Anemia :- Common But Rarely Talked

April 12, 2022

Anemia is a common but rarely talked about condition in which the body lacks enough healthy red blood cells to carry adequate oxygen to our body's tissue. Every part of our body needs a sufficient supply of oxygen to function effectively. Many of the symptoms of anemia, such as fatigue and shortness of breath, are caused by decreased oxygen delivery to our body's vital organs and tissues. 

Red blood cells contain an iron-rich protein called hemoglobin. Hemoglobin binds to oxygen in the lungs, allowing red blood cells to carry and deliver it throughout the body. 

Anemia is measured according to the amount of hemoglobin in our blood. There are different types and causes of anemia. Some types of anemia are mild and can be easily treated, while others can potentially cause serious health complications. Anemia can surface if our body:-    1) Doesn't make enough red blood cells, 2) continues bleeding, which can lead to loss of red blood cells quicker than they can be replaced, 3) Sometimes our own body's cells start destroying red blood cells, which leads to anemia.

Types Of Anemia:-

1. Normochromic, Normocytic Anemia:-

It is the type of anemia in which the circulating Red Blood Cells (RBCs) are normal in size (normocytic) and have a normal red color (normochromic), but the production of RBCs is impaired. This anemia commonly occurs as a result of :-

- Miscellaneous chronic infections and systemic diseases

- Heavy blood loss 

- Hemolytic anemia:- It's a type of anemia in which RBCs get destroyed faster than they produce. Cause:- autoimmune activity ( in which our body produces antibodies that attack and destroy red blood cells), side effects of certain medication, infections like malaria and exposure to toxins.

- Aplastic anemia:- It's a type of anemic condition in which our body stops producing enough new blood cells. Cause:- Genetics or because the bone marrow gets injured due to medications, radiation, chemotherapy, or infection. Other malignancies that commonly affect the bone marrow include multiple myeloma or leukemia. Sometimes, there's no apparent cause of aplastic anemia.

2. Hypochromic, Microcytic Anemia:-

The type of anemia in which the circulating RBCs are smaller than their usual size (microcytic) and have decreased red color (hypochromic). So, in this type of anemia, RBCs have less hemoglobin than normal and because of low hemoglobin, the RBCs appear pale. This anemia commonly occurs as a result of:- 

- Iron Deficiency:- It's caused by a shortage of iron in the body. This generally occurs due to blood loss (often in menstruating women or people with an ulcer) or due to poor absorption of iron. Absorption issues are common in people who have had gastric bypass surgery for weight loss.

- Thalassemia:- It is an inherited blood disorder in which the body doesn't make enough hemoglobin. Hemoglobin enables red blood cells to carry oxygen; therefore, this condition leads to anemia. 

- Certain chronic diseases and conditions can also cause microcytic anemia. This type of anemia is called Anemia of Inflammation. 

3. Normochromic macrocytic anemia:-

Macrocytic is a condition in which the RBCs are larger than they should be. It's a sign that a person can have an underlying health condition that may lead to a severe form of anemia. It commonly occurs as a result of:- 

1) Pernicious Anemia:- Pernicious anemia is caused by vitamin B12 deficiency and harms RBC production. Vitamin B12 is required by the body to produce red blood cells. A deficiency in vItamin B12 is caused when the stomach does not make enough intrinsic factor (IF). Intrinsic factor is a special protein that binds vitamin B12 so that it can be absorbed in the intestines. When the intestine cannot properly absorb vitamin B12, it leads to a deficiency.

2) Folate deficiency:- Folate-deficiency anemia is the lack of folic acid in the blood. Folic acid is a B vitamin that helps the body make red blood cells. Low levels of folic acid can cause megaloblastic anemia, i.e., red blood cells appear larger than usual, are fewer in number and are oval-shaped, not round. Sometimes these cells don't live as long as normal red blood cells. 

3) Sickle cell anemia:- it's an inherited disease in which the body produces abnormal hemoglobin, which causes the red blood cells to take on a crescent (or sickle) shape that impedes blood flow through the vessels.

Anemia Cause :-  Anemia can happen because of,

  • A diet lacking specific vitamins and minerals (low in iron, vitamin B-12, folate and copper).
  • Inherited blood disorders like sickle cell anemia or thalassemia.
  • Conditions that cause red blood cells to break down too fast (like hemolytic anemia).
  • Chronic conditions that cause the body to not have enough hormones to create red blood cells. These include hyperthyroidism, hypothyroidism, advanced kidney disease, lupus and other long-term diseases.
  • Blood loss related to other conditions such as ulcers, hemorrhoids or gastritis.

Signs and Symptoms of Anemia:-

Anemia signs and symptoms vary depending on the cause and severity of anemia. The signs of anemia are:

  • Fatigue
  • Weakness or tiredness 
  • Pale or yellowish skin
  • Irregular heartbeats
  • Shortness of breath
  • Dizziness or lightheadedness
  • Chest pain
  • Cold hands and feet
  • Headaches
  • Pain, including in your bones, chest, belly, and joints

Diagnosis:- There are various ways to diagnose anemia, but the most common way involves a blood test called a complete blood count (CBC). This measures a number of components, including:

  • Hematocrit levels( It involves comparing the volume of RBCs with the total volume of blood
  • Hemoglobin levels
  •  RBC count
  • If RBC, hemoglobin, and hematocrit levels fall below the normal range, a person is likely to have some form of anemia. 

How To Treat Anemia:- 

If anemia is caused by a poor diet or a more serious health problem. Then, both the anemia and its cause can be treated. 

  1. Iron-deficiency anemia is treated with:

            - Iron supplements taken orally.

            - Foods high in iron and foods that help our body absorb iron (like foods rich in Vit C).

            - Iron given through an intravenous (IV) infusion. (If you have chronic kidney disease (CKD).

            - Transfusions of red blood cells

  1. Anemia caused by internal bleeding is treated by: 

           - Surgery to stop it. 

           - Surgical repair to cure anemia in people with the paraesophageal type of Hiatal hernias, with or without ulcers (called Cameron's ulcers).

  1. Other types of anemia may require other types of treatment. For instance, genetic disorders (like beta thalassemia and sickle cell anemia) may require a bone marrow transplant.
  2.  Chronic Kidney Diseases that cause anemia are treated through iron supplementation (through oral or IV means) and can also include injections of erythropoietin (EPO). EPO is a hormone that tells the bone marrow to make red blood cells.

Anemia Diet:- 

The best way to design a diet plan for anemia is: to include foods rich in iron and vitamins, as these nutrients are essential to hemoglobin and red blood cell production. It should also include foods that help the body absorb iron better. There are two types of iron in foods: Heme iron and Non-heme iron.

Heme iron is found in meat, poultry, and seafood. Non Heme iron is found in plant foods and foods fortified with iron. The body can absorb both types, but it absorbs heme iron more easily. Many types of anemia can't be prevented through diet alone, but to avoid iron deficiency anemia and vitamin deficiency anemias include a variety of vitamins and minerals. Although there are a few things to be kept in mind:- 

  • Don't include iron-rich foods with foods or beverages that block iron absorption Like- coffee, tea, foods high in oxalates and high in calcium.
  • Include iron-rich foods with vitamin C-rich foods to improve iron absorption.
  • Include foods rich in folate and vitamin B-12 to support red blood cell production.

Bottom Line:- Anemia occurs when the levels of RBCs in our body are low and this condition makes our organs and tissues work harder to get oxygen. As a result, the person experiences fatigue, weakness, and shortness of breath. The body constantly produces and removes millions of red blood cells each day, but when this process is disrupted, it can cause anemia. One of the most common causes of anemia is nutrient deficiency. That is, deficiencies of iron, folate, or vitamin B12. However, anemia can also be caused by blood loss and a wide variety of underlying health conditions. 

Anemia can cause serious complications therefore, proper diagnosis, determining the cause, and developing a treatment plan are essential for treating anemia properly. 


Maneesha Rana
Functional Nutritionist

Maneesha has a master's in Nutrition and Dietetics. Practicing as a Nutritionist for 2.5 years, she believes ‘You’ are your only obstacle in the healing journey. Therefore, It's important to remind ourselves that we are the only person standing in the way of our next goal and simultaneously love our body. Her Mantra for better health is “Eating Mindfully, Breathing Deeply, and Living your life to the fullest.”

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