What Causes Anemia?
The House Call Doctor explains the different types of anemia, and their most common causes and symptoms–and fills you in on how anemia is diagnosed, and how to treat it.
Recently, my husband and I finally had the chance to go to the movies, after 3 years (since the birth of our twins.) We saw the intriguing sci-fi movie, “Lucy” (thanks to my sister, who babysat!) During the previews, there was one for a new movie called “Dracula,” which I simply cannot wait to see (it’s coming out right on time for Halloween, I presume!)
Of course, being both a doctor and the huge fantasy/sci-fi/vampire movie fan that I am, while watching this preview, I started thinking about how gravely ill all vampires appear. They look so pale and sickly–in fact, they just must be seriously anemic. Not to mention that their great thirst for blood must be a reflection of their body’s low iron stores…
In any case, this long intro is simply divulge how I came upon the idea for this week’s podcast topic: anemia.
Anemia is a diagnosis that I make on almost a daily basis in my practice as a physician. Despite it being such a common finding, though, it’s one that should not be ignored, because although in many patients it is easily treatable, it can occasionally be a sign of something more.
Anemia is often an initially vague finding that requires further detective work to delineate the cause. Although there are numerous causes of anemia, Iron-deficiency anemia (anemia due to low iron), specifically accounts for the majority of anemia subtypes, causing over 50% of all cases.
So let’s learn about anemia today, with a greater focus on iron-deficiency anemia.
What is Anemia?
Anemia refers to a wide range of disorders that disturb the production of a protein in red blood cells that’s called “hemoglobin.” You may have heard this medical term if your doctor has diagnosed you with anemia, as it is measurable in the blood stream via a simple blood test called a “CBC.”
Hemoglobin carries oxygen in the blood stream, so if we don’t have sufficient hemoglobin in our red blood cells, then we can’t carry oxygen–and we may not feel so well.
Though they rarely sport the stereotypical vampire “pale” look, those with anemia often report the following, more common symptoms:
- Fatigue
- Dizziness
- Heart palpitations or fast heart beat
- Shortness of breath
- Cravings for chewing ice
We need a good supply of iron in our bodies in order to produce hemoglobin (but be careful, because too much iron can also be toxic.) If we don’t have enough iron, then our hemoglobin production plummets, and we become anemic.
We need a good supply of iron in our bodies in order to produce hemoglobin (but too much iron can also be toxic.)
Causes of Anemia
The diagnosis of anemia really encompasses a wide range of sub-types (other than iron-deficiency,) depending on the specific cause of the anemia.
First, let’s talk about some of the less common causes of anemia:
- Alcoholism
- Malnutrition
- Pregnancy
- Lead poisoning (mostly in children)
- Vitamin B12 deficiency
- Alpha and Beta Thalassemias (inherited disorders)
- Leukemia
- Myelodysplastic Syndrome
- Kidney disease
- Liver disease
- Autoimmune disorders (such as lupus or rheumatoid arthritis)
- Chronic diseases (diabetes, chronic infections, malignancies, etc.)
Iron-deficiency anemia, on the other hand is due to diminished iron levels, via the following:
- Low iron intake: we are not consuming enough iron (going against the entire vampire theory, vegetarians are actually most at risk for this)
- Low iron absorption: we may be consuming enough iron, but it’s not getting properly absorbed from the gut into our blood stream (this might happen in patients with bowel resections, for instance)
- Iron loss (bleeding): we may be losing it in our stool (microscopically and gradually, so that it may be unnoticeable,) or via menstrual bleeding in women
Most iron-deficiency anemia cases are due to the latter–bleeding.
Diagnosis of Anemia
Anemia is often diagnosed via a blood test referred to as a “CBC,” in which a low hemoglobin level is first discovered. You may then be asked to return for further blood work to delineate the cause of the anemia. It’s important to find out why you are anemic, in order to address and treat the underlying cause. To find out if it’s due to iron-deficiency, your doctor can test your iron stores by ordering a test called “ferritin,” in addition to what we refer to as “iron studies.”
If your anemia is determined to be due to iron deficiency, the next step is to find out where the bleeding is coming from. Here are some important considerations:
- Menstruating Women: Iron-deficiency in menstruating women is often due to vaginal bleeding. If your periods are heavy, irregular, long in duration, or more frequent, then your doctor may decide to further evaluate your gynecologic status by performing further testing.
- Men and Post-menopausal Women: It’s very important to find out if the bleeding is coming from the gastrointestinal tract, especially in older adults, since microscopic bleeding can occur from a bleeding stomach ulcer, or from various problems with the colon. In fact, one of the presenting symptoms of colon cancer in older adults is often the discovery of iron-deficiency anemia. Your doctor may decide to do a colonoscopy or an upper endoscopy (cameras placed in the upper GI and lower GI tract, respectively.) They can also test your stool for blood, but it’s not as diagnostic as the colonoscopy.
Treatment of Iron-Deficiency Anemia
Increasing your iron intake only makes sense if your anemia is due to iron deficiency, and won’t help other types of anemia. And again, treating the iron-deficiency anemia requires treating the underlying cause, in order to stop the bleeding.
Besides that, short of turning you into Count Dracula, your doctor may also ask you to take over-the-counter iron supplements to restore your iron levels, and/or to increase your food iron intake (depending on the severity of your anemia.)
Here are some iron-rich foods to incorporate into your new vampire diet:
- Spinach
- Broccoli
- Peas
- Beans
- Nuts
- Prunes
- Dried raisins and apricots
- Meat, poultry, seafood
- Iron-fortified cereals
Vitamin C helps to absorb iron, so taking your iron supplement or consuming your iron-rich foods with foods high in Vitamin C (such as orange juice) will aid the absorption process.
Share your ideas and learn more quick and dirty tips on the House Call Doctor’s Facebook and Twitter pages!
Please note that all content here is strictly for informational purposes only. This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider. Please always seek a licensed physician in your area regarding all health related questions and issues.
Photos of blood test tube and iron-rich foods courtesy of Shutterstock.
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About the Author
Dr. Sanaz Majd is a board-certified Family Medicine physician who graduated from Drexel University College of Medicine in Philadelphia. Her special interests are women’s health and patient education.
