What is anaemia?

Anaemia is a condition that occurs when you have an abnormally low amount of red blood cells. Red blood cells contain haemoglobin, a red pigment that gives blood its colour. The job of haemoglobin is to carry oxygen around the body. When red blood cells and therefore haemoglobin are low the blood fails to supply the body's tissues with sufficient amounts of oxygen. As your lungs and heart will then have to work harder to get oxygen into the blood, symptoms of anaemia, such as difficulty in breathing will begin to develop.

The normal haemoglobin (HB) levels are:

Iron deficiency or anaemia is a global public health problem, which is as harmful as any epidemic. Here are a few facts:  

• India has the distinction of being one of the countries having high prevalence of anemia in 70%-80% of children,
• 65-75% of adolescents both boys and girls are victims of anemia, more so with girls as they have to supplement their iron loss during the menstrual cycle.
• 70% of pregnant women and 24% of adult men suffer from anaemia.

What causes anaemia?

There is not usually one cause of anaemia, however, the following are reasons why anaemia may develop:

• Heavy periods.
• Diet low in iron.
• Internal bleeding, for example if you have an ulcer or a tumour.
• Diet low in vitamin B12 or folic acid.
• Blood diseases such as leukaemia.
• Infections, such as malaria.
• Blood loss due to any cause
• Excessive destruction of red blood cells due to:

• Abnormality of haemoglobin like thalassemia,
• Deficiency of red cell enzymes like Glucose 6 phosphate dehydrogenase deficiency,
• Abnormality of red cell membrane like hereditary sperocytosis
• Auto immune haemolytic anaemias

• Inadequate production of red blood cells in bone marrow due to:

• Lack of raw materials e.g. nutritional anaemia.
• Depression of bone marrow e.g. chronic infections, drugs, radiation etc.
• Infiltration of bone marrow in conditions likes malignancy.

What are the different types of anaemia?

The main types of anaemia are caused by shortages of iron, vitamin B12 and folic acid, all of which are needed (among other things) to produce red blood cells, so if one or more of these are missing or running low then anaemia will develop.



1. Iron deficiency anaemia

The most common type of anaemia is iron deficiency anaemia, which basically means the body is running low on iron. The body needs iron to successfully produce haemoglobin the substance that carries oxygen throughout the body.

The main reason why people may have a shortage of iron is because the body is losing blood faster than the body can remake it. This can be caused by gastritis, piles, stomach cancer, ulcers or bowel cancer. In women the most common reason for iron deficiency is menstrual bleeding (periods). Another possible reason for a shortage of iron is diet, which is low in iron. Good sources of iron include fruit, dark green vegetables, wholemeal bread, fortified breakfast cereals, beans and meat.



Causes of iron deficiency anaemia

1. Due to reduced intake or absorption of iron:
• Iron poor diet
• Malabsorption syndromes
• Chronic diarrhoea
• Gastrointestinal surgery
2. Due to increased loss:
• Gastrointestinal bleeding due to any cause
• Hook worm infestation
• Bleeding disorders
• Excessive menstruation
3. Due to increased demands:
• Pregnancy
• Lactation
• Prematurity and low birth weight
• Adolescence
• Chronic illness

2. Vitamin B12 deficiency anaemia

The main cause of vitamin B12 deficiency anaemia (also called pernicious anaemia) is when there is inadequate absorption of vitamin B12 from the diet. This can be due to ulcers, stomach cancer, and diseases of the small intestine or from the after effects of surgery.

A vegetarian is at risk of developing pernicious anaemia because vitamin B12 is only found in foods of animal origin. Vitamin B12 can be found in liver, meat and dairy products.

Vitamin B12 is also essential for the nervous system, so if you have a lack of vitamin B12 you can also develop inflammation of the nerves or dementia.

3. Folic Acid deficiency

The main reason why you may have a lack of folic acid is due to a poor diet and if you drink excessive alcohol it can reduce the uptake of folic acid. Folic acid can be found in fresh fruit, raw green vegetables, beans and whole grain cereals.

Folic acid deficiency and vitamin B12 deficiency anaemia may also be known as megaloblastic anaemia.

What symptoms are linked with anaemia?

As anaemia causes a shortage of oxygen, the main symptom is usually chronic tiredness and palpitations. Other symptoms you may get could include:

• Pale appearance
• Shortness of breath and dizziness
• Fainting
• Angina
• A red, sore tongue and a reduced sense of taste, this is usually only a symptom with folic acid and vitamin B12 deficiency anaemia.

Symptoms of Anaemia                                              

• Weakness, irritability
• Paleness, fatigue, laziness
• Low physical performance
• Poor cognitive function
• Headaches, swelling in the legs
• Giddiness