Hematology branch deal with blood disorders. Iron deficiency anemia is a common type of anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body's tissues, so a low red blood cell count indicates that the amount of oxygen in your blood is lower than it should be.
Many of the symptoms of anemia are caused by decreased oxygen delivery to the body’s vital tissues and organs.
Anemia is measured according to the amount of hemoglobin — the protein within red blood cells that carries oxygen from the lungs to the body’s tissues. Anemia affects more than 1.6 billion peopleTrusted Source around the world. Women and people with chronic diseases such as cancer have the highest risk of developing anemia.
You can usually correct iron deficiency anemia with iron supplementation. Sometimes additional tests or treatments for iron deficiency anemia are necessary, especially if your doctor suspects that you're bleeding internally. Best to meet Hematology oncology specialists - Dr. Rajesh Bollam - Yashoda hospital Secunderabad Hyderabad
What causes anemia?
Dietary iron, vitamin B-12, and folate are essential for red blood cells to mature in the body. Normally, 0.8 to 1 percent of the body’s red blood cells are replaced every day, and the average lifespan for red cells is 100 to 120 days. Any process that has a negative effect on this balance between red blood cell production and destruction can cause anemia.
Causes of anemia are generally divided into those that decrease red blood cell production and those that increase red blood cell destruction.
Factors that decrease red blood cell production
The things that typically decrease red blood cell production, causing anemia, include:
- inadequate stimulation of red blood cell production by the hormone erythropoietin, which is produced by the kidneys
- inadequate dietary intake of iron, vitamin B-12, or folate
Factors the increase red blood cell destruction
On the other hand, any disorder that destroys red blood cells at a rate faster than they’re made can cause anemia. This typically occurs due to hemorrhaging, which can happen because of:
- gastrointestinal lesions
- excessive uterine bleeding
- cirrhosis, which involves scarring of the liver
- fibrosis (scar tissue) within the bone marrow
- hemolysis, a rupture of red blood cells that can occur with some medications or Rh incompatibility
- disorders of the liver and spleen
genetic disorders such as:
◦ glucose-6-phosphate dehydrogenase (G6PD) deficiency
◦ sickle cell anemia
Overall, however, iron deficiency is the most common cause of anemia. It accounts for nearly half of all anemia cases, and is a major nutritional disorder worldwide.
Daily nutritional requirements and anemia
Daily requirements for vitamins and iron vary according to sex and age.
Women need more iron and folate than men because of iron losses during their menstrual cycle and fetal development during pregnancy and breastfeeding.
According to the National Institutes of Health, the recommended daily iron intake for adults ages 19 to 50 are as follows:
Men and women over age 50 require only 8 milligrams (mg) of iron daily. A supplement may be needed if adequate iron levels can’t be acquired through diet alone.
Good sources of dietary iron include:
- chicken and beef liver
- dark turkey meat
- red meats, such as beef
- fortified cereals
Folate is the form of folic acid that occurs naturally in the body.
Males and females over the age of 14 require 400 micrograms of dietary folate equivalents (mcg/DFE) per day.
For women who are pregnant or breastfeeding, the recommended intake increases to 600 mcg/DFE and 500 mcg/DFE per day, respectively.
Examples of foods rich in folate are:
- beef liver
- great northern beans
You can also add folic acid to your diet with fortified cereals and breads.
The daily adult recommendation for vitamin B-12 is 2.4 mcg. Women and teens who are pregnant need 2.6 mcg per day, and those who are breastfeeding require 2.8 mcg daily.
Beef liver and clams are two of the best sources of vitamin B-12. Other good sources include:
- other dairy products
Vitamin B-12 is also available as a supplement for those who don’t get enough from their diet alone.
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What are the symptoms of anemia?
People with anemia appear pale and may often complain of being cold.
They may also experience:
- lightheadedness or dizziness, especially when active or standing up
- unusual cravings, such as wanting to eat ice, clay, or dirt
- trouble concentrating or tiredness
Some types of anemia can cause inflammation of the tongue, resulting in a smooth, glossy, red, and often painful tongue.
If anemia is severe, fainting may occur. Other symptoms include:
- brittle nails
- shortness of breath
- chest pains
Blood oxygen levels can be so low that a person with severe anemia can have a heart attack.
If you get a physical exam and you have anemia, your results may show:
- high or low blood pressure
- pale skin
- an increased heart rate
- a heart murmur
- enlarged lymph nodes
- an enlarged spleen or liver
- atrophic glossitis of tongue
People with signs or symptoms of anemia should seek medical attention, especially if fainting or chest pains occur.
How is anemia diagnosed?
A diagnosis of anemia begins with both your health history and your family health history, along with a physical exam.
A family history of certain types of anemia such as sickle cell anemia can be helpful. A history of exposure to toxic agents in the
home or workplace might point to an environmental cause.
Laboratory tests are often what’s used to help doctors find out the cause of the anemia.
Tests to diagnose anemia include:
- Complete blood count (CBC). The CBC blood test shows the number and size of the red blood cells. It also shows if levels of other blood cells like white blood cells and platelets are normal.
- Serum iron levels. This blood test shows if iron deficiency is the cause of anemia.
- Ferritin test. This blood test analyzes iron stores.
- Vitamin B-12 test. This blood test shows vitamin B-12 levels and helps your doctor determine if they’re too low.
- Folic acid test. This blood test reveals if serum folate levels are low.
- Stool test for occult blood. This test applies a chemical to a stool specimen to see if blood is present. If the test is positive, it means that blood is being lost somewhere in the gastrointestinal tract, from the mouth to the rectum. Problems like stomach ulcers, ulcerative colitis, and colon cancer can cause blood in stool.
Based on the results of these tests, doctors may order additional tests such as:
- an upper GI
- a barium enema
- chest X-rays
- a CT scan of your abdomen
How to treat anemia
Treating anemia depends on what’s causing it.
Anemia caused by inadequate amounts of dietary iron, vitamin B-12, and folate is treated with nutritional supplements. In some cases, injections of B-12 are needed as it isn’t absorbed properly from the digestive tract.
Your doctor and nutritionist can prescribe a diet that contains the proper amounts of vitamins, minerals, and other nutrients. A proper diet can help prevent this kind of anemia from recurring.
In some cases, if the anemia is severe, doctors use erythropoietin injections to increase red blood cell production in the bone marrow. If bleeding occurs or the hemoglobin level is very low, a blood transfusion may be necessary.