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 

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?

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?

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 makes you go low on energy. It is usually because your Haemoglobin is lower than normal. Normal range for females is 12- 14 gm & for males 13 - 15 gm. This technically means that the count of your red blood cells is abnormally low, so it can't carry enough oxygen to all parts of your body. This causes paleness and symptoms like generalized weakness, fatigue, low concentration, giddiness, and palpitations .
 
Follow these 7 home remedies to beat Anemia- 

1) Remember the ‘Apple a day’quote - it is more true for an Anemic than for anyone else.
2) Not just Apple, consume a ripe banana with 1 tbsp of honey twice a day. Honey helps in increasing the haemoglobin in blood. It is rich in iron, copper and manganese.
3) Soak handful of currants (munakka) for 4 hours. Remove seeds and have it every morning.
4) Mix a cup of beetroot juice, a cup of apple juice with honey and have it once a day. 
5) Have lots of green, leafy vegetables like spinach and cabbage. Tomatoes are very good too.
6) Consume fruits rich in iron such as watermelons, raisins, grapefruits, tomatoes, apples, bananas, oranges, strawberries and avocados.
7) Non vegetarian sources are rich in vitamin B12, which also increases HB. Have egg yolk, meat, seafood like tuna, clams, catfish, salmon, oysters and sardine.

Click on consult privately to ask me any questions that you might have on Anemia. Wishing you good health.

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