Anemia

Anemia is a condition characterized by too little hemoglobin or too few red blood cells in the blood. It is considered a symptom of an underlying disease or condition rather than a disease itself.

Red blood cells contain hemoglobin, which combines with oxygen from the lungs and transports it to the body's tissues. In the tissues, hemoglobin picks up carbon dioxide from the tissues and carries it to the lungs, where it is eliminated. Red blood cells are produced in bone marrow and circulate for about 120 days. After about 120 days, they are broken down in the spleen. Hemoglobin is produced from an iron-containing pigment called "heme" and a protein called "globin." When red blood cells are broken down by the spleen, the iron that forms part of the hemoglobin is recycled to form hemoglobin for new red blood cells.

Causes

The most common causes of anemia are deficiencies of iron, vitamin B12 and folic acid. Anemia may also be caused by loss of blood through gastrointestinal bleeding; common causes of this type of anemia are medications such as aspirin and ibuprofen, and cancer.

Two other forms anemia are hemolytic anemia, in which red blood cells are destroyed more rapidly than they can be adequately replaced, and sickle-cell anemia, in which the body produces abnormal hemoglobin.

Anemia occurs when there is too little iron stored in the body. Young children and adults on restricted diets or diets low in nutrition may not get enough iron in the foods they eat; this can lead to anemia. The digestive system may not be able to absorb enough iron; this occurs most often when part of the stomach has been removed.

General Types of Anemia

Nutritional deficiency anemias are caused by deficiencies in iron, vitamin B12 or folic acid.

Anemias of chronic blood loss are caused by heavy menstrual periods, stomach cancer, colon cancer or gastrointestinal bleeding brought on by non-steroidal anti-inflammatory medication.

Anemias caused by insufficient production of red blood cells are aplastic anemia, leukemias, myelomas, anemia of chronic renal failure and myelodysplastic syndromes.

Hemolytic anemias are sickle cell anemia, spherocytosis, elliptocytosis, hereditary nocturnal hemoglobinuria, G6PD deficiency, pyruvate kinase deficiency, the thalassemias, other hemaglobinopathies and autoimmune hemolytic anemias.

Symptoms

Anemia causes a reduction in the amount of oxygen that gets to the body’s tissues. Symptoms of tissues not getting enough oxygen usually do not become noticeable until the anemia becomes severe or has lasted for a long time:

• Fatigue, weakness or dizziness  

• Pale skin, gums or nail beds

• Shortness of breath or rapid heart beat with activity

• Headache

• Irritability

Diagnosis

Your health care provider will ask about symptoms that could indicate anemia. A complete blood count (CBC) is a blood test that can be used to confirm the diagnosis of anemia. Other blood tests may be ordered. 

If you suspect that you have anemia, it's important to see your doctor. Anemia can weaken body's resistance to illness or injury, and it limits your energy and productivity. It can also indicate a more serious medical condition. Treatment for anemia depends on the cause.

What to Do

To avoid nutritional anemias, make sure you include plenty of green, leafy vegetables in your diet to maintain an adequate amount of folic acid. Many breakfast cereals also contain folic acid as a supplement. Iron-fortified foods can also help iron reserves. You should avoid caffeinated drinks such as coffee, tea and colas during meals because they interfere with iron absorption.

If you are a woman with heavy periods or if you are pregnant, talk to your doctor about taking an iron supplement. Use an iron pot or skillet when cooking; some iron from the pot will be incorporated into foods you cook in the vessel. See your doctor if you have signs and symptoms of anemia. Your doctor will want to rule out the anemia as a warning sign of a more serious medical condition.