What is anemia?

Anemia is due to lack of haemoglobin in the blood which is below the normal level or due to less than normal levels of red blood cells in blood.

The haemoglobin helps carry oxygen in blood. Lack of haemoglobin thus causes deficiency of life giving oxygen to vital organs. (1-4)

Types of anemia

There are various causes of anemia. It could be due to:

Decreased production of RBCs in blood
Increased blood loss OR
Excessive destruction of RBCs
Causes of anemia
Anemia most commonly occurs due to nutritional problems. This includes lack of iron in the diet.
Iron deficiency is the commonest form of anemia.
In the United States 7% of toddlers ages 1 to 2 years old and 9-16% of menstruating women suffer from iron deficiency.
The poorer nations 30-70% of the people have iron deficiency anemia.
Iron and anemia

Since iron is needed for the manufacture of haemoglobin in the body its deficiency can lead to anemia.
Iron is found in meat, dried fruit and some vegetables.
Lack of iron may be caused due to bleeding especially in stomach ulcers or within the intestines.
Women before menopause commonly suffer from iron deficiency anemia due to heavy periods and increased demands during pregnancy.
Vitamins and anemia

Certain vitamins like vitamin B12 and folic acid or folate are also essential in the normal production of RBCs in blood. Their lack in diet may lead to anemia.
Both vitamin B12 deficiency and folate deficiency are more common in older people, affecting around 1 in 10 people above the age of 75.
There is an inherited condition called Pernicious anemia where patients find it difficult to use the vitamin B 12 in diet for production of healthy RBCs. This is a rare condition and affects 1 in 10,000 people in northern Europe.
Other causes of anemia

Increased blood loss due to surgery or major trauma may lead to anemia.
Excessive destruction of RBCs may occur due to certain conditions called haemolytic anemias. These are often inherited and include Sickle cell anemia, Thalassemia etc. Anemia can also occur in severe infections, cancers and due to exposure to a drug or toxin.
For example, the RBCs are made in bone marrow. If there is cancer in the marrows a shortage of good red blood cells results. This is called aplastic anaemia and may also occur with blood cancers like leukaemia.
Symptoms

Anemia signs and symptoms vary depending on the cause of your anemia. They may include:

Fatigue
Weakness
Pale or yellowish skin
Irregular heartbeats
Shortness of breath
Dizziness or lightheadedness
Chest pain
Cold hands and feet
Headache
At first anemia can be so mild that it goes unnoticed. But symptoms worsen as anemia worsens.

Treatment of anemia

Treatment depends on the cause of the anaemia. If the anaemia is due to a lack of iron, eating iron-rich food or iron supplements may be given. If, however, the cause of anemia is deeper like internal bleeding or cancers, the cause should be explored before treatment. When the anaemia is more severe, a blood transfusion may be prescribed.

Anemia - Causes, Symptoms & Treatment Of It!

Anemia (or anaemia) is a medical condition which generally occurs in a human body because of the lack of required healthy red blood cells (RBCs) or hemoglobin in the blood. Diagnosis of anemia is done through a blood test, a man is anemic when his hemoglobin level is less than 13.5 gram/100 ml and a woman is anemic when her hemoglobin level is less than 12.0 gram/100 ml.

Risk factors: People suffering from long-term or chronic diseases such as cancer are more susceptible of developing anemia. Hemoglobin is the salient constituent of red blood cells and is an iron rich protein. It provides the red color to the blood and binds oxygen. Red blood cells carry this oxygen to all the vital tissues and organs of the body. Due to lack of appropriate amount of red blood cells, the amount of blood required in a body to function normally is also low. One of the most prominent causes of occurrence of anemia is the deficiency of required amount of nutritional iron, vitamin B-12, and folate in the body. This iron is needed for the formation of hemoglobin. Apart from these causes, the other causes of anemia comprise of the following:

Loss of blood
Insufficient production of red blood cells (inadequate intake of iron, vitamin B-12)
Fast rate of destruction of red blood cells (disorders of liver and hemorrhage)
Diagnosis: It is relatively easy to detect an anemic person. The symptoms of anemia include pale appearance, complaint of cold, giddiness, unsteadiness, laziness, particularly when the person is in action or is standing up. Sometimes people suffering from anemia crave for eating clay, ice, or even dirt. Also, there are complains of exhaustion along with issues of constipation and concentration. Other indications of anemia are brittle nails, gasps for breath even in mild activities, and pain in the chest. Since the level of oxygen in the blood is low, there could be even scope of a heart attack.

A person suffering from anemia is usually diagnosed on the basis of a complete blood count. The blood test brings out if serum folate levels are quite low. In case the anemia is severe, sometimes doctors take the help of erythropoietin injections so as to foster the production of red blood cells in the bone marrow. In case there is bleeding or if the level of hemoglobin is low, it might become essential to carry out blood transfusion.

Treatment: Anemia is straightforward to diagnose and treat, but at the same time could prove to be deadly if it is left undiagnosed. Proper heed should be paid to the intake of adequate and required food which is rich in vitamins and minerals, dietary iron, folic acid, including other vitamins and minerals.

Anemia- How Does It Affect a Person's Health?

Iron is an essential nutrient and mineral that is required by adults and children alike. Iron helps move oxygen from the lungs to the rest of the body and helps muscles store and use oxygen. It is especially important for children because it aids development and prevents anaemia. Untreated iron deficiency in children can cause physical and mental delays. It can lead to less healthy red blood cells in the child's blood stream which will cause a delay in the growth of physical and mental faculties.

Risk factors for iron deficiency in children

Infants and children at highest risk of iron deficiency include:

Babies who are born prematurely or have a low birth weight
Babies who drink cow's milk before age 1
Breast-fed babies who aren't given complementary foods containing iron after age 6 months
Babies who drink formula that isn't fortified with iron
Children ages 1 to 5 who drink more than 24 ounces (710 milliliters) of cow's milk, goat's milk or soy milk a day
Children who have certain health conditions, such as chronic infections or restricted diets
Children ages 1 to 5 who have been exposed to lead
Adolescent girls also are at higher risk of iron deficiency because their bodies lose iron during menstruation.
Symptoms of iron deficiency anaemia

The signs and symptoms of iron deficiency anaemia in children may include:

Pale skin
Fatigue or weakness
Slow cognitive and social development
Inflammation of the tongue
Difficulty maintaining body temperature
Increased likelihood of infections
Unusual cravings for non-nutritive substances, such as ice, dirt or pure starch
Prevent iron deficiency in children

Take steps to prevent iron deficiency in your child by paying attention to his or her diet. For example:

Breast-feed or use iron-fortified formula. Breast-feeding until your child is age 1 is recommended. If you don't breast-feed, use iron-fortified infant formula.
Encourage a balanced diet. When you begin serving your baby solids, typically between ages 4 months and 6 months, feed him or her foods with added iron, such as iron-fortified baby cereal. For older children, good sources of iron include red meat, chicken, fish, beans and dark green leafy vegetables. Between ages 1 and 5, don't allow your child to drink more than 24 ounces (710 milliliters) of milk a day.
Enhance absorption. Vitamin C helps promote the absorption of dietary iron. You can help your child absorb iron by offering foods rich in vitamin C, such as melon, strawberries, kiwi, broccoli, tomatoes and potatoes.
Consider iron supplements. If your baby was born prematurely or with a low birth weight or you're breast-feeding a baby older than 4 months and he or she isn't eating two or more servings a day of iron-rich foods, talk to your child's doctor about oral iron supplements.
Make sure that you watch out for the tell tale signs of iron deficiency and take the necessary precautions to avoid the same. If you wish to discuss about any specific child related problem, you can consult a specilized pediatrician and ask a free question.

Iron Deficiency In Children

What do we mean by the term Anemia?

It is described as a decrease in the total number of red blood cells, or hemoglobin in the blood, or a decreased oxygen-carrying capacity of blood.

How to know if an individual has Anemia?

An individual with anemia may show one or more of the following signs or symptoms:
Shortness of breath, chest pain, and headache are especially seen with exercise as the oxygen supply decreases
Difficulty in concentration which is mostly seen in children
Easy tiredness, fatigue, and loss of energy
Dizziness because of low blood volume leading to hypotension
Hair loss especially while combing, washing hair. Also, hair becomes brittle and dry due to anemiaInsomnia (lack of sleep)
Cramps in legs especially calf muscle 
Rapid heartbeat with exercise as the demand for oxygen increases during exercise, so your heart beats faster than usual
Craving for indigestible substances, such as pica, paper, mud, ice, dirt, etc.
Koilonychia (spoon-shaped nails or upward curvature of the nails)
Soreness and cracks at the corners of the mouth
Very heavy menstrual periods or irregular bleeding because of low hemoglobin count
Pale skin is especially seen over the palms of your hands and under your nail beds. Also, the conjunctiva looks pale
Anemia due to Deficiency of Vitamin B12 Dementia (loss of memory)
Tingling sensation in the hands or feet
Loss of the sense of touch
Difficulty in walking
Stiffness in the arms and legs
Delayed growth and development in children
Swelling of the hands and feet
Episodes of severe pain in the joints, abdomen, and limbs as the red blood cells obstruct capillaries
Anemia by Chronic Red Blood Cell Destruction/Hemolytic anemia

Jaundice (yellowish or greenish pigmentation of skin and sclera of the eyes)
Brown or red colored urine due to the destruction of red blood cells
Fever due to the destruction of red blood cells
Small bruises under the skin
Abdominal pain because of enlargement of the spleen and liver
Black stools due to the destruction of the red blood cells
Anemia Caused by Chronic Lead Poisoning
Level of lead in blood is higher than 50  g/dLA blue-black line is seen on the gums. It is also known as a lead line
Abdominal pain
Constipation
Vomiting
Investigations 

Complete blood count: This test will help an individual know the percentage of hemoglobin in blood as well as red blood cell count. Also, mean cell volume (MCV) is used to categorize anemia.
Serum Ferritin Test: Ferritin levels below 15 20 micrograms/L in a person confirms iron-deficiency anemia.
Total Iron-Binding Capacity: It measures the blood's capacity to bind iron with transferrin.

How Can Anaemia Be Diagnosed?

A healthy kidney produces a hormone known as the erythropoietin. The latter assists the bone marrow to produce an adequate amount of RBC that carries oxygen to every nook and corner of the body. A damaged kidney results in less RBC production, thereby, creating a condition known as anemia. The hemoglobin count in the blood reduces significantly in this condition.

Anemia is characterized by shortness of breath, weakness and tiredness. It can affect sleep and a loss of appetite. A patient suffering from anemia reports of frequent headaches and a faster heart rate. These symptoms also surface when a person suffers from chronic kidney diseases (CKD). The condition gets worse as the disease progresses.

Treating anemia:
A patient suffering from anemia should be treated on time as there are many pitfalls of a lower hemoglobin level. The treatment will give instant relief from other symptoms that might have arrived with CKD. Doctors frequently prescribe Erythropoiesis Stimulating Agent (ESA) for patients suffering from CKD and suffering from anemia due to the shortage of erythropoietin. ESAs can be injected through an injection or intravenously. These injections stimulate the bone marrow to produce more RBCs. However, studies have revealed that ESAs increase the chance of strokes, heart attacks and blood clots. Furthermore, they aggravate tumor growth and shorten life expectancy for cancer patients. People undergoing ESA treatment should have periodic check-ups to ensure that the hemoglobin count is normal and under control.

Iron
Iron count in the body has an important role in treating patients suffering from anemia and CKD. In case the level of iron is too low in the body, ESAs fail to improve the condition of an anemic patient. The ferritin count of a patient should be in the range of 100-800 mcg/L. One more test known as TSAT reveals the number of iron required to produce RBCs in the body. In case the iron count is less, doctors often suggest iron pills to bring the count to a more accepted level.

Other causes
There could be other reasons for anemia as well. A doctor might further investigate the level of B12 and folic acid present in the body. Even an inflammatory condition can lead to anemia. A decreased count of any of the above-mentioned ingredients can cause anemia to a patient suffering from EKD.

Food items necessary to improve the condition
A healthy diet helps in improving the condition of an anemic patient. Iron deficiency is best addressed by fish and beef. Food rich in vitamin C helps the body to absorb more iron in the body. Certain food items that block the entry of iron in the body include tea, milk, albumen (egg white) etc. Therefore, you should be strictly avoid these items from your diet.

Kidney Disease - How It Is Related With Anaemia?

Thalassemia is a genetic (which is passed from parents to children through genes) blood disorder. People with Thalassemia disease are not able to make enough hemoglobin, which causes severe anemia. Hemoglobin is found in red blood cells and carries oxygen to all parts of the body. When there is not enough hemoglobin in the red blood cells, oxygen cannot get to all parts of the body. Organs then become starved for oxygen and are unable to function properly.

Symptoms

The symptoms depend on the type of thalassemia:

Thalassemia Minor: Thalassemia minor usually doesn t cause any symptoms. If it does, it causes minor anemia.
Beta-thalassemia: Beta-thalassemia comes in two serious types, which are thalassemia major, or Cooley s anemia, and thalassemia intermedia. The symptoms of thalassemia major generally appear before a child s second birthday. The severe anemia related to this condition can be life-threatening. Other signs and symptoms include:
fussiness
paleness
frequent infections
a poor appetite
failure to thrive
jaundice, which is a yellowing of the skin or the whites of the eyes
enlarged organs
This form of thalassemia is usually so severe that it requires regular blood transfusions.

Alpha-thalassemia: Alpha-thalassemia also has two serious types, which are hemoglobin H disease and hydrops fetalis. Hemoglobin H disease can cause bone issues. The cheeks, forehead, and jaw may all overgrow. Hemoglobin H disease can cause:
jaundice, which is a yellowing of the skin or the whites of the eyes
an extremely enlarged spleen
malnourishment
Hydrops fetalis is an extremely severe form of thalassemia. It occurs before birth. Most individuals with this condition are either stillborn or die shortly after being born.

Thalassemia - Symptoms Based on Types of Thalassemia 

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