Anemia Causes and Treatment

Anemia is a deficiency of red blood cells, hemoglobin, or both. Normally, each drop of blood contains about 250 million red blood cells. These tiny disk-shaped cells are filled with hemoglobin, a reddish pigment that carries oxygen from the lungs to the body cells and also carries some carbon dioxide from the cells back to the lungs. When the number of red cells or the amount of hemoglobin within them falls below certain levels, a person is said to be anemic.

Kinds of Anemias

Anemias are generally divided into three basic groups depending on their cause.

One kind of anemia is due to the loss of large amounts of blood from the body, usually from a profusely bleeding wound or an ulcer. Another kind of anemia occurs when too few red blood cells are produced. The third kind of anemia is due to the formation of red blood cells that are defective in some way and have a short life span.

Insufficient Production of Red Blood Cells

Normally, about 250 billion red cells are manufactured each day to replace those that are worn out and destroyed. Sometimes, the production is insufficient because of a lack of the substances needed for red-cell formation, such as iron, vitamin B12, or folic acid. The most common anemia of this type is iron-deficiency anemia. Except in infants and children, iron-deficiency anemia is not due primarily to a lack of iron in the diet. Rather, it is usually the result of iron loss due to bleeding or pregnancy. Thus, changing the diet to include liver or vitamins has little or no effect on this anemia, which is cured by treating the source of bleeding. Iron, in the form of tablets or rarely, by injections, should also be administered.

Pernicious anemia is due to the body's inability to absorb vitamin B12 from ingested foods. The absorption of this vitamin is normally aided by a special substance secreted in the stomach. In people with pernicious anemia, this substance is icking, and the disorder can be cured only by injections of vitamin B12. Closely related to pernicious anemia is folic-acid-deficiency anemia, which often occurs in people whose diet does not include vegetables. This form of anemia is readily cured by the administration of very small amounts of folic acid.

People afflicted with cancer, tuberculosis, or chronic kidney disease sometimes suffer from a type of anemia, called simple chronic anemia, which is not due to the lack of iron, vitamin B12, or folic acid. This anemia can be cured only by correcting the underlying disease.

Sometimes, insufficient production of red blood cells occurs when the bone marrow is damaged or diseased. One anemia of this type is aplastic anemia, which may result from the use of certain drugs, such as chloromycetin, or from exposure to irradiation. Aplastic anemia is difficult to treat and almost always requires the administration of blood transfusions. Cortisone-like drugs and male sex hormones have also been found to be helpful.

Defective Red Blood Cells

The most common of this third group of anemias is sickle-cell anemia, in which the red blood cells are misshapen and resemble tiny sickles. Sickle-cell anemia occurs mostly in Negroes and is inherited as a recessive trait. It is estimated that about 10 percent of all American Negroes carry this trait. A similar disorder is congenital spherocytosis, in which the red blood cells are shaped like tiny spheres.

In some hemolytic anemias, known as congenital nonspherocytic hemolytic anemias, the red blood cells are short-lived even though they are normal in shape. Sometimes, the red blood cells have a short life-span, not because they are defective, but because the person's body develops antibodies against his own red cells. This type of anemia is known as autoimmune hemolytic anemia and it can sometimes be treated with cortisone or cortisone-like drugs.

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