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OVERVIEW

What is anemia?

Anemia is one of the most common blood disorder in Canada. It affects your red blood cells and hemoglobin. This is the protein in red blood cells that carries oxygen from your lungs to the rest of your body. You need iron in order to make hemoglobin. Most people who have anemia have a shortage of iron. This condition is called iron deficiency anemia.

There are a few other types of anemia, including:

• Aplastic anemia. This occurs when your bone marrow has damaged stem cells. Your body fails to produce enough new blood cells. The condition affects your red blood cells, white blood cells, and platelets. Sometimes it is called bone marrow failure.
• Hemolytic anemia. This occurs when your body destroys red blood cells before they should. The normal lifespan of red blood cells is 120 days.
• Normocytic anemia. This occurs when your red blood cells are normal in size, but low in count.
• Pernicious anemia. This occurs when your body lacks vitamin B12. It causes a shortage of healthy red blood cells.
• Sickle cell anemia (a form of sickle cell disease). This is a genetic disease that affects your red blood cells. It occurs when you are born with 2 abnormal hemoglobin genes.

SYMPTOMS

Symptoms of anemia

Mild forms of anemia may not cause any symptoms. Fatigue, or feeling tired, is a common symptom. This is because the hemoglobin in red blood cells carries oxygen. A lack of oxygen reduces energy. It can cause your heart to work harder to pump oxygen. Anemia can produce other symptoms, such as:

• paleness
• shortness of breath
• cold hands and feet
• headaches
• dizziness
• fast, slow, or uneven heartbeat
• brittle nails or hair loss
• strange food cravings (known as pica).

Contact your healthcare provider if you have any of these symptoms. They can diagnose the type and cause of the condition.

CAUSES & RISK FACTORS

What causes anemia?

There are three main reasons why anemia occurs.

1. Your body can’t produce enough red blood cells.

Your body may not produce enough red blood cells if you lack certain nutrients. Low iron is a common problem. People who don’t eat meat or follow “fad” diets are more at risk of low iron. Infants and toddlers are at risk of getting anemia from a low-iron diet. Low vitamin B12 and folic acid can cause anemia as well.

Unable to absorb.  Certain diseases affect your small intestine‘s ability to absorb nutrients. For example, Crohn’s disease and celiac disease can cause low iron levels in your body. Some foods, like milk, can prevent your body from absorbing iron. Taking vitamin C can help this. Medicines, such as antacids or prescriptions to reduce acid in your stomach, can affect it as well.

Pregnancy.  Women who are pregnant or breastfeeding can get anemia. When you’re pregnant, you need more blood (up to 30%) to share with the baby. If your body lacks iron or vitamin B12, your body can’t produce enough red blood cells.

The following may increase your risk of anemia during pregnancy:

• Vomiting a lot from morning sickness
• Not getting enough iron-rich foods
• Having heavy periods before pregnancy
• Having 2 pregnancies close together
• Being pregnant with twins, triplets or more
• Becoming pregnant as a teenager
• Losing a lot of blood (for example, from an injury or during surgery).

Growth spurts. Children younger than 3 years of age grow so fast that their bodies may have a hard time keeping up with the amount of iron they need.

Normocytic anemia.  Normocytic anemia can be congenital (from birth) or acquired (from a disease or infection). The most common cause of the acquired form is a chronic (long-term) disease. Examples include kidney disease, cancer, rheumatoid arthritis, and thyroiditis. Some medicines can cause normocytic anemia, but this is rare.

2. Your body destroys red blood cells early and faster that they can be replaced.

Treatments, such as chemotherapy, can damage your red blood cells and/or bone marrow. Infection caused by a weakened immune system can lead to anemia. You may be born with a condition that destroys or remove red blood cells. Examples include sickle cell disease, thalassemia, and a lack of certain enzymes. Having an enlarged or diseased spleen can cause anemia, too.

3. You have blood loss that creates a shortage of red blood cells

Heavy periods may cause low iron levels in women. Internal bleeding, such as in your digestive or urinary tract, can cause blood loss. This can be caused by conditions such as a stomach ulcer or ulcerative colitis. Other reasons for blood loss include:

• cancer
• surgery
• trauma
• taking aspirin or a similar medicine for a long time.

DIAGNOSIS & TESTS

How is anemia diagnosed?

Contact your healthcare provider if you think you or your child might have anemia. They may do a physical exam and review your health history and symptoms. To diagnose anemia, your healthcare provider will probably test your blood. This test is called a complete blood count (CBC).  If you have anemia, your healthcare provider may need to do other tests to find out what’s causing it.

Can anemia be prevented or avoided?

You cannot avoid anemia caused by a genetic disease. You often cannot avoid it due to blood loss. If your blood loss is from heavy periods, receiving treatment can help prevent anemia. If your body can’t absorb certain nutrients, such as iron or vitamin B12, talk to your healthcare provider about taking a supplement. This can help manage your levels and prevent anemia.

A balanced diet can help prevent some types of anemia.  Foods high in iron include:

• red meat
• seafood
• organ meats, such as liver
• whole grains
• dried fruits
• nuts
• beans, especially lima beans
• dark green leafy vegetables, such as spinach and broccoli
• iron-fortified foods, such as breads and cereals (check the label)

TREATMENT

How is anemia treated?

Treatment depends on what’s causing your anemia. For example, if anemia results from losing too much blood, your healthcare provider will need to treat the cause of your blood loss. If anemia results from your diet being too low in iron, your healthcare provider may recommend a change in your diet or iron pills.

Living with anemia

Following treatment, most people go on to live normal, healthy lives. However, anemia can have lasting, or life-threatening, effects. These are more common if the condition is chronic, severe, or left untreated. They include:

• This is an issue with your heartbeat. It can be too fast, too slow, or uneven. Over time, this can lead to heart disease or heart failure.
• Organ damage. This can occur if an organ doesn’t get enough oxygen.
• Weakened immune system. This can be fatal if your immune system already is weak from cancer, disease (such as HIV/AIDS), or an infection

Children who have iron deficiency anemia have a higher risk of lead poisoning. They also can develop mental, motor, or behavioral problems over a long time.

Pregnant women who have iron deficiency anemia may have their baby premature or at a low birth weight. There also is a risk of needing a blood transfusion if you lose a lot of blood during delivery.

FOR MORE INFORMATION

Health Canada at:
https://www.canada.ca/en/health-canada.html