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 condition where the red blood cell count is reduced due to deficiencies within the system. This is usually caused by a lack of iron, folate and other related nutrients in the diet. Anemia is a major public health concern in India as over 50 percent of women are known to be anemic. This pushes up the mortality rate of young mothers and even children.

Some symptoms of Iron deficiency anemia
Anemia has a wide range of symptoms which varies from person to person. However there are some generic symptoms which can be noticed in most people. Some of these are
1. Pale appearance of skin - Many people exhibit this symptom where their skin appears to be pale as there is a reduced amount of oxy - hemoglobin in the skin.
2. Physical weakness, light headedness and fatigue - This is a general symptom, which many tend to suffer from and complain about. Fatigue and weakness may come in very quickly even with the slightest effort.
3. Hair loss - Many women may complain about hair loss due to Iron deficiency  anemia.

Some other symptoms are -
a. Breathlessness
b. Constipation
c. Missed or irregular periods
d. Numbness or burning sensations
e. Depression
f. Tinnitus among others

Causes of Iron deficiency anemia
The primary cause of Iron deficiency anemia is the lack of iron in the diet which causes the hemoglobin in the blood to be reduced. Some of the patients may still have Iron deficiencyanemia as they have developed gastrointestinal disorders which prevents the absorption of nutrients like iron within the body.

How to treat Iron deficiency anemia
Diet related anemia can be easily cured or controlled with changing diets. Inclusion of certain foods within the diet can easily reverse the Iron deficiencies. Some of the food items that help with deficiencies are:
1. Fortified cereals
2. Green dark leafy vegetables
3. Poultry items
4. Eggs
5. Meat
You may also require certain iron supplements if you have certain underlying conditions which is causing issues with iron absorption.

How to prevent Iron deficiency anemia
It is important, especially for women to go for regular checkups to your doctor and also a hemoglobin check up. Your doctor or dietician can tell you to include certain foods in your diet that include folate, iron and vitamin B 12 so that the level of hemoglobin in your blood can be maintained at healthy levels.

All About Iron Deficiency - Anemia

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?

Your body goes through drastic changes when you are pregnant. Your body makes more blood during pregnancy; for instance, prior to pregnancy, your body made approximately 5 litres of blood, but now it produces 7 to 8 litres of it.
Producing excess red blood cells requires haemoglobin, which in turn requires plenty of folate, iron and vitamin B12. If there is a deficiency in any of these requirements, you might develop anaemia.
Anaemia is a condition, which is characterized by a lack of red blood cells in the body. The risks of becoming anaemic during pregnancy include:
1. Being extremely fatigued
2. Miscarriages, premature birth, or low birth-weight
3. The baby can inherit anaemia from the mother
4. The child can have certain developmental delays
5. Postpartum depression (post-childbirth depression)

How it can be prevented?
To prevent such risks, it is important to implement the proper diet. Here are some dietary tips to prevent anaemia during pregnancy: 
1. Consume iron-rich foods: Foods that provide you with the best source of iron are 
i. Poultry and eggs
ii. Dark green and leafy vegetables (for example: spinach, broccoli and kale)
iii. Seeds and nuts
iv. Beans and lentils
v. Tofu
vi. Beetroot
vii. Ripe bananas

2. Don't forget the supplements: Foods are great sources of the nutrients you require, but they may be lacking at times. Ask your doctor for supplements like vitamin, folic acid and iron supplements mostly. Consuming supplements before pregnancy can go a long way in preventing anaemia.

3. Folic acid is important: Folic acid is very important for pregnant women. You must consume 400 milligrams of it to prevent anaemia and birth defects in babies. Foods that are rich in folic acid include:
i. Beans
ii. Muesli
iii. Broccoli
iv. Brussel sprouts
v. Asparagus

4. Vitamins are crucial: Vitamin C helps in iron absorption which boosts haemoglobin production. Some foods rich in vitamin C include
i. Citrus fruits
ii. Strawberries
iii. Kiwis
iv. Tomatoes
v. Bell peppers

5. Be vigilant while cooking: Sometimes while cooking foods, the wrong method can strip them of their iron content. So be careful not to fry, boil or stew such foods too much. Certain foods are best consumed raw; read the labels properly if in doubt.

6. Abstain from certain habits: Alcohol, tea, cigarette and coffee hinder iron absorption. So stop consuming them if you are trying to conceive or have conceived.

Dietary Tips to Prevent Anaemia in Pregnant Women

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

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