MEDICAL SURFARI: ANEMIA IMPLIES DEFICIENCY OF RED BLOOD CELLS

Anemia is a laboratory definition that implies a deficiency of red blood cells (RBCs) resulting in a decreased ability to adequately supply oxygen to body tissues. This may result from diminished numbers of RBCs, decreased oxygen carrying protein in the cells or RBCs that are smaller than normal. Anemias may be classified a variety of different ways. The physiological approach determines whether the deficiency in RBCs is due to a defect in production or in survival. Most anemias are the result of vitamin deficiencies that can be improved or corrected by eating a balanced diet with iron and vitamin supplements.

Some anemias are hereditary and yet others are caused by chronic disease and topic substances. The two most common forms of anemia are due to iron deficiency and folic acid deficiency.

The symptoms of anemia include fatigue, weakness, shortness of breath, numbness and tingling of the hands and feet, paleness, diarrhea and sores in the mouth or on the tongue. Some people may have headaches and others may develop a yellow appearance to the white of the eyes or the skin (jaundice). Irritability, low blood pressure, brittle nails, and diminished appetite may also be the result of anemia. The more rapidly an anemia develops, the more severe is its symptoms. An otherwise normal individual can tolerate as much as a 50 percent gradual reduction in oxygen carrying capacity without pronounced symptoms and people who are customarily very active are more likely to experience symptoms that are more pronounced than a more sedentary individual.

Iron deficiency anemia is the most common in the United States as one in five women of child-bearing age have this type of anemia. This may occur in men although one tenth as many men develop this condition. Menstrual blood loss as well as eating too few iron-rich foods and not absorbing enough iron are the most common causes of this condition among women. Iron deficiency also may result from pregnancy, breast-feeding, and blood loss from ulcer disease.

Folic acid deficiency anemia results when folic acid levels are too low. Folate, or folic acid, is necessary for RBC formation and growth. This vitamin is found in green leafy vegetables and liver as well as fresh fruits and other vegetables. The most common cause of this deficiency is a poorly balanced diet, alcoholism, or some type of malabsortpion intestinal disease. The need for this vitamin doubles during pregnancy and adequate levels are often not met by diets of pregnant women. Since low folic acid levels have been associated with low birth weight and development defects in babies supplementation is recommended throughout pregnancy.

Treatment of anemia requires identifying the underlying cause. If you have had the symptoms of anemia or have reason to suspect that you're developing anemia, consult your physician for a careful evaluation as most anemias can be treated relatively easily.

Worldwide Web Resources

Health Answers

222.healthanswers.com/database/ami/converted/000560.html

Through this web site, you can get information on 14 different types of anemias. Each web page includes causes, prevention, symptoms, diagnostic tests and treatment.

American Institute of Preventive Medicine

www.healthy.net/library/books/healthself/womens/anemia.htm

This web site focuses on the two most common types of anemia, iron-deficiency anemia and folic-acid deficiency anemia. It stresses how to identify the problem and medical self-care once it has been diagnosed.

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Surfari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.