What is Anaemia?
Anaemia is a condition in which you don't have enough red blood cells or haemoglobin to meet your body's needs. Red blood cells use haemoglobin to carry oxygen around your body. If you have anaemia, the tissues and organs in your body might not get enough oxygen. Anaemia symptoms can leave you feeling tired, weak and short of breath. There are mnay reasons why you may develop anaemia. It can be down to something as simple as your diet or it may sometimes be a sign of an underlying condition.
Types
- Aplastic anemia
- Iron deficiency anemia
- Sickle cell anemia
- Thalassemia
- Vitamin deficiency anemia
Causes of anaemia
Anaemia can be split into different types depending on the cause. In general, it develops because of one of the three mechanisms below.
- Your body isn’t making enough healthy red blood cells. This could be due to not getting enough iron, vitamin B12 or folate in your diet or to problems with absorbing these nutrients. If you have a problem with your bone marrow, this means you won’t produce enough blood cells.
- Your red blood cells are broken down too quickly by your body. This is called haemolytic anaemia.
- You’ve lost a lot of blood. This might be sudden, as from an injury for example. Or it could be gradual blood loss over a long time. This can happen if you are a woman and have heavy periods. It can also happen if you have a condition such as piles or peptic ulcers that cause bleeding in your bowels.
- Pregnancy – if you’re pregnant, you’ll need more iron and folate than normal so the amount you get from your diet may no longer be enough.
- Diet – if your diet is poor or you follow a vegan diet, you’re at greater risk of anaemia.
- A condition that affects the absorption of nutrients from your bowel. Some health conditions, such as Crohn’s disease, coeliac disease or pernicious anaemia might lead to a deficiency in some nutrients.
Causes of anaemia
Other causes of anaemia Some of the less common reasons why you may become anaemic are described below.
- A condition that affects your bone marrow – for example, leukaemia or aplastic anaemia. Because your bone marrow is where your blood cells are made, these conditions can mean you don’t make enough of them.
- A condition that affects your immune system – for example, infections, cancers (such as bowel cancer), and other diseases. These conditions can cause ongoing inflammation in your body, which can lead to fewer red blood cells being produced.
- An autoimmune condition such as rheumatoid arthritis or an infection such as glandular fever. These conditions can cause your body to destroy red blood cells.
- A genetic disorder such as thalassaemia or sickle cell anaemia. These cause red blood cells to be destroyed or misshapen so they don’t work properly.
- Chemotherapy for cancer treatment can affect your bone marrow. This may result in anaemia.
- Chronic kidney disease can affect the production of your red blood cells and lead to anaemia.
Symptoms of Anaemia
If you have anaemia that’s developed slowly over time, you may not have any symptoms at all. But you may eventually start to notice some symptoms.
You may:
- look pale
- feel tired and weak
- not feel able to do as much exercise as you normally would
- feel dizzy
- feel faint feel short of breath when you exercise
- have a thumping or unusual beating of your heart (palpitations)
Diagnosis of Anaemia
Your GP will ask about your symptoms and examine you. They may ask you questions about your diet and any medicines you’re taking, as well as any recent illnesses and your family history. Your GP may ask you to have a blood test. This will check the level of haemoglobin in your blood, how many blood cells you have, and the size and shape of them. Your GP may also check your levels of iron, vitamin B12, and folate. A blood test may be all you need if it’s obvious what’s causing your anaemia. If there isn’t an obvious cause, you may need to have further tests and scans. Depending on the results of your tests, your GP may refer you to a specialist doctor such as a haematologist (a doctor who specialises in blood disorders) for further tests and treatment.
Treatment of anaemia
The treatment you need will depend on what’s causing anaemia. If you have a health condition that may be causing anaemia, you’ll need treatment for this. And if medicines might be the cause, you may need to stop taking them and find an alternative.
Nutritional supplements and diet
If you’re found to be deficient in iron, folate or vitamin B12, you may need to take supplements of these to boost the levels in your body. Your GP may prescribe these for you. Iron and folate are usually taken as tablets, while you may have vitamin B12 as injections. You may need to continue to take supplements for several months until the levels in your blood are back to normal. Sometimes, you may need to carry on taking them for life. For more information on this, see our FAQ: How long will I need to take vitamin B12 supplements? Side-effects such as constipation, diarrhoea, nausea and sickness are common when taking iron tablets. Talk to your pharmacist if you have any problems – you may be able to try a different type of tablet.
Treatment of anaemia
If you have severe anaemia or it can’t be treated with nutritional supplements, your doctor may offer you one or more of the following treatments.
- Erythropoietin stimulating agents (ESAs) can help your bone marrow to make more red blood cells. It might be an option if you have anaemia associated with a long-term health condition such as kidney disease.
- A blood transfusion will give you blood from a carefully selected donor into one of your veins, via a drip in your arm. You might need to stay in hospital overnight after a blood transfusion. It’s used in all types of anaemia, although usually only as a last resort if you have particularly severe symptoms.
- Corticosteroids or surgery to remove your spleen (splenectomy) may be suggested by your doctor if your anaemia is caused by an autoimmune condition.
- Immunosuppressive therapy may be offered if you have a severe type of anaemia in which your bone marrow isn’t producing enough blood cells (aplastic anaemia).
- Stem cell transplant is sometimes recommended for people with aplastic anaemia. It involves replacing your bone marrow that isn’t working properly with stem cells from a donor. These cells can produce new, healthy bone marrow.
Complications of anaemia
You may develop complications if your anaemia is severe and you don’t get appropriate treatment. For example, anaemia can make an existing heart problem such as angina or heart failure worse. Other complications can vary depending on the type of anaemia you have. For example, if you have iron-deficiency anaemia, one potential complication is not being able to fight off infections as well. This is probably because of the effect a deficiency of iron has on your immune system. But more research is needed to prove this. If you have iron-deficiency anaemia when you’re pregnant, potential complications can affect your baby.
For example, your baby may be born:
- prematurely
- with a small birth weight
Prevention of anaemia
Although you can’t prevent many types of anaemia, eating a healthy, well balanced diet will help. This will make sure you’re getting enough iron, folate and vitamin B12, which can help to prevent some types of anaemia. To find out about good sources of these foods, see our treatment section. Talk to your GP or pharmacist if you follow a vegan diet because it could be worth taking supplements of certain vitamins that you may be missing. If you’re at risk of developing iron-deficiency anaemia, your GP may suggest you take regular iron tablets to prevent it. Some of the reasons why you may be at risk include:
- you have heavy periods
- your anaemia keeps coming back
- you have a condition that affects absorption of iron from your bowel
Source: Anaemia: Symptoms, Treatments, Iron Deficiency | Bupa UK