Guidebook to manage Anaemia

Contributed by – Healthians team

India has the most number of people suffering from anaemia in the whole world. Almost 51% of Indian women aged 15-49 are anaemic. In most cases, it’s mild but it can become serious and life-threatening for some people if certain things are not kept in mind. An important thing to note is that anemia is not a disease. It’s the result of a malfunction in the body. If you maintain a healthy lifestyle, the situation can easily be prevented.

Read on as we discuss everything about anaemia – from what it is to what you should do to keep it at bay. After all, only with complete knowledge, you can be healthier!

What is anaemia?

Anaemia is a condition wherein the healthy red blood cell count of the body is too low. In a routine blood test, it’ll be reported as low haemoglobin (an important protein in red blood cells). Haemoglobin carries oxygen to all parts of the body. So, a low red blood cell count implies low levels of oxygen in the body than it should be. As a result, body functions get hampered and various symptoms of anaemia like fatigue and pain start appearing. Anaemia can be both temporary and chronic. In most cases, it is mild but it can become serious and life-threatening.

There are certain people who are at high risk of developing anaemia. They are:

• Menstruating women, especially when there’s heavy bleeding
• Pregnant and breastfeeding women
• Infants, especially if premature
• Children going through puberty
• Vegetarians & vegans
• People suffering from cancer, stomach ulcers or any chronic disease
• People on fad diets

Causes of anaemia

The causes of anaemia are more than 400. But they are broadly divided into three categories:

1. Anaemia caused by blood loss – You can lose red blood cells through bleeding which may happen slowly over a long period of time and you may not even notice it. Causes include ulcers, hemorrhoids, gastritis, cancer, heavy menstrual bleeding, post-trauma or post-surgery.
2. Anaemia caused by decreased or faulty red blood cell production – This type of anemia happens when the body is not able to produce enough red blood cells or the cells produced may not work the way they should. Conditions like bone marrow and stem cell problems, iron deficiency, various vitamin deficiencies or some chronic diseases like kidney disease can cause it.
3. Anaemia caused by the destruction of red blood cells – Sometimes red blood cells may burst, causing hemolytic anaemia. You might have the condition by birth or it may develop later in life. Exact causes of hemolytic anaemia are unclear but may include an attack by the immune system, genetic conditions like thalassemia, infections, drugs, snake/spider venom, toxins from advanced kidney or liver disease, tumors, burns or hypertension.

Signs and symptoms of anaemia

People suffering from mild anaemia may not show any symptoms at all or may have only mild symptoms, while those suffering from severe anaemia may have many telltale signs. Listed below are some of the most common symptoms of anaemia.

• Weakness
• Pale skin
• Brittle nails
• Shortness of breath
• Headache
• Irritability
• Inability to concentrate
• Dizziness
• Cold hands and feet
• Irregular heartbeat
• Chest pain
• Sexual dysfunction
• Poor appetite

Complications due to untreated anaemia

If anaemia is left untreated, it can cause:

• Severe fatigue, which can make you incapable of performing everyday tasks.
• Complicated pregnancy.
• Heart problems, leading to heart failure.

Understanding test results

To diagnose anaemia your doctor may advise these blood tests:

• CBC
• Iron studies with ferritin
• Peripheral blood smear
• Haemoglobin HPLC study

Reference range*

Complete Hemogram / CBC: to be repeated every 3 months

• Haemoglobin (Hb)   11.5 – 16.0  g/dl
• Red Blood Cell count (RBC) 3.80 – 5.80 millions/cumm

Iron studies with Ferritin: to be repeated every 3 months

• Ferritin:  Men (20-60 years) : 22 – 322 ng/ml; Women (17-60 years) : 10 – 291 ng/ml
• Iron, Serum:  33 – 193 μg/dl
• TIBC : 250.0 – 400.0 μg/dl
• Transferrin Saturation: 16.0 – 50.0%

Peripheral blood smear: to be repeated every 3 months

Haemoglobin HPLC Study: only 1 time

*reference range may vary from lab to lab

Lifestyle recommendations to manage anaemia

Treatment of anaemia depends on the cause and severity of it. However, little lifestyle modifications can be helpful. Here are some do’s and don’ts to manage anaemia.

Do’s

• Make sure that your diet is rich in foods that provide all the vitamins, minerals and proteins as they are essential for red blood cell production.
• Eat green leafy vegetables only after blanching to reduce the concentration of oxalic acid content.
• For vegetarians, it is important to include 1 or 2 servings of green leafy vegetables in every meal.
• Use iron pots and pans to cook your meals, as to enhance the inorganic iron absorption from the cookware.
• Include iron-fortified food such as cereals, grains, nuts and beans in your diet.
• Drink plenty of water during the day to enhance metabolism.
• Include vitamin C rich foods like lemon juice, amla in your diet to enhance iron absorption and utilization.
• Pregnant women should take prenatal vitamins that include iron under the supervision of their doctor.
• Exercise regularly but in moderation. It’ll help deliver the optimum level of red blood cells to muscle tissues.

Don’ts

• Don’t drink tea and coffee with meals as it hampers iron absorption.
• Avoid foods that are stored in poor conditions as it may cause worms in the gastrointestinal tract which will lead to poor iron absorption.
• Restrict alcohol intake. It hampers nutrient absorption.
• Calcium-rich food also interferes with iron utilization. So, never have calcium-rich food with iron-rich food.
• Polished cereals should be avoided as they are deficient in B vitamins, which have a role in RBC formation.
• Always cover cut or cooked food. Air contact diminishes the Vitamin C value of cut/ cooked food.
• Complex carbohydrates should also not be combined with iron-rich meals.
• Excess consumption of refined products like pasta, bread, and refined products should be discouraged as they are deficient in iron due to the processing.

Please note that before making any sudden changes in your diet and lifestyle, consult with your doctor and/or get a health checkup done. It will help you better understand your health and know what is right for you and what may cause complications.