Contributors: Mariah Rossi and Dr. Emran of Simple Health Radio
On this episode of Simple Health Radio, Dr. Emran talks about Anemia. Anemia is a common medical condition that affects up to 25% of the world population. There are 400 different types of anemia. Because there are so many types, Dr. Emran will explain the most common forms of anemia, basic cell anatomy, and how it is diagnosed.
Anemia is a lack of healthy red blood cells. In order to understand anemia, we must understand the blood. In blood, there are liquid parts and solid parts. In the liquid parts, there are red blood cells, white blood cells, and platelets. Anemia is related to red blood cells.
Red b cells are round and flexible so that when the heart pumps them throughout the body, they don’t break apart. They also have an indentation in the center to increase surface area. The job of a red blood cell is to carry oxygen away from the lungs and bring carbon dioxide back to the lungs as efficiently as possible. They do not have a nucleus because they don’t divide, they are just carriers. They are created in the bone marrow and absorbed in the spleen with a lifespan is about 100 days.
They are red because of hemoglobin, which is the chemical that binds to oxygen and carbon dioxide. “Heme” also means iron, which is red and similar to the color of rust. When carbon dioxide is at high levels, the blood turns blue, which can be seen in veins. However, if you cut a vein, the blood is oxidized immediately and turns red. Arteries are deeper in the body and are red because they have fresh oxygen being carried away from the heart.
To test for anemia, a Complete Blood Count or CBC is used. It is the most accurate way to see if a person is anemic. If the hemoglobin is above a certain value, then you are not anemic. If it is below a certain value, then you are anemic. After this value is determined, there are other tests to confirm an anemia diagnosis and the specific causes.
Doctors will look at blood cells under a microscope and determine the types of red blood cells. There are three different types: microcytic, normocytic, and macrocytic which refer to the different sizes of the red blood cells.
If it is normal sized, it is normocytic. If it is smaller than expected, it is microcytic and if it is bigger than expected it is macrocytic. The varying sizes determine where the deficiency is coming from. Normocytic means there is no vitamin deficiency causing it – the blood cell itself is the problem. Microcytic means there is a vitamin problem, including an iron deficiency. Lastly, macrocytic can originate from varying types of deficiencies such as Vitamin B12 or Folic Acid.
There is also a measurement called a Reticulocyte count. Reticulocytes are baby red blood cells. If the count is high, then it means that the body is producing more red blood cells appropriately in response to anemia, but if it is low, then the body is not producing red blood cells.
The symptoms of Anemia include fatigue, paleness, dizziness, inability to exercise, weakness, changes in skin color, irregular heartbeat, shortness of breath, chest pain, and cold hands or feet.
The cause of anemia is based on one of 3 issues: the body isn’t making red blood cells, there is too much bleeding or spleen destroys healthy red blood cells. Basically, it’s a problem with production, bleeding out, or destruction.
Iron deficiency anemia is the most common anemia globally and it is microcystic because the red blood cells are smaller than expected. In order to combat these people need to change their diet or take supplements. Iron is a metal and constipation side effect of taking it.
A Folic Acid or Vitamin B12 deficiency can cause macrocytic anemia. People who have this type can be at risk of other problems. A common cause of this is gastric bypass surgery used to lose weight because the body can no longer absorb vitamins from food in the stomach. Patients have Pernicious Anemia and need to take supplemental vitamins. In this type of Anemia, the blood cells look bigger.
People with chronic diseases may have anemia, as it stresses the body. Pregnancy can also cause anemia and about 80% of women will be anemic during pregnancy and postpartum. Women are suggested to take prenatal vitamins before, during, and after pregnancy. Six weeks after giving birth, there will be a checkup to make sure the red blood cell count is normal.
Hemolytic Anemia occurs when the body destroys the red blood cells faster than the bone marrow can produce them. These people will have an elevation of their bilirubin numbers because the hemoglobin is broken down and spreads into the blood.
Sickle Cell Anemia is a genetic type of anemia. The blood cells have an abnormal shape and get trapped in small veins. People with sickle cell anemia have severe pain and develop chronic conditions that can lead to death.
To prevent anemia, the first step is to modify your diet. Eat a variety of foods, keep a colorful plate, and talk to your doctor about taking a multivitamin. Always discuss your labs with your doctor and keep copies for yourself so you can track your progress. Go to the nearest ER if you have any complications.
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