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Anemia: The Basics

Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Dec 23, 2018
Last Modified Date: Dec 23, 2018
Published Date: Dec 23, 2018

TABLE OF CONTENTS

Chapter 1: Anemia: The Basics Chapter 2: Your CBC Test Chapter 3: Know the Signs of Anemia to Protect Your Health Chapter 4: Treating Anemia


Anemia: The Basics

What Is Anemia?

Anemia is a condition that occurs when the body cannot produce enough red blood cells to move necessary oxygen towards tissues and organs. It can also occur when there is a large amount of red blood cells; but, some are deformed. This is the case of sickle cell anemia that is a problem often making patients feel weak, dizzy or tired. It can cause breathing difficulties, cold extremities, pale or sallow skin and frequent headaches.

The risk of anemia increases as patients age. In younger people, the problem is often a sign of bad nutrition. Older people with poor diets can become anemic too; but they may also get this blood disorder because of a more severe medical condition like kidney disease. Cancer patients and other people with serious problems also frequently develop anemia. It is essential for anyone who is feeling such symptoms to have their health checked by a professional. Anemia has to be addressed and the best way to do is to get your blood tested.

Anemia is a blood disorder

Types of Anemia

While the symptoms and end result of anemia are the same in all types of this condition, the causes can be very different. For instance, nutritional anemia is usually caused by a lack of vitamins or other important nutrients in the diet. Low folic acid or iron are common, for instance. Many people can correct these issues by consuming more dark leafy green vegetables, nuts, dried fruit and red meat, as well as fortified grains, citrus fruits and beans. Supplementation is also possible; but, many supplements come with some risk and should be taken only under the supervision of a qualified medical professional. This is especially applicable in older patients.

Not all iron deficiency anemia is caused by a poor diet. Many patients suffering from blood loss also develop this problem. If the source of the blood loss isn’t immediately apparent, taking iron supplements can mask the true cause of the problem. For instance, a patient suffering from an internal hemorrhage who uses supplements to treat anemia may have normal ranges in a blood test, but the blood loss will continue to be a problem. While iron deficiency is the most common cause of anemia all over the world, it may not be the most common causative agent among older patients. Professionals explain that only a third of anemic cases in older people are due to iron deficiency. It is essential to be tested and not delay seeking help when you think you might be anemic. For those to pick to put this condition on hold, further complication would start developing such as starting to develop some severe kidney problems, among many others. Talking with your doctor, or other medical professional, as soon as possible, increases the chance of patients getting the right treatment.

Anyone who has a blood test indicating anemia, in the results, should take steps immediately. Finding out the root cause of anemia, especially for older patients, should always take precedence. In some cases, it may be necessary to contact a hematologist or other blood disorder specialist. The cost of additional testing may seem daunting, but it’s worth it on the long run. Patients who take the time to find out the cause of their anemia are more likely to stay healthy and avoid kidney trouble as well as other serious conditions.

Your CBC Test

When you want a comprehensive status of your health and well-being, you need to know about your blood, which does everything from fighting infections to transporting oxygen through your body. A complete blood count (CBC) test gives you a clear, well-rounded understanding of your health and identifies a range of disorders and potential risks. Discover what a CBC test involves and when to get one. Also, find out what you can learn from such an important blood test.

Red Blood Cell Count

One of the most important aspects of a CBC is assessing your red blood cells, or erythrocytes. Red blood cells contain hemoglobin, a protein responsible for carrying oxygen to your body's tissues. Having the right number of red blood cells helps you get the optimal oxygen supply throughout your body, making your red blood cell count critical to your health.

Ideally, you want your count to be within the normal range for red blood cells, which varies slightly between men and women. Men typically have between 4.7 and 6.1 million red blood cells per microliter of blood, while women normally have 4.2 to 5.4 million per microliter. It's easy to assume that a red blood cell count below the normal range could lead to insufficient oxygen levels, while a higher count could mean more oxygen throughout your body. However, both high and low red blood cell counts can lead to complications and serious health issues.

In many cases, conditions like anemia, leukemia, thyroid disorders, or nutritional deficiencies can lower your red blood cell count below the normal range. This low red blood cell count can cause fatigue, dizziness, headaches, pale skin, increased heart rate, and other health issues. In contrast, smoking, congenital heart disease, kidney cancer, pulmonary fibrosis, and other serious conditions can increase your red blood cell count above the normal range. An overly high count can lead to joint pain, tender palms and soles, and difficulty sleeping.

If you notice any of the typical symptoms of a high or low red blood cell count, getting a CBC test could help you pinpoint the problem. If your CBC test reveals an abnormal red blood cell count, talk with your doctor about the cause and determine whether you'll need additional tests to get a proper diagnosis. In some cases, lifestyle changes such as quitting smoking, exercising more, and adopting a more nutritious diet can help you shift your red blood cell count back to a normal, healthy range.

Red Cell Distribution Width

As important as your red blood cell count is, you'll also want to know your red cell distribution width. This test assesses the volume and size of your red blood cells and measures the variation throughout your body. Since red blood cells should have an optimal size to carry sufficient oxygen to your tissues, taking a red cell distribution width blood test can tell you whether they are abnormally small or large. It could also indicate which impact it has on your health.

A red cell distribution width test is a standard part of the CBC test. However, you'll want to pay special attention to these values if you have symptoms like iron and vitamin deficiencies, dizziness and numbness, a family history of blood disorders, or a chronic illness like HIV or AIDS.

A normal red cell distribution width test should reveal red blood cells that measure between 6 to 8 micrometers in diameter. If your test values are higher than normal, there's a chance you have anemia, a nutrient deficiency disorder, blood disorders like thalassemia, liver disease, heart disease, or certain cancers. Ask your doctor to review the test results with you; and, find out if you need additional tests or treatment to address the abnormal results.

White Blood Cell Count

Low red blood cell count can indicate anemia

Although red blood cells make up a larger proportion of your blood, white blood cells are just as important to your health. Also known as leukocytes, white blood cells are responsible for keeping your body free from infections and invaders. They are responsible for attacking viruses, keeping bacteria out of your bloodstream, and preventing you from getting sick, but not all white blood cells are identical. Your body makes five different types that specialize in digesting bacteria, creating antibodies, destroying cancer cells, triggering allergic reactions, and many more immune-related tasks.

Like red blood cell count, normal white blood cell count varies slightly between men and women. Men typically have 5,000 to 10,000 white blood cells per microliter of blood, while women generally have 4,500 to 11,000 per microliter. Since most white blood cells have an average lifespan of only a few days, a white blood cell count outside of the normal range can indicate a problem with your bone marrow's ability to produce these cells or a serious illness that impacts your body's ability to maintain a healthy supply of these cells.

Both high and low white blood cell counts can indicate short-term or long-term health problems. Illnesses related to HIV or AIDS as well as cancer-related chemotherapy and radiation treatments can all cause low white blood cell counts. Infections, certain medicines, myeloproliferative disorder, and blood cancers such as leukemia and lymphoma can cause overly high white blood cell counts.

Whether your count is too high or too low, talk with your doctor about additional tests, physical exams, and other steps you should take to address the issue or any underlying conditions. In many cases, you'll need to complete white blood cell count tests routinely to make sure your body is producing and maintaining a healthy level of these cells.

White Blood Cell Differential Count

While your white blood cell count can reveal a lot about your health, you also need to check your white blood cell differential count. Although this count is a standard part of the CBC test, your doctor might request a white blood cell differential count specifically to assess whether you have a condition like anemia, leukemia, or a serious infection. This count measures the percentage of each of the five types of white blood cells to confirm that you have a healthy ratio of each.

A normal white blood cell differential count typically has the following percentages of each type of white blood cell:

  • Basophils: 0.5 to 1 percent
  • Eosinophils: 1 to 4 percent
  • Lymphocytes: 20 to 40 percent
  • Monocytes: 2 to 8 percent
  • Neutrophils: 40 to 60 percent
  • Young Neutrophils: 0 to 3 percent

Abnormally high or low white blood cell differential count can point to a wide range of conditions. For example, a high percentage of neutrophils may come from eclampsia or rheumatoid arthritis, while a low percentage of neutrophils may happen due to the flu or a serious bacterial infection. A high percentage of lymphocytes could indicate to mononucleosis or blood cancer, while a low percentage of lymphocytes may happen due to chemotherapy or sepsis. If your results are outside the normal range, consult with your doctor for additional testing and treatment.

Platelet Count

A CBC test does not only mean counting red and white blood cells. This comprehensive test also assesses your platelet count. After all, platelets might be the smallest components of your blood, but these cell fragments have an important job. They respond to signals about cell damage, which prompts them to change shape as necessary, bind together, form clots, and stop bleeding.

Taking a CBC test can reveal whether your platelet count is within the normal range, which is between 150,000 and 450,000 platelets per microliter of blood. Like all components that make up your bloodstream, platelets should be within that normal range to keep you healthy. An overly low or high count can signal a serious condition.

Also known as thrombocytosis, a high platelet count can cause excessive and spontaneous blood clots in your vessels, which may lead to a heart attack or stroke. Whether bone marrow problems or ongoing conditions like anemia are the cause of your thrombocytosis, your doctor can suggest an effective course of action.

If you have a low platelet count, or thrombocytopenia, you could suffer from frequent bruising or bleeding. Issues ranging from medications and treatments to kidney infections and excessive alcohol consumption can lead to a low platelet count, and your doctor can advise about an appropriate resolution.

Mean Platelet Volume

An optimal platelet count is essential to good health; but, platelet volume and size are just as important. A mean platelet volume test checks the size of these tiny cell fragments, as this measurement impacts your platelets' ability to form clots.

A normal mean platelet volume is typically between 2.65 and 2.9 micrometers in diameter. Since larger platelets are usually younger, an abnormally high mean platelet volume may mean your body produces too many of these cell fragments. In contrast, an overly low result may mean that you are not producing enough new platelets, which could be linked to conditions like inflammatory bowel disease or certain types of anemia.

Although you should talk with your doctor about any CBC test abnormalities, it's important to know that a high or low mean platelet volume doesn't necessarily indicate a serious health concern. After all, lifestyle factors, like exercising frequently or living in a high-altitude location, can impact your platelet size and volume without causing a disorder or health issue. If your test results are outside the normal range, consult with your doctor. He will compare your mean platelet volume to your platelet count and other CBC test factors to determine whether you need treatment.

Hematocrit

While red blood cells typically make up a large portion of your blood, it's important to get an exact measurement. That's why a CBC profile also includes a hematocrit test, which assesses the proportion of red blood cells to the total volume of blood in your body. Also known as a packed-cell volume test, this assessment is standard if you suspect that you might have anemia or if you have related symptoms like fatigue, dizziness, or pale skin.

Normal ranges for hematocrit tests change significantly as you age and undergo major life changes like pregnancy. Standard hematocrit levels for men are usually between 42 and 54 percent, while normal levels for women are between 38 and 46 percent.

A hematocrit level below the normal range could point to conditions like ulcers, internal bleeding, sickle cell anemia, cancer, or nutritional deficiencies. A high hematocrit level could indicate dehydration, overproduction of red blood cells, or congenital heart disease, but it may also result from living in a high-altitude place. If your hematocrit levels are high or low, ask your doctor whether you need treatment. In general, slightly abnormal levels don't require additional action, but extreme levels may suggest a serious health concern that demands urgent care.

Hemoglobin

Since hemoglobin is responsible for critical tasks such as moving oxygen throughout your body and exchanging carbon dioxide for oxygen, understanding your hemoglobin count is essential. A CBC test includes your hemoglobin count, which is typically between 14 and 18 grams per deciliter for men and between 12 to 16 grams per deciliter for women.

If your hemoglobin count is lower than the normal range, you are basically considered anemic. While anemia is not uncommon, it could result from a range of causes that include nutritional deficiencies, kidney failure, blood loss from ulcers or certain types of cancer, or bone marrow problems. No matter the cause of your low red blood cell count, you will want to talk with your doctor about treatments and additional steps to maintain your health. In some cases, you may also want to follow up about your risk for related conditions like Hodgkin's lymphoma, cirrhosis, or hypothyroidism.

A hemoglobin count that's higher than normal typically results from a body that is compensating for a lack of oxygen. Living at a high altitude and undergoing some temporary dehydration can both increase your hemoglobin count; so, can smoking. Your doctor can advise whether a high hemoglobin count is a cause for concern and whether you should take steps to address any related symptoms.

Diagram of hemoglobin molecule

Mean Corpuscular Volume

When you order a CBC test, you'll also determine your mean corpuscular volume (MCV), a test that measures the average size of your red blood cells. While this test is a standard part of the CBC, your doctor may also recommend this test if you have symptoms like constant fatigue, unusually cold hands and feet, or abnormally pale skin. Since these indicators often result from blood disorders, an MCV test can help you understand the cause of your symptoms and assess possible treatments.

For adults, the normal MCV is between 80 and 96 femtoliters. A substantially lower result indicates that your red blood cells are unusually small, which could signal anemia or thalassemia, an inherited condition linked to anemia. A notably higher result indicates overly large red blood cells, which could signal that you have liver disease, hypothyroidism, or a B vitamin deficiency.

If your MCV is outside the normal range, your doctor will typically assess the results in relation to other factors like your hemoglobin and red blood cell count. From there, your physician may recommend additional testing to rule out serious conditions or prescribe a course of treatment for anemia.

Mean Corpuscular Hemoglobin

Sufficient hemoglobin is essential for healthy blood. A mean corpuscular hemoglobin (MCH) test, which is standard with a CBC test, can tell you exactly how much hemoglobin is present in each of your red blood cells. If your count is higher or lower than average, it will not be very obvious at first and you will not notice any symptoms. If your condition changes, or your levels do not improve over time, you may notice a loss of stamina, tiredness, dizziness, confusion, and weakness.

For adults, a normal mean corpuscular hemoglobin level is 27 to 33 picograms per cell. Conditions including macrocytic anemia, liver disease, overactive thyroid, cancer-related complications, and excessive alcohol consumption can all cause your MCH level to be higher than normal. Since these conditions can all have significant effects on your health, your doctor may suggest a treatment plan that incorporates strict changes to your diet.

A result below the normal range may indicate common issues like anemia, nutritional deficiencies, or some level of malnutrition. A low MCH level may also result from a related condition like celiac disease or excessive menstruation, both of which may lead to anemia. Depending on your health history and the potential causes of your low hemoglobin level, your doctor may recommend a vitamin or nutrition assessment, a diet or lifestyle change, or some other treatment.

Mean Corpuscular Hemoglobin Concentration

Closely related to your MCH level, your mean corpuscular hemoglobin concentration (MCHC) is a strong indicator of how healthy your hemoglobin is. This test reveals the average weight of your red blood cells' hemoglobin by comparing it against the volume of your red blood cells.

Like other components of the CBC test, MCHC test results that are above or below average can indicate a range of health problems. Most adults have an MCHC value between 33.4 and 35.5 grams per deciliter. Low MCHC levels could suggest anemia, which may be related to issues like Crohn's disease or celiac disease, as well as more rare conditions like parasitic infections or certain cancers. If your test results suggest one of these issues, your doctor may recommend additional blood tests or an endoscopy, or perhaps will suggest treatments that address low iron levels or excessive blood loss.

If your MCHC levels are higher than average, you may have autoimmune hemolytic anemia, especially if you have symptoms like chest pain, abdominal discomfort, weakness, or fainting. These results could also signal a condition like hereditary spherocytosis, which includes symptoms such as jaundice and gallstones. Your doctor will likely reference the rest of your CBC test and consider your health and family history before making a diagnosis or creating a treatment plan.

Indicators of Health Problems

By assessing many components of your blood, a CBC test can be incredibly helpful in detecting potentially serious health problems. Although a CBC doesn't always provide a direct diagnosis for conditions or disorders, this test can alert your doctor to health issues and offer a roadmap for additional testing and diagnosis. Since your CBC test reflects both your results and the average range, you can easily determine whether your blood is considered normal or if you may have a health concern.

While a CBC test most often identifies anemia and related conditions, it can also enable your doctor to pinpoint debilitating infections, life-threatening problems with your bone marrow, or blood cancers like leukemia. This test can alert your doctor of internal bleeding or conditions that prevent your body from producing a sufficient quantity of platelets or blood cells. If you have common symptoms like fatigue and weakness, a CBC test can help your medical team find the root cause. Your CBC test can also reveal important vitamin and nutrient deficiencies and help you correct them before they cause long-term effects.

What does High MCH Results in your Blood Test mean

MCH stands for Mean Corpuscular Hemoglobin, and is a calculation of the average amount of hemoglobin contained in each of a person's red blood cells. Hemoglobin is the substance that carries oxygen from the lungs, to the cells through the bloodstream. Abnormally high or low levels of MCH, as determined by blood testing, can be an indication of a number of problems in the body, ranging from nutrient deficiencies to chronic diseases.

The MCH blood test is done as a component of a blood test called a Complete Blood Count (CBC), which evaluates the composition of the blood, checking hematocrit, white blood cells (WBC) and platelets as well as hemoglobin and red blood cells (RBC). It is usually required to get an overview of one’s general health. MCH is not measured directly, but calculated based on the hemoglobin value (Hgb), which is the total measure of hemoglobin in the blood; and the RBC, which is the number of red blood cells in the blood. To calculate MCH, the Hgb is divided by RCB, yielding an average amount of hemoglobin per red blood cell. Normal levels of MCH are between 26 and 33 picograms (pg) of hemoglobin per RBC.

What Is High MCH and What Can It Mean

MCH levels over 34 pg are generally considered abnormally high. The most common reason for high MCH is macrocytic anemia, which is a blood disorder in which the body fails to produce enough red blood cells. In macrocytic anemia, red blood cells that are produced are larger than usual, each carrying more hemoglobin than normal-sized cells would. This condition can be caused by deficient levels of vitamin B-12 or folic acid in the body; nutrients found in foods like fish, liver, green leafy vegetables and fortified cereals. These contribute to efficient red blood cell production and may be lacking in your diet, you may not be able to absorb them or there may be other reasons your body cannot process them. Symptoms of macrocytic anemia can include:

  • Unexplained fatigue
  • Heart palpitations
  • Pallor
  • Heart complications

Since this can interfere with heart function, early diagnosis of macrocytic anemia is important.

Other possible reasons for a high MCH test include several other forms of anemia, thyroid dysfunction, chemotherapy, certain infections, over use of estrogen-containing medications, some forms of leukemia and hereditary spherocytosis; a condition that causes a shortage of red blood cells.

What Low MCH Test Results Can Indicate

MCH levels below 26 pg are considered abnormally low. Common causes of Low MCH include blood loss, iron deficiency and microcytic anemia, which is a condition in which red blood cells are abnormally small, carrying less hemoglobin. Other potential causes of a low MCH test include hemoglobinopathy, which is a group of disorders that cause changes in the structure of hemoglobin, and iron-deficiency anemia.

If you have had a CBC done; and, results show MCH levels that are higher or lower than normal, further investigation is warranted. While abnormal results are not necessarily an indication of serious health issues, as noted in the above lists; they can be significant, so it is important to rule them out. Many of the possible causes of abnormal MCH levels require treatment to protect health and well-being, such as anemia or other blood disorders, thyroid disease and nutritional deficiencies.

Your doctor may be able to determine the cause of abnormal MCH results with the help of other components of the CBC, such as MCV results, which measure the average size of red blood cells, or MCHC, which measures hemoglobin concentration. Blood tests to determine your nutritional status may also be done to determine whether nutritional deficiencies are an issue. If your doctor suspects thyroid disease to be the root cause of your abnormal MCH levels, a blood test called a thyroid function panel may be needed to evaluate the health and function of your thyroid gland. Depending on an evaluation of your general health and any symptoms you may be experiencing, your doctor may order a variety of other tests to determine the cause of your high or low MCH results.

A CBC is commonly included in a bloodwork ordered by your doctor during an annual checkup. Also included in this standard test bundling is a comprehensive metabolic panel (CMP), urinalysis, hemoglobin A1c, and lipid panel. This package is available at Health Testing Centers for only $89.

Information on Treatment Effectiveness

Many doctors order CBC tests to identify unknown problems; but, this blood test can also provide helpful information about existing health concerns and the progress of your treatment. If you're taking a medication or following a treatment plan, your doctor may order periodic CBC tests to assess how effective the therapy has been as well as to determine how to proceed.

If you have already been diagnosed with anemia or another blood disorder, routine CBC tests can help your medical team monitor your health over an extended period of time. While a CBC test can be particularly helpful if you're undergoing chemotherapy or radiation treatment, this test can also check your red and white cell count and confirm other blood count metrics. This will allow your doctor to assess how well a prescription medication is working. Since a CBC test can be essential for assessing a person’s general health, it may be wise to order it once a year. It is convenient, affordable and only takes a couple of minutes to be completed. It's a smart way to gain key insight about your health and medical treatments.

Whether you want to assess how effective your medical treatments are or you are just curious about potential health risks, a CBC can answer your questions. By giving you a complete picture of your health status, this common blood test can also provide both you and your doctor with a wide range of information about your overall condition. Order a complete blood count test from Health Testing Centers to get a better handle on your health today.

Know the Signs of Anemia to Protect Your Health

Anemia is a condition in which there are fewer red blood cells in the body than normal, It is also when red blood cells present in the body do not function properly. Since red blood cells transport oxygen throughout the body, a shortage or malfunction of these vital cells can have serious effects on health. Anemia is one of the most common blood disorders, affecting more than 3 million Americans. Symptoms of anemia vary according to the type and severity of the disorder and its underlying causes.

What is Anemia?

Red blood cells carry hemoglobin, an iron-rich protein that bonds with oxygen in the lungs and transports it to cells throughout the body. Anemia is a family of disorders that affect the red blood cells, reducing the amount of them in the bloodstream or the amount of hemoglobin they carry. Some of the main causes of anemia include:

Blood loss – While blood loss from acute injuries can cause anemia, the more common cause is gradual, often undetected, blood loss. Many women suffer borderline anemia with blood loss during the monthly menstrual cycle, and GI bleeding, which can occur with conditions like ulcerative colitis, diverticulitis and colon cancer, or with daily use of certain medications, such as aspirin or NSAIDS. Hemorrhoids, gastric ulcers and intestinal parasites are other common causes of blood loss that can lead to anemia.

Impaired red blood cell production – If the body fails to produce an adequate supply of replacements for aging red blood cells, anemia can occur as the overall number of red blood cells in the bloodstream diminishes. Inadequate red blood cell production can be caused by nutritional deficiencies, such as low levels of iron, vitamin B-12 and folic acid in the body. Damage or disease in the bone marrow, where red blood cells are produced, can be the underlying cause as well, and can stem from autoimmune diseases, radiation, viral hepatitis, kidney disease and some medications, among other causes.

High rates of red blood cell destruction – Anemia can occur when red blood cells are destroyed at a faster rate than healthy bone marrow can produce new cells to replace them. The spleen is primarily responsible for the destruction of aging red blood cells, filtering them from the bloodstream to be broken down. A variety of diseases and health conditions, including malaria, lupus and tuberculosis, can cause the spleen to enlarge, which can lead to accelerated red blood cell destruction and anemia. In inherited forms of anemia, such as sickle cell disease or thalassemia, red blood cells are deformed, causing the spleen to trap and destroy them. Over time, this heavy work load typically results in spleen enlargement, which steadily increases the rate of red blood cell destruction.

Other causes include a hormone deficiency, vitamin deficiency due to a chronic condition like Crohn's, and pregnancy.

Common symptoms of anemia

Symptoms of Anemia

  • Frequently reported symptoms of anemia include:
  • Weakness
  • Fatigue
  • Lightheadedness or dizziness
  • Shortness of breath
  • Rapid or irregular heartbeat
  • Headache
  • Cold hands and feet
  • Abnormally pale skin, nail beds and/or mucus membranes
  • Jaundice, or yellowing of the skin and/or whites of the eyes
  • Chest pain
  • Ringing, pounding or whooshing sounds in the ears
  • Mental confusion
  • Irritability, depression or mood swings

Since the symptoms of anemia can also be risk factors of other diseases and disorders, they could possibly be overlooked or misdiagnosed. In fact, anemia is usually discovered through abnormal blood test results, rather than recognized by means of its signs and symptoms.

Diagnosis and Treatment

Diagnosis of anemia is done by means of a physical examination to detect any signs or symptoms of anemia; and, one will need some blood testing. Initial screening is generally done with a blood test called a Complete Blood Count, or CBC, which measures the number, size, hemoglobin content and volume of red blood cells in the bloodstream. Other blood tests that may be used to confirm an anemia diagnosis and/or help determine causes of the disorder include testing of blood iron, B-12 and folate levels, and testing for indicators of autoimmune disorders, red blood cell fragility, enzyme defects and red blood cell abnormalities that can lead to anemia.

Treatment depends largely on the type, severity and causes of anemia, and can include medications, blood transfusions, dietary changes and supplementation. When the cause of anemia lies in chronic diseases or health conditions, treating those underlying causes can often improve or resolve anemia.

Treating Anemia

Treating Anemia Effectively Means Finding Its Source

Anemia is a blood disorder in which an individual's blood does not contain enough red blood cells to circulate oxygen efficiently or the red blood cells in the bloodstream do not contain enough hemoglobin to carry oxygen in sufficient quantities. The chief goals of anemia treatment are:

  • To raise an affected individual's red blood cell count or hemoglobin
  • To treat the underlying causes of anemia
  • To prevent complications of the disorder, which can include heart and nerve damage
  • To alleviate anemia symptoms which may include fatigue, shortness of breath and cardiac symptoms, among others.

The means of reaching those goals differs according to the type of anemia diagnosed and its underlying causes, as determined by medical testing.

Iron Deficiency Anemia

Iron is essential to the production of a protein in red blood cells called hemoglobin, which, in turn, is essential to oxygen transportation to all cells within the body via the bloodstream. Iron deficiency can happen due to a supply problem, such as inadequate amounts of dietary iron consumption or poor iron absorption, or can be a demand issue, with the body producing more new red blood cells than normal to compensate for blood loss, growth spurts or pregnancy, depleting the body's iron stores.

The two most common forms of iron deficiency anemia treatment are dietary changes and iron supplements. Supplements are generally used to accomplish a rapid increase in iron stores in the body or in cases of severe deficiency. They are available in prescription and over-the-counter forms, and may be necessary for several months or longer.

Dietary changes include the addition of iron-rich foods to the diet, such as lean meats, seafood, iron-fortified cereals, cooked dry beans, and dark green leafy vegetables. Doctors generally recommend that iron-rich foods be combined with foods rich in vitamin C, like citrus fruits or tomatoes, since it boosts iron absorption.

When iron deficiency anemia is severe or is linked to certain health conditions, other treatments may be necessary. Among the possibilities are blood transfusions, medications to increase red blood cell production or surgical intervention to address sources of internal bleeding.

Pernicious Anemia

Another nutrition-related form of anemia, pernicious anemia occurs when the body is deficient in vitamin B-12 due to poor absorption. Since B-12 is essential to the production of healthy red blood cells, deficiency decreases the number of them in the bloodstream. Absorption can be hindered by intestinal problems, poor dietary intake or a lack of intrinsic factor, a protein made in the stomach that facilitates B-12 absorption.

Pernicious anemia treatment involves taking care of one’s B-12 deficiency, most commonly done with B-12 shots. High-dose B-12 oral supplement or nasal sprays may be an option for some patients. Increasing dietary intake of B-12 rich foods in the diet, such as meat, fish, eggs, and dairy products is typically recommended.

Aplastic Anemia

Aplastic anemia stems from damaged bone marrow, which manufactures red blood cells, and impairs production of red blood cells, as well as white blood cells and platelets. Aplastic anemia is rare, but serious, and can be inherited or caused by certain diseases, treatments, drugs or toxins, among other factors. Treatment may include blood transfusions, stem cell transplants and medications.

Hemolytic Anemia

This is a condition in which the body destroys red blood cells too early, before their average lifespan of 120 days is complete. When so many are destroyed that the body cannot replace them, anemia occurs. It can be caused by hereditary red blood cell abnormalities, such as sickle cell or thalassemias, autoimmune disorders and certain diseases, infections, drugs, or toxins. Treatment depends upon the underlying causes, but may include medications, nutritional supplements, blood transfusions, and stem cell transplants.

Testing and Diagnosis: An Essential First Step to Appropriate Anemia Treatment

While these are the major forms of anemia, there are many others, and an accurate diagnosis is essential to appropriate and successful treatment of anemia and its underlying causes. For that reason, a patient who shows symptoms of anemia or has had signs of the disorder discovered during routine medical care should be thoroughly evaluated before any treatment begins.

Typically, that evaluation begins with a blood test called a Complete Blood Count, or CBC. This test is used to determine the number of red blood cells in the bloodstream, as well as their size, volume and hemoglobin content. Depending upon CBC results and other factors, such as personal and family health history, other testing may be indicated, such as B-12 and folate levels, testing for antibodies and other factors that can indicate autoimmune disorders, bone marrow tests, enzyme testing or liver function testing, among others. Additionally, in cases of anemia due to blood loss, various imaging procedures may be used to locate sources of internal bleeding.

Dietary changes include the addition of iron-rich foods to the diet, such as lean meats, seafood, iron-fortified cereals, cooked dry beans, and dark green leafy vegetables. Doctors generally recommend that iron-rich foods be combined with foods rich in vitamin C, like citrus fruits or tomatoes, since it boosts iron absorption.

When iron deficiency anemia is severe or is linked to certain health conditions, other treatments may be necessary. Among the possibilities are blood transfusions, medications to increase red blood cell production or surgical intervention to address sources of internal bleeding.

References:

Your guide to anemia. National Heart, Lung, and Blood Institute. www.nhlbi.nih.gov/files/docs/public/blood/anemia-yg.pdf

Marx JA, et al., eds. Anemia, polycythemia and white blood cell disorders. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2014.

Schrier. S,L. Approach to the adult patient with anemia. www.uptodate.com/home

Anemia. National Heart, Lung, and Blood Institute. www.nhlbi.nih.gov/health-topics/anemia

World Health Organization. Micronutrient deficiencies. (n.d.).

U.S. Department of Health & Human Services -National Heart, Lung and Blood Institute. Other names for anemia. (2012). Retrieved from www.nhlbi.nih.gov/health-topics/anemia

U.S. Department of Health & Human Services -National Heart, Lung and Blood Institute. What are the signs and symptoms of iron-deficiency anemia? (2014). Retrieved from www.nhlbi.nih.gov/health-topics/iron-deficiency-anemia#Signs,-Symptoms,-and-Complications

U.S. Department of Health & Human Services -National Heart, Lung and Blood Institute. What is anemia? (2012). Retrieved from https://www.nhlbi.nih.gov/health/health-topics/topics/anemia/