ANEMIA

We all have some knowledge about Anemia, right? Like what it is, why it occurs, some common symptoms, and all. It is a very common blood disease and a serious global public health problem.

WHO estimates that 42%of children less than 5 years of age and 40%of pregnant women worldwide are anemic.

So this time we will go through the topic ANEMIA, its standard definition, categorizations, symptoms, and causes. Here we begin.

DEFINITION

According to the World Health Organization (WHO), Anemia is defined as hemoglobin (Hb) levels <12.0 g/dL in women and <13.0 g/dL in men.

Anemia is a condition in which the number of red blood cells or the hemoglobin concentration within the cells is lower than normal. Hemoglobin is needed to carry oxygen and if the Red Blood count in a body is too low or abnormal, or not enough hemoglobin, then there will be a decreased capacity of the blood to carry oxygen to the body’s tissues which results in symptoms.

CLASSIFICATION OF ANEMIA

Anemia can be classified in two different ways :

 ETIOLOGICAL CLASSIFICATION -

The etiological approach classifies anemia based on causes, which can be further divided into three groups :

Decreased RBC production :

In this case, enough Red Blood Cells may not be created in the body, or they may not function in the way they should, because of insufficient minerals and vitamins needed in the formation of RBCs.

The things that typically decrease RBC production, causing anemia, include:

• Inadequate stimulation of red blood cell production by the hormone erythropoietin, which is produced by the kidneys.
• Inadequate dietary intake of iron, vitamin B12, or folate.
• Hypothyroidism (under-active thyroid).

Increased RBC destruction :

The destruction of RBCs is called hemolysis. It can be caused due to an autoimmune problem in which the immune system malfunctions and sees your own RBCs as foreign substances and destroys them. Many more conditions are resulting in increased RBC destruction hence causing anemia.

Blood loss :

We all know that blood is made up of 4 main components i.e, Red Blood Cells, White Blood Cells, Plasma, and Platelets. So when there occurs severe blood loss, the RBCs are also decreasing. Not only in severe conditions, but this can also happen slowly over a long period of time, without being noticed by us. The best possible example of this is Menstruation. Women who suffer from heavy menstrual periods are more prone to this type of anemia where red blood cells are lost to bleeding. Other conditions include :

• Accidents
• Child Birth
• Post Surgical bleeding
• Liver cirrhosis
• Excessive Uterine bleeding
• Fibrosis (scar tissue) within the bone marrow
  
  

MORPHOLOGICAL CLASSIFICATION -

The morphological approach categorizes anemia based on the size of RBCs (e.g. the Mean Corpuscular Volume - MCV), This is also further arranged into three groups :

Microcytic (small RBCs) :

Microcytic Anemia is defined as the presence of small, red blood cells in a peripheral blood smear and is usually characterized by a low MCV (less than 83 microns 3). 

Normocytic (normal-sized RBCs) :

In Normocytic anemia, the Red Blood Cells are normal sized but in a very low number. The mean corpuscular volume (MCV) in Normocytic anemia is between 80 and 100 femtolitres (fL), which is within the normal and expected range but, the hematocrit and hemoglobin are decreased.

Macrocytic (large RBCs) :

Macrocytic anemia is a type of anemia that causes unusually large red blood cells. Red blood cells larger than 100 fL are considered macrocytic.

So these were the grouping or categorization of Anemia. Now let us move on to the types of Anemia one by one.

TYPES OF ANEMIA

There are more than 400 types of Anemia at present, yeah of course we can't talk about all of those now, so we will only focus on the main types of anemia. Here they are :

Iron Deficiency Anemia -

This is the most common type of anemia among the population. As the name implies, Iron Deficiency Anemia occurs due to insufficient iron in the body. Without enough iron, our body can't produce enough Hemoglobin - a substance in red blood cells that enables them to carry oxygen.

This can cause due to the inability of the body to absorb iron from food that we consume, or because of less intake of iron-rich food. In terms of pregnant and breastfeeding mothers, even after taking iron-rich food and the body being able to absorb iron, some women may diagnose Iron Deficiency Anemia. This is because, the body needs more iron in these conditions, than what is normally required.

Megaloblastic Anemia -

Megaloblastic anemia is caused when RBCs are not produced properly, like, the cells may be too large in size, and may not be fully matured. These cells fail to exit the bone marrow to enter the bloodstream and deliver oxygen because of this abnormal structure. 

It is caused by medications or inherited defects in the metabolism of vitamin B12 or folic acid.

Pernicious Anemia -

It is a type of megaloblastic anemia in which the body is unable to absorb vitamin B12 due to a lack of intrinsic factor in stomach secretions, leading to decreased RBCs

It is an autoimmune condition that is rarely be found in 0.1 percent of the total population. People over 60 years of age are the highly vulnerable group are those who are thought to be affected by this condition.

Hemolytic Anemia -

 It is a type of anemia in which red blood cells are destroyed faster than they can be made. The destruction of red blood cells is called hemolysis. 

It can be caused due to medication reactions, diseased heart valves, autoimmune conditions, and many more. Hemolytic Anemia can be divided into two :

• Inherited Hemolytic Anemia
• Acquired Hemolytic Anemia

In Inherited Hemolytic Anemia there are 2 other types of anemia,

• Sickle Cell Anemia -
  In this, the red blood cells have an abnormal crescent shape, block small blood vessels, and do not last as long as normal red blood cells.
• Thalassemia -
  In this, the body produces an abnormal form of hemoglobin which results in excessive destruction of RBCs.
  
  

Aplastic Anemia -

It is a condition that occurs when our body stops producing enough new blood cells.

Aplastic anemia occurs as a result of bone marrow damage. The damage may be present at birth or occur after exposure to radiation, chemotherapy, toxic chemicals, drug effects, or infection.

SYMPTOMS OF ANEMIA

The symptoms of anemia vary from person to person. It depends on how severe the anemia is and how quickly it develops. Usually, the symptoms increases as anemia get worst.

Some symptoms include:

• Weakness and loss of energy
• Dizziness
• Headache
• Sore tongue
• Pale skin, dry skin, or easily bruised skin
• Unintended movement in the lower leg
• Rapid (fast) heartbeat
• SOB (Shortness Of Breath)

Symptoms of Anemia

REACHING  TO THE CONCLUSION

NOTE - IF YOU ARE HAVING ANY OF THESE SYMPTOMS OR YOU FEEL THAT YOU MIGHT BE ANEMIC, I RECOMMEND YOU TO CONSULT A DOCTOR AND NOT TO SELF DIAGNOSE ANY DISEASE. DOING THIS CAN CAUSE SERIOUS COMPLICATION AND IS ABSOLUTELY DANGEROUS. IN THE SAME WAY, DO NOT SELF MEDICATE YOURSELF, RATHER I URGE YOU TO TAKE MEDICAL OPINIONS. 

Hope you all have attained some more information about Anemia. Eat healthy and iron-rich foods and get enough of vitamin B12 and folic acid in your diet, so as to prevent anemia.
This year, let us be healthy, staying away from all illnesses and preserving our precious health, after all, we are fighting a great pandemic and have made it till now. Let us carry a hope that at least this year we will be able to fight this Covid 19 efficiently and completely.

Stay Healthy and Safe.

-JESLIN MARIAM JOSE