Anemia is a disorder in which a person lacks the number and size of red blood cells, or the shape and concentration of hemoglobin, to carry adequate oxygen to the body. This fact causes a series of symptoms in the person suffering from this condition.
Dr. Amparo Santamaría Ortiz, specialist in Hematology and Head of the Department of Hematology of the University Hospitals Vinalopo-Torrevieja, in Alicante, answers some of the most frequent doubts that arise in relation to this disorder.
What types of anemia are there?
There are an infinite number of types of anemia, but there are some that are more frequent. Among them are:
- Anemias due to nutrient deficiencies: anemia due to lack of vitamin B12, anemia due to lack of iron and anemia due to lack of folic acid.
- Anemias associated with chronic diseases: such as inflammatory diseases like lupus or cancer.
- Hereditary anemias: such as thalassemia.
The most common anemia in the world, which, according to the WHO (World Health Organization) is the second cause of morbidity in the world, is iron deficiency anemia, which is an indicator of nutrition and health.
What are the symptoms that indicate a case of anemia?
The most common symptoms include feelings of fatigue, tiredness, weakness and skin pallor. Severe anemia can even cause shortness of breath, dizziness, chest pain and tingling, among other symptoms.
In iron deficiency anemia there is a very significant symptom, which is the so-called “pica”, which is the intense desire to eat and chew substances that have no nutritional value, such as ice, clay, earth or paper.
What are the causes of anemia?
Anemia depends on multiple causes. The most frequent is iron deficiency anemia, which has its origin in an inadequate intake of iron-containing foods, such as red meat. It can also be caused by blood loss through the gastrointestinal tract or by heavy menstruation in women.
In other types of anemia, such as B12 deficiency, the origin is found in a poor food intake, or because the vitamin is not well absorbed by the digestive tract. This type of anemia is known as pernicious anemia.
On the other hand, the cause of chronic anemias is an inadequate iron metabolism associated with the underlying disease or age.
In other cases, it is because the bone marrow stops making red blood cells, as happens in blood cancers, such as leukemia, myeloma, etc.
In thalassemia, the cause is genetic, where the red blood cells are smaller, but in most cases, they are asymptomatic.
What treatment should be followed to correct anemia?
Treatment depends on the type of anemia. If it is a deficiency type, iron supplements, vitamin B12, folic acid or other vitamins and minerals should be taken orally or intravenously, although in the case of vitamin B12 it can also be intramuscular.
In other cases, depending on the cause, Erythropoietin (known as EPO), a drug that helps the bone marrow produce more blood cells, may be given. And in some cases, blood transfusions may be given.
What is the relationship between anemia and pregnancy?
It should be noted that anemia can be a cause of infertility, so women who want to become pregnant should be tested for anemia.
During pregnancy the most common types of anemia are
- Anemia of pregnancy: this is a decrease in hemoglobin due to dilution, since during pregnancy the woman retains fluids and, when counting red blood cells, it appears that there are fewer, but it is dilutional and is not considered abnormal.
- Iron deficiency anemia.
- Iron deficiency anemia.
- Anemia due to B12 deficiency.
- Anemia due to folic acid deficiency.
Anemia during pregnancy has its origin in the fact that, during the gestation period, the baby usually needs iron to grow and develop, so it takes nutrients from the mother.
In these cases, anemia manifests itself with different more or less intense symptoms, such as tiredness, weakness, tingling and sometimes shortness of breath.
To avoid anemia during pregnancy, it is important that, during this stage, the patient is closely monitored with blood tests by a hematologist, to assess the different treatments needed. In general, to avoid anemia it is necessary to follow a good diet adapted to each woman and with the necessary supplements. The proper diet, if there are no contraindications, should include red meat, fish (well cooked seafood: clams and mussels) and with low mercury content such as salmon or cod. They should also eat foods of animal origin such as milk, meats, eggs and poultry, as they can prevent vitamin B12 deficiency. Vegan women, who do not eat plant-based foods, are the most likely to be vitamin B12 deficient and often need vitamin B12 injections and other supplements during pregnancy.