Anaemia is a condition in which there is a reduction of oxygen transport in the blood due to a decrease in haemoglobin content. Symptoms include; fatigue and loss of energy, rapid heart beat, shortness of breath, headache, difficulty concentrating, dizziness, pale skin, leg cramps, and insomnia. There are a number of factors that can cause this condition; for example, lack of essential nutrients, disruption within the site of production, a failure of the red blood cell to develop or become structurally changed thereby compromising their function.
Iron Deficiency Anaemia
Iron deficiency anaemia is due to a shortage of iron which leads to a reduction in the level of haemoglobin produced. Excess iron is toxic, therefore the assimilation of iron is usually sufficient for the body’s needs, the rest is excreted. Women need more iron than men to make up for the amount they loose during their menstrual period. Around 1 mg of iron is lost for every day of bleeding during menstruation. In pregnancy the need for iron increases to meet the needs of the developing foetus. Increased demand also occurs during periods of rapid growth, as in adolescence. It is estimated that around 1 in 5 women are affected by iron deficiency anaemia. There are a number of causes which can result in a deficiency. As has been implied a deficiency can result due to insufficient levels of iron in the diet or due to excess demand at that moment in time.
Is found in every cell of the body combined with protein. 60 to 70% is contained within haemoglobin. Due to a lack of iron the body will produce less haemoglobin. Iron is stored in the liver, spleen and bone marrow and drawn on when needed. 5% is found in myoglobin (muscle oxygenating protein). Iron is poorly absorbed, in particular non-heme (that is iron found in vegetables). Phytates found in whole grain and oxalates found in certain vegetables bind to some of the iron and make it unabsorbable. Vitamin C convert ferric iron to ferrous which is better absorbed. This is then bound to the protein transferrin and travels to the bone marrow to produce red blood cells. Some goes to the liver and spleen. The body conserves iron well, but there is a risk of toxicity as a result of oxidation, therefore the body will absorb enough dependent upon requirements. Due to menstruation Women need more iron intake than men.
Citrus fruits that contains vitamins C help with iron absorption. Copper (also helps form haemoglobin), Cobalt, and Manganese also improves iron absorption. Iron is required for some of the important enzymes involved in energy production and protein metabolism. Iron absorption is compromised by low stomach acid, phosphates, oxalates, and phytates. Caffeine, and tea can also reduce iron absorption. Some studied have suggested that excess Calcium intake may also interfere with Iron absorption.
Deficiency signs and symptoms. Anaemia, pallor, dry skin, poorly formed upturned nails, brittle hair, easily tired, weak, lack of energy, increased susceptibility to infection, learning disabilities, cold sensitivity, constipation, poor appetite, and sore inflamed tongue.
When taken in excess Iron can cause symptoms of; fatigue, headaches, pallor, pulse, and rapid increase in respiration.
In Pernicious anaemia - Vitamin B12 deficiency (megaloblastic anaemia) results form a deficit in Folic acid or Vitamin B12. While reduced Folic acid levels are diet related, a lack of B12 may also be as a result of poor absorption (which is the most common cause). Vitamin B12 is dependent upon Intrinsic Factor for absorption which is produced by the gastric cells of the stomach. Autoantibodies can lead to a destruction of Intrinsic factor and also a reduction in hydrochloric acid. The reduction of hydrochloric acid will also result in a decrease in the absorption of iron and in the digestion of protein. In this condition iron deficiency anaemia may also be present. Stomach acid declines with age. As a result of this deficiency the maturation of erythrocytes is impaired and they become enlarged and subsequently destroyed. Vitamin B12 deficiency may lead to nerve damage which can cause tingling and numbness in the hands and feet, muscle weakness, and loss of reflexes. Other symptoms of vitamin B12 deficiency involve the digestive tract. These symptoms include nausea and vomiting, heartburn, abdominal bloating and gas, constipation or diarrhoea, loss of appetite, and weight loss. A smooth, thick, red tongue is also a sign of vitamin B12 deficiency and pernicious anaemia.
B12 also contains Cobalt. It requires intrinsic factor produced in the stomach for absorption. The thyroid hormone also facilitates absorption. Excess calcium intake may interfere with B12 absorption. The body can store B12 but for a limited amount of time. It is necessary for the health of the nervous system and for folic acid metabolism, and plays a role in reducing homocysteine levels which are associated with cardio-vascular disease. High alcohol and caffeine intake, oral contraception, chronic digestive disorders, hyperthyroidism, can interfere with B12 absorption.
Functions; Maintenance of the nervous system, metabolism and formation of red blood cells, Maintenance of growth, metabolism of fat, protein and carbohydrate, Essential for the integrity of cell membranes, and the production of epithelial cells. Increases energy. Is needed to process folic acid
Folic acid, Vitamin B9
Acts as a coenzyme for a multitude of functions. Vitamin B12 is required to convert Folic acid into an active form, however Folic acid deficiency can mask B12 deficiency. Folic acid aids in red blood cell production by carrying the carbon molecule to the larger heme molecule. It is central to all rapidly dividing cells. With B12 and vitamin C it helps in the breakdown and utilisation of protein and many amino acid conversions. It is used in the formation of nucleic acids for RNA and DNA. It is required for the proper balancing of the brain's neurotransmitter levels of catecholamines; epinephrine and norepinephrine. Plays a critical role in the development of the infant nervous system. Reduces high levels of homocysteine which can contribute to arterial damage and blood clots in blood vessels,
Levels can be reduced by; smoking, deficiency in B12 and Vitamin C, alcohol, and oral contraceptives.
Aplastic anaemia is when the body doesn't produce enough red blood cells. Sometimes the cause is unknown. The condition can be as a result of an infection, certain medicines including radiation therapy, an autoimmune disease and exposure to toxic chemicals. As it is a failure of production within the bone marrow itself there will also be a decrease in the production of leucocytes (white blood cells) and platelets. As well as the usual signs and symptoms of anaemia other symptoms are observed, which include; frequent or prolonged infections, being more easily bruised, nosebleeds and bleeding gums, and prolonged bleeding from cuts.
Haemolytic anaemias is as a result of the excessive destruction of erythrocytes, Causes include; an over proactive spleen, genetic defects, immune reactions, toxins, infections such as malaria, and transfusion reactions. One example is Sickle cell anaemia which leads to the abnormal formation of haemoglobin, resulting in the changed shape of the erythrocyte from a disk to a sickle shape. The change of shape results in a shorter life span of the cells, from 120 days to only 20, which will lead to a lower erythrocyte level within the blood. The reduced flexibility of the cell potentially leads to an obstruction within the small blood vessels. Symptoms include; fatigue, pain crises, dactylics (swelling and inflammation of the hands and/or feet), arthritis, bacterial infections, sudden pooling of blood in the spleen, liver congestion, lung and heart injury, and leg ulcers.
Haemolytic disease of newborn is when the mother makes antibodies to the baby’s red blood cells ‘rhesus factor’. Being given an incompatible blood type during a transfusion can also lead to difficulties for similar reasons.
A genetic condition resulting in an abnormality in the production of haemoglobin, thereby reducing the amount of haemoglobin synthesised and the number of erythrocytes. One type predominantly affects people from Greece and Italy while another affects mainly those from Southeast Asian decent. Signs and symptoms are dependent upon the type and severity of the condition and includes; weakness, pale or yellowish skin, facial bone deformities, slow growth, fatigue, abdominal swelling, and dark urine.