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 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?

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?

The lack of red blood cells or hemoglobin in the blood is termed as anemia. You may also be diagnosed as anemic is your red blood cells do not have a high enough hemoglobin count. Since hemoglobin is responsible for the amount of oxygen in our blood, being anemic results in a decreased flow of oxygen in the blood. 

There are 5 different types of anemia. These are:
1. Iron deficiency anemia: when the iron levels of the blood are lower than normal. 
2. Sickle cell anemia: when the red blood cells are shaped like a'sickle' and hence more fragile. This is an inherited condition. 
3. Thalassemia - when the body does not produce enough red blood cells or hemoglobin. This is also an inherited condition.
4. Megaloblastic anemia - when the blood does not have enough vitamin b12 and hence cannot transport hemoglobin through the body. 
5. Hemolytic anemia - when the red blood cells are rapidly removed from the blood due to an infection, medication or disease. 

Lack of oxygen can have a serious effect on the organs of the body. Hence the symptoms of anemia are also the effects of the disease. 
Some of these are: 
Lack of energy
Fatigue
Dizziness
Chest pain
Difficulty breathing
Abnormal heartbeat
Reduced attention span
Numbness of the hands and feet. 

Anemia can also lead to a number of major health problems such as:
1. Heart disease: anemia is directly linked to heart disease. When the blood carries less oxygen, the heart needs to work harder to pump it to the rest of the body. Thus, people who are anemic are at a higher risk of having a heart attack than a non anemic person. Anemia can also lead to arrhythmia or a condition where the person suffers from an irregular heartbeat. 

2. Pregnancy complications: one of the first and most vital supplements prescribed to a pregnant woman is iron. Iron is essential not only for a healthy baby, but also for your own body. Anemia caused by a lack of iron can result in premature birth and a number of other complications at the time of pregnancy. 

3. Increased risk of infections: lack of oxygen in the blood can affect your immune system by lowering its ability to fight infections. This makes the body vulnerable to diseases. 

4. Cognitive damage: anemia in children can result in a greatly reduced attention span and weaken their memory. Sometimes, even when treated, this can result in permanent scarring and reduced iq levels. 

Fighting anemia is not hard. Consult your doctor instantly if you recognize any of its symptoms and start eating food rich in iron to fight this disease.

Anaemia and How It Can Affect Your 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

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