Anemia is a condition whereby the body doesn’t not produce adequate quantities of red blood cells, which interferes with the oxygen supply to the body’s tissues. There are many different types of anemia, and it’s important to get an accurate diagnoses so the correct treatment procedures can be followed.
Understand that the most common cause of anemia is blood loss.
Blood loss is the most common cause of anemia, particularly with iron-deficiency anemia. Iron-deficiency anemia (IDA) is especially common among women and people whose diets are low in dietary iron.
Women who have heavy menstruation, or who are pregnant, breastfeeding, or have recently given birth are at a higher risk of developing iron-deficiency anemia.
Furthermore, people who have undergone major surgery and/or physical trauma accompanied by heavy bleeding, have gastrointestinal conditions like Crohn’s disease or ulcerative colitis, or have peptic ulcers are also at risk for having iron-deficiency anemia due to bleeding tendencies associated with these diseases.
Monitor your diet; poor diets can lead to anemia.
Eating unhealthy food such as those bought from fast food chains could lead to series of health conditions including anemia. Maintaining a healthy diet that is rich in iron, vitamin B12, and folic acid can help you gain a healthy body.
Such vitamins and minerals can be found in: vegetables such as spinach, beetroot, and tomatoes; fruits such as pomegranates, peaches, and prunes; and moderate consumption of red meat. The recommended dietary allowance for iron in both male and female are as follows:
7-12 months – 11 mg; 1-3 years – 7 mg; 4-8 years – 10 mg; 9-13 years – 8 mg; 14-18 years – 12 mg; 19-50 years – 12 mg; 51 years and older – 8 mg.
For vitamin B12, the recommended daily allowance for both male and female are as follows: 1-3 years – 0.9 mcg; 4-8 years – 1.2 mcg; 9-13 years – 1.8 mcg; 14 years and older – 2.4 mcg; Pregnant women – 2.6 mcg; and Breastfeeding women – 2.8 mcg.
The recommended dietary allowance for folic acid for male and female includes: Birth to 6 months – 65 mcg; 7-12 months – 80 mcg; 1-3 years – 150 mcg; 4-8 years – 200 mcg; 9-13 years – 300 mcg; 14-18 years – 400 mcg; and for 19 years and above – 400 mcg.
Watch out for abnormal hormone levels.
Hormones play a crucial role in maintaining health and thus preventing anemia. However, in cases where certain hormone levels are unstable, there is a significantly increased chance of developing certain diseases which lead to anemia.
For example, hypothyroidism or low levels of thyroid hormones may cause anemia. A low level of thyroid hormones significantly affects erythropoiesis (the process of making red blood cells in the bone marrow) which in turn decreases the level of red blood cells in the blood stream, causing anemia.
In women who are in their perimenopausal stage, levels of estrogen tend to increase, resulting in uterine overgrowth and breakdown, leading to irregular heavy bleeding causing anemia.
Understand that some chronic diseases can lead to anemia.
Many diseases can cause anemia and these include:
Crohn’s disease (a disease which causes digestive bleeding)
Systemic Lupus Erythematosus (an autoimmune disease which causes blood abnormalities leading to heavy menstruation and gastrointestinal bleeding)
Chronic Kidney Disease (a disease wherein your kidneys fail to produce sufficient quantities of a hormone called erythropoietin, which stimulates the bone marrow to produce red blood cells).
Take note if you are pregnant.
Pregnant women need to increase their intake of dietary iron to support their own health, along with their baby’s. When insufficient iron is given to body, it may result in a decreased production of red blood cells causing anemia.
Know that you can inherit some types of anemia.
Inherited conditions are from genetic linkages or anemia being transferred from parents to children. One type of genetic anemia is called aplastic anemia.
This kind of anemia is rare but often a serious health condition where the bone marrow which produces blood cells fails to do its job and results in decreased levels of red blood cells, white blood cells, and platelets.
Sickle cell anemia is an inherited disease with a lifelong course. People with this condition tends to have sickle-shaped blood cells instead of the normal “doughnut” shaped cell. Sickle cells also tend to be stiff and sticky, leading to an increased risk of blood flow blockage.
In thalassemia, blood hemoglobin lacks the specific protein chains it needs in order to do its function. Thalassemia can either be Thalassemia major or Thalassemia minor depending on the inherited faulty gene from both or one parent, respectively.
Hemolytic anemia occurs when the bone marrow is unable to replace the red blood cells and is destroyed earlier than the normal life span of 120 days. Symptoms vary from mild to severe. This type of anemia quite often can be treated and controlled, though this depends on the severity of the condition.
Look for symptoms of iron-deficiency anemia.
Typically, people with this kind of anemia often feel tired and sluggish. This is due to the fact that the red blood cells do not function efficiently when transporting oxygen to different parts of the body. Common symptoms may also include:
Poor appetite, slowed growth and developmental/behavioral problems in infants, pale skin, weak nails, headaches, and dizziness, as the decreased red blood cells in the circulation disrupt bodily metabolism.
Most people with this type of anemia crave unusual non-food substances like ice, dirt, and laundry starch which, according to studies, is a normal behavioral response to iron-deficiency anemia.
Overtime, a person with this type of anemia may develop the so-called restless leg syndrome which creates a creepy-crawly sensation on the arms and legs. Further study is required to explain the relationship between restless leg syndrome and anemia, but 20% of patients with restless leg syndrome also have anemia.
Recognize symptoms of pernicious anemia.
This type of anemia is caused by a Vitamin B12 deficiency and it is often characterized by feelings of tiredness accompanied by a sensation of having cold hands and feet.
This is because vitamin B12 is needed in the production and maturation of red blood cells which stabilize bodily metabolism.
Over the span of time where the vitamin deficiency is not treated, nerve problems may occur such as numbness and tingling of the upper and lower extremities, muscle weakness, irritability, and the possibility of walking problems because vitamin B12 is needed by the nerves to function efficiently and regulate movement mechanisms.
Consider whether or not you may have aplastic anemia.
Symptoms of decreased red blood cells may include the following: tiredness, weakness, shortness of breath, pale skin, dizziness, headaches, and chest pains.
Additionally, decreased white blood cell production symptoms may also include: fever, infections, and lingering flu-like symptoms because the functions of white blood cells is to fight infection throughout the body.
Furthermore, decreased platelet production is associated with bleeding, bruising, petechiae (red spots), nose bleeds, bloody stool, and skin rash because the main function of platelets are to stop bleeding tendencies.
Look for signs of hemolytic anemia.
Certain specified symptoms are associated with this type of anemia and these symptoms includes:
Jaundice (yellowish discoloration of the skin), pain in the upper abdomen, reddish to brown urine, enlarged spleen, leg ulcers and pain.
The symptoms included may resemble other medical problems associated with blood disorders, so the patient will need to be tested extensively before a diagnosis is made.
Miscarriage or stillbirth is a severe manifestation of alpha thalassemia, a form of thalassemia. stillbirth happens because affected fetuses suffer from severe anemia and heart failure during the course of the mother’s pregnancy. Additional symptoms include:
Bone deformities, as the bone mineral metabolism is usually affected by this condition; jaundice occurs from high levels of bilirubin (an end-product of hemoglobin degradation); enlargement of the spleen, liver, and heart occurs due to excessive destruction of abnormal red blood cells; and presenting a pale and listless appearance.
In patients with thalassemia minor, there may be small red blood cells but no obvious symptoms. However, in thalassemia major, infants in their first year of life often progress to having severe anemia which results in slowed growth and bone problems.
Watch for signs of sickle cell anemia.
The most common symptom of sickle cell anemia is bodily fatigue due to lack of oxygen in the blood. Sudden pain may affect the bones, lungs, abdomen, and joints as a result of sickle cell crisis.
The pain can either be acute or chronic. Acute pain associated with sickle cell crisis often lasts for hours or even days. Chronic pain lasts for weeks to months and may limit your daily activities. It can also be very mentally draining.
Subsequent and prolonged sickle cell crises can damage your bones, kidneys, lung, and heart.
Look for signs of fanconi anemia.
Most infants with this type of anemia develop birth defects which include bone defects, eye and ear defects, skin discoloration, and congenital heart defects. They may also have developmental problems such as low birth weight, slow growth, small head size, lower than normal height, and intellectual disability.
Adults may manifest symptoms such as less developed sex organs, starting menstruation earlier, starting menopause earlier, and experiencing difficulty in getting pregnant and carrying pregnancy full term.
All of these symptoms are due to the fact that fanconi anemia greatly affects the bone marrow, resulting in abnormal red blood cells leading to developmental delays and multi-organ dysfunction.
Get a complete blood count done to see if you have iron-deficiency anemia.
If your doctor suspects that you have iron-deficiency anemia, he/she will likely work you up for series of tests which including a complete blood count (CBC).
This is a test which measures the number of red blood cells and white blood cells, and also measures the levels of hemoglobin (the red pigment in the blood), levels of hematocrit (the proportion of red blood cells in the blood), and the mean cell volume (the volume for the average red blood cell in a given sample) by drawing a blood sample, usually from veins located inside of the elbow and back of the hands.
The person may feel a little pain upon the insertion of the needle and slight throbbing upon the withdrawal of blood.
Get a serum ferritin test done.
A serum ferritin test measures the amount of ferritin (the blood cell protein that contains iron) using a blood sample.
The blood sample is then tested using the serum iron test (which measures the level of iron in the blood serum) and the total iron binding capacity test (which assesses your body’s ability to transfer iron)
The serum iron test and the total iron binding capacity test can be helpful if the serum ferritin level ranges from 46 to 99 microgram per liter. However, a bone marrow biopsy may be necessary for a definitive diagnosis.
Undergo a bone marrow biopsy.
This test is done with no special preparations, but the doctor will first check your blood pressure and heart rate. The procedure can be done by a hematologist, oncologist, nurse, or a specialized medical technologist.
The bone marrow exam takes at least 30 minutes. Local anesthesia is used at the injection site to reduce the pain. A large bore needle is used to collect the bone marrow tissue from the chosen site, which is usually at the top ridge back of the hipbone. For infants, the site is on the lower leg part.
You may feel a little pain upon insertion and after the procedure you may feel tenderness within the area for a week or more. For clients whose symptoms and physical evaluations are negative, a trial for iron approach can be considered and checked for one month.
Get a serum vitamin B12 test done to see if you have pernicious anemia.
Serum vitamin B12 is the commonly used method for diagnosing this type of anemia. A serum B12 amount of less than 111 pmol/mL may reliably indicate deficiency.
While an amount less than 89 pmol/mL can define neurological deficiency. Folic acid levels should also be known because folic acid co-exists with vitamin B12 levels. Vitamin B12 deficiency can lead also to deficient red cell folate levels.
The test is performed by withdrawing a blood sample from the vein inside the elbow. which will make you feel a little pain upon insertion. The doctor may also request that you avoid eating or drinking for 6- 8 hours before the test.
Bone marrow aspiration can also be used to find a distinctive diagnosis for vitamin B12 and folic acid deficiency. Bone marrow aspiration is done by making a small incision (usually on the back of the hipbone) before inserting a needle into the bone marrow. The doctor will then withdraw bone marrow fluid. You may feel a short sharp pain as the needle is inserted. The procedure should only take a few minutes.
Talk to your doctor about the blood work needed to diagnose aplastic anemia.
A complete blood count is the initial step for a diagnosis of aplastic anemia. In aplastic anemia, the number of red blood cells, white blood cells, platelets, and reticulocytes (immature red blood cells) in the blood is insufficient, resulting in several complications that can lead to organ disfunction over time.
Hemoglobin electrophoresis (a test for the different types of hemoglobin in the blood stream) can show elevated levels of fetal hemoglobin (a hemoglobin type found in newborn babies), which are also observed in patients with aplastic anemia.
The test is done by withdrawing a blood sample from the vein inside of the elbow or at the back of the hands. A bone marrow biopsy may also be done to check for the blood cells quantitatively and qualitatively. In aplastic anemia, the blood cells tend to be hypo-cellular, which means that there are abnormally few blood cells in circulation.
Get blood work done to test for hemolytic anemia.
The first step in diagnosing this type of anemia is getting a complete blood count to check for the following: red blood cells, white blood cells, platelets, hemoglobin, and hematocrit. Other blood tests include:
Reticulocyte count, as these cells are often present in high amounts in hemolytic anemia. The doctor will ask you if you do have hemophilia (a blood clotting disorder), fainting history, and other conditions before taking this test.
Haptoglobin test, this is a test to measure the levels of haptoglobin (a chemical that combines with hemoglobin). Levels of this tend to be low in hemolytic anemia.
Test for bilirubin levels. If these are high, it can suggest the presence of this kind of anemia. Bone marrow aspiration and biopsy can also be done.
Do a work up to see if you have thalassemia.
A complete blood count is again the initial step. Patients with thalassemia often have few healthy red blood cells and low hemoglobin levels. Those who have alpha or beta thalassemia traits tend to have smaller sized red blood cells.
Prenatal testing can also be done by taking a sample of amniotic fluid/tissue from the mother’s placenta called amniocentesis. This test can show if the baby has thalassemia and how severe it may.
The doctor will use an ultrasound providing a guide for the insertion. You will be asked to lie on your back, exposing your abdomen. A thin, hollow needle will be inserted into the uterus to take a sample of fluid.
Have a doctor study your blood to see if you have sickle cell anemia.
A simple blood test for hemoglobin can detect if a person has sickle cell anemia.
Doctors can also diagnose whether a baby has sickle cell anemia before birth by taking a sample of amniotic fluid/tissue from the placenta.
This test can be done as early as 10 weeks of pregnancy to determine the sickle cell gene.
Test for fanconi anemia.
Genetic testing is the primary approach in diagnosing fanconi anemia. A chromosome breakage test is often used. If FA is present, chromosomes in the blood sample tend to break and rearrange when mixed with test chemicals.
Cytometric flow analysis: If FA is present, the chromosomes in the blood will tend to break rapidly upon receiving a test chemical.
Mutation screening: This detects mutations in your genes and usually uses skin cells.