Yasmin Williams
ANAEMIA IS the medical
condition in which the red cells in the blood are not able to take enough oxygen to the body's cells. This occurs either because there are too few red blood cells or because the haemoglobin the iron-containing protein in the red blood cells is not adequate.
We can put causes of anaemia in three main groups conditions causing loss of red blood cells; conditions which produce increased destruction of red cells; and conditions which cause decreased production of red cells.
LOSS OF RED BLOOD CELLS
Loss of red blood cells may occur quickly, acutely or may occur slowly over a longer period of time chronic loss. Acute loss of red blood cells may occur, as a result of blood loss because of trauma to the body as in a motor vehicle accident or during surgery or accompanying child birth. Chronic loss of red blood cells may go undetected for quite a long period of time and may be the result of heavy menstrual periods, ulcers and cancerous growths of the stomach and intestines, worm infestation and haemorrhoids or 'piles'. Chronic blood loss may also be the result of blood in the urine because of disease in the kidney.
Increased destruction of the red cell occurs because there is either abnormality of the red cell or the haemoglobin which the red cell contains. Many of these
conditions are hereditary and therefore cannot be prevented, for example, sickle cell disease and thalassemia where there is
bnormal haemoglobin and
hereditary spherocytosis where there are abnormally-shaped red cells which die prematurely. There are also the cases of autoimmune haemolytic anaemia where the body does not recognise the red cells as 'self' and produces chemical (antibodies) to the red cells with subsequent
premature destruction.
Iron-deficiency anaemia is said to be the most common type of anaemia and occurs when there is not enough iron in the body. Normally, when the red cells in the body die, the iron in them is recycled. Blood loss depletes the body of this iron for new cell
production. Not enough iron in the diet can also cause iron-deficiency anaemia. Vitamin C enhances the absorption of
iron-rich foods which are
especially important for children during their growth spurts and for pregnant and menstruating females.
Folate and B12 deficiency anaemia occur because of absence in the diet or problems related to absorption. It is
suggested that women in the childbearing age take folate to prevent birth defects. In most cases of vitamin B12 deficiency, the stomach cannot absorb B12 due to the absence of a substance called intrinsic factor
(autoimmune condition) and these persons must take vitamin B injections for life! Much B12 is found in meat and dairy and therefore strict vegetarians may not get enough B12 in their diets. However, dietary-related B12 deficiency is said to be rare.
CHRONIC DISEASE
Anaemia is also associated with chronic disease, such as AIDS, cancer, rheumatoid
arthritis, lupus, kidney disease. These conditions interfere with the production of the red blood cells.
Drug therapy for cancer, radiation therapy and other 'toxins' can cause decrease production of not only red cells but also white cells (needed to fight infection) and platelets (needed to prevent bleeding). This condition called 'aplastic anaemia' can be life-threatening.
If you are at risk for 'anaemia', do not wait to experience the dizziness, weakness, breathlessness and easy fatiguability which can occur as your haemoglobin level falls. Take control. See your doctor or health care provider for a routine blood count and further studies.
Dr. Yasmin Williams is a family doctor and public health specialist; email: yourhealth@gleanerjm.com.
