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You Ought To Know

  • Anaemia refers to the reduction of the concentration of haemoglobin under ideal circumstances.
  • The end result of iron deficiency is nutritional anaemia.
  • Weakness, breathlessness, giddiness, headache, sore tongue, palpitation are a few symptoms.
  • Most of the people suffering from anaemia can be treated by oral preparation of iron


What is Anaemia?

What are the types of anaemia and what causes the same?

What are the pre disposing factors for anaemia?

What are the signs and symptoms of anaemia?

What needs to be done?

What are the preventive measures one should follow?


What is Anaemia?

Anaemia is defined as a reduction of the concentration of haemoglobin for a certain individual under ideal circumstances. Therefore a haemoglobin value may be normal for one person but subnormal for another.


The World Health Organisation defines the normal ranges for women as 120 - 160 grams per litre and for men as 130 - 170 grams per litre.


What are the types of anaemia and what causes the same? 


Iron-deficiency anaemia is the most common type of anaemia. It is rather a syndrome caused by malnutrition in its widest sense. It affects up to 30 per cent of the world's population, and 14 per cent of all women of childbearing age even in developed countries have iron-deficiency anaemia.


Menstrual blood loss can lead to anaemia, but the most common factor is a diet not containing enough iron-rich foods or not being able to absorb enough iron. Any other cause of bleeding will result in iron-deficiency anaemia (e.g. stomach ulcers).


Pregnancy, breastfeeding and blood loss from the gastrointestinal tract (from ulcers or cancer) also can cause decreased iron levels. A poor diet puts anyone, at any age, at risk of iron-deficiency anaemia.


The recommended daily intake of iron for the adolescence is as follows:



Iron (mg/day)



10-12 years



13-15 years



16-18 years




Folic-acid-deficiency anaemia: Folic acid is an essential requirement for the development of normal red blood cells and is absorbed from food. A lack of folic acid interferes with the normal development of red blood cells and produces an abnormal cell called a macrocyte. This does not have as much haemoglobin as normal red cells and therefore the patient may become iron deficient. Furthermore these cells don't last as long as normal.


Folic acid deficiency occurs when there is insufficient folic acid in the diet or when it is poorly absorbed. During pregnancy, the body needs more than twice the normal amount of folic acid. Therefore it is essential that pregnant mothers take additional folic acid.

Finally there is good evidence that if additional folic acid is taken before conception and during the early months of pregnancy, folic acid may prevent such birth defects as spina bifida.


§         Pernicious anaemia: Vitamin B12 is essential in the normal development of red blood cells. When the intestinal tract is unable to absorb vitamin B12, a vitamin deficiency develops leading to what is called a 'megaloblastic' anaemia. These are early abnormal red blood cells that also cannot carry enough haemoglobin, thus leading to anaemia.


Other causes:

  • Chemotherapy-induced anaemia: Many patients with cancer develop anaemia. Sometimes the anaemia is as a result of the cancer itself and in other people it is as a result of the treatment for the cancer.
  • Anaemia related to kidney disease: Anaemia is one of the most important complications of kidney failure because of its effect on a patient's well being, but there are ways of treating the condition. It is as a result of kidneys not producing enough of the hormone erythropoietin. This hormone is crucial for the formation of new red blood cells.
  • As a result blood does not contain enough red cells and becomes less and less effective at carrying oxygen making one feel tired and sluggish.
  • Aplastic anaemia: This is rare. It is usually the result of the unexplained failure of the bone marrow to produce blood cells
  • Haemolytic anaemia: Haemolysis is a term that describes the breaking up of red blood cells, leading to release of haemoglobin into the plasma. This can be as a result either of an inherited condition or from one acquired after birth. The best known of the inherited haemolytic anaemia are sickle cell anaemia (which mainly afflicts African–Americans) and thalassaemia (which tends to affect people of a Mediterranean background).


Pre disposing factors of Anaemia

    • Generally, dietary deficiency or ignorance on the part of the diet to be consumed is the commonest cause.
    • Malnutrition
    • Loss of blood (iron) during menstruation.
    • Worm infestation also leads to anaemia.
    • Ingestion of certain drugs may cause bleeding into the stomach e.g., Aspirin. Hence frequent intake of Aspirin especially in the form of O.T.C drugs (over the counter) without consulting the doctor may lead to anaemia due to blood loss.
    • Diseased conditions: Especially conditions where there is a continuous slow loss of blood in the form of bleeding piles, haemoptysis in pulmonary tuberculosis (blood in the sputum), malaria (because malarial parasites enter and destroy red cells), menorrhagia (excessive bleeding during menses in women).
    • During pregnancy and while feeding a baby, a woman has to provide for the baby’s needs from her own stores, but the fact that she is not menstruating compensates to some extent for this loss.
    • Autoimmunity (the body treats its own cells as foreign matter and destroys them in the same way as bacteria does).


What are the signs and symptoms of anaemia?

Symptoms are vague unless the anaemia is severe and concentration of haemoglobin is reduced to, say, half the normal value.

The signs and symptoms usually suggestive of anaemia are:

1) Pallor (pale looks) of skin and internal lining of eyelids.
2) Weakness, breathlessness.
3) Giddiness, headache.
4) Recurrent glossitis (sore tongue).
5) Palpitation.
6) Amenorrhoea in females.
7) Hair loss.

8) Insomnia (inability to sleep).

What needs to be done?
Blood tests- to confirm levels of haemoglobin in blood, confirm the type of anaemia and possible causes.
Stool test- to rule out worm infestation.

 Management and Remedies

  • Most of the people suffering from anaemia can be treated by oral preparation of ferrous sulphate, given as a tablet, to be consumed after meals, once or twice a day, as advised by the physician.
  • Deworming - A course of de-worming treats the worm infestation if this is a contributing factor.
  • If there is any excess blood loss, such as in haemorrhage, or excessive menstrual loss, it needs to be treated (by a physician or gynaecologist).
  • Spinach, carrot or beetroot mixed together in a blender to make a ‘tonic’ juice contains valuable minerals and vitamins. Try it for breakfast or dinner.
  • Fresh fruit and vegetables will have a far better long-term effect.
  • Green leafy vegetables, fresh fruits, dates, honey etc should be included in the diet.


What are the preventive measures one should follow?

  1. Dietary deficiencies should be corrected.
  2. The use of ‘over the counter’ drugs should be strictly avoided.
  3. Slightest suspicion should make one cautious to seek doctor’s advice, because if treated or ignored the condition may worsen.

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