by bone marrow failure, myelodysplasia – where abnormal red blood cells fail to mature properly – or, in some cases, a reaction to certain medications. If aplastic anemia is suspected, a doctor may refer the patient to a hematologist for a bone marrow biopsy to determine the cause. Treatment may include medications or blood transfusions.

Hemolytic anemia results from the premature destruction of red blood cells within the bloodstream. It can stem from mechanical factors such as a faulty heart valve or aneurysm, infections, or autoimmune disorders. Diagnosis often involves specialized blood tests and microscopic examination of red blood cells. Treatment varies based on the cause and may involve consultation with a vascular or heart specialist, antibiotic therapy, or medications that suppress the immune response.

Anyone who suspects they may be at risk for anemia should consult a doctor. A medical professional can determine the most effective treatment plan and, if necessary, refer the patient to a hematologist specializing in blood disorders.

Is Anemia Preventable?

Although many forms of anemia cannot be avoided, maintaining a healthy diet can help reduce the risk of iron and vitamin deficiencies that lead to anemia. Consuming iron-rich foods such as beef, dark leafy greens, dried fruits, and nuts can support healthy red blood cell production. Vitamin B-12, found in meat and dairy products, is also essential. Folic acid, which is present in citrus juices, legumes, dark leafy greens, and fortified cereals, plays a crucial role in preventing certain types of anemia.

Taking a daily multivitamin can further help prevent nutrient-related anemia. However, older adults should avoid taking iron supplements for iron-deficiency anemia unless specifically directed by a doctor.