What is Anemia?
Anemia, commonly known as paleness, is a condition caused by having fewer red blood cells than normal, which is commonly found in the general population. To determine whether someone has anemia, it can be observed from the symptoms that occur because red blood cells are responsible for delivering oxygen to cells and tissues throughout the body. A decrease in red blood cells can cause various abnormalities, ranging from increased fatigue. Some people may feel that
- they get more tired when doing activities, for example, previously climbing two or three flights of stairs was not tiring, but now it becomes more exhausting
- some people may feel tired and weak even when resting
- some may feel irritable and have unclear thoughts
- if anemia is severe, it may affect heart function, causing the heart to work harder up to heart failure, or affect brain function, causing fainting or loss of consciousness. Symptoms may vary in severity depending on the level of red blood cells in the body and the ability to adapt to anemia. In clinical practice, anemia can often be detected before symptoms appear, such as during blood donation or annual health check-ups
What Causes Anemia?
To know if a patient has anemia, it is usually a result of certain causes. Sometimes it may be an early symptom of a serious disease. Therefore, every time anemia is detected, the cause must always be investigated to plan appropriate treatment. The causes of anemia can be divided into 3 main mechanisms:
1. Decreased red blood cell production, which can be due to several causes such as
- deficiency of nutrients essential for red blood cell production, mainly iron, vitamin B12, and folic acid
- chronic kidney disease, causing a lack of factors that stimulate red blood cell production
- bone marrow diseases such as bone marrow aplasia, bone marrow cancer, bone marrow infections, etc.
- certain chronic diseases such as cancer, rheumatoid arthritis, autoimmune diseases, etc.
2. Increased destruction of red blood cells in the body. These diseases cause red blood cells to break down more easily than normal. Patients often have yellowing of the skin and eyes (jaundice). Common causes in Thailand include:
- Thalassemia, a common inherited disease. Patients with this disease have a wide range of symptoms, from mild symptoms to rapid anemia during fever. Some may have anemia with jaundice and enlarged liver and spleen from a young age
- G-6PD deficiency hemolytic anemia, an inherited disease mostly found in males. Normally, patients have no symptoms, but infections or certain medications can trigger red blood cell breakdown, causing rapid anemia, jaundice, and dark-colored urine
- Autoimmune hemolytic anemia, commonly found in women of reproductive age and may be associated with other autoimmune diseases
- Certain infections such as malaria, clostridium, mycoplasma, etc.
3. Blood loss can occur suddenly, such as in accidents or hemorrhage, or gradually as chronic blood loss, such as menstrual bleeding in women or gastrointestinal bleeding in men and postmenopausal women. Patients with chronic blood loss often develop iron deficiency as well
What to Do If You Suspect Anemia?
If you have the symptoms mentioned above, have been told you look pale or yellowish, or have had blood tests showing low red blood cells, you should see a doctor to confirm whether the symptoms are due to anemia and identify the cause. Generally, the doctor will take a detailed history and perform a physical examination to guide diagnosis and select appropriate laboratory tests to find the cause.
Important laboratory tests include a complete blood count and examination of blood smear morphology. Patients do not need special preparation or fasting before these blood tests. The complete blood count will show whether the patient truly has anemia by looking at hemoglobin and hematocrit levels. Some patients can be diagnosed with the cause of anemia from this test, while others may require additional laboratory tests to find the cause.
Criteria for Diagnosing Anemia
- Anemia is diagnosed based on hemoglobin and hematocrit values
Treatment of Anemia
Generally, the treatment of anemia depends on the severity of symptoms. If symptoms are severe, the patient should be treated in the hospital, rest without exertion, receive oxygen, and may require blood transfusion. For patients with mild symptoms, outpatient treatment may be provided. The most important principle in treating anemia is to find and treat the underlying cause. Sometimes anemia detection can lead to the discovery of hidden serious diseases, which benefits early treatment and satisfactory outcomes.
