Anaemia

Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal.

Haemoglobin consists of haeme (iron) and globin (protein). Both of these elements are required for supplying oxygen and nutrients to all parts of the body.

For men, anemia is typically defined as hemoglobin level of less than 13.5 gram/100 ml and in women as hemoglobin of less than 12.0 gram/100 ml.

Reasons

Generally, decreased red blood cell production, increased RBC destruction or blood loss are the mechanisms responsible for anaemia. All conditions causing anaemia usually work through one of these mechanisms. Causes include:

  1. Nutritional deficiencies (most notably iron or vitamin deficiencies).
  2. Inherited disorders (such as thalassemia or sickle cell anaemia).
  3. Infections.
  4. Some kinds of cancer.
  5. Exposure to certain medicines or chemicals.
  6. Autoimmune haemolysis (where the red blood cells are destroyed by a dysfunction in the body’s own immune system).
  7. Excessive bleeding.

In India, the commonest cause of anaemia is iron deficiency. The Indian diet is generally low in iron, making growing children, menstruating women, pregnant women and strict vegetarians (whose diet has less absorbable iron ) more susceptible to iron deficiency. Iron deficiency is also caused by slow, chronic blood leak such as from gastric ulcers (in India, a bacterial infection called helicobacter pylori is very common and causes such ulcers), tapeworm infestations in the gut, haemorrhoids (piles), heavy menses or cancers of the gut. 

Spotting Anaemia

Generally, most people do not experience many symptoms even when haemoglobin drops below 12 grams - until it drops to less than 10 grams or so. Early symptoms could include:

  1. Light-headedness.
  2. Fatigue.
  3. Shortness of breath.
  4. Inability to perform some activities that the patient could previously do.

In cases where the haemoglobin drops to seven grams or less, people may have difficulty performing activities of their daily living. For instance, there may be difficulty moving around the house, in putting on clothes, cooking, or even in taking a bath.

In cases where the haemoglobin is less than four grams, the patient may become prostrate, unable to perform any significant activity. There is the grave risk of heart failure and even death.

Treatment should be directed at the cause of the anemia, and may include: 

  1. Blood transfusions
  2. Corticosteroids or other medicines that suppress the immune system
  3. Erythropoietin, a medicine that helps your bone marrow make more blood cells
  4. Supplements of iron, vitamin B12, folic acid, or other vitamins and minerals
  5. Intravenous or injected iron. 

 Dietary Factors to Combat Anemia

Iron found in foods is either in the form of heme or non-heme iron:

  • Heme Iron. Foods containing heme iron are the best sources for increasing or maintaining healthy iron levels. Such foods include (in decreasing order of iron-richness) clams, oysters, organ meats, beef, pork, poultry, and fish.
  • Non-Heme Iron. Non-heme iron is less well-absorbed. About 60% of the iron in meat is non-heme (although meat itself helps absorb non-heme iron). Eggs, dairy products, and iron-containing vegetables have only the non-heme form. Such vegetable products include dried beans and peas, iron-fortified cereals, bread, and pasta products, dark green leafy vegetables (chard, spinach, mustard greens, and kale), dried fruits, nuts, and seeds.
  • The vitamin C helps the body absorb iron. Avoid caffeinated drinks such as tea and coffee as they can interfere with iron absorption.

Source: Adapted from an article by Dr. Srinivas Chakravarthy Gummaraju