Anaemia is a common condition described as a condition in which red blood cells no longer provide enough oxygen to the tissues. Its causes are multiple but it is most often the consequence of an iron deficiency. More than a billion human beings are reported to suffer from iron deficiency worldwide.
Blood is composed of 3 different types of cells:
- The red blood cells (or red blood cells) that contain the haemoglobin that transports oxygen;
- White blood cells (or leukocytes) that defend the body from infections;
- Platelets that are involved in the blood clotting process.
Every day, millions of red blood cells are produced by the bone marrow to replenish stocks and replace older cells. To produce these red blood cells, the body needs various compounds such as: iron, vitamin B12 and vitamin B9.
Anaemia is defined as an abnormal decrease in the level of haemoglobin in the blood.
Haemoglobin is the pigment contained in red blood cells that gives the blood its red colour. It transports oxygen to the tissues.
A normal haemoglobin level varies according to gender and age. Anaemia occurs when the pigment reaches thresholds below:
- 14 g/dL (grams per deciliter of blood) in a new-born;
- 13 g/dL in an adult male;
- 12 g/dL in an adult woman;
- 5 g/dL in a pregnant woman.
There are two main types of anaemia:
- Central anaemia’s;
- Peripheral anaemia’s.
Symptoms of the disease
Depending on the severity of the anaemia, the symptoms are different.
Mild anaemia with a slightly decreased haemoglobin level will cause few or no symptoms. Especially if its installation was progressive and therefore the body was able to adapt to it.
When the anaemia worsens, we can observe:
- A pallor;
- Shortness of breath at effort and then at rest;
- Persistent fatigue;
- Dizziness, dizziness, weakness;
- Difficulties concentrating, reading or remembering;
- A lack of motivation and desire;
- A decrease in libido;
- Difficulties in performing their usual activities;
- Physical, emotional or psychological exhaustion.
The presence of one or more of these symptoms should lead to consultation with a doctor.
A more severe, older, or faster onset anaemia can have cardiac (aggravation of heart disease) or pulmonary consequences (aggravation of COPD, for example).
To diagnose anaemia, the doctor prescribes a CBC (blood count, also called a blood count) from a blood sample to determine the patient’s haemoglobin level. If this level is below the threshold values (13 g/dL for a man, 12 g/dL for a woman and 10.5g/dL for a pregnant woman) then the presence of anaemia is demonstrated.
Further tests are then prescribed to determine the origin of the anaemia, including the GMV (mean blood cell volume). When this parameter is low, anaemia is caused by iron deficiency, inflammation or genetic disease. On the other hand, when it is high, it can be said that anaemia is linked to a deficiency of vitamin B12 or vitamin B9.
The level of reticulocytes (precursor cells of red blood cells) provides an indication of the functioning of the bone marrow. When it is high, it is referred to as peripheral or “regenerative” anaemia.
Depending on the context and the results of the CBC, the doctor may prescribe further blood tests. For example, in the case of sickle cell disease, which is an inherited haemoglobin disease, the observation of red blood cells is sufficient to establish the diagnosis (red blood cells are no longer round but sickle-shaped).
A myelogram (bone marrow examination) may also be requested.
The treatment of anaemia depends on its severity. Indeed, it must be managed quickly if haemoglobin levels are below 8 g/dL. Most often, blood transfusion is used.
As anaemia is very frequently linked to a deficiency, it is necessary to treat them. For example, an oral iron-based drug is prescribed. In case of excessive losses or if the treatment is poorly tolerated, an iron infusion may be proposed.
Concerning the treatment of vitamin B12 deficiency, it varies according to the cause:
- In case of Biermer anaemia, vitamin B12 is supplied by intramuscular injections;
- In case of nutritional deficiency, digestive disorders (Crohn’s disease or celiac disease) or after stomach surgery, vitamin tablets are prescribed.
A vitamin B9 deficiency requires a higher consumption of certain foods (liver, spinach, asparagus, rice, etc.). The doctor may prescribe additional tablets to be taken orally. On the other hand, in pregnant women, supplementation is systematic.
When anaemia is associated with another disease, it must be treated so as not to amplify the symptoms. In chronic kidney disease, when iron deficiency is known, the doctor prescribes erythropoietin (EPO) injections to stimulate the production of red blood cells in the bone marrow.
For haemolytic anaemia’s, there is no specific treatment. Corticosteroids can be used in cases of autoimmune origin.