What is anaemia?

Anaemia is a condition in which the number of  healthy red blood cells circulating in the blood is low. The work of the red blood cells is to carry oxygen to the body tissues and organs.

What causes anaemia ?

Low levels of healthy red blood cells can occur if:

  • The body is not making enough red blood cells. This happens when one is not getting enough of the nutrients that it uses to make red blood cells. Common nutrients that may be lacking in one’s diet include iron, vitamin b12,folate. It may also be because the body is not able to absorb sufficient nutrients because of problems with the gut. Diseases of the bone marrow, where most blood cells are produced, can lead to less than normal production.
  • The body is losing blood at a much faster rate than it can replenish. This occurs during bleeding. Bleeding may not always be visible. Common causes of bleeding include: abnormally long, heavy ,or frequent menstrual bleeding; problems causing injury or damage to the gut; long term use of certain pain medications. Certain worm infestations like hookworms can cause loss of blood. The parasites suck blood from the wall of the intestines. Excessive bleeding from injury can lead to anemia.
  • Anemia can occur if the body is destroying the red blood cells at a faster rate than it can replace them. Problems affecting the spleen can lead to increased destruction of red blood cells. Inherited blood disorders in which red blood cells are abnormally shaped or have abnormal enzymes lead to increased destruction of the abnormal cells. These include conditions like sickle cell disease, hereditary spherocytosis, or Glucose-6-phosphate dehydrogenase deficiency

How does anaemia make one feel?

The problems that anaemia causes can vary depending on what is causing it and how severe it is. When it is mild no problem may be noticed. As anaemia worsens the following problems may be noticed:

  • The child may look pale and frequently complain of feeling cold particularly in the hands and feet.
  • There can be a general feeling of tiredness and body weakness
  • One can have shortness of breath and chest pain
  • One may feel dizzy or lightheaded. When anaemia is severe fainting may occur.
  • Some people with anaemia may have the unusual urge to eat things that are not food like clay,dirt or ice.
  • The tongue may become smooth, swollen, red and painful.

What complications can anaemia cause?

Severe fatigue. One can get too tired to do even simple tasks.

Heart problems. When one is anaemic the heart will need to work harder to compensate for the low oxygen. This can make the heart beat rapidly and sometimes irregularly. If no treatment is given the heart can become enlarged and eventually fail.

Severe anaemia can lead to death.

How is anaemia diagnosed?

You will need to visit your doctor if you notice any symptoms that may suggest anaemia.

Typically the doctor will begin by taking a history to understand your problem better. A physical exam will be done . Laboratory tests will be done to confirm the anaemia, quantify its severity and find out what is causing it. The following tests help to diagnose anaemia:

Complete blood count (CBC) also called a full haemogram. It shows the doctor the number and size of red blood cells as well as the concentration of haemoglobin. It also shows if the other blood cells like white cells and platelets are normal.

Blood iron levels. This measures the amount of iron circulating in the body. Doctors will order this test when they are concerned that lack of iron could be causing your symptoms.

Ferritin blood test. Ferritin is a protein found inside cells that stores iron and releases it in a controlled fashion. Checking the ferritin levels helps measure the amount of iron stored in the body.

Vitamin B-12 test. Vitamin B-12 is needed in the body to make enough red blood cells and keep your nervous system functioning optimally. For most people eating a balanced diet it’s rare to have vitamin B-12 deficiency. The doctor may order this test if he suspects low levels of it could be causing your symptoms.

Folate test. This test measure the amount of folic acid in the blood. Folate, or folic acid, is a type of B vitamin that is important for cell growth and metabolism.

A reticulocyte count test. Reticulocytes are the newly produced immature red blood cells. Measuring the reticulocyte levels helps to assess the ability of the bone marrow to produce new red blood cells. It also helps to distinguish between the different causes of anaemia.

A blood film (or peripheral blood smear). In this test a drop of blood is spread thinly over a glass slide and stained. This allows various blood cells to be examined under the microscope. It helps to reveal certain problems associated with blood disorders.

Stool test. Stool microscopy can be done to rule out parasitic infestation. Occult blood in the stool may be checked to screen for bleeding in the gut.

How is anaemia treated?

The kind of treatment will depend on the type of anaemia one is having and how severe it is.

Make an appointment with the doctor if you have any of the symptoms mentioned above.

How can I prevent anemia in my child?

Some types of anaemia can be prevented. Especially those that are caused by lack of certain nutrients in the diet.

Include iron rich foods in the diet. Examples of iron rich foods are liver, meats, beans, lentils, iron-fortified cereals, dark green leafy vegetables, and dried fruit.

Folate is found in fruits and fruit juices, dark green leafy vegetables, green peas, kidney beans, peanuts, and enriched grain based foods.

Vitamin B-12 is found in meat, dairy products, and fortified cereal and soy products.

Vitamin C. This helps the body to absorb iron. It is abundant in citrus fruits and juices, peppers, broccoli, tomatoes, melons and strawberries