Causes of anemia
In the vast majority of cases (up to 90%), anemia is caused by iron deficiency. Iron is part of hemoglobin and is involved in the process of hematopoiesis. Iron-deficiency anemia
occurs when there is insufficient consumption of iron-containing foods (primarily meat and vegetables). Anemia can also occur with the right diet, for example, if iron is not absorbed by the body due to existing problems with the gastrointestinal tract. Blood loss can also contribute to the development of anemia. However, blood loss does not have to be large. Frequent nosebleeds, bleeding gums, hemorrhoids, and heavy periods can cause anemia.
Possible causes of anemia include a lack of vitamin B 12 or folic acid, but these types of disease are much less common. Hemolytic anemia is also isolated, characterized by increased (faster) destruction of red blood cells.
Anemia can be genetically determined, that is, it can be hereditary.
Differences between anemia in adults and children
According to WHO, about 2 billion people in the world suffer from anemia. The majority are children of different ages. Almost half of them are preschoolers, and a little more than a quarter are young school-age patients. And in adults, the disease occurs quite often. This syndrome is dangerous for both children and adults, and in adults the treatment period is somewhat longer.
Anemia in children may be associated with a specific cause: periods of rapid growth. The mechanisms of hematopoiesis are still imperfect, and the growth spurt requires an increased amount of nutrients. This may be associated with a temporary decrease in hemoglobin levels in the blood. However, this is still not a variant of the norm, but a syndrome that deserves close attention from a doctor. Anemia can lead to decreased defenses, poor weight gain, loss of appetite, weakness, and tearfulness. Timely methods of diagnosing and treating anemia will allow you to correct the condition and prevent complications.
The most dangerous complication of iron deficiency anemia (IDA) in adults is hypoxic coma. With high blood loss, it can cause death. Therefore, it is important to consult a doctor in time.
Symptoms of anemia
Lack of hemoglobin leads to oxygen starvation, manifested by symptoms typical of anemia such as:
General weakness
With anemia, muscle tissue does not receive sufficient nutrition. The patient feels constantly tired, he does not have enough strength for normal life activities.
Drowsiness
The body lacks strength, which means it needs additional rest. Drowsiness develops. A person suffering from anemia is almost never alert; as a rule, he wants to sleep.
Pallor
Pale skin due to anemia is caused by a decrease in the number of red blood cells (erythrocytes) in the blood.
Dizziness
With anemia, the brain also receives insufficient nutrition. This may cause dizziness.
flickering
The flickering of “flies” before the eyes is caused by insufficient nutrition of the structures of the visual apparatus.
Fainting
If the decrease in hemoglobin is significant, fainting is possible - episodes of loss of consciousness.
Headache
With anemia, headaches are often observed.
More about the symptom
Cardiopalmus
You may experience palpitations with little physical activity or at rest.
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Dyspnea
Shortness of breath with anemia is caused by the fact that the body tries to compensate for the lack of oxygen by increasing its supply. Breathing becomes more frequent.
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Prevalence of IDA
Iron deficiency anemia in women is a common pathological condition. Thus, according to WHO (2015), severe iron deficiency is observed in every third woman of reproductive age and in every second pregnant woman, being an important cause of chronic fatigue and poor health, and the third most common cause of temporary disability in women aged 15– 44 years old [12, 19]. In the Russian Federation, despite active preventive and therapeutic measures, the prevalence of IDA remains very high. For example, in Moscow, anemia occurs in almost 38% of gynecological patients [20, 21] and is the most common concomitant pathological process and the first manifestation of the underlying disease, determining the severity of its course and treatment tactics. The main reasons for the development of IDA in women are heavy menstrual bleeding, pregnancy, childbirth (especially repeated ones) and lactation. Anemia often accompanies uterine fibroids, adenomyosis, hyperplastic processes in the endometrium, and ovarian dysfunction. During normal menstruation, 30–40 ml of blood is lost (which is equivalent to 15–20 mg of iron). The critical level corresponds to a blood loss of 40–60 ml, and with a blood loss of more than 60 ml, iron deficiency develops. In women suffering from abnormal uterine bleeding of various origins, the amount of blood lost during one menstruation can reach 200 ml (100 mg of iron) or more. In such situations, the loss of iron exceeds its intake and IDA gradually forms [20].
The most important medical and social problem is anemia in pregnant women, which, according to WHO, is detected in 24–30% of women in economically developed countries and in more than 50% of women in countries with low economic levels [3, 22].
A survey of pregnant women conducted as part of clinical studies in the 2000s showed a high incidence of anemia even among residents of prosperous European countries. Thus, in Belgium (n=1311), Switzerland (n=381) and Germany (n=378) iron deficiency was diagnosed in 6% and 23% (serum ferritin (SF) <15 μg/l) in the first and third trimesters, respectively, of Belgian women; in 19% (SF<12 µg/l) - in Switzerland and Germany. The prevalence of IDA (Hb <110 g/L, SF <15 μg/L) was 16% in Belgium and 3% in Switzerland, although 65–66% of Belgian and Swiss women received dietary iron supplementation during pregnancy. In Germany, IDA was diagnosed in 12% of women [23].
In Russia, according to the Ministry of Health, the incidence of anemia in pregnant women varies from 39% to 44%, in postpartum women - from 24% to 27% [24]. A 2021 systematic review and meta-analysis found that in low- and middle-income countries, pregnancy anemia increases the likelihood of preterm birth by 63%, low birth weight by 31%, perinatal mortality by 51%, and neonatal loss by 2 ,7 times [25].
During pregnancy, there is a significant physiological increase in the need for iron for the normal functioning of the placenta and fetal growth. The total amount of iron required for a normal pregnancy is 1000–1200 mg. To complete a normal pregnancy without developing iron deficiency, a woman must have iron stores in the body at conception of ≥500 mg, which corresponds to an SF concentration of 70–80 μg/L [20, 23].
Methods for diagnosing anemia
Anemia is diagnosed based on laboratory tests.
General blood analysis
A complete clinical blood test is the basic test for determining anemia. For a more detailed diagnosis of certain types of anemia, additional studies may be prescribed.
More information about the diagnostic method
Sign up for diagnostics To accurately diagnose the disease, make an appointment with specialists from the Family Doctor network.
Clinical manifestations of iron deficiency
The clinical manifestations of iron deficiency are diverse and can be reduced to two main syndromes: hypoxic and sideropenic. Hypoxic syndrome combines symptoms common to all anemia: pallor, increased heartbeat, tinnitus, headache, weakness. Sideropenic syndrome includes taste perversion, dry skin, changes in nails, hair loss, angular stomatitis, burning tongue, and dyspepsia. The variety of clinical symptoms of iron deficiency can be explained by a wide range of metabolic disorders, which are caused by dysfunction of iron-containing and iron-dependent enzymes [6, 8, 9, 26, 27].
Symptoms that are less associated with anemia, but may be a manifestation of iron deficiency, include neurotic reactions and neurasthenia, decreased performance, muscle weakness and general tolerance to physical activity, disorders of metabolic processes in the myocardium, peripheral circulation and microcirculation, low-grade fever [6] . Exotic symptoms of IDA include urgency to urinate/defecate, urinary incontinence due to weakening of the sphincter apparatus, and difficulty swallowing due to atrophic changes in the esophageal mucosa [5, 12]. According to modern data, restless legs syndrome (Willis-Ekbom disease) may be one of the most common clinical manifestations of iron deficiency [28, 29].
Anti-infective immunity disorders in patients with impaired micronutrient status and IDA are complex [30]. On the one hand, iron deficiency prevents the development of pathogenic microorganisms that require iron for their own growth and reproduction. On the other hand, iron deficiency indirectly leads to disruption of cellular resistance mechanisms and to infections (decreased microbicidal activity of granulocytes, impaired proliferation of lymphocytes). In general, the predisposition of patients with IDA to the development of infectious diseases is not as great as previously thought. Moreover, treatment of IDA with parenteral iron supplements increases the risk of developing infections, probably due to the availability of administered iron for the rapid growth of pathogenic microorganisms [7, 26].
Anemia Treatment Methods
Treatment of anemia is aimed, first of all, at identifying and eliminating the cause of the disease. In case of detected iron deficiency (vitamin B12, folic acid), replacement therapy is carried out with drugs that compensate for this type of deficiency. A special diet high in essential substances is also prescribed.
Doctor visit
If you are concerned about weakness, dizziness, drowsiness and other symptoms that suggest anemia, we recommend that you consult a general practitioner or family doctor at any of the clinics of JSC “Family Doctor”. The high professionalism of our specialists and modern equipment allow us to effectively treat anemia, including during pregnancy, breastfeeding and other periods that require a special approach.
Make an appointment Do not self-medicate. Contact our specialists who will correctly diagnose and prescribe treatment.
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Attention to hemoglobin
Low hemoglobin is a phenomenon that is not always given due attention. Few doctors make the diagnosis “anemia” a separate line. We generally believe that there is nothing terrible here, “all my life I’ve had this hemoglobin - and it’s okay, it’s alive.” At the same time, due to a decrease in hemoglobin, all organs, systems, and tissues of the body regularly experience a lack of oxygen and receive less nutrition.
What hemoglobin is considered low? Here it is worth turning to the average WHO data, which are also used for laboratory testing. So, the standards look like this:
Men - below 130 g/l;
Women - below 120 g/l.
It is important to remember that anemia is not an independent disease, but a manifestation and/or complication of another serious disease. It cannot be ignored, and in any case the life prognosis is unfavorable. I'm not exaggerating. When a person has a heart attack or stroke (and these diseases are not uncommon in our country), anemia significantly aggravates the course of the disease, causes additional difficulties in treatment and worsens the prognosis. After all, how to save a person whose blood does not carry oxygen to his organs?
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