Anaemia

What is meant by Anaemia? 

Anaemia takes place whenever the red blood cell count in circulation comes down in a human body. This is the most prevalent blood-related disorder that impacts a large chunk of global population, as stated above. Some of the usual symptoms may include chest pain, headaches and paleness of skin. This often takes place when any of the other ailments play havoc with the ability of the body to churn out healthy red blood cells or cover any abnormality in terms of sudden increase of breakdown of red blood cells or any losses.  Anaemia is a reduction in the overall red blood cells (RBC) or haemoglobin count in blood. leading to a reduced ability of blood to bear oxygen. Whenever there is a slow onset of anaemia, vague symptoms surface like a constant feeling of tiredness, shortness of breath, weakness and inability to exercise correctly. Whenever there is a swift onset of anaemia, the symptoms may cover a sense of passing out, confusion, consciousness losses and increased thirst. Anaemia may also be caused by lower production of red blood cells, blood losses and higher breakdownsof red blood cells orblood loss in abundance due to gastrointestinal bleeding and trauma. Normal haemoglobin levels in Indians(National health portal):

• For males is 13.8 – 17.2 gm/dl;
• For females 12.1 – 15.1 gm/dl,
• For children 11 – 16 gm/dl
• For pregnant females 11 – 15.1 gm/dl

Lower haemoglobin count, less than the lower limit for the gender and age indicates anemia, and haemoglobin level below 10 gm/dl needs treatment with iron/vitamin supplements. Causes of lower production may include deficiencies which have been mentioned above along with bone marrow neoplasms and thalassemia. Higher breakdown causes may be infections such as malaria, autoimmune ailments and sickle cell anaemia. The red blood cell size and haemoglobin content in RBCs are factors determining the classification of anaemia.

Anaemia- Major Causes

Red blood cells are imperative for the survival of the body since they are carriers of haemoglobin, which is a complex protein containing iron molecules. These are molecules which carry oxygen to the rest of the body from the lungs. Some conditions and ailments which may lead to a lower level of red blood cells. Several kinds of anaemia occur without any particular cause. It may sometimes be tough to zero in on a specific objective as well. Here’s looking at some of the key reasons- 

• Anaemia resulting from iron deficiencies- most common form of anemia, usually due to a deficiency of iron either due to lower consumption or absorption. A lower count of red blood cells is often due to lack of ample iron in your body. This may be due to dietary deficiencies, endurance training, frequent blood donation, consuming certain food items, having specific digestive conditions such as Crohn’s disease or surgical removal of a portion of the gut. 
• Anaemia due to blood loss- This is the second most frequent kind of anaemia, which occurs on account of iron deficiencies. This is due to iron shortage, which is majorly due to loss of blood. Whenever the body loses any blood, it will react by pulling water in from tissues positioned outside the bloodstream in a bid to keep blood vessels suitably filled. The extra water leads to dilution of blood, and hence, red blood cells get diluted in the process. Blood loss can either be chronic or rapid or even acute. The quick blood loss can occur due to childbirth, surgery, a rupture in blood vessels or trauma. Chronic blood loss involves cancer, tumours or stomach ulcers, , haemorrhoids usage of any NSAIDs or non-steroidal anti-inflammatory drugs like ibuprofen and aspirin. Menstrual bleeding can also be a cause. 
• • Anaemia due to lower/faulty production of red blood cells- The bone marrow is a spongy and soft tissue located at the centre of your bones. This is vital for the development and making of red blood cells. The bone marrow churns out stem cells which eventually develop into the essential red blood cells, platelets and white blood cells. There are several ailments which can impact the bone marrow including leukaemia, which is a condition where excessive quantities are produced for white blood cells which work as a disruptor for usual production of red blood cells.  In chronic kidney diseases due to an absence of erythropoietin, there is a deficit production of RBCs leading to anemia.
• Sickle cell anaemia- Red blood cells are often not shaped right and experience abnormal breakdowns swiftly. The blood cells formed like crescents can also get hinged in smaller blood vessels, leading to severe pain. 
• Stem cell and bone marrow issues- Aplastic anaemia happens whenever no stem cells are there, or few stem cells are present. Thalassemia occurs whenever red blood cells cannot mature/grow suitably. 
• Anaemia due to vitamin deficiency- Folate and Vitamin B12 are vital for red blood cell production. In case of deficiency of either of them, the production of red blood cells is lower. Some examples include pernicious anaemia and megaloblastic anaemia. In chronic alcoholism as well there is a relative deficiency of vitamin B12 leading to megaloblastic anemia.
• Anaemia due to increased destruction of red blood cells- Red blood cells usually have lifespans of 120 days in our bloodstream although they can be removed/eliminated before. Autoimmune haemolytic anaemia is something which can be put in this category where the immune system of the body erroneously identifies its red blood cells as foreign substances and attacks them likewise. Excessive haemolysis may take place due to infections, particular drugs and antibiotics along with spider/snake venom, autoimmune attacks, toxins due to advanced liver/kidney ailments, vascular grafts and prosthetic heart valves, extreme hypertension, enlargement of spleen and clotting issues. 

Major Symptoms of Anaemia 

Symptoms of anaemia include the following: 

• Skin paleness on a prolonged basis
• Paleness of tongue or
• Constant fatigue and low energy levels 
• Irregular or fast heartbeat
• Shortness of breath
• Headaches
• Chest Pain
• Light-headedness 

In addition There are quite a few specific types of anaemia with other symptoms, as listed below: 

• Folic acid deficiency anaemia- diarrhoea, irritability and smooth tongue
• A plastic anaemia- frequently occurring infections, fever and skin rashes
• Haemolytic anaemia- dark colour in urine, jaundice, abdominal pain and fever
• Sickle cell anaemia- fatigue, painful swelling in the hands and feet and jaundice

Management of Anemia:

Decision on treatment is usually taken by the doctor after establishing a cause through different blood /bone marrow investigations including Hemoglobin and RBC count and hematocrit estimations, peripheral blood smear examination, haemoglobin electrophoresis, Vitamin B12 and folic acid levels estimation, bone marrow biopsy, upper and lower GI endoscopy etc. There are several kinds of treatments for anaemia. These usually aim at scaling the count of red blood cells. This also leads to an increase in oxygen amounts carried by the blood. Treatments are generally influenced by anaemia cause and type. 

• Anaemia due to iron deficiency- Iron supplements are usually recommended along with changes in daily diets. In case of a condition due to blood loss, the bleeding has to be discovered and stopped medically. 
• Anaemia due to Vitamin deficiencies- The treatments include B-12 shots along with dietary supplements including B12 and folate. 
• Blood transfusion: In very severe anemia the treating doctor may start a blood transfusion. Required in acute blood loss and periodically in sickle cell anemia and major thalassemia.
• Thalassemia- The treatments include folic acid based supplements along with spleen removal and bone marrow transplants at times in tandem with blood transfusion. 
• Anaemia from chronic ailments- These are usually anaemia conditions linked to severe conditions. The emphasis will thus be majorly on treatment of this particular condition. Erythropoitin Alfa is a suitable medication that may be provided as an injection for scaling up red blood cell production in people with kidney issues.
• Aplastic Anaemia- The patient usually gets a blood transfusion or bone marrow transplant in this case. 
• Sickle Cell Anaemia- In this case, treatments include oxygen therapy, intravenous fluids, and pain relief. There may also be folic acid supplements along with antibiotics and blood transfusions. There are cancer medications used in some cases by doctors
• Haemolytic Anaemia- Patients should always bypass medication that may make things worse. They may receive immunosuppressant drugs and other treatment for infections. It may be necessary to opt for blood-filtering and plasmapheresis in some situations. 
• In case anaemia is caused by alcoholism, then, along with consuming vitamins and maintaining the suitable nutrition plan, consumption of alcohol has to be stopped from the outset. 
• Anemia may be caused due to certain drugs as well the consumption of which may need to be stopped in consultation with the treating physician.

Disclaimer : The details provided herein is meant for informative purposes only. For detailed information related to the disease and its treatment please consult a relevant qualified specialist.

Dietary Aspects- 

In case of nutritional deficiencies that have caused anaemia, there may be a recommended diet plan which is rich in iron to combat resulting symptoms. These are food items which have higher iron counts- 

• Iron added pieces of bread/cereals
• Beans and pulses
• Leafy and dark green vegetables such as watercress and kale
• Red and white meat
• Brown rice
• Seeds and nuts
• Tofu
• Fish
• Dried fruits like raisins, apricots and prunes
• Eggs 

Major Risk Factors-  

Anaemia may occur in people of diverse ages and genders. However, below listed specific aspects heighten the risk: 

• Pregnancy and childbirth
• Menstruation
• Ages between 1-2 years
• Pre-term birth
• A diet low in minerals, vitamins and iron 
• Blood loss from injuries or surgeries
• Severe or long-term ailments including kidney diseases, AIDS, diabetes, heart failure, cancers, rheumatoid arthritis and liver diseases
• A family history of anaemia that has been inherited like sickle cell anaemia
• Intestinal ailments which impact nutrient absorption

There are a few common kinds of anaemia which can be prevented easily by consuming a healthy diet plan and restricting consumption of alcohol. Many different types of anaemia can be bypassed by regularly visiting a doctor and getting blood tests done whenever any problem arises. In case of senior citizens, regular blood tests are recommended by the doctor, even when there are no specific symptoms to identify anaemia and accordingly prompt medical advice.  If not associated with any chronic and severe ailment, nutritional anaemias are easy to treat with oral supplementations of iron and vitamins. A 3 months course of iron supplement either orally daily or as an injection periodically treats most of the anemias. Also, as majority causes are nutritional deficiency, its an easily preventable disease if iron risch food is taken on a daily basis. Vitamin C along with iron helps in its absorption and animal source of iron are easily absorbed than plant sources.