Anaemia: Understanding “low blood count”

Feb 18, 2018 News

By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine

Anaemia or better known as “low blood count” is a condition in which you don’t have enough healthy red blood cells to carry adequate oxygen to the body’s tissues. It is a worldwide problem and affects approximately 25% of the world’s population. Preschool aged children and women are more affected than the rest of the population. Having anaemia may make you feel tired and weak. It can be temporary or long term, and it can range from mild to severe. In the severe form it is life-threatening.

WHAT ARE THE SYMPTOMS OF ANAEMIA?

Common symptoms are due to the reduced amount of oxygen in the body. These include tiredness, having little energy (lethargy), feeling faint and becoming easily breathless.
Less common symptoms include headaches, a ‘thumping heart’ (palpitations), altered taste, and ringing in the ears (tinnitus).
You may look pale.
Various other symptoms may develop, depending on the underlying cause of the anaemia.

WHAT ARE THE CAUSES OF ANAEMIA?

There are many causes of anaemia. These include the following:

A lack of Iron or Iron deficiency anaemia. Iron is needed to form red blood cells which carry oxygen throughout the body. This is the most common cause of anaemia.
Lack of certain vitaminssuch as folic acid and vitamin B12
Red blood cell problems, such as thalassaemia, sickle cell anaemiaand other causes of haemolytic anaemia. In these conditions the red cells are fragile and break easily in the bloodstream.
Bone marrow problemsand leukaemia are uncommon; however, they can cause anaemia.
Other conditionssuch as rheumatoid arthritis and chronic kidney disease can also cause anaemia.

Today, we will focus on Iron deficiency anaemia given how common it is. It is also the more easily reversible of the causes of anaemia.

WHAT CAUSES IRON-DEFICIENCY ANAEMIA?

The following are some reasons that may lead to a lack of iron and result in iron-deficiency anaemia:

Pregnancy or childhood growth spurts. These are times when iron is needed more than usual because the mother will need more iron to cater for her and the needs of the fetus.
Heavy menstrual periods. The amount of iron that you eat may not be enough to replace the amount that you lose from heavy periods.
Poor absorption of iron. This may occur with some gut (intestinal) diseases – for example, coeliac disease and Crohn’s disease.
Bleeding from the gut (intestines). Some conditions of the gut can bleed enough to cause anaemia. You may not be aware of losing blood this way. The bleeding may be slow or intermittent and you can pass blood out with your stools (faeces) without noticing.
If you eat a poor or restricted diet. Your diet may not contain enough iron.

HOW CAN I CHECK FOR ANAEMIA?

A simple blood test can measure the amount of haemoglobin in your blood and count the number of red blood cells per millilitre (ml). Although this test can confirm that you are anaemic, it does not identify the cause of your anaemia.

Sometimes the underlying cause is obvious. For example, anaemia is common in pregnancy and in women who have heavy menstrual periods. In these situations, no further tests may be needed and treatment with iron tablets may be advised. Whenever the cause of the anaemia is not clear, further testing to determine the cause is usually advised.

HOW IS ANAEMIA TREATED?

Some causes of anaemia are more serious than others and it is important to find the reason for anaemia. The treatment of anaemia depends on the underlying cause. For many people this may simply be iron tablets. For others it may be a course of vitamins or other more complex treatments. Patients with severe anaemia, may most likely require blood transfusion to improve.

WHAT ARE SOME FOODS THAT I CAN EAT TO HELP MY ANAEMIA?

The amount of iron we need depends on our age and sex. The best sources of iron come from animal products – mainly red meat. However, we get a good proportion of iron from non-animal sources too.

Iron sources include:

Liver and kidney: They contain high levels of iron (note that pregnant women should avoid liver).
Red meat and also poultry.
Fish and shellfish – for example sardines, crab, shrimps, tuna, mackerel, bass and trout.
Cereal and cereal products
Wholegrain bread
Nuts and seeds
Green leafy vegetables – for example, broccoli, spinach, watercress and kale.
Beans and pulses – for example, baked beans, peas, chickpeas, black-eyed beans and kidney beans.
Dried fruit – for example, raisins, prunes, currants and figs.

If you are constantly tired and weak, get checked for anaemia; it is the kind of tiredness that sleeping can’t fix.

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