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Be Well Red – A guide to Anaemia

Every 2nd Indian woman is anemic

The prevalence rate among pregnant women is 87%

More than 95% of children, adolescent girls and pregnant women suffer from anemia

1 in every 5 maternal deaths is due to anemia

What is Anemia?

Anemia is a condition that occurs when the number of red blood cells (RBCs) and/or the amount of haemoglobin found in the red blood cells drops below normal. Red blood cells and the haemoglobin contained within them are necessary to transport and deliver oxygen from the lungs to rest of the body. Without a sufficient supply of oxygen, many tissues and organs throughout the body can be adversely affected.

Anemia is a fairly common condition, affecting both men and women of all ages, races and ethnic groups. However, certain people have increased risk of developing anemia. These include people with diets poor in iron and vitamins, chronic diseases such as kidney disease, diabetes, cancer, inflammatory bowel disease, a family history of inherited anemia, chronic infections such as tuberculosis or HIV, and those who have had significant blood loss from injury or surgery.

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The main causes of anemia include:

  • Impaired or decreased production of RBCs by the bone marrow due to nutritional deficiency (e.g., iron deficiency, B vitamin deficiencies), bone marrow failure (e.g., aplastic anemia, myelodysplastic syndrome), or diseases that involve the bone marrow (e.g., infection, lymphoma, solid tumor).
  • Loss of RBCs due to bleeding or to increased destruction of RBCs as in hemolytic anemia.

Some of the more common causes of anemia, especially those that are not typically associated with white blood cell and platelet abnormalities are summarized  below:

Iron Deficiency : 

Deficiency of iron leads to decreased amounts of haemoglobin; low levels of haemoglobin in turn leads to decreased production of normal RBCs

Causes – Blood loss; diet low in iron; poor absorption of iron

Pernicious Anemia and Vitamin B12 Deficiency :

RBCs do not develop as they normally would because of lack of B vitamins (B12 and folate); leads to decreased production of RBCs

Causes – Lack of intrinsic factor (needed for B12 absorption); diet low in B vitamins; decreased absorption of B vitamins

Aplastic :

Bone marrow is unable to produce enough blood cells; a life-threatening condition

Causes – Cancer therapy, exposure to toxins, autoimmune disease, viral infections

Hemolytic :

RBCs are destroyed faster than the bone marrow can replace them

Causes – Inherited causes such as sickle cell disease and thalassemia; other causes include transfusion  of incompatible blood, autoimmune disease, certain drugs (penicillin)

Anemia of Chronic Diseases : 

Various conditions over the long term can cause decreased production of RBCs

Causes – Kidney disease, rheumatoid arthritis, diabetes, tuberculosis, HIV, Crohn disease, cancer and others

There are many more conditions that can, for various reasons, result in some level of anemia, such as:

  • Bleeding – significant bleeding resulting from, for example, trauma or surgery (acute) or from gastrointestinal bleeding (ulcers) occurring over time (chronic)
  • Leukemia (acute or chronic)
  • Lymphoma
  • Myelodysplastic Syndrome
  • Multiple Myeloma
  • Myeloproliferative Neoplasms

In our next blog topic we will talk about the different type of Anaemia.