01/03/2021
ANEMIA:
Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen. Symptoms of anemia -- like fatigue -- occur because organs aren't getting what they need to function properly.
Anemia is the most common blood condition in the U.S. It affects about 3.5 million Americans. Women and people with chronic diseases are at increased risk of anemia. Important factors to remember are:
Certain forms of anemia are hereditary and infants may be affected from the time of birth.
Women in the childbearing years are particularly susceptible to iron-deficiency anemia because of the blood loss from menstruation and the increased blood supply demands during pregnancy.
Older adults also may have a greater risk of developing anemia because of poor diet and other medical conditions.
There are many types of anemia. All are very different in their causes and treatments. Iron-deficiency anemia, the most common type, is very treatable with diet changes and iron supplements. Some forms of anemia -- like the anemia that develops during pregnancy -- are even considered normal. However, some types of anemia may present lifelong health problems.
Iron-deficiency anemia occurs because of a lack of the mineral iron in the body. Bone marrow in the center of the bone needs iron to make hemoglobin, the part of the red blood cell that transports oxygen to the body's organs. Without adequate iron, the body cannot produce enough hemoglobin for red blood cells. The result is iron-deficiency anemia. This type of anemia can be caused by:
An iron-poor diet, especially in infants, children, teens, vegans, and vegetarians
The metabolic demands of pregnancy and breastfeeding that deplete a woman's iron stores
Menstruation
Frequent blood donation
Endurance training
Digestive conditions such as Crohn's disease or surgical removal of part of the stomach or small intestine
Certain drugs, foods, and caffeinated drinks
Vitamin-deficiency anemia may occur when vitamin B12 and folate are deficient. These two vitamins are needed to make red blood cells. Conditions leading to anemia caused by vitamin deficiency include:
Megaloblastic anemia: Vitamin B12 or folate or both are deficient
Pernicious anemia: Poor vitamin B12 absorption caused by conditions such as Crohn's disease, an intestinal parasite infection, surgical removal of part of the stomach or intestine, or infection with HIV
Dietary deficiency: Eating little or no meat may cause a lack of vitamin B12, while overcooking or eating too few vegetables may cause a folate deficiency.
Other causes of vitamin deficiency: pregnancy, certain medications, alcohol abuse, intestinal diseases such as tropical sprue and celiac disease
During early pregnancy, sufficient folic acid can prevent the fetus from developing neural tube defects such as spina bifida.
Bone marrow and stem cell problems may prevent the body from producing enough red blood cells. Some of the stem cells found in bone marrow develop into red blood cells. If stem cells are too few, defective, or replaced by other cells such as metastatic cancer cells, anemia may result. Anemia resulting from bone marrow or stem cell problems include:
Aplastic anemia occurs when there's a marked reduction in the number of stem cells or absence of these cells. Aplastic anemia can be inherited, can occur without apparent cause, or can occur when the bone marrow is injured by medications, radiation, chemotherapy, or infection.
Thalassemia occurs when the red cells can't mature and grow properly. Thalassemia is an inherited condition that typically affects people of Mediterranean, African, Middle Eastern, and Southeast Asian descent. This condition can range in severity from mild to life-threatening; the most severe form is called Cooley's anemia.
Lead exposure is toxic to the bone marrow, leading to fewer red blood cells. Lead poisoning occurs in adults from work-related exposure and in children who eat paint chips, for example. Improperly glazed pottery can also taint food and liquids with lead.
Dietary Changes and Supplements
Low levels of vitamins or iron in the body can cause some types of anemia. These low levels may be due to poor diet or certain diseases or conditions.
To raise your vitamin or iron level, your doctor may ask you to change your diet or take vitamin or iron supplements. Common vitamin supplements are vitamin B12 and folic acid (folate). Vitamin C sometimes is given to help the body absorb iron.
Iron
Your body needs iron to make hemoglobin. Your body can more easily absorb iron from meats than from vegetables or other foods. To treat your anemia, your doctor may suggest eating more meat—especially red meat (such as beef or liver), as well as chicken, turkey, pork, fish, and shellfish.
Non-meat foods that are good sources of iron include:
Spinach and other dark green leafy vegetables
Tofu
Peas; lentils; white, red, and baked beans; soybeans; and chickpeas
Dried fruits, such as prunes, raisins, and apricots
Prune juice
Iron-fortified cereals and breads
You can look at the Nutrition Facts label on packaged foods to find out how much iron the items contain. The amount is given as a percentage of the total amount of iron you need every day.
Iron also is available as a supplement. It's usually combined with multivitamins and other minerals that help your body absorb iron.
Doctors may recommend iron supplements for premature infants and infants who are fed breast milk only or formula that isn't fortified with iron.
Large amounts of iron can be harmful, so take iron supplements only as your doctor prescribes.
Vitamin B12
Low levels of vitamin B12 can lead to pernicious anemia. This type of anemia often is treated with vitamin B12 supplements.
Good food sources of vitamin B12 include:
Breakfast cereals with added vitamin B12
Meats such as beef, liver, poultry, and fish
Eggs and dairy products (such as milk, yogurt, and cheese)
Foods fortified with vitamin B12, such as soy-based beverages and vegetarian burgers
Folic Acid
Folic acid (folate) is a form of vitamin B that's found in foods. Your body needs folic acid to make and maintain new cells. Folic acid also is very important for pregnant women. It helps them avoid anemia and promotes healthy growth of the fetus.
Good sources of folic acid include:
Bread, pasta, and rice with added folic acid
Spinach and other dark green leafy vegetables
Black-eyed peas and dried beans
Beef liver
Eggs
Bananas, oranges, orange juice, and some other fruits and juices
Vitamin C
Vitamin C helps the body absorb iron. Good sources of vitamin C are vegetables and fruits, especially citrus fruits. Citrus fruits include oranges, grapefruits, tangerines, and similar fruits. Fresh and frozen fruits, vegetables, and juices usually have more vitamin C than canned ones.
If you're taking medicines, ask your doctor or pharmacist whether you can eat grapefruit or drink grapefruit juice. This fruit can affect the strength of a few medicines and how well they work.
Other fruits rich in vitamin C include kiwi fruit, strawberries, and cantaloupes.
Vegetables rich in vitamin C include broccoli, peppers, Brussels sprouts, tomatoes, cabbage, potatoes, and leafy green vegetables like turnip greens and spinach.
Medicines
Your doctor may prescribe medicines to increase the number of red blood cells your body makes or to treat an underlying cause of anemia. Some of these medicines include:
Antibiotics to treat infections.
Hormones to treat heavy menstrual bleeding in teenaged and adult women.
A man-made version of erythropoietin to stimulate your body to make more red blood cells. This hormone has some risks. You and your doctor will decide whether the benefits of this treatment outweigh the risks.
Medicines to prevent the body's immune system from destroying its own red blood cells.
Chelation (ke-LAY-shun) therapy for lead poisoning. Chelation therapy is used mainly in children. This is because children who have iron-deficiency anemia are at increased risk of lead poisoning.
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