General Description

Anemia is a condition where there are too few red blood cells (RBC), and, as a consequence, too little hemoglobin in the blood. Hemoglobin is a red-colored, iron-containing protein that transports oxygen in the blood. Anemia also describes a problem with the way hemoglobin picks up oxygen, even when there are normal levels of it present. Hemoglobin carries oxygen from the lungs to various tissues in the body. All tissues need oxygen to survive, so a less than optimal amount of it can cause damage on a cellular level.

Causes

The most common cause of anemia is iron deficiency, but this may in turn be caused by a large number of things. Although anemia is a very serious condition, it can sometimes be due to something as simple as diet (see below).

• Red blood cell-related conditions, like a deficient number of cells

• Significant blood loss, for example from a hemorrhage

• Destruction of blood cells, for example from a disease or other condition

• Iron deficiency - the most common cause. Iron is essential for your body to make blood

• Vitamin deficiency, where other minerals and elements, especially vitamin B-12 and folic acid, are lacking

• Disease, especially cancer, Crohn's disease, rheumatoid arthritis and other inflammatory diseases that interfere with the body's ability to make red blood cells

• Diseases of the bone marrow and blood can also cause anemia, such as leukemia, myeloma and lymphoma

• Kidney failure

Types of Anemia

• Diet-related anemia, usually from an iron deficiency; this is the most easily-treated

• Microcytic anemia, a type of anemia characterized by small red blood cells. Some causes are: iron deficiency, chronic disease, deficient hemoglobin, lead poisoning, and heredity

• Macrocytic anemia, a type characterized by large red blood cells, a condition in cells that generally means there are not enough of them. Some causes are: an autoimmune condition or disease that interferes with vitamin absorption, gastric bypass surgery (when it removes too much of the functioning part of the stomach which keeps nutrients from being absorbed) and heredity

• Hemolytic anemia is where the red blood cells are destroyed faster than the body can replace them. Blood diseases can cause this, as well as autoimmune disorders; even some antibiotics can affect the body's production of red blood cells

• Aplastic anemia is the body's inability to produce all types of blood cells. This is a rare condition that affects the bone marrow and is thought to be an autoimmune disease

• Sickle cell anemia is a condition where the red blood cells are misshaped and die early

• Thalassemia, also called Mediterranean anemia, is a hereditary condition where there are too few red blood cells and too little hemoglobin in them. This condition does not require treatment in its mild form, but some people with it need blood transfusions

Symptoms

• Fatigue, especially muscular

• Trouble concentrating

• Dizziness, sometimes fainting spells

• Yellowing of eyes and skin

• Coldness and paleness of skin, paleness of the nail bed (the area where the nails begin)

• Cold hands and feet

• Trouble walking. The body takes oxygen from the legs to cover vital organs

• Enlarged spleen

• Shortness of breath

• Rapid or irregular heart rate

• Low blood pressure

• Angina (chest pain caused by the heart muscle not getting enough oxygen), usually only when symptoms of heart disease are already present

• In serious cases, heart attack

• Other less common symptoms may include swelling of limbs, bloody stools, recurring heartburn, and excess sweating

Anemia, the Elderly, and Medications

Anemia is increasingly becoming used to predict chances of mortality in the elderly because it is often present in people who are undernourished. Many medications interfere with or suppress the body's ability to process essential vitamins and minerals, a leading cause of anemia.

• Because aged people are more likely to take medications, and larger numbers of medications, their chances for developing anemia are far greater than those who take few or no medications. Additionally, the body becomes less able to process the necessary vitamins and minerals with increased age, so the elderly have a double exposure to anemia.

• Studies published in the New England Journal of Medicine show that elderly patients with heart problems, including heart attacks, who go to the hospital with anemia are less likely to survive based on the severity of the anemia they're suffering from. The studies also suggest that treating the cause of the anemia, from drug interactions to basic dietary deficiencies, can save many lives.

• Older men are have lower levels of testosterone, which can cause anemia

• Stomach acid reducers interfere with the absorption of essential vitamins and minerals, especially folic acid and vitamin B-12, both essential nutrients that combat anemia. In addition, as people age, stomach acid, which is needed for proper digestion, diminishes. Also, a large segment of the population has severe digestive problems, including GERD (acid reflux), which are caused by not enough stomach acid. In an unfortunate twist of fate, many people are fooled by Big Pharma into taking ant-acids and acid-suppressing medications to combat GERD, when, in reality, the opposite is needed. This situation alone is a major cause of anemia, especially in older people. See our GERD section if you have this condition.

• Other medications that can cause anemia are those that deplete vitamins and minerals, like antibiotics, anti-depressants, anti-inflammatories, cholesterol-lowering drugs, blood pressure drugs, estrogen and even tranquillizers, all of which interfere with, and in some cases stop, absorption. Everything from the creation of hemoglobin to the transfer of oxygen into the blood stream relies on the large number of vitamins and minerals that the body is supposed to process from food.

Testing

There are two approaches to studying and diagnosing anemia, one that looks at the production and loss or destruction of red blood cells, the other by looking at the relative size of the cells.

• Broadly speaking, tests measure the number of red blood cells, their size, and the amount of hemoglobin in them. This can be done with a process called flow cytometry, which is essentially a computer that takes readings and measurements of blood as it flows past sensors.

• Testing involves looking at the hematocrit level, the volume that red blood cells take up in the blood, as well as the MCV (mean corpuscular volume), which measures the average size of the red blood cells in the patient. A further test, the RDW, measures the relative deviation in size of the blood cells. Furthermore, the Reticulocyte Production Index measures the production of red blood cells in the bone marrow where they are made.

Remedies