Anemia - symptoms and treatment of anemia

Fatigue, paleness, dizziness – these are symptoms that are easy to ignore, but they can be a sign of a serious health problem, which is anemia. Anemia affects millions of people, and its causes, symptoms and treatment are much more complex than you might think. In this article, we explain what anemia is, what its types are, how to recognize it and treat it effectively.

Anemia is a disease that affects millions of people worldwide, often remaining undiagnosed for a long time. Medically, it is also referred to as anemia, which means a condition in which the body has too few red blood cells or their ability to carry oxygen is impaired. Anemia is a condition that can have many causes and just as many forms - from mild to life-threatening. One of the most commonly diagnosed forms is iron deficiency anemia, but there are many more types of anemia. Anemia can have many causes, and its course can be varied - from almost asymptomatic to severe organ failure. What is anemia from a hematological perspective? It is a complex set of symptoms resulting from a deficiency of functional erythrocytes or the hemoglobin contained in them.

Medical classification distinguishes various types of anemia, including microcytic, megaloblastic , aplastic, hemolytic , and sickle cell anemia . Each type has different causes and mechanisms of development. A particularly dangerous form of anemia is the so-called pernicious anemia, resulting from the lack of absorption of vitamin B12. Different types of anemia require an individual diagnostic and therapeutic approach, which is why their proper diagnosis is a key element of effective treatment.

As we wrote in politykazdrowia.com , the US Food and Drug Administration (FDA) has approved the first two cell-gene therapies for the treatment of sickle cell anemia. Although the disease still occurs sporadically in Poland, demographic changes related to globalization, migration, and international travel may affect the increase in the number of cases.

Patients who will be treated with these methods will be subject to long-term observation, the FDA says.

One of the main causes of anemia is iron deficiency – an element necessary for the synthesis of hemoglobin, which transports oxygen. The most common cause of anemia in women of reproductive age is heavy menstruation, while in older people it is more often a result of bleeding from the digestive tract. In the case of hemolytic anemia, the process of destroying red blood cells occurs faster than their production, which leads to a sudden deficiency. Microcytic anemia, caused by long-term iron deficiency, results in the formation of erythrocytes smaller than standard, with a limited ability to bind oxygen. In many cases, chronic blood loss, especially from the digestive tract or genital tract, leads to the development of anemia. When iron reserves in the body are depleted, anemia associated with iron deficiency develops – the most common form of anemia in the world.

Chronic diseases such as kidney disease, rheumatoid arthritis or cancer are also important. In their course, the body cannot effectively use iron stores, which leads to the so-called anemia of chronic diseases. The risk of anemia cannot be underestimated in pregnant women, because pregnancy anemia can threaten not only the health of the mother, but also the proper development of the fetus.

Many patients ignore the first symptoms for a long time, not realizing that they may indicate anemia. Anemia often shows symptoms only when the haemoglobin level drops drastically. Symptoms may include chronic fatigue, dizziness, shortness of breath during physical exertion, pale skin and a feeling of cold. Symptoms include brittle nails, tinnitus or problems with concentration - especially in cases of long-term anemia. In the initial phase, anemia may be asymptomatic or cause very non-specific symptoms, which makes it difficult to detect it quickly. The most common symptoms of anemia are weakness, dizziness and a feeling of rapid heartbeat even with little exertion.

It is worth noting that the symptoms of aplastic anemia can be sudden and very severe. In this rare form, the bone marrow does not produce enough blood cells, which results not only in anemia but also in bleeding diathesis and susceptibility to infections. Similarly, the symptoms of hemolytic anemia can be sudden - there is sudden weakness, jaundice and dark urine as a result of the breakdown of red blood cells.

In the face of increasing symptoms, it is crucial to quickly recognize anemia. Diagnosis of anemia is based primarily on blood tests – basic morphology, ferritin level, hemoglobin concentration and analysis of red blood cell indices (MCV, MCH). Evaluation of the number of erythrocytes and their morphology is also crucial – these parameters allow to determine whether the bone marrow is responding properly to the deficiency. In cases where its failure is suspected, a bone marrow biopsy may be necessary. Treatment depends on the cause of the anemia, which is why it is extremely important to classify it correctly. In the case of iron deficiency anemia, oral preparations are used, and if absorption is difficult – intravenous iron.

Effective treatment of anemia involves not only supplements but also eliminating the source of the problem. In patients with pernicious anemia, cyclic injections of vitamin B12 are necessary, while in chronic anemias, erythropoietin is often used. In some cases, a blood transfusion may be necessary, especially if the hemoglobin level falls below critical values.

Treatment of anemia should always be tailored to its type and cause. When the cause of anemia is iron deficiency, supplementation of this element is crucial. Modern therapeutic regimens recommend an individual approach - in some patients oral preparations are sufficient, but in cases with absorption disorders or gastrointestinal diseases, intravenous administration gives better results. In pernicious anemia, caused by vitamin B12 deficiency, treatment requires regular intramuscular injections, often for the rest of life. In many cases, chronic blood loss, especially from the gastrointestinal tract or genital tract, leads to the development of anemia. When iron reserves in the body are depleted, anemia associated with iron deficiency develops - the most common form of anemia in the world.

Diet is also of particular importance. What to eat with anemia depends on its type. In microcytic anemia, products rich in heme iron are recommended - red meat, liver, fish - as well as leafy vegetables and legumes, supported by vitamin C, which increases iron absorption. Folic acid, present in spinach and legumes, among others, is indispensable in megaloblastic anemia.

Effective diagnostics of anemia does not end with the detection of a low hemoglobin concentration. It is important to understand the mechanism that led to anemia. For this purpose, a blood count with a smear is performed, analyzing the size and shape of red blood cells. In microcytic anemia, MCV is reduced, which indicates iron deficiency. In macrocytic anemias - such as pernicious anemia - this indicator can be elevated.

The next diagnostic steps include ferritin, TIBC, vitamin B12 and folic acid levels. Stool tests for occult blood are also important in diagnosing anemia, especially in people over 50, to rule out bleeding from the digestive tract as a potential source of the problem. Diagnosing anemia must be comprehensive - without it, therapy will not bring the expected results.

In cases of suspected more severe forms, such as aplastic anemia, a bone marrow biopsy may be necessary. This test allows the assessment of hematopoietic activity and the exclusion of other diseases of the hematopoietic system. If the bone marrow shows a lack or significant reduction in the number of cells, the diagnosis of aplastic anemia is almost certain. It is worth emphasizing that the bone marrow plays a fundamental role in the production of all morphological elements of the blood, including erythrocytes, and its failure can have very serious consequences.

Each type of anemia poses different diagnostic and therapeutic challenges. Microcytic anemia is most often the result of chronic iron deficiency and is characterized by reduced red blood cells. In sickle cell anemia, a genetic disorder, red blood cells take on a sickle shape and are easily destroyed. In hemolytic anemia, it is the accelerated breakdown of red blood cells that dominates the clinical picture.

Anemia can be different, but the common denominator of these forms is insufficient oxygenation of tissues. Symptoms, although sometimes similar, differ in intensity and time of appearance. Often, only a thorough laboratory analysis allows us to determine what type of anemia we are dealing with and what the treatment of anemia looks like in a given case.

A type of anemia is vitamin deficiency anemia, but also anemia of chronic diseases, in which the problem is not a lack of components, but their impaired mobilization. Treatment of such cases requires support for the underlying disease, e.g. control of inflammation or improvement of kidney function. In aplastic anemia, where blood production in the bone marrow is impaired, a transplant or the use of immunosuppressive drugs is often necessary.

Adjusting therapy to the type of anemia is a prerequisite for success. There is no single universal solution, because anemia results from various mechanisms – from deficiency to immunological or genetic. Therefore, in treatment, it is important not only to know the pharmacotherapy regimens, but also to understand what specifically caused the anemia in a given case.

In some patients, anemia is autoimmune in nature – the body destroys its own red blood cells, which is often associated with an enlarged spleen and the need to monitor it. In the long run, this can lead to multiple organ failure, especially the heart and kidneys.

Among the nutrients that are key to healthy blood, vitamin B12, iron, and folic acid play fundamental roles. Their deficiencies not only lead to the development of anemia symptoms, but also to permanent neurological disorders if they are not supplemented in time. Treatment of megaloblastic anemia, in which red blood cells are abnormally large and dysfunctional, requires the administration of vitamin B12 and folic acid in appropriate doses.

It is worth remembering that not every supplementation brings the expected effect if you do not take care of treating the causes and changing your lifestyle at the same time. Supplements are support, but the foundation should be a full-fledged diet and causal treatment, which gives the greatest chance for permanent recovery. In each case of supplementation, it is worth consulting a doctor, who will select the right dose and form of the preparation, taking into account the test results and the individual needs of the body.

Yes, anemia can be dangerous, especially if it is not recognized and treated early enough. Chronic oxygen deficiency leads to serious disorders in the heart, nervous system and functioning of the entire body. In extreme cases, untreated anemia can increase the risk of heart attack, stroke or complications during pregnancy.

The duration of anemia treatment depends on its cause, the degree of advancement, and the body's response to therapy. In mild cases, improvement may occur after a few weeks of supplementation, but full blood parameter balance may take up to 3–6 months. In chronic anemias, treatment may be long-term or even lifelong.

Treatment mainly consists of iron supplementation – initially orally and if necessary intravenously. At the same time, the source of deficiency, e.g. chronic bleeding, should be eliminated. Supplementation usually lasts several months and should be carried out under the supervision of a doctor to avoid side effects and inappropriate dosage.

The basis of diagnostics is a blood count with the determination of hemoglobin concentration, hematocrit and MCV/MCH indicators. Additionally, it is worth checking the level of ferritin, vitamin B12, folic acid and determining TIBC. In some cases, stool tests for occult blood and a gastroenterology or hematology consultation may be necessary.