Anemia in very simple terms means lowered Hemoglobin (Hb) levels. But how does it impact our health and well-being? This is the question crossing the minds of many when we equate lowered hemoglobin levels with illness. Well, Hb is the protein present within the red blood cells (RBC). It imparts the red color to our blood. It performs the important function of carrying oxygen from the lungs to all parts of our body. Mammals need oxygen for normal metabolism. So lowered Hemoglobin levels means lowered oxygen-carrying capacity of blood. This leads to the deprivation of oxygen to vital organs which start functioning sub-optimally.
The symptoms of anemia can be any of the following:
Tiredness
Fatigue
Shortness of breath
Palpitations
Pale skin/mucous membranes
Light-headedness
Headaches
So, who are the at-risk individuals?
Females in the reproductive age group are more prone to anemia as they may suffer from excessive bleeding during menses known as polymenorrhoea.
Perimenopausal females who may have unexpected heavy bleeding during menses.
Pregnant females due to inadequate dietary intake of nutrients.
Even small children at the time of weaning may become anemic. Up until 6 months, mothers' milk is sufficient to provide all the nutrients needed by the baby. But after 6 months the baby’s nutrient requirement increases, which needs to be supplemented in diet. The inability to do so will lead to anemia in children.
Individuals having chronic bleeding conditions like gastric ulcers, piles, variceal bleeding etc will also have low Hb levels.
The cause of anemia is multifold.
Most common cause is nutritional deficiency like Iron deficiency, Vitamin B12 and folic acid deficiency. Iron forms an important component of the Hemoglobin molecule and so is needed for the formation of blood.
Other causes of anemia are bleeding which can be either acute massive bleeding like at the time of any major surgery, accidents, during childbirth.
Bleeding can also occur because of any chronic cause like portal hypertension, stomach or intestinal ulcer, piles, or varices (distended blood vessels in the esophagus) which may rupture and cause life-threatening bleeding. Even a female suffering from heavy menses will be anemic due to excessive blood loss during her menses.
As age advances numerous other health ailments stealthily enter our life and we start living with them. One such ailment is kidney disease. It can be quite subtle but even chronic kidney disease can lead to anemia as the hormone erythropoietin needed to stimulate the production of RBC’s is synthesized by the kidneys.
If you are feeling low, and fatigued most of the time chances are that you may be anemic.
So how do we test for anemia? We can start with the simple and easily available laboratory investigation which is a Complete Blood count (CBC) along with a peripheral blood smear study. Let us say that it is the baseline for all the further investigations needed. If the CBC confirms that the hemoglobin level is low, then various tests are recommended to know the root cause of anemia. We must rule out the nutritional causes by doing the following tests- Iron studies, Vitamin B12 levels etc.
Also there can be other causes of anemia like Thalassemia or sickle cell disease which are known as Hemoglobinopathies, there is a genetic defect in the hemoglobin molecule itself. Since it is genetic it is passed from one generation to the other. The test to detect these conditions is known as HPLC (High Performance Liquid Chromatography). This tells us exactly what is the percentage of different types of hemoglobins in our body and whether we are suffering from Thalassemia or Sickle cell disease.
In addition to the above tests more tests like endoscopy for gastric or intestinal bleeding, USG for any uterine cause needs to be considered.
With such a huge armamentarium of tests available at our disposal, there is no reason for anyone to be suffering from anemia. So get yourself tested today if you have any of the symptoms and get treated for the same as early as possible.
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