Iron deficiency anaemia is one of the most prevalent blood disorders, characterised by a deficiency of red blood cells and haemoglobin. Haemoglobin, the protein responsible for transporting oxygen from the lungs to other parts of the body, relies on iron to function properly. Hence, the majority of people with anaemia have insufficient iron levels leading to this condition.
Several other types of anaemia exist, including:
Aplastic anaemia results from damaged stem cells in the bone marrow. This condition inhibits blood cell production, affecting red blood cells, white blood cells, and platelets. Bone marrow failure is a term that is sometimes used.
Haemolytic anaemia occurs when the body destroys red blood cells prematurely. Red blood cells usually have a lifespan of 120 days.
Normocytic anaemia, where red blood cells are of normal size but present in low numbers.
Pernicious anaemia arises due to vitamin B12 deficiency, leading to a red blood cell deficit.
Sickle cell anaemia is a form of sickle cell disease, a genetic disorder affecting red blood cells. The condition occurs when an individual is born with two abnormal haemoglobin genes.
Symptoms of anaemia
Anaemia symptoms may vary, and mild forms may not present symptoms. However, fatigue or feeling exhausted is a common symptom, as the oxygen-carrying haemoglobin in red blood cells is deficient, resulting in low energy levels. The lack of oxygen may make the heart to work harder. This may lead to symptoms such as paleness, shortness of breath, cold hands and feet, headaches, dizziness, and a fast, slow, or uneven heartbeat. Other signs may include brittle nails or hair loss, and strange food cravings, also known as pica. If you experience any of these symptoms, contact your doctor who can diagnose the type and cause of the condition.
The cause of anaemia can be attributed to various factors.
Insufficient production of red blood cells
Inadequate intake of certain nutrients, such as iron, vitamin B12, and folic acid, is a common dietary cause of anaemia. People who follow fad diets or don't consume meat are more prone to low iron levels. Infants and toddlers are at risk of developing anaemia due to a low-iron diet.
An absorption difficulty can also cause anaemia. Some diseases can affect your small intestine's ability to absorb nutrients, leading to low iron levels in the body. For instance, Crohn's disease and celiac disease can cause this condition. Certain foods, such as milk, can prevent iron absorption in the body. Vitamin C can aid iron absorption. Some medications, such as antacids or acid-reducing prescriptions, can also impact nutrient absorption.
Pregnancy and breastfeeding can increase the risk of anaemia as your body needs more blood (up to 30% more) to provide for the baby. However, if your body lacks iron or vitamin B12, it may not produce enough red blood cells.
Several factors can increase the risk of anaemia during pregnancy, including:
Frequent vomiting from morning sickness
A diet low in nutrients
Heavy periods before pregnancy
Having two pregnancies close together
Carrying multiple babies at once
Experiencing significant blood loss due to injury or surgical procedures.
Children under the age of 3 are susceptible to anaemia due to their rapid growth. This can make it difficult for their bodies to obtain and maintain enough iron.
Normocytic anaemia can be present from birth (congenital) or acquired due to disease or infection. The acquired form is often caused by chronic conditions such as kidney disease, cancer, rheumatoid arthritis, and thyroiditis. While some medications can also cause normocytic anaemia, this is rare.
Red blood cells are destroyed by your body faster rate than they can be replaced.
Treatments like chemotherapy can harm your red blood cells and/or bone marrow, leading to anaemia. Infections caused by a weakened immune system can also result in anaemia. Additionally, some individuals are born with conditions that destroy or remove red blood cells. These conditions include sickle cell disease, thalassemia, or a deficiency in certain enzymes. An enlarged or diseased spleen can also contribute to anaemia.
Blood loss can lead to red blood cell shortages in your body.
Low iron levels in women may result from heavy periods. Blood loss can also occur due to internal bleeding, for example, in the digestive or urinary tract. This can be caused by stomach ulcers or ulcerative colitis. Blood loss can also occur due to other reasons, such as cancer, surgery, trauma, or taking aspirin or similar medications for an extended period.
What is the process for diagnosing anaemia?
If you suspect you or your child has anaemia, consult your doctor. Your doctor will conduct a physical examination and assess your medical history and symptoms. To diagnose anaemia, a blood test known as a complete blood count (CBC) will be performed. Depending on the CBC results, your doctor may need to perform further tests, such as a bone marrow test. These additional tests can help identify the underlying cause of anaemia or any other related medical condition.
Is it possible to prevent or avoid anaemia?
It is impossible to prevent anaemia caused by genetic disease. However, some types of anaemia can be prevented by taking measures to avoid blood loss. If blood loss is due to heavy periods, treatments can prevent anaemia. If your body cannot absorb certain nutrients like iron or vitamin B12, you can talk to your doctor about taking supplements to manage your levels and prevent anaemia.
A balanced diet that includes iron-rich foods can also prevent some types of anaemia. These foods include red meat, seafood, organ meats, whole grains, dried fruits, nuts, beans, and dark green leafy vegetables. Foods rich in vitamin C, such as citrus fruits or juice, peppers, and broccoli, can help your body absorb iron. However, some foods can make it difficult for your body to absorb iron, such as coffee, tea, milk, egg whites, fibre, and soy protein. These foods should be avoided if you have iron deficiency anaemia.
Vitamin B12 sources include meat, poultry, organ meats, fish, shellfish, eggs, dairy products, and milk, as well as some fortified cereals, grains, and yeasts. Foods high in folic acid (folate) include dark green leafy vegetables, asparagus, beans, peas, lentils, bananas, oranges, and orange juice.
Pregnant individuals may be tested for anaemia or take an iron supplement to prevent it. However, there is insufficient evidence to assess the benefits and risks of screening all pregnant individuals for iron deficiency anaemia or having them take an iron supplement. Evidence is also lacking for screening children aged 6 to 24 months. However, you can help prevent your child from getting iron deficiency anaemia by using iron-fortified formulas and cereals, and introducing foods high in iron starting around 12 months of age. It's imperative to keep all iron products out of reach of children, as iron can be toxic if taken in large amounts.
Treatment options for anaemia depend on the type, cause, and severity of the condition, as well as the patient's overall health. Treatment aims to increase the number of healthy red blood cells that carry oxygen throughout the body. Treatment may also involve addressing the underlying cause of anaemia. For example, if anaemia results from blood loss, the doctor will need to address the cause of the blood loss.
In cases where anaemia is caused by a nutrient deficiency, dietary changes may be recommended to increase nutrient levels or improve nutrient absorption. In some instances, medications can be prescribed to stimulate red blood cell production. This may include erythropoietin shots for normocytic anaemia or hormone medications for heavy periods. Antibiotic medications can treat infections that cause anaemia. Additionally, some medications may prevent red blood cell destruction.
In severe cases, more aggressive treatment may be required. This can include surgical procedures to address blood loss or spleen removal. Treatment options may also include blood transfusions or bone marrow stem cell transplants.
Individuals with chronic diseases or other health conditions that cause anaemia should work with their doctor to manage the condition effectively.
Coping with anaemia
After receiving appropriate treatment, many individuals can live a normal, healthy life. However, anaemia can lead to lasting or potentially life-threatening effects, particularly if it is chronic, severe, or left untreated. These effects may include:
Arrhythmia is a condition that affects your heartbeat rhythm and can increase your risk of heart disease or heart failure over time.
Organ damage can occur when the organs do not receive sufficient oxygen.
A weakened immune system can be fatal if you already have a weakened immune system due to cancer, disease (such as HIV/AIDS), or an infection.
Children with iron deficiency anaemia have an increased risk of lead poisoning and may experience long-term mental, motor, or behavioural issues.
Pregnant women with iron deficiency anaemia may give birth prematurely or have a baby with a low birth weight. Additionally, if you experience significant blood loss during delivery, there is a risk of needing a blood transfusion. Anaemia may be associated with postpartum depression.
Here are some questions to ask your doctor regarding anaemia:
If I've had anaemia before, does it mean I'll always have it or is there a chance of it recurring?
If I develop anaemia during pregnancy, is there a risk of passing it on to my child?
If I experience anaemia during pregnancy, does it increase my chances of having it again in the future?
If my anaemia is caused by an underlying health condition, what is the likelihood of passing it on to my children?