Anemia

Answer 1

Definition

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.

See also:

• Anemia due to B12 deficiency
• Anemia due to folate deficiency
• Anemia due to iron deficiency
• Anemia of chronic disease
• Hemolytic anemia
• Idiopathic aplastic anemia
• Megaloblastic anemia
• Pernicious anemia
• Secondary aplastic anemia
• Sickle cell anemia
• Thalassemia

Causes, incidence, and risk factors

While many parts of the body are essential to making red blood cells, most of the work is done in the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form blood cells.

Healthy red blood cells last between 90 and 120 days. Parts of your body then remove old blood cells. A hormone called erythropoietin made in your kidneys signal your bone marrow to make more red blood cells.

Hemoglobin is the oxygen-carrying protein inside red blood cells. It gives red blood cells their red color. People with anemia do not have enough hemoglobin.

Possible causes of anemia include:

• Certain medications
• Chronic diseases such as cancer, ulcerative colitis, or rheumatoid Arthritis
• Genes -- some forms of anemia, such as thalassemia, can be inherited
• Kidney failure
• Blood loss (for example, from heavy menstrual periods or stomach ulcers)
• Poor diet
• Pregnancy
• Problems with bone marrow such as lymphoma, leukemia, or multiple myeloma
• Problems with the immune system that cause the destruction of blood cells (hemolytic anemia)
• Surgery to the stomach or intestines that reduces the absorption of iron, vitamin B12, or folic acid

Symptoms

Possible symptoms include:

• Chest pain
• Dizziness or light-headedness (especially when standing up or with exertion)
• Fatigue or lack of energy
• Headaches
• Problems concentrating
• Shortness of breath (especially during exercise)

Some types of anemia may have other symptoms, such as:

• Constipation
• Problems thinking
• Tingling

Signs and tests

The doctor will perform a physical examination, and may find:

• Pale skin
• Rapid heart rate

Some types of anemia may cause other findings on a physical exam.

Blood tests used to diagnose some common types of anemia may include:

• Blood levels of vitamin B12, folic acid, and other vitamins and minerals
• Bone marrow examination
• Red blood countand hemoglobin level
• Reticulocyte count
• Ferritin level
• Iron level

Other tests may be done to identify medical problems that can cause anemia.

Treatment

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

• Blood transfusions
• Corticosteroids or other medicines that suppress the immune system
• Erythropoietin, a medicine that helps your bone marrow make more blood cells
• Supplements of iron, vitamin B12, folic acid, or other vitamins and minerals

Expectations (prognosis)

The outlook depends on the cause.

Complications

Severe anemia can cause low oxygen levels in vital organs such as the heart, and can lead to a heart attack.

Calling your health care provider

Call your health provider if you have any symptoms of anemia, or any unusual bleeding.

References

Marks PW, Glader B. Approach to anemia in the adult and child. In: Hoffman R, Benz EJ, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 34.

Answer 2

Definition

Anemia is a condition in which the body does not have enough healthy red blood cells. Red blood cells provide oxygen to body tissues.

See also:

• Anemia due to B12 deficiency
• Anemia due to folate deficiency
• Anemia due to iron deficiency
• Anemia of chronic disease
• Hemolytic anemia
• Idiopathic aplastic anemia
• Megaloblastic anemia
• Pernicious anemia
• Secondary aplastic anemia
• Sickle cell anemia
• Thalassemia

Causes, incidence, and risk factors

While many parts of the body help make red blood cells, most of the work is done in the bone marrow. Bone marrow is the soft tissue in the center of bones that helps form blood cells.

Healthy red blood cells last between 90 and 120 days. Parts of your body then remove old blood cells. A hormone called erythropoietin made in your kidneys signals your bone marrow to make more red blood cells.

Hemoglobin is the oxygen-carrying protein inside red blood cells. It gives red blood cells their red color. People with anemia do not have enough hemoglobin.

Possible causes of anemia include:

• Certain medications
• Chronic diseases such as cancer, ulcerative colitis, or rheumatoid arthritis
• Genetics: Some forms of anemia, such as thalassemia, can be inherited
• Kidney failure
• Blood loss (for example, from heavy menstrual periods or stomach ulcers)
• Poor diet
• Pregnancy
• Problems with bone marrow such as lymphoma, leukemia, or multiple myeloma
• Problems with the immune system that cause the destruction of blood cells (hemolytic anemia)
• Surgery to the stomach or intestines that reduces the absorption of iron, vitamin B12, or folic acid
• Too little thyroid hormone (underactive thyroid, or hypothyroidism)
• Testosterone deficiency

Symptoms

Possible symptoms include:

• Chest pain
• Dizziness or light-headedness (especially when standing up or with activity)
• Fatigue or lack of energy
• Headaches
• Problems concentrating
• Shortness of breath (especially during exercise)

Some types of anemia may have other symptoms, such as:

• Constipation
• Problems thinking
• Tingling

Signs and tests

The doctor will perform a physical examination, and may find:

• Pale skin
• Rapid heart rate
• Heart murmur

Some types of anemia may cause other findings on a physical exam.

Blood tests used to diagnose some common types of anemia may include:

• Blood levels of vitamin B12, folic acid, and other vitamins and minerals
• Red blood countand hemoglobin level
• Reticulocyte count
• Ferritin level
• Iron level

Other tests may be done to identify medical problems that can cause anemia.

Treatment

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

• Blood transfusions
• Corticosteroids or other medicines that suppress the immune system
• Erythropoietin, a medicine that helps your bone marrow make more blood cells
• Supplements of iron, vitamin B12, folic acid, or other vitamins and minerals

Expectations (prognosis)

The outlook depends on the cause.

Complications

Severe anemia can cause low oxygen levels in vital organs such as the heart, and can lead to a heart attack.

Calling your health care provider

Call your health provider if you have any symptoms of anemia, or any unusual bleeding.

References

Marks PW, Glader B. Approach to anemia in the adult and child. In: Hoffman R, Benz EJ, Shattil SS, et al, eds. Hematology: Basic Principles and Practice. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2008:chap 34.

Reviewed By

Review Date: 02/28/2011

David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital.

Answer 3

Do you feel tired and listless? Do you find your mind drifting during the day? Do you get dizzy or short of breath whenever you climb the stairs? There are a few possible reasons for the way you feel, but you could have anemia. You could even have anemia without noticing any symptoms at all.

Anemia is a problem with hemoglobin, a substance in red blood cells that carries oxygen throughout your body. Without enough hemoglobin, your heart and other organs can't get the oxygen they need to work. When your organs slow down, you slow down and you start feeling tired and listless.

Many different health conditions can cause anemia, from heavy blood loss during a woman's period, to pregnancy, to an underactive thyroid gland. Healthy red blood cells are made in your bone marrow, the soft tissue in the middle of your bones. Any disease that damages blood marrow, such as lymphoma or leukemia, can also affect your red blood cell production. Anemia can also be caused by an immune system problem that damages red blood cells, or surgery to the stomach or intestines.

How do you know if you have anemia?

You may feel tired, dizzy, and have trouble concentrating. You may get sick more often. People with anemia often complain of chest pain, headaches, or shortness of breath. Your skin might look pale, like you haven't seen the sun for months.

Because these can also be symptoms of other conditions, your doctor will confirm that you have anemia by taking a blood test to check your red blood cell count and hemoglobin level. Blood tests can also look for problems that may be causing your anemia, such as a vitamin or iron deficiency.

If you are anemic, it's very important to treat it. When your body isn't getting enough oxygen, it can starve vital organs like your heart. This can lead to a heart attack.

How you treat anemia really depends on the cause. If the problem is with your bone marrow, you may take a medicine called erythropoietin, which will help your bone marrow make more red blood cells. If the problem is a vitamin or mineral deficiency, your doctor may prescribe iron, vitamin B12, or folic acid supplements. Or, you may need a blood transfusion to replace damaged red blood cells with healthy ones.

How well you do really depends on what's causing your anemia. Call your doctor if you have any symptoms like fatigue or shortness of breath. Once your doctor can find and treat the cause of your anemia, you should have more energy and start feeling like your old self again.

Reviewed By

Review Date: 10/25/2011

Alan Greene, MD, Author and Practicing Pediatrician; also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.