Did you know that Thalassemia is a common blood disorder in India, that?s passed through families (just the way it was passed to Abhishek Bachchan because megastar Amitabh Bachchan is a carrier). It is characterized by excessive destruction of red blood cells or genetic mutation, leading to anaemia. Today is World Thalassemia Day, lets understand about the disease.

Thalassemia can be classified into alpha and beta, depending on the globin genes that are affected.

1. Thalassemia Minor - Usually doesn?t have any symptoms, except for minor anaemia.

2. Beta Thalassemia - Has two serious types.

2.A) Thalassemia Major: This type usually happens before a child?s second birthday and requires regular blood transfusions. The condition is life-threatening. Symptoms include anaemia, fussiness, frequent infections, paleness of the skin, poor appetite, enlarged organs and jaundice.

2.B) Thalassemia Intermedia: It is a less severe form and doesn?t require blood transfusions. The symptoms include anemia, jaundice, extremely large spleen and malnourishment.

3. Alpha Thalassemia: Only in rare cases this severe form of Thalassemia may be present. Known as Hydrops Fetalis, this condition usually occurs before birth and children are either stillborn or die soon afterwards.

How to live with Thalassemia:

Take steps to be as healthy as possible. Follow a balanced diet eating plan as per the recommendation of your doctor. Take iron supplement only if prescribed. It is recommended that patients get themselves vaccinated whenever needed, especially if their spleen has been removed. Meanwhile, always be on a lookout for the signs of infections (such as fever) and lower your risk of infections. Thalassemia can spark fear, anxiety, depression and stress. That?s why, doctors recommend that patients receive adequate emotional support.

Treatment:

The treatments depend on the kind of Thalassemia an individual has. Usually, treatment procedures include blood transfusions, bone marrow transplants, removal of spleen or gallbladder specific medications and supplements.

If you have any more questions on this topic, click on consult privately to ask me.

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Read Dr. Jatin Soni's Health Tip on The Occasion of World Thalassemia Day

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?

Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal. Haemoglobin is the main part of red blood cells and it binds oxygen. If you have few or abnormal red blood cells, or your hemoglobin is low, the cells in your body will not get enough oxygen. Anemia can last temporarily or for a long-term, and it can range from mild to severe. If you suspect you have anemia, see your doctor immediately because it can be a warning sign of a serious illness. A person who has anemia is called anemic.

Sign and symptoms of anemia: Because a low blood cell count decreases oxygen delivery to every tissue in the body, anemia can cause a variety of signs and symptoms. It can also worsen the state of any other underlying medical condition. If anemia is mild, it may not cause any symptoms. If anemia is chronic, the body may adapt and compensate for the change. In this case, there may not be any symptoms until anemia becomes more severe. Anemia signs and symptoms may vary depending on the cause of the condition. These may include fatigue, weakness, pale or yellowish skin, irregular heartbeats, breathlessness, dizziness, chest pain, cold hands and feet, and headache.

Causes of anemia: Anemia occurs when your body doesn t have enough red blood cells. This can happen if: 

Your body doesn t make enough red blood cells: The bone marrow is essential for the creation of red blood cells. A number of diseases can affect the bone marrow, including leukemia, where too many abnormal white blood cells are produced. This disrupts normal production of red blood cells.
Bleeding causes you to lose red blood cells more quickly than they can be replaced: Iron deficient anemia is the most common type of anemia which often falls into this category. It is caused by a shortage of iron, which most often results due to blood loss. Blood loss can be acute and rapid or chronic. Rapid blood loss can happen at the time of surgery, childbirth, trauma, or a ruptured blood vessel. 
Your body destroys red blood cells: Red blood cells have a lifespan of 120 days in the bloodstream but they can be destroyed or removed beforehand. In one type of anemia, the body s immune system mistakenly identifies its own red blood cells as a foreign substance and attacks them. Excessive red blood cell breakdown can also occur due to infections, the use of certain drugs, snake or spider venom, severe hypertension, and in the case of clotting disorders.
Treatment of anemia: The treatment of anemia varies greatly. First, the underlying cause of anemia needs to be identified and corrected. Most of the times, iron supplements will be needed to correct iron deficiency. In severe anemia, blood transfusions may be necessary. Vitamin B12 injections are necessary in some cases who are suffering from a specific type of anemia.

Prevention of anemia: Many types of anemia can t be prevented. But iron deficient anemia and vitamin deficient anemia can be avoided by having a diet that includes a variety of vitamins and nutrients, including iron, folate, vitamin B12, and vitamin C.

Anemia - What Causes It?

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!

Iron deficiency anemia is a type of anemia, which occurs due to deficiency of iron. Iron is the main component of hemoglobin. So, a decrease in the hemoglobin level results in iron deficiency anemia.
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What are the Signs and Symptoms of Iron Deficiency Anemia?

Signs and symptoms appear when anemia is moderate to severe. In the mild stage, iron deficiency anemia often goes unnoticed. The signs and symptoms of iron deficiency anemia are:

Extreme fatigue (weakness)
Pale skin and brittle nails
Reduced  appetite
Headache, dizziness, or lightheadedness
Cold hands and feet with tingling numbness
Chest pain, palpitations, or shortness of breath
Inflammation or soreness of the tongue
Unusual cravings for indigestible substances, such as ice, dirt, or starch. 
What are the Causes of Iron Deficiency Anemia? 

Inadequate iron intake: Your body gets iron from the food you eat. If you consume too little iron, then your body may become iron deficient. Hence, resulting in anemia.
Inability to absorb iron: Iron is absorbed into your bloodstream from the food in your small intestine. In conditions like an intestinal disorder, this absorption of iron is hampered which results in iron deficiency anemia. Also, when your small intestine is bypassed or removed surgically, absorption of iron is hampered.
Blood loss: Red blood cells in your blood contain iron, and if the blood loss is severe, you can end up having iron deficiency. Conditions, such as bleeding hemorrhoids, colorectal cancer, and heavy menstruation can result in iron deficiency anemia.
Pregnancy and lactation: During pregnancy and lactation period, the iron requirement of the mother is more, and when it is unfulfilled, she may end up having iron deficiency anemia. 
Which Group is at Risk? 

Vegetarians
Women
Infants and children 
Frequent blood donors
How is it Diagnosed?

Diagnosis is made with the help of: 

Patient s history  
Blood tests, such as CBC and serum ferritin
Some additional tests, such as colonoscopy, endoscopy, and sonography to diagnose the underlying cause
Treatment

Treating the underlying cause is the primary step. 

Severe cases: When the iron level is too low, blood transfusion and even intravenous iron is given
Mild to Moderate Cases: Iron and vitamin C supplements are given in mild and moderate cases of iron deficiency anemia.
Can you Prevent Iron Deficiency Anemia?

Yes. You can prevent iron deficiency anemia by including iron-rich foods in your diet, such as:

Dark green leafy vegetables, such as spinach, peas, and beans
Dry fruits, such as raisins and apricots
Red meat, pork and poultry, and seafoodIron-fortified cereals, bread, and pasta
Include vitamin C-rich foods in your diet to enhance iron absorption. Vitamin C is found in Grapefruit, oranges, strawberries, lemons, and melonsLeafy greens, broccoli, peppers, and tomatoes

Iron Deficiency - What Are The Possible Signs And Symptoms?

Anemia refers to a condition wherein the body possesses fewer red blood cells than what it contains under normal circumstances. Oxygen gets carried by the red blood cells to tissues and organs all over the body, thereby enabling them to use the necessary energy from food. A person suffering from anemia, will have his red blood cells carrying less amount of oxygen to organs like heart and brain, thus interrupt smooth functioning of the organs. Kidney disease leads to the problem of anemia. In fact, it is a very common side effect of kidney disease, wherein the body fails to produce the required amount of red blood cells.

What results in anemia?
A person can suffer from the problem of Anemia, when sufficient amount of red blood cells are not there in the body. Oxygen is carried through a person s bloodstream by the Red blood cells, providing him energy and also ensure that the bones, muscles and organs function properly. Anemia can make a person feel weak and very tired as he or she is unable to receive the required amount of energy.

How can chronic kidney disease lead to anemia?
Anemia is common among people, who suffer from chronic kidney disease, though the problem can occur to anyone. People suffering from chronic kidney disease may have anemia during the early stages of their kidney disease and as the kidney problem gets worse, so does anemia. Improper functioning of kidneys generally link towards the problem of anemia. People, who suffer from complete loss of kidney function, tend to develop the problem of anemia. Kidney failure leads to a person, requiring dialysis or kidney transplant, for ensuring longevity.

Anemia becomes even more common in chronic kidney disease, if a person:

Has high diabetes.
Is suffering from heart problems.
Has a high level of blood pressure.
Some of the other causes of anemia in people, suffering from kidney disease include loss of blood from hemodialysis and lower levels of some of the nutrients like iron, folic acid and vitamin B12, found in food.
These three nutrients are essential for the red blood cells to make haemoglobin, which is the main carrier of protein through oxygen in red blood cells.

Signs and symptoms of anemia with chronic kidney disease
The signs and symptoms of anemia in someone, suffering from chronic kidney disease are:

He might have terrible weakness.
A person might suffer from headaches on a frequent basis.
There would be problems with regard to concentration.
The color of the skin would become pale.
Treatment
A doctor would try and increase the levels of iron in a person s body, as the first step of treatment. Iron pills would help in improving the levels of iron and haemoglobin. Red Blood Cell transfusion is another way to treat this problem. Transfusion would be done inside the patient s vein by raising the level of the patient s blood consisting of red blood cells, thereby also increasing the amount of oxygen. Vitamin B12 and Folic Acid supplements are also suggested by healthcare providers, to help treat anemia.

Anemia - How Chronic Kidney Disease Can Lead To It?

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