Analyzing Anemias

Original Image by Hector Lazo via Flickr

By: Nikki Nies

Anemia is a term that’s thrown around a lot in the health world, but do you know there are over 400 types of  anemia? It requires a table for me to explain the differences.  To make matters more complicated, there are different symptoms that are indicative of the type of anemia as well as best route of prevention.

The basic term anemia means a condition that develops when blood lacks enough healthy red blood cells or hemoglobin.

Type of Anemia	Possible Causes	Symptoms	Treatment
Iron Deficiency Anemia	Inadequate iron intake secondary to poor diet (i.e. veganism with insufficient heme iron) Blood loss Inadequate absorption from diarrhea, achlorhydria, intestinal disease (i.e. celiac disease, atrophic gastritis, partial or total gastrectomy) Inadequate use to chronic GI disturbances Increased iron requirement for growth of blood volume Increased excretion because of excessive menstrual blood, hemmorhage from injury or chronic blood loss Defective release of iron from iron stores into plasma and defective iron use Pale skin Extreme fatigue Cold extremities Irritability Brittle anils Inflammation or soreness of tongue Dizziness Headache Fast heartbeat Restless less syndrome Poor appetite Unusual cravings for non-nutritive substances (i.e. dirt, starch) Iron supplementation Monitor amount of absorbable dietary iron consumed Take iron supplements with vitamin C to increase absorption of iron	Headache Fast heartbeat Restless less syndrome Poor appetite Unusual cravings for non-nutritive substances (i.e. dirt, starch)	Iron supplementation Monitor amount of absorbable dietary iron consumed Take iron supplements with vitamin C to increase absorption of iron
Anemia of chronic disease (ACD)	Cancer—lymphoma and Hodgkin’s disease Liver cirrhosis Long term infections: (i.e. hepatitis C, HIV/AIDS) Autoimmune disorders (i.e. ulcerative colitis, Crohn’s disease, systemic lupus erythematosus) Chronic kidney disease Headache Paleness Shortness of breath Feeling weak or tired	Headache Paleness Shortness of breath Feeling weak or tired	Treatment is dictated by underlying cause—often times it resolves itself Recommend iron supplements when needed Not recommended for those with normal/high ferritin levels since iron stores are adequate With kidney disease, erythropoietin may be given to stimulate bone marrow
Pernicious Anemia (B12 deficiency)	Deficiency of vitamin B12—often secondary to lack of intrinsic factor  Weakened stomach lining  autoimmune condition where body’s immune system attacks intrinsic factor protein Genetics—rare Malabsorption in small intestine Fatigue Shortness of breath Dizziness Yellowish skin Chest pain Arrthymias Enlarged heart Muscle weakness Nausea Vomiting Heartburn Abdominal bloating Gas Constipation Diarrhea Loss of appetite Weight loss Enlarged liver Numbness in extremities Monthly injections of vitamin B12 High protein diet (1.5 g/kg) High consumption of green leafy vegetables since they contain iron and folic acid High consumption of meats, eggs, milk and milk products since they are high in B12 If prescribed metformin, one should increase calcium as consumption has been shown to reverse vitamin B12 absorption B12 RDA for men and women: 2.4 mcg/day	Fatigue Shortness of breath Dizziness Yellowish skin Chest pain Arrthymias Enlarged heart Muscle weakness Nausea Vomiting Heartburn Abdominal bloating Gas Constipation Diarrhea Loss of appetite Weight loss Enlarged liver numbness in extremities	Monthly injections of vitamin B12 High protein diet (1.5 g/kg) High consumption of green leafy vegetables since they contain iron and folic acid High consumption of meats, eggs, milk and milk products since they are high in B12 If prescribed metformin, one should increase calcium as consumption has been shown to reverse vitamin B12 absorption Meet B12 recommendations for men and women: 2.4 mcg/day
Macrocytic Anemia	Macrocytosis—deficiency of vitamin B12 leads to decrease synthesis in RBC  Lack of intrinsic factor who have undergone gastrectomy or who have pernicious anemia Folate deficiency malabsorption of vitamin B12 secondary to small bowel bacterial overgrowth, tapeworm, drugs, ileal bypass, ileal enteritis or sprue sore tongue enlarged spleen low level of hemoglobin nausea fatigue weight loss smooth tongue weakness irritability pale lips brittle nails	sore tongue enlarged spleen low level of hemoglobin nausea fatigue weight loss smooth tongue weakness irritability pale lips brittle nails	Treat underlying cause/disease Megaloblastic macrocytic anemia: Take vitamin B12 and folic acid supplement May require daily injections of vitamin B12 if deficiency is severe
Sickle Cell Anemia	An inherited disease that impacts African Americans Red blood cells become crescent shaped because of genetic defect Pain Hand foot syndrome Delayed growth Swelling extremities Episodes of severe pain Pale skin or nails Yellow tint to skin Signs of stroke Fever Vision problems Antibiotics—penicillin Pain relieving medications Hydroxyurea—reduces frequency of painful crises and may reduce need for blood transfusions Blood transfusions Stem cell transplant Supplemental oxygen	Pain Hand foot syndrome Delayed growth Swelling extremities Episodes of severe pain Pale skin or nails Yellow tint to skin Signs of stroke Fever vision problems	Antibiotics—penicillin Pain relieving medications Hydroxyurea—reduces frequency of painful crises and may reduce need for blood transfusions Blood transfusions Stem cell transplant Supplemental oxygen

These facts may sound alarming, but it’s good to have this chart on hand.  This chart shouldn’t be used for self diagnosis,  but having a better idea of the classifications of the types of anemia is good to know.

Sources:http://health.nytimes.com/health/guides/disease/anemia-of-chronic-disease/overview.html

http://www.mayoclinic.com/health/iron-deficiency-anemia/DS00323/DSECTION=symptoms

http://www.webmd.com/a-to-z-guides/understanding-anemia-basics

http://www.mayoclinic.com/health/sickle-cell-anemia/DS00324/DSECTION=symptoms