What is anemia? Symptoms you should know.

• Anemia is a condition where the body has a lower than normal number of red blood cells, or hemoglobin, resulting in insufficient oxygen supply to the various organs. This leads to symptoms such as fatigue, weakness, dizziness, palpitations, and possibly pale or yellowish skin.
• Early signs and signs to watch for include unusual fatigue even with light activity, pale face, pale conjunctiva, pale lips and nails, dizziness, lightheadedness, fainting, palpitations, shortness of breath, or chronic headaches.
• Anemia is not always caused by iron deficiency. It can also be caused by folate or vitamin B12 deficiency, chronic diseases, bone marrow disorders, genetic blood disorders like thalassemia, hemolytic anemia, or chronic blood loss such as abnormally heavy menstruation or gastrointestinal bleeding.
• Foods that help combat anemia and promote red blood cell production include foods high in iron, along with foods containing folate and vitamin B12, as well as consuming fruits and vegetables high in vitamin C to enhance iron absorption from plant sources.

Many people experience fatigue, lightheadedness, and dizziness, often mistakenly believing it's due to insufficient rest or stress. However, these symptoms can actually be signs of anemia, a condition where the body has a lower-than-normal amount of red blood cells or hemoglobin. This results in insufficient oxygen supply to various organs. Those with this condition experience easy fatigue, pale skin, and are often mistakenly attributed solely to iron deficiency. But what are the real causes? This article provides the answers.

What is Anemia?

Anemia is a condition where the body has a lower than normal amount of red blood cells, resulting in inefficient oxygen transport to various organs. Causes include nutritional deficiencies, chronic blood loss, or certain underlying medical conditions. Common symptoms include fatigue, dizziness, difficulty breathing, and pale or yellowish skin. If left untreated, it can lead to serious complications such as heart attack, fainting, or death.

Symptoms of Anemia

The severity of symptoms depends on the cause. In the early stages, there are often no symptoms, and they gradually worsen until they become noticeable. If anemia is caused by another disease, the body may show symptoms of that disease first, making it difficult to detect until a blood test is performed. This condition is therefore considered a silent threat, and its warning signs include

• Unusual fatigue
• Dizziness, lightheadedness
• Palpitations, rapid heartbeat
• Difficulty breathing, shortness of breath
• Cold hands and feet due to insufficient blood supply
• Pale skin, yellowing of the skin, or yellowing of the eyes

What Causes Anemia?

A decrease in red blood cell production

This can be caused by a deficiency in essential nutrients for blood production, such as iron, vitamin B12, and folate, or by chronic diseases that directly affect the body, such as chronic kidney failure, liver disease, leukemia, and bone marrow disease. Pregnancy is also a contributing factor, as it increases the amount of plasma in the blood, leading to anemia.

Acute blood loss

Anemia can result from both acute blood loss, such as major wounds from accidents, surgery, childbirth, or hemorrhage, and chronic blood loss, such as stomach ulcers, hemorrhoids, or prolonged abnormally heavy menstruation.

Red blood cells destroyed faster than normal

Anemia can occur when the body destroys red blood cells faster than it should. This is often seen in individuals with genetic disorders or infections, such as thalassemia, immunodeficiency hemolytic anemia (AIHA), sickle cell anemia, and Plasmodium glutamate (PGDA), the protozoan infection that causes malaria.

Anemia may not always be caused by iron deficiency. Why?

Anemia is a condition where there are fewer red blood cells or hemoglobin than normal. It has various causes besides iron deficiency. Self-medicating with iron supplements without knowing the exact cause is risky, as iron supplements can worsen symptoms in some diseases.

Other causes of anemia include

• Vitamin deficiencies, such as vitamin B12 and folate, often found in strict vegetarians or those with intestinal malabsorption problems.
• Chronic diseases such as kidney failure, liver disease, cancer, rheumatoid arthritis, or SLE, which reduce the bone marrow's ability to produce red blood cells.
• Bone marrow abnormalities such as leukemia or aplastic anemia, leading to inefficient red blood cell production.
• Fragile red blood cells, caused by autoimmune disorders, G-6PD deficiency, or malaria infection.
• Thalassemia, a genetic disorder that produces abnormal hemoglobin, resulting in easily broken red blood cells. Iron supplements in this group can lead to dangerous iron accumulation in the body.
• Blood loss, both acute from accidents and chronic, such as heavy menstruation or gastrointestinal bleeding.

How to Check for Anemia Yourself

Self-observation is only for detecting warning signs. If you experience several symptoms together, you should see a doctor for a complete blood count (CBC) to confirm the diagnosis. Do not self-medicate with vitamins.

• Symptoms include unusual fatigue, easy tiredness even with light activity, and lack of energy even with sufficient rest.
• Dizziness, palpitations, lightheadedness when changing positions quickly (sitting or standing), and an abnormally fast heartbeat.
• Observe for paleness. Check the mucous membranes of the eyes, lips, palms, and nails in bright light. If they appear unusually pale, consult a doctor.
• Difficulty breathing, shortness of breath, wheezing, or chest pain during exertion due to reduced oxygen intake.
• Other symptoms include frequent headaches, cold hands and feet, lack of concentration, or mental fatigue.
• If paleness is accompanied by abnormal bleeding, such as black stools, bloody stools, or unusually heavy menstrual bleeding, see a doctor immediately to determine the cause of blood loss.

Who is at risk of anemia?

• Women of childbearing age are at risk of iron deficiency due to regular menstrual blood loss.
• Pregnant women experience increased plasma volume, leading to decreased red blood cell concentration.
• The elderly are at risk due to decreased nutrient absorption efficiency and bone marrow function. This also includes chronic diseases that affect blood production.
• Patients with chronic diseases such as kidney disease, cancer, liver disease, or lupus (SLE) directly affect the body's red blood cell production process.

Complications from anemia

Severe anemia that is not properly treated can be life-threatening because the body lacks oxygen, causing the heart to work harder to pump blood. This stress on the heart can lead to arrhythmias, heart failure, or a fatal heart attack.

Diagnosing Anemia

The doctor will begin by taking a personal and family health history and performing a physical examination. Then, a blood test will be performed to measure hemoglobin levels. The standard value for men should not be lower than 13 g/dL, and for women, it should not be lower than 12 g/dL. Laboratory tests may include

1. Complete Blood Count (CBC) Analyzes hemoglobin levels, hematopoietic triglycerides (Hct), and examines the quantity, size, and shape of red blood cells, white blood cells, platelets, as well as vitamin B12 and folate levels.
2. Blood Smear A drop of blood is placed on a slide for staining and microscopic examination to assess the shape of red blood cells and hemoglobin levels in detail.
3. Bone Marrow Biopsy Used to diagnose complex blood disorders such as leukemia, aplastic anemia, or anemia of unknown cause that cannot be determined by routine tests.

Treatment Guidelines for Anemia

• Iron Deficiency or Blood Loss Iron supplementation is given to increase hemoglobin levels, especially if the anemia is due to acute blood loss or internal bleeding. Doctors may use surgery to stop bleeding.
• Vitamin deficiencies Supplement with vitamin B12 or folate to help normalize red blood cell production.
• Chronic diseases Focus on treating the underlying cause. For example, chronic kidney disease may involve the use of erythropoietin (a hormone that stimulates red blood cell production).
• Bone marrow diseases Treatment depends on the symptoms and severity and may include medication, chemotherapy, radiation therapy, or bone marrow and stem cell transplantation.
• Immune-induced red blood cell breakdown Immunosuppressant drugs are used to stop the destruction of red blood cells and restore balance to the immune system.
• Sickle cell anemia Focus on symptom relief and prevention of complications, such as oxygen therapy, intravenous fluids for pain relief, and antibiotics.
• Thalassemia In severe cases, regular blood transfusions, iron chelation therapy, splenectomy, or bone marrow transplantation, which has a chance of cure, may be used.

Self-care to prevent anemia

• Eat a diet rich in essential nutrients, emphasizing foods high in iron, vitamin B12, and folate, such as liver, meat, egg yolks, leafy green vegetables, and whole grains, especially for pregnant women.
• Supplement vitamins appropriately Vitamin supplements can be taken as recommended by a doctor.
• Drink enough water to support healthy blood circulation.
• Get regular health checkups, especially for high-risk groups such as the elderly, those with underlying medical conditions, or women who experience significant menstrual bleeding, to monitor for and receive timely treatment.

What foods help fight anemia?

• Foods high in iron Red meat, liver, blood, organ meats, egg yolks, seafood, leafy green vegetables (spinach, kale), and whole grains directly contribute to hemoglobin and red blood cell production.
• Foods high in folate (vitamin B9) Dark leafy green vegetables (spinach, broccoli), asparagus, and dried beans help bone marrow produce healthy red blood cells.
• Foods high in vitamin B12 Meat, fish, eggs, milk, and fortified cereals prevent megaloblastica and support the nervous system.
• Foods high in vitamin C Oranges, guavas, kiwis, berries, and tomatoes improve the absorption of plant-based iron.
• Beans and whole grains Pumpkin seeds, almonds, soybeans, and whole grains are sources of protein and iron for those who don't consume much meat.

Note: Patients with kidney disease or thalassemia should consult a doctor before taking iron supplements to prevent iron overload.

Does drinking tea and coffee increase the risk of anemia?

Tannins and polyphenols in tea and coffee inhibit iron absorption, especially iron from plant sources. Regularly consuming beverages with meals may lead to iron deficiency and slow down the treatment of anemia.

Recommendations for those at risk of anemia

• Avoid consuming beverages with meals. Do not drink tea or coffee immediately after a main meal.
• Drink beverages away from meals. Allow at least 1-2 hours after a meal or after taking iron supplements.
• Increase your vitamin C intake. Eating citrus fruits with meals can reduce the effects of tea and coffee and stimulate iron absorption.
• Be mindful of calcium. Calcium from milk or supplements may also interfere with iron absorption, so taking them at separate times is the best approach.

Treating Anemia at Vibhavadi Hospital

Anemia is a condition that can affect many people, especially women. Symptoms such as dizziness, fatigue, palpitations, and paleness may be signs of anemia. If you suspect you have anemia or need a health checkup, you can get tested at Vibhavadi Hospital. We have expert doctors and modern equipment to ensure more targeted treatment.