Causes, Treatment, and Symptoms of Anemia

Anemia

Anemia, defined as a condition characterized by a decreased number of red blood cells or diminished concentrations of hemoglobin in the blood, hinders the blood’s ability to adequately transport oxygen to various tissues throughout the body. Hemoglobin naturally serves to carry oxygen, and its deficiency, whether due to an insufficient number of red blood cells or abnormal variations therein, can severely impair this function. It is critical to note that the normal concentration of hemoglobin required for blood to perform properly varies between individuals, influenced by several factors including age, gender, altitude, smoking status, and whether an individual is pregnant. According to the World Health Organization’s 2008 statistics, the global prevalence of anemia can reach up to 24.8%. It is found that the incidence is lowest among men, approximately 12.7%, while it peaks in preschool-aged children at about 47.4%. Furthermore, data from 2011 indicated that pregnant women are more likely to experience anemia, with an incidence of roughly 38% compared to about 29% in non-pregnant women.

Symptoms of Anemia

A person with mild anemia may not exhibit any symptoms. However, more pronounced cases can lead to specific signs that aid physicians in identifying the type and cause of anemia. It is advisable to seek medical consultation if symptoms associated with anemia arise. Common symptoms include fatigue or weakness, attributed to low energy levels resulting from decreased hemoglobin and, subsequently, reduced oxygen levels in the body. To compensate, the heart increases its blood output throughout various body regions. Additional symptoms may include but are not limited to:

Pale skin.
Shortness of breath.
Cold extremities.
Headaches.
Dizziness.
Irregular heart rate.
Brittle nails.
Hair loss.
Increased cravings for non-nutritive substances, known scientifically as pica.

For further information on the symptoms of anemia, please refer to the article: Symptoms of Anemia.

Causes and Types of Anemia

Anemia can be categorized into three primary types based on its underlying causes as detailed below:

Anemia Due to Blood Loss

Blood loss is a leading cause of anemia, which can occur rapidly or chronically. In chronic cases, individuals may lose red blood cells slowly over extended periods. Notably, blood loss can also lead to reduced iron levels, resulting in what’s termed iron deficiency anemia, the most prevalent form of anemia, which will be elaborated on later. Major causes of blood loss include:

Gastrointestinal disorders, such as ulcers, hemorrhoids, gastritis, or gastrointestinal cancers.
Use of nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen, which might cause ulcers or gastritis as side effects.
Heavy menstrual bleeding in women.
Trauma or surgical interventions.

Anemia Due to Impaired Red Blood Cell Production

Anemia can also arise from the body’s inability to produce sufficient red blood cells or produce red blood cells that do not function properly. Various factors contribute to this type of anemia, including deficiencies in essential vitamins and minerals required for optimal red blood cell production. Below are subtypes of anemia related to impaired red blood cell production:

Iron Deficiency Anemia

This condition stems from several factors, often related to inadequate iron levels in the body or poor absorption of iron. As previously mentioned, blood loss is a significant contributor. Other causes include:

Use of certain medications, such as antacids.
Pregnancy and breastfeeding, where iron intake may not meet increased bodily demands, leading to lower iron levels.
Dietary restrictions resulting in inadequate iron intake, especially in individuals following vegetarian diets, or excessive consumption of caffeine-containing beverages.
Gastrointestinal problems, like Crohn’s disease, or surgeries involving removal of parts of the stomach or intestines.
Other factors such as frequent blood donation or specific physical training regimens.

Vitamin Deficiency Anemia

This type of anemia occurs due to insufficient quantities of certain vitamins, particularly vitamin B12 and folic acid, which are integral for producing healthy red blood cells. A deficiency can result from inadequate dietary intake, problems with absorption, or complications that limit the body’s ability to convert these vitamins into usable forms. Vitamin deficiency anemia types include:

Vitamin B12 Deficiency Anemia: Obtained from various foods like milk, eggs, and meats, insufficient intake may lead to deficiency. This condition also encompasses pernicious anemia, caused by the immune system attacking stomach cells that produce intrinsic factor, essential for B12 absorption.
Folic Acid Deficiency Anemia: Commonly known as vitamin B9, folic acid is sourced from fruits and leafy green vegetables. A lack of these can lead to deficiency due to poor dietary choices or absorption issues.

Bone Marrow and Stem Cell Disorders

The bone marrow is responsible for blood cell production; thus, any diseases or disorders affecting it can lead to anemia due to disrupted red blood cell production. Examples include various blood cancers, such as lymphoma and leukemia. Types of anemia emanating from bone marrow or stem cell issues include:

Aplastic Anemia: A rare disorder resulting from various causes, including viral infections, exposure to toxic chemicals, certain medications, or radiation, resulting in significantly reduced blood cell production.
Thalassemia: This hereditary disorder impacts hemoglobin protein production due to genetic defects, leading to abnormal or decreased production of hemoglobin and, consequently, red blood cells. The two main types are alpha and beta thalassemia, with several subtypes under both categories.
Lead Poisoning Anemia: Chronic exposure to high levels of lead can result in anemia and systemic damage to vital organs, including the brain and kidneys.

Sickle Cell Anemia

Sickle cell anemia primarily affects hemoglobin, characterized by abnormal hemoglobin S, which causes red blood cells to assume a sickle or crescent shape. This alteration in cell shape leads to accelerated cell destruction and subsequent anemia. Symptoms often present early in childhood, including jaundice due to rapid red blood cell breakdown.

Anemia Related to Chronic Kidney Disease

Patients with chronic kidney disease may develop anemia due to the kidneys’ compromised ability to produce erythropoietin, a hormone essential for red blood cell production, resulting in decreased blood cell generation.

Hemolytic Anemia

This condition occurs when red blood cells are destroyed faster than they can be produced, resulting in a lifespan of less than four months. Hemolytic anemia can be either hereditary or acquired, the former being genetically passed down. Common causes include autoimmune reactions, infections, or exposure to toxins. Variants include autoimmune hemolytic anemia, which occurs when the immune system mistakenly targets red blood cells, and drug-induced hemolytic anemia, where certain medications trigger the immune response against red blood cells. Other potential causes include:

Infections.
Exposure to venoms from snake and spider bites.
Severe liver or kidney diseases.
Severe hypertension.
Use of prosthetic heart valves or vascular bypass surgeries.
Coagulation disorders.
Spleen enlargement.

For additional details on the causes of anemia, refer to the article: What Causes Anemia.

Diagnosing Anemia

A healthcare professional typically diagnoses anemia through a series of tests and health history assessments. The process usually begins with a complete blood count (CBC), which provides comprehensive insights into blood components and characteristics. Diagnosis is primarily based on hemoglobin or hematocrit readings, alongside potential microscopic examinations of red blood cells to determine the underlying causes. These tests help diagnose anemia, ascertain its cause, and monitor the patient’s condition and treatment responses.

Treatment for Anemia

The primary goal of anemia treatment is to restore healthy red blood cell production to ensure sufficient oxygen transportation throughout the body. This can generally be achieved by increasing red blood cell or hemoglobin levels, or both. Additionally, addressing the root causes of anemia is vital. Treatment approaches may vary by individual based on the type, underlying causes, severity, and overall health. Common treatment options include:

Administration of vitamins and mineral supplements.
Modification of dietary habits.
Prescribing specific medications.
Blood transfusions from healthy donors.
Bone marrow transplantation.
Splenectomy, suited for certain cases of hemolytic anemia.
Antibiotic treatment when infections are a contributing factor.

For more detailed information on anemia treatments, please see the article: Anemia Treatment.

Complications of Anemia

Without proper treatment, anemia can lead to various health complications, including:

Severe fatigue, hindering one’s ability to perform daily tasks.
Cardiovascular problems: Anemia can cause an accelerated heart rate or arrhythmias, as the heart compensates for oxygen deficits, potentially resulting in cardiomyopathy or heart failure.
Pregnancy complications: Pregnant women suffering from folic acid deficiency anemia may be at an increased risk for premature births.
Severe complications: Certain hereditary anemias, such as sickle cell anemia, can lead to life-threatening complications, while significant blood loss can result in acute severe anemia, posing serious health risks.

To learn more about the complications of anemia, check the article: What are the Complications of Anemia.

Notes:

(*) Hemorrhoids: This condition involves swollen veins in the lower rectum and anus, leading to irritation and potential discomfort or pain, though it can often be managed and prevented.

(*) Crohn’s Disease: A chronic inflammatory bowel disease that causes inflammation in the digestive tract.

(*) Cooley Anemia: A severe form of beta-thalassemia involving mutations in both genes responsible for beta-globin chain synthesis, with severity varying widely.