Iron deficiency anemia
डिस्क्रिप्सन
Definition
Anemia means that you have lesser hemoglobin [a protein in red blood cells (RBCs) that carries oxygen] or fewer RBCs than normal. This causes less oxygen to reach your cells. As a result, you may feel weak and get tired easily.
This oxygen requirement depends on age, sex, altitude, smoking, and pregnancy status. The normal level of hemoglobin is:
1. Men: 13.8 to 17.2 g/dL of blood
2. Women: 12 to 15 g/dL of blood
Causes and Risk Factors
There are many causes of anemia:
1. Taking a diet poor in iron, vitamin B12 or folic acid
2. Conditions that interfere with absorption of vitamin B12, such as parasitic infections, HIV disease, Crohn’s disease
3. Heavy menstrual bleeding
4. Blood disorders such as thalassemia or sickle cell anemia
5. Glucose-6-phosphate dehydrogenase (G6PD) deficiency that causes anemia when exposed to certain food, medicines, infections, or stress
6. Problems with the bone marrow that may be caused due to certain medications, or cancer treatment or may be present since birth.
7. Stomach ulcers, hemorrhoids, gastritis, cancer
Depending on what causes anemia, it is classified as:
1. Iron deficiency anemia
2. Megaloblastic anemia caused by deficiency of vitamin B12 and/or folate.
3. Pernicious anemia caused by poor absorption of vitamin B12 by the intestines.
4. Aplastic anemia caused by failure of the bone marrow to make sufficient RBCs.
5. Hemolytic anemia caused by triggers such as fava beans that cause abnormal destruction of RBCs.
6. Sickle cell anemia that is inherited from parents and causes deformed (sickle shaped) RBCs that cannot carry enough oxygen.
Signs and Symptoms
Common symptoms of anemia include:
1. Weakness
2. Fatigue (tiredness)
3. Dizziness
4. Shortness of breath
5. Paleness of skin or yellowish skin
6. Chest pain
7. Irregular heartbeats
8. Headache
Investigations
1. Blood tests:
a) Complete blood count (CBC) -- to check for levels of hemoglobin and RBC count for total number of RBCs in blood.
b) Iron, vitamin B12, folic acid levels in blood since these are required for new RBCs.
2. Urine culture for infection.
3. Special blood tests may be required to detect rare causes of anemia.
Treatment
The treatment of anemia will depend on the cause and include:
1. Iron and folic acid supplement
2. Vitamin B12 supplement
3. Blood transfusion
4. Bone marrow transplants for aplastic anemia where body’s own bone marrow cannot produce enough blood cells
Taking an iron rich diet will help in both treatment and prevention of anemia. Include the following in your diet:
1. Liver (chicken)
2. Nuts such as peanuts, walnuts, almonds, raisins, prunes
3. Red beetroot juice or carrot juice
4. Apples, figs, peaches
5. Whole grain, spinach, beans, dark green leafy vegetables
Avoid having milk, tea, coffee, or other calcium rich food when consuming food rich in iron or when taking iron supplements.
When consuming iron rich food, have them with foods rich in vitamin C to increase absorption. These include orange or lemon juice, fruits such as kiwis, strawberry, and guava.
Complications and When Should You See a Doctor
See a doctor if you feel tired and breathless even while doing normal work or if you have other symptoms of anemia.
If not treated, anemia can have serious health complications. It can cause irregular heartbeat and heart failure. Some serious forms of anemia such as hemolytic anemia may even cause death.
Prognosis and Prevention
Anemia is easily curable. For anemia caused by a deficiency of iron, vitamin B12 or folate, taking a diet rich in them can help prevent anemia.
For anemia due to other causes, outlook will depend on the cause of anemia and its severity.
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