Understanding, Managing, and Treating Anaemia

Did you know that anaemia affects nearly a quarter of the world’s population? Or that in some cases, it can be cured with a simple change in diet? However, anaemia can also have serious health indications, including cancer, kidney disease, and sickle cell anaemia. But just what is anaemia, and how best should it be treated and managed? Here is what you need to know about anaemia, its health ramifications, and how to successfully manage and treat it.

Just What is Anaemia?

Let’s start with what anaemia is, as well as a few things to know about haemoglobin and red blood cells—both of which are key biomarkers in anaemia.

First, haemoglobin is a protein found in our red blood cells and is responsible for delivering oxygen to all our tissue cells. It is produced in the bone marrow and is the pigment which gives blood its colour.

Second, red blood cells are the actual cells that carry the oxygen bound to its haemoglobin content throughout the blood.

Third, haematocrit is the ratio of the volume of red blood cells to the total volume of blood.

So it is now clear that both the haemoglobin and the red blood cells are closely related. Much of the medical literature defines anaemia as a deficiency in the level of haemoglobin or as a deficiency in the level of red blood cells in your body. The effect is the same at the end, where there is not enough oxygen carrying capacity in your blood, and your heart needs to work overtime as a result of this.

There are many forms of anaemia, each with its own cause. Anaemia can be temporary or long term, and can be mild to severe. Treatments for anaemia range from taking supplements to undergoing medical procedures. You may be able to prevent some types of anaemia by eating a healthy, varied diet.

Symptoms of anaemia can include:

  • Weakness
  • Always feeling cold and/or tired
  • Racing heart
  • Dizziness
  • Fainting
  • Pale skin tone
  • Shortness of breath

Causes of Anemia

Anaemia occurs when your blood doesn’t have enough red blood cells. This can happen when:

Your body doesn’t make enough red blood cells.

  1. Iron deficiency is the commonest type of anaemia worldwide, caused by a shortage of iron in your body. Your bone marrow needs iron to produce haemoglobin, and without adequate iron your body can’t produce enough haemoglobin for the red blood cells. This is a microcytic anaemia.
  2. Vitamin deficient anaemia. In addition to iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these nutrients can cause a Macrocytic anaemia.
  3. Anaemia of chronic disease. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn’s disease and other chronic inflammatory diseases — can interfere with the production of red blood cells.
  4. Aplastic anaemia. This rare, life-threatening anaemia occurs when your body doesn’t produce enough red blood cells. Causes of aplastic anaemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
  5. Anaemia is associated with bone marrow disease. Diseases such as leukemia and myelofibrosis, can cause anaemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
  6. Thalassemia : alpha and beta. These conditions occur when the body does not produce enough of the alpha or beta protein, and the red blood cells do not form properly.

Bleeding causes you to lose red blood cells more quickly than they can be replaced

  1. Acute bleeding such as in a motor vehicle accident with blood loss
  2. Chronic bleeding such as menstruation that is heavy (incidentally also causing iron deficiency), and also bleeding from your gastrointestinal tract.

Your body destroys red blood cells

  1. Hemolytic anaemias. This group of anaemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anaemia, or you can develop it later in life.
  2. Sickle cell anaemia. This inherited and sometimes serious condition is an inherited haemolytic anaemia. It’s caused by a defective form of haemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.

How is an Abnormal Reading Corrected?

In all cases of anaemia, the primary goals are to treat the underlying cause of the anaemia (iron supplements, vitamin B12 or folate rich diets, investigate and stop source of bleeding, treat the chronic disease, etc.), and to correct the actual low oxygen carrying capacity if necessary (oxygen therapy, blood transfusion, iron or supplement infusion, erythropoietin injection).

What About Menstruation?

Naturally, menstruation in women can lower red blood cell counts, for the simple reason that it involves blood loss.

It is for this reason that women of menstruating age should increase their consumption of blood building nutrients, such as iron, folate and vitamin B-12, which can be found in such foods as leafy greens, liver, grass fed meats, legumes and beets.

These foods should be a regular part of their diet, and additional iron, folate, and vitamin B-12 can also be added through supplementation, although a whole food diet is encouraged.

When Should You See a Doctor?

The possibility of a blood or bone marrow disease is nothing to be taken lightly, meaning that any time you have unexplained symptoms of abnormal hemoglobin, it should be addressed immediately by a qualified medical professional.

And, this is in addition to any annual blood work performed by your physician during your routine checkup, including a Complete Blood Count (CBC).

What Other Tests Should be Taken?

Finally, there are tests other than CBC which may be needed to evaluate the cause and type of anaemia present.

For instance, a haemoglobin electrophoresis test can show any blood disorders or genetic mutations of your blood’s haemoglobin. This makes it useful in screening for such abnormalities as sickle cell anaemia and should be performed as part of your annual examination.

Nutritional blood testing can also be used to indicate vitamin deficiency anaemia, which can be caused by a lack of iron (perform a full iron profile in your blood), serum vitamin B-12, and serum folate. Blood smear and the CBC will typically tell you the type of anaemia present and guide further testing.


If you’re interested in learning more about red blood cells and how they affect your body, read on more about it in our biomarker post here!

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