Anemia

This blog is created as part of assignment for Pathophysiology of Haemopoietic & Lymphoid System (QPT20803)

Sunday 18 December 2016

what you should know about anemia. 

1. it is not a disease
  • Many people may think of anemia as a disease, but it’s really more of a deficiency or a disorder. 
  • For the average person, their bone marrow is able to produce the right amount of red blood cells that the body needs to carry oxygen throughout the body. 
  • When there isn’t enough vitamins or minerals around, then the red blood cells can become weak and die early or the bone marrow might not be able to produce enough of them.


2. younger women have higher risk than male to get anemia. why?
  • The natural monthly cycle of the average younger woman can cause her to become anemic. 
  • Blood loss can quickly lead to anemic conditions as well, so accidents or deep wounds can cause it as well.
  •  People who give blood on a regular basis may find that there is a period of time after a donation where they are anemic.

Saturday 17 December 2016

FAQs about Anemia

Happy Sunday readers! For those who are viewing our blog for the first time, allow me to give you a brief idea about anemia. Let’s have an interview with one of the medical field expert, Dr. Allen Nissenson.

Dr. Allen Nissenson is a professor of medicine and director of the dialysis program for the David Geffen School of Medicine at the University of California, Los Angeles. He has written two medical textbooks on kidney disease treatment and was president of the National Anemia Action Council, a patient advocacy group.




Q: Anemia can result from a wide range of diseases and conditions. What are the most prominent causes?
A: The biggest categories are nutritional anemias, which are mainly iron deficiency, but also deficiencies in folic acid or vitamin B12. Another major cause is bleeding, usually from the gastrointestinal tract. Chronic diseases that have an inflammatory component, like rheumatoid arthritis, can also cause anemia.
And then there’s cancer itself, or the side effects from treating cancer, that can cause anemia. Another prominent cause is deficiencies in erythropoietin, or Epo, a hormone that stimulates red blood cell production, which is almost entirely a problem in people with kidney disease.
Q: A lot of symptoms of anemia share the same characteristics as being overworked or just tired. How do you tell the difference between normal fatigue and anemia?
A: You really can’t. One of the dilemmas with anemia is that the symptoms are pretty ubiquitous: tiredness, weakness, some difficulty in thinking clearly. They’re all kind of vague.
So what we tell people is if you have these symptoms and they go on for a long time or seem to be interfering with your ability to function normally, then you should see your doctor. One of the things you need to get checked is your hemoglobin level — the protein that carries oxygen in red blood cells — to see if that’s part of the anemia.
Q: Is there a specific cutoff point of hemoglobin that indicates whether someone is anemic?
A: One of the challenges is defining what normal is, and there’s no uniform acceptance of normal hemoglobin levels. The one most doctors use is from the World Health Organization. A hemoglobin level below 13 for men and below 12 for women is considered anemic.
Q: Nutritional deficiencies are a common cause of anemia. Do these arise from a poor diet or underlying disease?
A: Bleeding is one of the most prominent causes of iron deficiency, because when you bleed you lose red blood cells that contain iron. But there still is a significant prevalence of nutritional iron deficiencies, which is much more common in pregnant women and children because of their diets.
Nutritional iron deficiency is the biggest cause of anemia worldwide, and it’s a problem is some segments of the United States. For folate or vitamin B12, it’s much less common to be deficient.
Q: How difficult is to live with anemia?
A: It’s very tough. One of the things we learned, however, is that the ability of the body to adapt is tremendous. Over time, even people with moderately severe anemia say, “You know, I really don’t feel that bad.”
Although people are fatigued or can’t do as much as they could before, they slowly adapt their lifestyle. Instead of walking to the grocery store once a week, they may go once a month and buy everything they need because they’re too tired to keep going back. There’s a lot of adaptation that takes place, but anemia can be very debilitating.
Q: Is anemia life-threatening?
A: The only life-threatening anemia is if you have massive hemorrhaging. But chronic anemia can be life-threatening indirectly in the sense that prolonged, severe anemia can cause the heart to enlarge and overwork, leading to heart failure. So through that mechanism, anemia can lead to serious morbidity or mortality.
Q: The Food and Drug Administration has issued warnings on three similar anemia drugs: Procrit, Aranasep and Epogen. How safe are these to use?
A: The studies that raised the red flags were either in cancer patients or in people with kidney disease, and they all showed something similar: if you attempt to correct the anemia completely back up to normal hemoglobin levels, that’s not a good idea. You start getting strokes or heart attacks, blood-clotting problems or increased mortality.
The recent studies that the F.D.A. flagged were just studies. Kidney specialists weren’t practicing this way — they were waiting for the studies. So we’re going to continue practicing the way we were, which is to give modest doses of the drugs, with modest improvements in hemoglobin.
Q: Are the drugs potentially dangerous for the elderly or other groups?
A: There are no studies to help us figure that out. There’s no question that since cancer patients and kidney patients are so different, but the same problem has arisen, I think people need to be extremely cautious with the use of these drugs.
One dilemma now is that if someone wanted to do a study on normalizing hemoglobin levels in the elderly with these drugs, I think an institutional review board that has to approve the ethics of studies like this would have a very difficult time because of the concerns of the risks.
Q: The F.D.A. says the drugs are safe to use in small doses that keep oxygen-carrying hemoglobin just below a level that is considered normal. Is this enough to help anemia patients feel better?
A: The quality of life benefit is seen with pretty modest increases of hemoglobin. It looks like you get the biggest bang for the buck early on. If you push the doses, then you start to see the toxicity.
Q: Are red blood cell transfusions a potentially safer option given the new concerns about the drugs?
A: As long as you’re aiming for a moderate increase in hemoglobin, the drugs are so much simpler and have few or any side effects unless you start pushing them hard. Whereas with transfusions, you still have the risk of infectious diseases and other issues.
Q: Are there lifestyle measures, like diet or exercise, that can treat anemia?
A: In the chronic conditions, there is probably very little that can be done. Obviously for nutritional anemia, improving nutrition will help. Probably the only thing you can do is to go to a higher altitude, because there’s less oxygen available.
As a result, the cells that make Epo detect that and then stimulate Epo to make more red blood cells. Even people with chronic illnesses have slightly higher hemoglobin when they go to altitude for a period of time.

 Retrieved from The New York Times

10 Easy Ways to Add Iron to Your Diet

Iron deficiency is the most common form of nutritional deficiency – especially among children and pregnant women – according to the Center for Disease Control and Prevention.  Not getting enough can cause iron deficiency anemia and make you more susceptible to illness and infections; it can even cause premature delivery in pregnant women. So how much should you be getting? Women ages 19 to 50 should be consuming 18 milligrams of iron per day – and a whopping 27 milligrams if they’re pregnant – while men at this age only need 8 milligrams. “There are two types of iron: Heme iron from animal sources and non-heme iron from plant sources,” says Frances Largeman-Roth, RD, and New York Times bestselling author. “It’s important to get both types from your diet.
There are some amazing sources of iron to add to your diet. Here are some ideas that don’t take too much thought and there’s a little here something for everyone. These sources are anti-inflammatory and also easy for your body to absorb.
1. Cooked spinach
                                    greens


2. Oysters












3. Meat



4. Salmon




5. Soybean




6. Liver



7. Tempe



8. Tofu



9. Dark chocolate



10. Broccoli




10 Facts About Iron Deficiency Anemia


Hello guys, I'm back. Anyone missing me? haha. Just kidding. Today, I would to boost your knowledge about iron deficiency anemia. 



                                                            Let's go!         

1. Iron deficiency is the most prevalent nutrient deficiency worldwide, it is estimated than 1.6 billion people are iron deficient anaemic and that over 3 billion people are iron deficient.
2. The prevalence of iron deficiency and iron deficiency anaemia is similar in developed and developing nations.
3. Iron deficiency anaemia develops when the body does not have enough iron for a prolonged period so it is subsequently forced to use stored or back up iron supplies resulting in a permanent reduction in red blood cell production .

 
4. Those at highest risk of iron deficiency are those with rapid blood or iron loss for example menstruating women at a reproductive age and those individuals with increased iron requirements for example young children and pregnant women due to increased growth rates.
5. Iron deficiency in pregnant women has been estimated to be the cause of one in five cases of maternal morbidity and almost 40% of all perinatal maternal deaths are liked to anemia.

6. Often women will enter pregnancy with adequate iron stores but will develop iron deficiency in the later stages of pregnancy
7. Iron deficiency in pregnant women has been estimated to be the cause of one in five cases of maternal morbidity and almost 40% of all perinatal maternal deaths are liked to anemia. Iron deficiency anemic mothers are 30-45% less likely to have favorable pregnancy outcomes. Furthermore, infants born to anemic mothers are more likely to become anemic (odds ratio: 5.7) as they are born with less than half of the normal iron stores.

8. It is also believed that iron deficiency and anemia results in more than 20,000 deaths in children under five years old in the United States.
9. Iron deficiency causes long term negative health implications for example decreased immune mechanisms and morbidity from infections, decreased physical capacity and performance.
10. Iron deficiency is commonly treated through dietary changes and supplementation. Treatment of iron deficiency anemia varies individually depending on severity; often including dietary changes, supplements and medicines. Severe cases of iron deficiency anemia may require blood transfusions, direct iron injections and intravenous iron therapy.
 p/s: I will write a post soon about easy ways to include extra iron in your diet. Thank you for your time my beloved readers. Love you all. Take care of your health 

Monday 5 December 2016

reported cases of anemia

Evening guys. 

Still in topics of anemia. Do you all knows the prevalence of anemia cases in Malaysia specifically? Do you ever wonder how many reported cases in Malaysia? Do you want want to know?

In Malaysia, anaemia in pregnant women still constitute a major and challenging health problem. 

Around 30% of women of reproductive age (corresponding to approximately 2 million women) have anaemia according to the WHO surveys. In a recent study of young women, 32% were anaemic, and in 88% the anaemia was due to ID. Eventually, most women of reproductive age in Malaysia will end up becoming pregnant and having children. 

When non-pregnant women with IDA become pregnant, they have a poor starting position for a good pregnancy and for a good outcome of pregnancy, unless they take adequate iron supplements from early pregnancy.

The prevalence of anemia is 35% and mostly of the mild type and more prevalent in the Indian and Malays.

Prevalence of anemia among women of reproductive age (% of women ages 15-49) in Malaysia was 20.70 as of 2011. Its highest value over the past 16 years was 32.00 in 1995, while its lowest value was 20.70 in 2011.


The diagram shows the percentage of anemia cases in Malaysia from the year 1995 till 2011. 
    
YearValue
199532.00
199631.30
199730.60
199830.00
199929.20
200028.50
200127.70
200226.80
200326.00
200425.20
200524.50
200623.70
200723.00
200822.20
200921.50
201020.90
201120.70

From the table, we can see that the number of cases has been decreased year and by year and it is a good indicator of our country health care.

 

Anemia and Friends

Hello guys, have you got an idea about anemia from our previous post? Still a bit lost? Or did you forget already? Okay then, let me do a quick recap and refresh your brain again and again. Hope you guys did not get bored with us okay. 
Anemia is diagnosed as any condition in which there is a decreased number of circulating red blood cells. Conditions where our body does not produce enough healthy red blood cells, destroys too many red blood cells, or loses circulating red blood cells can all lead to anemia. Red blood cells are critical to our body's well-being. They carry hemoglobin, a complex protein that contains iron molecules.
The main function of these molecules is to carry oxygen from the lungs to the rest of the body.If there are not enough red blood cells, an individual may experience symptoms such as feeling tired or weak.
This post is getting intense, right? Yes, Anemia is not something you can play around with. In order for you to fight anemia, we must get to know who are their friends. Friends?? Yes!! Anemia and friends. Anemia did has friends, not a normal one obviously. Haha. 
So, let's go!! we find their friends and fight together all of them. 
  "Come and join us!"- from Abam Sado
                                     
Basically, they are more than 400 types of Anemia currently known and these are divided into three main groups according to their cause:

§      Anemia caused by blood loss
§      Anemia caused by decreased production or production of faulty red blood cells
§      Anemia caused by the destruction of red blood cells
Causes of anemia
There is no single cause of anemia. Due to the great number of anemia types, it can sometimes be difficult to pinpoint the exact cause.
Below is a general overview of the common causes of the three main groups of anemia:
1) Anemia caused by blood loss

The most common type of anemia - iron deficiency anemia - typically falls into this category. In this case, the disorder is brought on by a shortage of iron, most often caused by blood loss.
The blood loss can be categorized as acute and rapid or chronic. Rapid blood loss can include surgery, childbirth, trauma, or a ruptured blood vessel.
Chronic blood loss is more frequent among patients diagnosed with anemia. Here, the blood loss can be a result of stomach ulcers, cancer, or tumor. Women who undergo heavy menstrual bleeding may also be at risk of developing anemia.
When blood is lost, your body reacts by pulling in water from tissues outside the bloodstream in an attempt to keep the blood vessels filled. This additional water dilutes the blood, and, as a result, the red blood cells are diluted.
2) Anemia caused by decreased or faulty red blood cell productions

A patient's diet can be a cause of anemia. A lack of iron or vitamin-rich foods severely affects the body's ability to produce enough red blood cells.
Vegetarians are particularly at risk of anemia due to the elimination of meat which is high iron content. However, there are other iron-rich foods like leafy greens or iron and vitamin supplements that can be incorporated into the diet.
Located in the center of our bones is a soft, spongy tissue, called bone marrow, which is essential for the creation of red blood cells. Bone marrow produces stem cells, which develop into red blood cells, white blood cells, and platelets.
Bone marrow can be affected by a number of diseases such as leukemia, where abnormal white blood cells are produced in excess, which disrupts normal production of red blood cells.
3) Anemia caused by the destruction of red blood cells


Red blood cells typically have a life span of 120 days in the bloodstream, but they can be destroyed or removed beforehand.
One type of anemia that falls into this category is autoimmune hemolytic anemia, where the body's immune system mistakenly identifies its own red blood cells as a foreign substance and attacks them. Excessive hemolysis (red blood cell breakdown) can occur due to many other medical conditions.


Saturday 3 December 2016

Management

MANAGEMENT  

Avoidance of substances that may precipitate haemolysis is essential. Usually no further management is required, although if haemolysis is marked there may be benefit from folate supplementation.

                                           Management of acute haemolysis




seek specialised advise


blood transfusion


Dialysis in acute kidney injury


Management of chronic haemolysis 


splenectomy (removing of spleen)

supplementation with folic acid


avoid naphthalene ( found in mothballs)