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What To Know About Anemia

Anemia occurs when there is a decrease in circulating red blood cells. When this happens, the blood cannot provide enough oxygen to the body. A person with anemia may feel tired or weak.

Around 3 million people in the United States have some type of anemia.

Other health conditions, such as those that interfere with the body's production of healthy red blood cells (RBCs) or increase the rate of the breakdown or loss of these cells, can cause anemia. Anemia can lead to symptoms including fatigue, shortness of breath, and lightheadedness.

In this article, we explain the types, symptoms, and causes of anemia, as well as the treatments available.

The most common symptom of anemia is fatigue. Other common symptoms include:

  • pallid complexion
  • a fast or irregular heartbeat
  • shortness of breath
  • chest pain
  • headache
  • lightheadedness
  • However, symptoms vary from person to person. Some people with mild anemia may experience few or no symptoms.

    There are many forms of anemia, and each type has telltale symptoms. Some common types of anemia include:

  • iron deficiency anemia
  • vitamin B12 deficiency anemia
  • aplastic anemia
  • hemolytic anemia
  • Iron deficiency anemia

    The most common form of anemia, iron deficiency anemia involves the body producing too few RBCs due to a lack of iron in the body. It may develop as a result of:

    It can cause symptoms including:

  • fatigue
  • lightheadedness
  • cold extremities
  • Learn more about iron deficiency anemia.

    Vitamin B12 deficiency anemia

    Vitamin B12 is essential for the production of RBCs. If a person does not consume or absorb enough B12, their RBC count may be low.

    Some symptoms include:

  • difficulty walking
  • confusion and forgetfulness
  • vision problems
  • diarrhea
  • glossitis, which is a smooth, red tongue
  • Learn more about vitamin B12 deficiency anemia.

    Aplastic anemia

    This rare blood condition happens when the bone marrow cannot produce enough new RBCs. It is most often a result of an autoimmune disease that damages stem cells. This occurs despite having normal iron levels.

    It can cause symptoms such as:

  • fatigue
  • frequent infections
  • skin rashes
  • bruising easily
  • Learn more about aplastic anemia.

    Hemolytic anemia

    This type of anemia happens when RBCs are destroyed faster than the body can produce new ones. A variety of conditions can cause this, such as autoimmune diseases, infections, bone marrow problems, and inherited conditions such as sickle cell disease and thalassemia.

    Hemolytic anemia can cause symptoms including:

    Learn more about hemolytic anemia.

    The body needs RBCs to survive. They transport hemoglobin, a complex protein that attaches to iron molecules. These molecules carry oxygen from the lungs to the rest of the body.

    Various health conditions can result in low levels of RBCs and cause anemia.

    There are many types of anemia and no single cause. In some people, it can be difficult to identify what is causing a low RBC count.

    The three main causes of anemia are:

    Blood loss

    Iron deficiency anemia is the most common form of anemia, and blood loss is often the cause. Blood loss can lead to low levels of iron in the blood, causing anemia.

    When the body loses blood, it draws water from tissues beyond the bloodstream to help keep the blood vessels full. This additional water dilutes the blood, reducing the RBC count.

    Blood loss can be acute (short term) or chronic (long term).

    Some causes of acute blood loss include surgery, childbirth, and trauma. However, chronic blood loss is more often responsible for anemia. Chronic blood loss may result from conditions such as a stomach ulcer, endometriosis, cancer, or another type of tumor.

    Other causes of anemia due to blood loss include:

  • gastrointestinal conditions, such as hemorrhoids, cancer, or gastritis
  • the use of nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen
  • heavy menstrual bleeding
  • Decreased or impaired RBCs

    Bone marrow is the soft, spongy tissue at the center of bones, and it plays an essential role in creating RBCs. The marrow produces stem cells, which develop into RBCs, white blood cells, and platelets.

    A number of diseases can affect the bone marrow. One of these is leukemia, a type of cancer that triggers the production of excessive and abnormal white blood cells. This disrupts the production of RBCs.

    Problems with bone marrow can also cause anemia. Aplastic anemia, for example, occurs when few or no stem cells are present in the marrow.

    In some cases, anemia happens when RBCs do not grow and mature as usual. This happens in people with thalassemia, a hereditary form of anemia.

    Destruction of RBCs

    RBCs typically have a life span of 120 days. However, the body may destroy or remove them before they complete their natural life cycle in the bloodstream.

    Autoimmune hemolytic anemia is caused by the destruction of RBCs. It occurs when the immune system mistakes RBCs for a foreign substance and attacks them.

    There is a range of treatments for anemia. Each aims to increase a person's RBC count, which increases the amount of oxygen in the blood.

    The required treatment depends on the type of anemia a person has. Treatments for common forms of anemia include the following:

  • Iron-deficiency anemia: Iron supplements and dietary changes can help, and a doctor will identify and address the cause of any excessive bleeding if present.
  • Vitamin deficiency anemia: Treatments can include dietary supplements and vitamin B12 injections.
  • Thalassemia: Treatments include folic acid supplements, iron chelation, and, for some people, blood transfusions and bone marrow transplants.
  • Anemia due to chronic disease: The doctor will focus on managing the underlying condition.
  • Aplastic anemia: Treatment for aplastic anemia involves blood transfusions or bone marrow transplants.
  • Sickle cell anemia: Doctors treat this with oxygen therapy, pain relief medication, and intravenous fluids. They may also prescribe antibiotics, folic acid supplements, blood transfusions, and a cancer drug called hydroxyurea.
  • Hemolytic anemia: The treatment plan may include immunosuppressant drugs, treatments for infections, and plasmapheresis, which filters the blood.
  • If nutritional deficiencies are responsible for anemia, eating more iron-rich foods can help.

    Some foods that are high in iron include:

  • iron-fortified cereal and bread
  • leafy green vegetables, such as kale, spinach, and watercress
  • pulses and beans
  • brown rice
  • white or red meats
  • nuts and seeds
  • fish
  • tofu
  • eggs
  • dried fruits, including apricots, raisins, and prunes
  • Anemia can occur in people of all ages, sexes, and ethnicities. However, the following factors increase a person's risk of developing a form of the condition:

  • being born prematurely
  • being 6–24 months old
  • menstruating
  • being pregnant and giving birth
  • consuming a diet low in vitamins, minerals, and iron
  • taking medications that inflame the stomach lining, such as NSAIDs
  • having a family history of inherited anemia
  • having an intestinal disorder that affects the absorption of nutrients
  • losing blood
  • having a chronic illness such as AIDS, diabetes, kidney disease, cancer, rheumatoid arthritis, heart failure, or liver disease
  • There are various ways to diagnose anemia, but the most common method involves a blood test called a complete blood count (CBC). This test measures a number of components, including:

  • hematocrit levels, which involves comparing the volume of RBCs with the total volume of blood
  • hemoglobin levels
  • RBC count
  • A CBC can give an indication of a person's overall health. It can also help a doctor decide whether to check for underlying conditions such as leukemia or kidney disease.

    If RBC, hemoglobin, and hematocrit levels fall below the typical range, a person likely has some form of anemia.

    However, it is possible for a healthy person's levels to fall outside this range. A CBC is not conclusive, but it is a helpful starting point for a doctor to make an accurate diagnosis.

    The outlook for a person with anemia depends on its cause.

    Sometimes, people can prevent or manage anemia with dietary changes alone. Other types of anemia require more significant treatment protocols, and some can be life threatening without treatment.

    If a person feels continually weak and tired, they should contact a doctor for testing.

    Below are some commonly asked questions about anemia.

    Can a person live a long life with anemia?

    Following treatment, most people with anemia live normal, healthy lives. However, the condition can have lasting or life-threatening effects – especially if the anemia is severe, chronic, or left untreated. In these instances, arrhythmia and organ damage can pose a risk.

    Can a person tell if they are anemic from their eyes?

    According to a 2021 study, anemia can manifest as pallor, or an absence of color, inside the eyelids. However, pallor can happen for many reasons. Only a blood test can confirm if a person has anemia.

    How can a person treat anemia themselves?

    It is not advisable for a person to treat anemia themselves. Rather, a person should consult a doctor to understand the best course of treatment for the type and severity of anemia they have.

    If a person has mild iron-deficiency anemia, a doctor may recommend that the person treat it at home by eating more foods that contain iron and vitamin C.

    Is anemia a permanent condition?

    Anemia ranges from mild to severe and can be temporary or chronic, the latter meaning it lasts a long time and may never go away completely.

    How fast does anemia go away?

    How fast anemia goes away depends on the type and severity of anemia and the treatment recommended.

    For example, in a person with iron-deficiency anemia, it generally takes three to six months for iron supplements to restore their iron levels. For others, anemia is a chronic and long-lasting condition.

    Anemia occurs when a low number of RBCs are circulating in the body. This reduces the person's oxygen levels and can lead to symptoms such as fatigue, pale skin, chest pain, and breathlessness.

    Common causes are blood loss, reduced or impaired RBC production, and the destruction of RBCs.

    A doctor can use a CBC test to help detect anemia. Treatment varies depending on the type, but it may include dietary changes, supplements, medications, blood transfusions, and bone marrow transplants.


    Are Anemia And Thalassemia The Same Thing?

    Thalassemia is a genetic condition that can lead to many complications, with anemia being one of the hallmarks. Treatments can help keep anemia from developing.

    Thalassemia and anemia are both red blood cell conditions, and they're often linked. However, they're not the same condition. Although the conditions are separate, thalassemia, a genetic condition, often leads to anemia.

    Treating thalassemia can help prevent anemia and other complications. Keep reading to learn more about how they differ.

    Thalassemia is an inherited condition that causes your body to make an atypical form of the protein hemoglobin.

    Hemoglobin is found in red blood cells and carries oxygen. When you have thalassemia, red blood cells don't get the right amount of oxygen and are destroyed.

    This can lead to anemia, a health condition that occurs when your body doesn't have enough healthy red blood cells.

    This means that although thalassemia can lead to anemia, they aren't the same condition.

    Also, there are many things that can lead to anemia, including nutritional deficiencies, chronic conditions, and injuries. Thalassemia is always caused by genetics.

    Not everyone with thalassemia has symptoms. Symptoms often develop in late childhood or adolescence and might include:

    However, it's also possible to have severe thalassemia. This is called thalassemia major, a type of thalassemia beta. This type of thalassemia typically causes symptoms that appear before a child's second birthday. These symptoms include:

    Anemia can be mild, moderate, or severe. If you have mild anemia, you might not experience any symptoms. When symptoms of anemia occur, they can include:

    Thalassemia often quickly leads to anemia, but it's possible to have it without developing anemia. Treating thalassemia can help prevent anemia.

    For instance, you can take iron supplements and other medications, and if you have moderate or severe thalassemia you might receive regular blood transfusions to prevent anemia and other complications.

    More treatments, such as stem cell transplants, can also be options.

    Thassalemia and anemia are closely linked conditions, but they aren't the same. Thalassemia is a genetic condition that damages your red blood cells, and anemia is a condition caused by a lack of healthy red blood cells.

    This means that it's common for thalassemia to lead to anemia.

    Treating thalassemia with options such as iron supplements, medications, blood transfusions, and bone marrow transplants, can help prevent anemia and other complications.


    What Is Severe Aplastic Anemia?

    Severe aplastic anemia is a rare blood disorder where an autoimmune reaction leads to your bone marrow not producing enough blood cells.

    Depending on the severity of aplastic anemia symptoms, doctors classify it as:

  • non-severe
  • severe
  • very severe
  • Newer treatments like bone marrow transplants and immunosuppressant medications have vastly increased survival rates and quality of life for people with severe aplastic anemia. People with untreated severe aplastic anemia tend to have very poor outlooks.

    Researchers still don't fully understand why aplastic anemia develops. It's believed to be related to an autoimmune reaction against the cells in your bone marrow that produce blood cells.

    Read on to learn more about this rare disorder, including symptoms, causes, and treatment options.

    People with severe aplastic anemia have low levels of:

  • red blood cells
  • white blood cells
  • platelets
  • Most symptoms of aplastic anemia are related to low levels of these three types of blood cells.

    Potential symptoms include:

    In about two-thirds of cases, the cause of aplastic anemia isn't known. When the underlying cause isn't known, it's called idiopathic aplastic anemia.

    Researchers don't fully understand why aplastic anemia develops, but it's thought to be triggered by an autoimmune reaction where a type of white blood cell (a T-cell) attacks stem cells in your bone marrow that produce blood cells.

    This autoimmune reaction may be triggered by a combination of genetics and environment.

    About 70% of aplastic anemia cases are thought to be acquired, meaning they're triggered by environmental factors like:

  • medications, such as some chemotherapy medications
  • toxic chemicals
  • viral infections like viral hepatitis
  • The remaining 30% of cases are thought to be hereditary, meaning they're linked to genes passed through families.

    The most common hereditary cause is Fanconi anemia. Fanconi anemia is usually a recessive disease caused by mutations in the FANC gene, but about 2% of cases develop from a gene mutation on the X chromosome. "Recessive" means you need an associated mutation from both parents to develop the disease.

    Severe aplastic anemia can develop at any age, and it occurs in all sexes about equally. Some research reports a slightly higher occurrence in males.

    It's thought to affect about 1 in 430,000 people in Europe and the United States and about 3 times more people in East Asia.

    Other potential risk factors include:

    Severe aplastic anemia can lead to complications like:

    Doctors use a variety of tests to diagnose aplastic anemia and rule out other blood conditions like leukemia or myelodysplastic syndrome.

    Tests include:

    Doctors can also use the results of these tests to determine the severity of your aplastic anemia. Factors that determine the severity of aplastic anemia include your:

  • number of functioning bone marrow stem cells
  • neutrophil (a type of white blood cell) count
  • platelet count
  • reticulocyte (immature red blood cell) count
  • In recent years, researchers have developed stem cell transplants as a potential cure for aplastic anemia. A stem cell transplant involves injecting stem cells from the bone marrow of a donor to replace your own stem cells.

    Researchers have developed clearer treatment guidelines for severe aplastic anemia than non-severe.

    The standard first-line therapy for a person with severe aplastic anemia is usually a stem cell transplant. The stem cells come from a genetically compatible donor. The donor is often a close relative, but it can also be a stranger.

    If a suitable donor isn't available for a bone marrow transplant or if you're not a candidate, immunosuppressants are generally used as the primary treatment to stop the autoimmune reaction.

    Immunosuppressants you might receive include:

  • equine antithymocyte globulin
  • cyclosporin A
  • It's still not fully understood why these medications reduce symptoms in some people with aplastic anemia.

    People who don't respond to these medications might receive eltrombopag. This medication may also be combined with equine antithymocyte globulin or cyclosporin A.

    The symptoms of aplastic anemia can be vague, especially in the early stages. But it's important to see your doctor if you develop potential signs, such as:

  • unexplained weight loss
  • fatigue
  • bleeding or bruising
  • purple dots on your skin
  • Severe aplastic anemia may lead to rapid death if it's untreated. More than 75% of people with aplastic anemia survive at least 5 years after receiving a bone marrow transplant from a suitable donor.

    Aplastic anemia life expectancy with treatment

    In a 2020 study, researchers examined the long-term survival of 302 people with anaplastic anemia treated with either a stem cell transplant or immunosuppressive therapy.

    They found that 44% of people who received a stem cell transplant and 40% of people who received immunosuppressant therapy were alive 30 years later. The results were better in recent years.

    The researchers also found that 96% of people who were still alive 25 years later were in complete remission at their last follow-up.

    With treatment, many people with severe aplastic anemia are now able to live for many years in remission.

    The symptoms of aplastic anemia can be vague in the early stages but tend to get worse over time. It's important to reach out to a doctor if you develop concerning symptoms like atypical bleeding or bruising.






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