What is causing the Anemia?

Introduction

A common complaint most Nigerians present with in the hospital is ‘’Doctor, I think I am short of blood’’ or ‘’I think I have low blood’’. Some patients have their various reasons; it could be that they get tired persistently or they feel they are pale even when everyone thinks otherwise. Sometimes it is because they have just finished a course of antibiotics and wrongly believe that taking a blood tonic must follow. In most cases, they have not got anemia!

Definition

Anemia is a condition where there is a decreased amount of red blood cells or haemoglobin such that there is not enough to carry the required amount of oxygen to the tissues. It is said to occur in men when the haemoglobin level is less than 13.5 g/100ml and in women with haemoglobin is less than 12g/100ml.

Anemia may be caused by three major mechanisms • Blood loss: From trauma causing bleeding, gastrointestinal bleeding especially from ulcers or diverticular disease, heavy menstrual periods, cancers, such as colon or gastric cancers. • Reduced red blood cell production: from deficiency of nutrients such as iron for example as seen in hookworm infestation which is common in Africa, deficiency or low vitamin B12 and folate, some chronic illnesses such as kidney or liver failure, also low red cell production in diseases of the bone marrow (where production of red cells takes place) • Increased red blood cell destruction: May occur in sickle cell anemia, in infections such as malaria, in autoimmune disease and as a side effect of some medications. Anemia is also common in pregnancy and inherited conditions such as G6PD deficiency.

Anemia may be asymptomatic, meaning without symptoms, especially in its mild form. Common symptoms are varied and sometimes depends on the cause of anemia. They include tiredness, easily fatigued, palpitations or fast and irregular heart beat, headache, pale skin, chest pain and dizziness. Note that any of these symptoms could be as a result of other disease conditions, therefore a proper diagnosis is always required before the conclusion is reached that the problem is anemia. A blood test is required to confirm anemia and the type of anemia.

Treatment

In treating anemia, sometimes the only requirement is to eat a healthy diet rich in iron, folate and vitamin B12 such as green leafy vegetables, beef, beans, seafood, nuts and some cereal. You may also be required to take supplements as prescribed by the doctor. This is very important because in some cases of anemia, taking iron supplement is forbidden while in other cases taking a folic acid supplement could be harmful. Other treatment options include treatment of the underlying cause of anemia, deworming in the case of hookworm infestation, blood transfusion to replace sudden blood loss and surgery in some cases.

Prevention

Although some causes of anemia are not preventable, some are: premarriage and preconception counseling may be necessary if you have inherited disorders such as sickle cell and thalassemia. Eating a balanced diet may help prevent deficiencies, regular deworming which is always a plus in Africa. Tips: Do not start blood tonic except you are sure you have anemia. Let your doctor alone determine the type of supplements you can take. Eat iron rich food to prevent anemia. Get genetic counseling prior to marriage and conception if you have inherited disorders that may lead to anemia.

Written with Dr. D. Talabi, Family Medicine Physician, Lagos.
Dr. Ngozi Onuoha. Copyright 2016, Health4Naija LLC. All Rights Reserved.
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