Feeling run down? It could be anemia.
Anemia is a silent condition.
Anemia starts out as a subtle feeling of constant tiredness. As it progresses, you can’t concentrate, you feel dizzy and your head aches. Advanced anemia causes heart palpitations, cold feet and hands, shortness of breath and chest pain.
Anemia occurs when blood does not transport enough oxygen to the rest of the body. In a healthy person, oxygen is transported from the lungs to the rest of the body by hemoglobin, a protein manufactured by bone marrow and found in red blood cells. As red blood cells circulate through the lungs, the hemoglobin contained in these cells picks up the oxygen and carries it through the bloodstream, feeding other cells in the body.
When the body does not have enough iron, the bone marrow cannot produce hemoglobin and the body becomes anemic.
The symptoms of anemia may mimic those of a heart attack, since both conditions are caused by lack of oxygen. If you experience heart palpitations, shortness of breath and chest pain, you should see your health care provider immediately to rule out a heart problem.
In addition to iron deficiency, anemia can be caused by deficiencies of folate and vitamin B-12. Diseases such as cancer, rheumatoid arthritis, Crohn’s disease, kidney failure, as well as genetic disorders can also cause a person to become anemic. Sickle cell anemia can be very serious and could lead to death if not treated.
Other conditions such as blood loss due to an injury, heavy periods and pregnancy may also cause the condition.
About 20 percent of women, 50 percent of pregnant women, and 3 percent of men do not have enough iron in their bodies. The solution, in many cases, is to consume more iron-rich foods.
Anemia and women – the hidden dangers
Anemia occurs when there is a shortage of red blood cells or when these red blood cells don’t have enough hemoglobin, a protein that carries oxygen from the lungs to all parts of the body. Hemoglobin is what gives blood its bright red color. And as the traditional phrase suggests, “red blooded” women (and men) are more energetic and powerful than those with anemia.
According to Stacey Gusman, DNP-C, a family nurse practitioner with Ministry Victory Medical Group’s Owen clinic, “In addition to fatigue and weakness, symptoms include dizziness, headache, numbness in the hands and feet, sallow skin, pale lips and nail beds, a low body temperature, irritability and, in extreme cases, shortness of breath and chest pain. Anemic people tend to lag behind the crowd at school and at work simply because their hearts have to work harder to deliver oxygen to the body.” About 10 times as many women as men develop iron-deficiency anemia, the most common kind. In fact, more than 20 percent of American women are anemic, but the majority don’t know they are and attribute the symptoms to stress and the rigors of daily life.
Generally, anemia develops because of:
- blood loss.
- an inability to make enough red blood cells.
- an abnormal break down or destruction of red blood cells.
Gusman explains, “There are many types of anemia. By far the most common is iron-deficiency anemia. Iron is needed for the production of hemoglobin, and a deficiency can develop for several reasons.” Gusman outlines the following potential reasons for iron deficiency anemia.
Menorrhagia is the medical term for heavy menstrual bleeding. Heavy menstrual bleeding may by itself be a reason to see your doctor since it could lead to anemia. In many cases, menorrhagia is caused by uterine fibroids, non-cancerous growths in the uterus that appear during the childbearing years.
Pregnancy causes changes in a woman’s body that create an increased need for iron. Particularly during the last trimester, a woman’s blood volume will increase by as much as 50 percent. During this time, the baby will be storing iron for its first 6 months of life and will take all he or she needs regardless of what the mother has available. If the mother is anemic at this time, the baby may not get enough.
Postpartum anemia is common and exaggerates the stress and fatigue that all new parents experience. Particularly vulnerable are women who were anemic during the last trimester, had multiple births or lost a lot of blood during childbirth. One study of first-time mothers found that 22 percent had postpartum anemia (hemoglobin of less than 10grams/deciliter) and that these mothers had a high frequency of insufficient milk syndrome, resulting in a tendency to quit breast feeding early.
Diet plays a roll. Most people eating a balanced diet will get enough iron. Foods rich in iron include meat, poultry, fish, eggs and dairy products so women eating a vegetarian or vegan diet may have to eat fortified foods such as cereals to get enough iron. Other non-animal sources of iron include tofu; green, leafy vegetables; and dried fruits such as apricots, prunes and raisins.
Substances that can inhibit absorption of iron include tannins in tea, calcium and phosphorus in milk, casein and whey protein, wheat brain, spinach, Swiss chard, chocolate, soft drinks, antacids and calcium supplements.
Vitamin C, however, aids absorption. Nutritionists recommend getting at least 500 milligrams of vitamin C from foods such as citrus fruits, strawberries and tomatoes with each meal.
Regarding diet, Gusman says, “Even eating a relatively healthy diet, it’s easy for some women to become anemic, and the symptoms are likely to go unnoticed. Getting a diagnosis is important since vital organs can be damaged if they go too long without getting the oxygen they need.”
Over time, the heart has to work harder, increasing the risk of hypertension and congestive heart failure. Diagnosis requires a clinical evaluation plus a comprehensive laboratory analysis of the blood. Treatment usually consists of dietary changes and supplemental iron plus efforts to stop the abnormal bleeding.
What are the most common types of anemia?
- Iron deficiency anemia. Blood tests show that red blood cells are smaller and paler when there is an iron deficiency. When your body has shortage of iron, your bone marrow cannot make hemoglobin for your red blood cells. Usually, iron deficiency anemia can be treated by adding more iron to your diet. However, this type of anemia may be caused by loss of blood from bleeding or heavy menstruation as well. If loss of blood is the cause, treatment may require surgery to stop the bleeding.
- Pernicious or vitamin deficiency anemia causes red blood cells to enlarge, but there are fewer in number. The body needs folate and vitamin B-12 to produce enough healthy red blood cells. The condition may be treated by eating more foods containing folic acid and vitamin B-12. If the body is unable to absorb these vitamins due to another condition, supplements or injections may be necessary.
- Anemia of chronic disease. Some chronic diseases, such as HIV/AIDS, cancer, rheumatoid arthritis, kidney failure, Crohn’s disease and other chronic inflammatory diseases may hinder red blood cell production. Since this type of anemia is caused by an underlying medical condition, treatment will be dictated by the needs of the patient and may include a blood transfusion or injections of synthetic hormones to promote red blood cell production.
- Aplastic anemia is a rare, life-threatening anemia caused when infection, drugs or autoimmune disease decreases the bone marrow’s ability to manufacture red blood cells. Treatment may include blood transfusions or bone marrow transplants.
- Anemia associated with bone marrow disease. Recently, myelodysplasia, also known as pre-leukemia has been in the public eye as many in our country have watched Robin Roberts, anchor of ABC’s Good Morning America® journey through the disease. Anemia caused by this and similar diseases such as leukemia, multiple myeloma, myeloproliferative disorders and lymphoma, compromise blood cell production in the bone marrow. This type of anemia can cause a life-threatening cessation of the blood making process. Treatment may include simple medication, chemotherapy and bone marrow transplantation.
- Hemolytic anemias occurs when red blood cells are destroyed faster than they are replaced by bone marrow. This type of anemia may be inherited or may happen later in life. Treatment may include eliminating certain medications, treating infections, suppressing the immune system, blood transfusions or blood filtering.
- Sickle cell anemia is an inherited condition caused when abnormal hemoglobin causes red blood cells to form a crescent (sickle) shape. Sickle-shaped red blood cells do not live as long as normal red blood cells, resulting in a shortage. Treatment may include oxygen, pain relieving medication, supplements, blood transfusions and bone marrow transplants.
- Inherited anemias. Thalassemia or Cooley’s anemia is a genetic disease usually found in people of Mediterranean or Asian descent. It can be mild or severe. Some carriers of the gene have no symptoms. Severe thalassemia is treated with blood transfusions and treatments that remove iron from the blood.
- Fanconi’s anemia is another inherited condition which affects the bone marrow resulting in low production of red blood cells. The condition can be treated with growth medications, hormones, steroids, blood transfusions and bone marrow transplants.
Diet may alleviate anemia
Iron deficiency anemia can be treated by adding an iron supplement or eating more iron-rich foods. These foods include: beans, spinach, beef and other meats, lentils, dark green leafy vegetables and dried fruit. A well-balanced diet should include many of these and help prevent anemia. It is important to remember that you will also need to eat foods that contain vitamin C such as citrus fruits melons and berries to help the body absorb the iron. Vitamin deficiency anemia can also be prevented by eating food rich in folate and vitamin B-12. Folic acid is found naturally in citrus fruits and juices, bananas, dark green leafy vegetables, legumes and fortified breads, cereals and pasta. Vitamin B-12 can commonly be found in liver, fish, beef, lobster, cheese and eggs.
While changing your diet to include more vitamin- and iron-rich foods may help, these may not treat the underlying cause of anemia. If you are feeling run down and tired, make an appointment with your health care provider and get a simple complete blood count (CBC) test.