Who Let The Doc Out?! #007: What you need to know about anemia

Anemia is a condition characterized by a decrease in the proportion of red blood cells in your body. Red blood cells carry an important protein known as hemoglobin.

Hemoglobin is responsible for carrying oxygen in the body and delivering it to your tissues and organs, and it is what gives your red blood cells and blood their red color.

When you have anemia, your hemoglobin levels are also low. This means the tissues and organs in your body may bot receive adequate oxygen. Because of this, anemia is a very dangerous condition that must be identified and corrected early.

Risk factors and causes of anemia

Anemia is not a disease. Instead, it usually presents as a manifestation of pathological processes in the body which must be dealt with to correct the anemia.

Certain groups of people are at a higher risk of developing anemia, and they include the following:

  • Infants: Babies are usually born with high amounts of hemoglobin and large iron stores. Because of this, during the first six months of their life, they are protected from iron deficiency. However, after six months, babies require external sources of dietary iron other than breastmilk, as breastmilk does not contain adequate iron.
  • Pregnant women: During pregnancy, the volume of blood increases to fulfill the oxygen and nutrient requirements of both the mother and the fetus. Since iron is integral to the formation of blood components, pregnant women need to double their intake of iron from external sources and are often at high risk of anemia due to iron deficiency.
  • Elderly people: They usually have low dietary intake of iron due to issues with feeding due to dentition issues and poor appetite. They also commonly have chronic illnesses which may predispose them to anemia.
  • Menstruating women: Some women may have excessively heavy or long periods, and this blood loss can cause anemia. This condition is usually seen in women with uterine fibroids.
  • Other groups of people at risk include: People on blood-thinning medication, people with blood disorders like sickle cell disease, thalassemia, and blood cancers.

The causes of anemia are broadly categorized into four groups:

  • Anemia due to blood loss: This can occur due to heavy bleeding from trauma, surgery, or heavy menses, or gastrointestinal conditions like ulcers, varices, and gut cancers.
  • Anemia due to faulty or decreased red cell production: This is seen in conditions like sickle cell disease, thalassemia, and bone marrow disorders and malignancies like leukemia. Certain nutrient deficiencies like iron deficiency, Vitamin B12 deficiency, and folate deficiency are also common causes of decreased red cell production.
  • Anemia due to destruction of red cells: This is seen in conditions like severe malaria, chemotherapy, advanced cancer, autoimmune disorders like lupus, and splenic enlargement.
  • Anemia due to chronic disease: Certain chronic conditions can impair red cell production or cause increased red cell destruction, for example end-stage renal disease, hypothyroidism, diabetes, and cancer.

Signs and symptoms of anemia

The symptoms of anemia are typically a manifestation of oxygen deprivation in your tissues and organs. They include:

  • Headache
  • Dizziness
  • Palpitations (a fast heartbeat)
  • Generalized weakness
  • Shortness of breath
  • Chest pain
  • Cold hands and feet

You may also see physical signs like paleness of the light areas of the skin like the palms and soles. Depending on the cause of the anemia, there are also specific signs you can look out for, for example:

  • In iron deficiency anemia, patients may have difficulty swallowing, brittle fingernails, and an increased tendency to chew or suck ice.
  • In Vitamin B12 deficiency, the patient may present with a burning sensation in the tongue or the feet.
  • In patients with gastrointestinal bleeding, they may have tarry stools or frank blood in the stool or the vomit.

How is anemia diagnosed?

Anemia is diagnosed by a laboratory test known as a full blood count. With this, your doctor can assess the number and size of your red blood cells, your hemoglobin levels, and other parts of blood. They may also ask for a blood smear to further examine the shape of your red blood cells and look for any abnormalities.

How is anemia managed?

The management of anemia depends entirely on correcting the cause of the reduced red cells. If a patient has lost blood after trauma, they may need a blood transfusion to replenish lost blood volume. Correcting micronutrient deficiencies with dietary advice and supplements will usually help patients with anemia due to iron, Vitamin B12, or folate deficiency.

Some cases may require surgical intervention, for example bleeding esophageal varices or ulcers. Patients with end-stage renal disease may require kidney transplants and exogenous hormone therapy.

Innocent Immaculate Acan is a medical doctor and writer currently working at Adjumani Hospital. She won the Writivism Short Story Prize in 2016 and has published an illustrated children’s book titled The Pearl Trotters in Black, Yellow, Red. She was part of the 2018 class of the Young and Emerging Leaders Project.

Innocent Immaculate Acan