Anaemia

(Latin: Without blood)

Anaemia can be tested with a simple blood test.

What is it?
Anaemia is a condition that comes about as a result of reduced oxygen delivery to the tissues (hypoxia), generally due to a decrease in the total number of RBCs and consequently haemoglobin concentration. The lower the haemoglobin level, the more severe the anaemia.

Symptoms:
Anaemia can sometimes be asymptomatic (no symptoms) or can present with a series of symptoms including: pallor (pale skin appearance), tiredness and lethargy, headaches, shortness of breath (commonly post-exercise), dizziness and fainting, increased heart rate, palpitations (heart flutters / uneven heart rate).

Classification:
There are lots of different types of anaemia and the type depends on what’s causing it. For example, iron deficiency anaemia – the most common type of anaemia amongst the general population. This is caused by lack of iron, in the diet or in the blood (more complicated but generally due to ferritin levels (a blood protein which stores Iron)). There are other causes of anaemia, including, but not limited to:

  • Vitamin B12 / folate deficiency (‘pernicious anaemia’).
  • A secondary complication of an inflammatory disease (‘anaemia of chronic disease – AOCD’), the most common type of anaemia amongst the elderly.
  • Increased RBC destruction secondary to certain diseases like sickle cell disease or as a side effect to certain drugs, like the antibiotic cephalosporin (‘haemolytic anaemia’).
  • Anaemia can also be caused by kidney disease, as the kidneys (when healthy) produce a hormone called erythropoietin which is crucial to the regulation of RBC production (erythropoiesis).

Diagnosis: 
In order to diagnose anaemia, a blood test is taken, and your red blood cell (RBC) count is assessed for lower than normal levels. If you do have a low RBC count, the doctor or nurse will generally look at another value, called the mean corpuscular volume (MCV) to see if that is increased, decreased or normal. The MCV is a value that represents the average size of your red blood cells. This helps to determine the type and cause of the anaemia. For example, a high MCV can indicate vitamin B12 / folate deficiency – pernicious anaemia, and conversely, a low MCV can indicate iron-deficiency anaemia. The doctor or nurse may also do a ferritin blood test to confirm iron-deficiency anaemia if they suspect it.

Treatment: 
Treatment largely depends on the type of anaemia you have and what’s causing it. It can be as simple as adding more iron to your diet, taking vitamin supplements or taking medication to improve kidney function for example. 

If you suspect that you might have anaemia, do speak to your doctor or local public health nurse as it is easily diagnosed and, in most cases, easily treated.

Polycythaemia. (Latin translation: many blood cells)
This condition is basically the opposite of anaemia, and arises in response to any condition in which the blood contains less oxygen than normal, which causes the body to produce more RBCs. This condition used to be seen in high-altitude dwellers due to the air being very thin with low oxygen levels but in the UK, this isn’t the case, and it is most commonly seen in patients with chronic lung disease, cyanotic heart disease, athletes who dope and cigarette smokers. 

The carbon monoxide in tobacco smoke binds irreversibly to the haemoglobin which creates a sort of fake anaemia causing the body to overproduce RBCs in response – which then strains and damages the heart and the circulation. 
There are two types of polycythaemia:

  • Primary Polycythaemia (Rubera Vera); very rare malignant bone cancer that enlarges spleen, increases viscosity of blood and can cause headaches, increased BP etc. 
  • Secondary Polycythaemia; most common and occurs due to the previously mentioned causes. Can arise due to dehydration.

This article was intended as an information piece and should not be taken as medical advice. If you or someone you know suspects that they have a condition, you should consult your doctor as soon as possible.

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