Anaemia is a condition in which the blood has too little haemoglobin or too few healthy red blood cells to carry oxygen around the body properly. It can cause tiredness, weakness, breathlessness, dizziness, paleness, chest symptoms or reduced ability to exercise.
The spelling anemia appears in some sources. iWiki uses the British spelling anaemia, while keeping the other spelling as an alias for backlinks.
Red Blood Cells and Haemoglobin
Red blood cells contain haemoglobin, the protein that carries oxygen. The NHS explains that the amount of oxygen delivered to body tissues depends on the number of red blood cells and how well they work.
Anaemia is usually detected with a full blood count. Important values can include haemoglobin, red blood cell count, haematocrit, mean corpuscular volume and related red cell indices.
Causes
Anaemia has many possible causes. Common groups include:
- iron deficiency, often linked to blood loss, heavy periods, pregnancy, poor intake or absorption problems;
- vitamin B12 or folate deficiency;
- blood loss, including gastrointestinal bleeding, trauma, surgery or menstruation;
- chronic disease or inflammation;
- kidney disease, which can reduce erythropoietin signalling;
- bone marrow disorders;
- haemolysis, where red blood cells are destroyed too quickly;
- inherited conditions such as sickle cell disease or thalassaemia.
Finding the cause matters because treatment for one type of anaemia may be wrong for another.
Symptoms
Symptoms depend on severity, speed of onset and cause. Mild anaemia may cause few symptoms. More significant anaemia can cause:
- tiredness or weakness;
- shortness of breath;
- dizziness or faintness;
- palpitations;
- headache;
- pale skin;
- cold hands or feet;
- chest pain or worsening heart symptoms in vulnerable people.
Iron deficiency can also cause brittle nails, hair loss, sore tongue or unusual cravings such as ice in some people.
Diagnosis
Diagnosis usually starts with a full blood count. Further tests depend on the pattern. These may include ferritin and iron studies, vitamin B12, folate, kidney function, inflammation markers, reticulocyte count, blood film, haemolysis tests or tests for blood loss.
In adults with confirmed iron deficiency anaemia, especially men and post-menopausal women, clinicians often consider gastrointestinal blood loss as a possible cause. British Society of Gastroenterology guidance focuses on investigation and management of iron deficiency anaemia in adults.
Iron Deficiency Anaemia
Iron deficiency anaemia is one of the most common types. The NHS says it is often caused by blood loss or pregnancy and is treated with iron tablets and iron-rich foods, alongside treatment of the underlying cause.
Food can help maintain iron intake, but established iron deficiency anaemia often needs iron replacement. Oral iron is common, while intravenous iron may be used where tablets are not tolerated, not absorbed or not enough.
Vitamin Deficiency Anaemia
Vitamin B12 and folate are needed for normal red blood cell production. Deficiency can cause anaemia with larger-than-normal red cells and may also cause neurological or mouth symptoms, depending on the deficiency.
Treatment depends on the cause. Vitamin B12 deficiency may require injections or tablets. Folate deficiency is usually treated with folic acid after B12 deficiency has been considered.
Anaemia of Chronic Disease
Long-term inflammation, infection, kidney disease, cancer or autoimmune disease can affect red blood cell production and iron handling. Treatment is aimed at the underlying condition where possible, and some cases need specialist management.
Treatment
Treatment depends on the cause and urgency. Options can include:
- iron tablets, liquid iron or intravenous iron;
- vitamin B12 or folate replacement;
- treating bleeding or absorption problems;
- managing kidney disease, inflammatory disease or cancer;
- blood transfusion in selected urgent or severe cases;
- specialist treatment for inherited or bone marrow conditions.
The aim is not just to raise haemoglobin. It is also to identify and treat the reason it became low.
See Also
References
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