Estimates about anemia clearly indicate that the condition affects a significant percentage of global populations. Around 40 percent of pregnant women and an equal percentage of children below the age of 5 are estimated to have low hemoglobin concentration levels worldwide. Unknown to a significant percentage of affected individuals, anemia can cause death in certain cases. This makes it absolutely necessary to avail treatment on time, to prevent the condition from aggravating into an unfortunate state. The right kind of measures will help reduce the side effects of anemia and help individuals to lead a life that is as close to normal as possible.


A majority of patients and caregivers are lulled into a sense of safety due to the common or high prevalence rates. This is an erroneous assumption; here is a detailed look at the effects to help individuals appreciate the need for suitable action.


What happens when the hemoglobin levels dip?


Individuals with low anemia are likely to present some of the following symptoms; it is necessary to note that all symptoms are likely to be mild initially and gradually turn severe over a period of time.



Reasons for drop in hemoglobin levels that lead to anemia


Low hemoglobin levels could be broadly attributed to two different reasons – a health condition that develops at some point in life due to one of many possible ailments, and a condition that is inherited. Regardless of the type, the main characteristic of anemia is when red blood cells are not produced in sufficient quantities by the body, or when the individual bleeds at a rate wherein the red blood cell count drastically reduces, or finally a health condition causes the body to destroy healthy red blood cells.


It is necessary to add that bleeding could occur as a result of injury/trauma or internal bleeding due to one of many possible conditions. For instance, internal bleeding could occur as a result of blood vessel damage, inadequate clotting factors, medications that cause bleeding, medications that damage the stomach lining, high blood pressure that cause aneurysms, diseases that afflict the gastro intestinal tract, drugs, and endometriosis.


What is the role of hemoglobin in red blood cells?


Red blood cells get the red color from hemoglobin, which plays a vital and important role in the body. The supply of oxygen from the lungs to the body depends heavily on hemoglobin, which is essentially a red protein, with four subunits. Known medically as the oxygen transport metalloprotein, hemoglobin moves oxygen to the entire body. A reduction in hemoglobin levels beyond a particular level can be serious in nature, demanding blood transfusion.


Red blood cells typically live for around 100 days, with the body replacing the cells in time. This is carried out by a sequence of actions in the body. The bone marrow is responsible for producing red blood cells, and reasons for anemia include possible diseases of the bone marrow, apart from loss of red blood cells as mentioned above, due to bleeding. Lesser production could be attributed to poor coordination between various nutrients, the kidneys and the bone marrow. As outlined above, red blood cells are produced through a sequence of actions, and any poor functioning in the sequence can impact the production.  Individuals with renal impairment may also suffer from anemia; and similarly, individuals with dietary intake that results in lesser nutrition will also be anemic.


Difference between acute anemia and chronic anemia


The primary difference between acute anemia and chronic anemia is the duration and cause of the condition. Individuals who are diagnosed with anemia that is attributed to something that occurs quickly and could possibly last for a shorter duration. Chronic anemia refers to the condition that develops gradually, and possibly lasts for a longer duration with stronger side effects of anemia. It is necessary to be able to identify the onset of symptoms accordingly and on time to prevent undesirable or adverse conditions.


Different types of anemia


Anemia is classified by different parameters, including the size of the blood cells. Microcytic anemia refers to the condition wherein the blood cells are smaller than average size. This is mainly due to lower iron levels in the body.  This could mainly be attributed to congenital conditions such as thalassemia. Normocytic anemia refers to the condition when the blood cells size is actually normal in size, though with a lesser count, than the average or desirable count. This condition typically occurs when the individual’s kidneys are afflicted with disease. Macrocytic anemia refers to the condition when the size of blood cells is larger than the average size. This condition occurs due to excessive alcohol consumption, poor nutrition, and diseases that affect the immune system.


Symptoms of anemia


The symptoms associated with anemia are effectively slightly different and determined by the classification of the condition, though the general symptoms may be similar. For instance, diarrhea is a symptom of folic acid anemia. This condition could also result in individuals ending up with a tongue that is smooth.


Symptoms such as urine with abnormal color, and low-grade fever are indicative of Hemolytic anemia. The symptoms associated with this condition are similar to symptoms linked to jaundice. Fever and frequent infections are indictive of Aplastic anemia. Other symptoms include the outbreak of rashes.

Unusual tiredness, and inflammation in hands/feet are indicative of sickle cell anemia. The swelling in the hands and feet are most likely to be painful in nature.


General symptoms of anemia regardless of type


As mentioned above, there are specific symptoms that indicate a particular type of anemia. Confirmation of the condition and appropriate treatment is only on the basis of laboratory reports. It is necessary to add, that regardless of the type of anemia, there are symptoms that are generally common to all the types.  The most common symptom across different types of anemia is fatigue. While there may be other reasons for tiredness, anemic individuals are known to experience fatigue.  Similarly, the color of the skin may turn pale among all patients with low hemoglobin levels, when compared with skin color prior to the condition. It is necessary to add that individuals with mild or moderate levels of anemia may not experience any of these symptoms.


Other commonly experienced symptoms include pain, discomfort in the chest, and change in heart beat rate. Anemic patients generally tend to experience frequent headaches, in addition to reporting difficulty in breathing/shortness of breath. A light headed or dizzy feeling is another possible symptom that is common across all types of anemia.


Treatment options/regimen for anemia

The actual treatment for anemia is decided on conclusion of tests to determine the type of anemia and the underlying cause for low hemoglobin levels. The objectives of treatment include treating or managing the underlying conditions. This will help to boost the red blood cell count to levels that are considered as safe. Treatments are intended to help improve oxygen supply throughout the body, which in turn helps to mitigate or resolve health issues due to inadequate supply of oxygen. Treatment options include:


#1 Bone marrow transplants – This involves replacement of bone marrow from healthy cells, either from the patient or from a donor.

#2 Blood transfusion – This involves transferring blood intravenously into the body’s blood circulation to boost hemoglobin levels.

#3 Iron supplements – Elemental iron through oral formulations helps to treat iron deficiency in patients. This method is suitable only for certain types of anemia.

#4 Dietary modifications – Patients are typically advised to modify diets so as to improve intake of iron in the body, which will in turn improve hemoglobin levels.

#5 Immunosuppressive therapy – This option is suitable for patients with aplastic anemia, and in cases where the patient cannot undergo a bone marrow transplant.

#6 Vitamin b-12 injections – Vitamin B12 deficiency causes anemia as the body requires the vitamin to produce red blood cells. Specifically known as pernicious anemia, the condition is managed with intramuscular Vitamin B12 injections.


Other possible causes of anemia


In addition to the main reasons for anemia, there are other possible conditions that cause anemia. This is mainly because anemia is linked to red blood cells, and any condition that brings about a reduction in red blood cells automatically becomes a possible cause for anemia. Reduced hemoglobin count could occur either due to blood loss or due to diseases. For instance, cancer, tumors and ulcer could trigger a loss of blood. Other reasons for loss of blood include gastrointestinal conditions, menstruation and hemorrhoids.


High risk categories 


While the number of people globally who are anemic is high in terms of percentage of populations, there are specific categories of individuals who can be classified as high-risk categories, who are more prone to the condition. Pregnant women with excessive bleeding, and menstruating women with heavy loss of blood, belong to this category. Babies born prematurely are likely to end up anemic at some point of time in life later. Certain medications are also likely to cause internal bleeding, which could cause low hemoglobin levels.

Individuals with poor nutrition are also likely to end up anemic, as poor nutrient intake could impact the coordinated functions required in the body and the bone marrow for the production of red blood cells. Patients with congenital conditions are likely to experience side effects of anemia. As outlined above, diseases are a reason and this includes patients with cancer, kidney complications, AIDS and liver issues. The impact of diseases on blood loss could be a direct effect or an indirect effect, such as an impact on bone marrow or kidneys. Patients with gastrointestinal conditions also belong to the category of high-risk individuals who may be prone to anemia. Other individuals in this category include blood donors who donate blood frequently. Patients with auto immune disorders, hypertension and snake bite victims are also likely to end up with low hemoglobin levels. Finally, individuals with prosthetic heart valves, also fit into this category due to possible intravascular hemolysis, arising from structural deterioration or possible paravalvular leak.


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