Anaemia

What is Anaemia ?

Decrease in the oxygen carrying capacity of blood is known as Anemia. This is due to a deficiency of red blood cells (RBCs) in the blood. It may be due to decreased production or increased destruction of the red blood cells. Decrease in hemoglobin concentration by more than 10% below the average value denotes anaemia.

Leafy vegetables and fruits are rich in Iron

What is the function of Red Blood Cells?

Red Blood Cells, also known as RBCs or Erythrocytes perform the function of transporting the oxygen through the blood, to various parts of the body. They are filled with hemoglobin (Hb), which gives them a red color. When the red blood cells reach the lungs, they absorb oxygen and carry it to all the cells in the body. The cells use the oxygen to fuel the burning of sugar and fat. This produces the energy required by the body. The process is called oxidation, during which carbon dioxide is released as a waste product. The carbon dioxide binds itself to the red blood cells and is transported to the lungs, where it is exchanged for fresh oxygen during breathing.

What is the normal level of RBCs in the blood?

Normal average RBC count in the blood is 4.8 million/cubic mm. for women and 5.2 million/cubic mm. in men.

Where are the RBCs produced in the body?

RBCs are produced in the bone marrow. The cells of the bone marrow undergo multiplication and maturation, producing and realeasing the RBCs in the blood.

What factors are responsible for the production of RBCs?

Iron, Vitamin B12, Folic acid, trace elements, proteins, and Vitamin C and B complex are all essential for the production of RBCs. These substances are obtained from the diet. Lack of oxygen (hypoxia) stimulates the release of a hormone called erythropoietin from the kidney. This hormone acts as a stimulant for production of RBCs.

What is the life span of RBCs?

RBCs have an average life span of 120 days. They are replaced by fresh cells from the bone marrow. When RBCs are destroyed, haemoglobin is released from them. This is broken into the haem (iron) and globin (protein) components. The iron present in haem is utilized again. The remaining is converted into bilirubin (bile pigment).

What is Haemoglobin ?

Hemoglobin is the red pigment of RBCs. It consists of two parts, a protein known as globin (96%) and iron in the form of a pigment called haem(4%). Hemoglobin combines with Oxygen to form oxyhaemoglobin, which is how oxygen is transported in the blood.

What is normal level of Hemoglobin in the blood?

The normal level of hemoglobin in an average Indian adult male is about 13-15 gm Hb/100 ml of blood. In an adult female the normal level is 12-14 Gm Hb/100 ml of blood.

How does the body get the iron it requires?

The normal loss of iron in the body is about 1mg a day. In women who are menstruating, the additional requirement due to blood loss is about 0.5 mg daily. A normal diet contains about 10-15 mg of iron and about 5-10% of this is absorbed. This is usually sufficient under normal circumstances. Fish, liver, egg yolk, crab and oysters are rich in iron. The iron in meats is known as haem iron and it is better absorbed than the iron found in a vegetarian diet. Green leafy vegetables, peas, lentils, cereals and some fruits contain iron.

What are the causes of Iron deficiency Anemia?

Iron deficiency is very common in Indians particularly in children and pregnant women. The main causes of Iron deficiency anemia are: Dietary deficiency of iron.. Increased demand of iron, and other nutrients necessary for proper absorption of iron, during pregnancy, lactation and menstrual blood loss in women. Growing children too have an increased need for iron. Chronic blood loss due to heavy menstrual bleeding in women, bleeding disorders of gastrointestinal tract, worm infestations and surgical procedures. Chronic diarrhea and dysentery are other common conditions among Indians, when there is an excessive loss of blood from the body. Increased destruction of RBCs in haemolytic disorders e.g. thalassaemia. Reduced production of RBCs due to improper functioning of the bone marrow.

What are the symptoms of Iron deficiency Anemia?

· Symptoms of iron deficiency anemia usually do not appear until a person's hemoglobin percentage (level of red pigment in the blood) drops below 10g per deciliter · Tiredness, reduced muscular endurance and palpitations (awareness of the heartbeat) are the first symptoms to appear · Behavioral and learning problems in children due to disturbances in the brain function · Shortness of breath and dizziness is common · If the anemia is severe, angina (chest pain), headache and leg pains can occur.

In pronounced and long-term cases of iron deficiency anemia, there may be some unique symptoms.

· Dryness in the mouth and throat · Sores at the corners of the mouth (angular stomatitis) · An altered sense of touch · A smooth tongue · In extreme cases, the nails can become brittle and spoon shaped, with vertical stripes and a tendency to fray. · An insatiable craving for specific foods, e.g. sweets · Brittle hair · Difficulty in swallowing

Symptoms associated with worsening of anemia include shortness of breath, palpitation and angina (chest pain). Iron deficiency can, in rare cases, cause permanent changes to the mucosa (soft lining) in the throat (Plummer-Vinson syndrome). This condition is a preliminary stage to cancer.

How does a doctor diagnose anaemia due to iron deficiency?

From the physical examination, a doctor may be able to come to a diagnosis of anemia. An analysis of the blood cells will show whether a person is suffering from anemia. Advanced tests to examine the proteins (ferritin and serum iron) which are involved in the storage and transport of iron in the body, can confirm the presence of iron deficiency anemia.

What is the treatment for iron deficiency anemia?

The treatment of iron deficiency anemia will be done by treating the cause of the anemia as well as by providing iron supplements. Once the blood loss or the cause of the anemia has been treated, iron tablets could rapidly reverse the anemia. These tablets could irritate the stomach and should be preferably taken after food. Iron tablets could color the stools black and cause constipation or diarrhea.

Tips to avoid anemia

· A nutritious and varied diet should be taken. · Liver, whole meal bread, cereals, eggs and dried fruit are rich in iron. · Loss of blood in the stools or urine, or heavy menstrual bleeding should prompt a person to seek immediate medical advice. · During pregnancy, the expectant mother should consult the doctor as to when and how to take the iron supplements. Daily iron requirements in pregnancy are about three times higher than normal. Some iron is conserved during pregnancy, but there is an increased requirement by the fetus and due to loss of blood during delivery. Iron is also present in breast milk, which increases the requirement of iron in lactating mothers.