• Anemia

    Definition

    Anemia is a low level of healthy red blood cells (RBC). RBCs carry oxygen from the lungs to the rest of the body. When red blood cells are low the body does not get enough oxygen. This can cause symptoms such as fatigue, pale skin, or irregular heartbeat.
    There are several specific types of anemia, including:
    Red Blood Cells
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    Causes

    The main causes of anemia are:
      Blood loss, such as that caused by:
      • Heavy menstrual periods
      • Bleeding in the digestive tract
      • Bleeding in the urinary tract
      • Surgery
      • Trauma
      • Cancer
      Abnormally low RBC production, due to: Abnormally high RBC destruction, caused by inherited disorders such as:
      • Sickle cell anemia
      • Thalassemia —difficulty in manufacturing hemoglobin
      • Enzyme deficiencies

    Risk Factors

    Risk factors that may increase your chances of anemia include:
    • Women of childbearing age
    • Pregnancy
    • Older adults with other medical condition
    • Infants younger than two years
    • Poor diet low in iron, vitamins, and minerals
    • Blood loss (eg, due to surgery or injury)
    • Chronic or serious illness
    • Chronic infections
    • Family history of inherited anemia (eg, sickle cell anemia, thalassemia)

    Symptoms

    Symptoms of anemia may include:
    • Tiredness
    • Feeling faint
    • Paleness
    • Shortness of breath
    • Dizziness
    • Headache
    • Coldness in the hands and feet
    • Pale skin
    • Chest pain
    • Rapid or irregular heartbeat

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Other tests may include:
      Tests of your blood:
      • Complete Blood Count (CBC)
      • Other blood tests
      • Blood smear
    • Stool sample
    • Bone marrow aspiration or biopsy

    Treatment

    Talk with your doctor about the best plan for you. Options include:

    Nutrition

    Your doctor may suggest changes to your diet. The diet may include foods rich in iron, vitamin C, vitamin B12, and folate. Vitamins or iron supplements may be added.

    Medications

    To help treat your anemia or your symptoms, your doctor may prescribe:
    • Antibiotics
    • Hormone treatment
    • Epoetin
    • Medications that act on the immune system
    • Chelation therapy (for lead poisoning)

    Blood Transfusions

    A blood transfusion delivers blood cells from healthy donor blood.

    Bone Marrow or Stem Cell Transplant

    This procedure places healthy bone marrow or stem cells in the body. The goal is for the new tissue to produce healthy blood cells. This procedure carries risk. It is only done in severe cases of anemia.

    Surgery

    Critical bleeding may be treated with surgery. In cases of very high RBC destruction, your spleen may need to be surgically removed.

    Prevention

    Most inherited forms of anemia cannot be prevented. But the following steps may be taken to prevent certain types of anemia:
    • Eat a diet rich in iron and vitamins
    • Take iron or vitamin supplements, as recommended by your doctor
    • Treat underlying causes of anemia
    • Report signs and symptoms, especially chronic fatigue, to your doctor

    RESOURCES

    Iron Disorders Institute http://www.irondisorders.org

    National Anemia Action Council http://www.anemia.org

    CANADIAN RESOURCES

    Anemia Institute http://www.anemiainstitute.org

    Government of British Columbia Ministry of Health http://www.gov.bc.ca/health/

    References

    Anemia—differential diagnosis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 8, 2011. Accessed November 2, 2012.

    Anemia. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/anemia/anemia%5Fwhatis.html . Accessed November 1, 2012.

    Guralnik JM, Eisenstaedt RS, Ferrucci L, Klein HG, Woodman RC. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood . 2004;104:2263-2268.

    Nissenson AR, Goodnough LT, Dubois RW. Anemia: not just an innocent bystander? Arch Intern Med . 2003;163:1400-1404.

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