Understanding Anaemia Causes, Types, Symptoms, and Effective Treatments

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What is Anaemia?

Anaemia (or anemia) is a condition where your body doesn’t have enough healthy red blood cells to carry oxygen, leading to symptoms like fatigue, weakness, and shortness of breath. Poor nutrition, blood loss, infections, or chronic diseases can all contribute to it. Common types of anaemia include iron-deficiency anaemia, vitamin B12-deficiency anaemia, and hemolytic anaemia.

Iron Deficiency Anaemia

Iron deficiency anaemia occurs when the body does not have enough iron to produce sufficient haemoglobin. Haemoglobin is the protein in red blood cells that is responsible for transporting oxygen. The lack of haemoglobin will result in fewer and smaller red blood cells to be produced, leading to various symptoms and health problems.

Vitamin B12-Deficiency or Folate Deficiency Anaemia

Vitamin B12 or folate (Vitamin B9) deficiency anaemia occurs when a lack of these essential vitamins leads to the production of large, immature red blood cells. These abnormally large red blood cells are unable to function effectively, impairing the body's ability to transport oxygen, which results in symptoms like fatigue and weakness.

Hemolytic Anaemia

Hemolytic anaemia occurs when red blood cells are destroyed faster than the body can produce them. This rapid destruction leads to a shortage of healthy red blood cells, impairing the body’s ability to carry oxygen. Common causes include autoimmune diseases, infections, or inherited conditions like sickle cell disease.

Anaemia Symptoms

Iron deficiency Anaemia Symptoms

Iron deficiency anaemia often doesn’t show obvious symptoms, but common signs include:

Fatigue
Headache
Weakness
Irritability
Shortness of breath
Difficulty during exercise
Brittle nails
Sore tongue
Restless legs syndrome

Unusual symptoms may also occur, such as pica (cravings for non-food items like cornstarch, clay, or dirt) and pagophagia (an unusual craving to chew on ice).

Symptoms of Vitamin B12 or Folate Deficiency

Vitamin B12 and folate are essential for maintaining a healthy nervous system. A deficiency in either can lead to a variety of symptoms, including:

Extreme tiredness and lack of energy
Pins and needles or numbness
Sore, red tongue
Mouth ulcers
Muscle weakness
Vision problems
Psychological issues such as depression, anxiety, confusion, or even dementia
Memory, understanding, and judgment difficulties

These symptoms can occur even if there is no anaemia, highlighting the importance of vitamin B12 and folate for overall health.

Symptoms of Hemolytic Anaemia

Symptoms of hemolytic anaemia can include:

Fatigue and weakness
Pale or jaundiced (yellow) skin
Shortness of breath
Rapid heart rate
Dark urine (due to broken-down red blood cells)
Enlarged spleen or liver
Dizziness or lightheadedness
Chest pain (in severe cases)

These symptoms arise due to the body’s inability to maintain a sufficient number of healthy red blood cells for oxygen transport.

Anaemia Causes

Anaemia can be caused by a variety of factors depending on the type.

Iron Deficiency Anaemia Causes

Low Iron Diet: Common among vegetarians or vegans who don't consume enough plant-based iron or supplements.
Poor Iron Absorption: Conditions like Crohn's disease, celiac disease, or gastric bypass surgery can reduce the body’s ability to absorb iron.
Increased Iron Demand: Pregnancy, childhood growth spurts, and adolescence increase the body’s iron needs.
Blood Loss: Heavy menstruation, gastrointestinal bleeding, or significant injuries can lead to iron depletion.

Vitamin B12 and Folate Deficiency Anaemia Causes

Pernicious Anaemia: The immune system attacks stomach cells, preventing the absorption of vitamin B12 from food. This is the most common cause of vitamin B12 deficiency.
Dietary Deficiencies: A lack of vitamin B12 or folate in the diet, particularly in vegans who don't take supplements or eat fortified foods, or due to long-term poor or restrictive diets.
Medications: Certain drugs, such as anticonvulsants and proton pump inhibitors (PPIs), can interfere with the absorption of these vitamins.
Age: Older adults are more prone to B12 and folate deficiencies, with around 1 in 10 people over 75 affected.

Hemolytic Anaemia Causes

Premature Red Blood Cell Destruction: Caused by autoimmune diseases, infections, or inherited conditions such as sickle cell disease.
Medications: Some medications, like antibiotics and antimalarials, can trigger hemolysis (destruction of red blood cells).
Infections: Certain infections like malaria or parvovirus can lead to the premature destruction of red blood cells.

Each type of anaemia has specific causes, and understanding these can help in diagnosing and treating the condition effectively.

Anaemia Diagnosis

Diagnosing anaemia typically involves reviewing medical history, a physical examination, and conducting specific tests. The main diagnostic tools include:

Complete blood count (CBC)	Haemoglobin (Hb) - low haemoglobin levels are a sign of anaemia. Haematocrit (Hct) - refers to the number of red blood cells; low RBC count may indicate anaemia.li> Red Blood Cell (RBC) count - refers to the number of red blood cells; low in RBC may indicate anaemia. Mean Corpuscular Volume (MCV) - refers to the measurement of the average size of RBC; iron deficiency anaemia patients usually have smaller than normal RBCs, which is a condition called microcytic. Mean Corpuscular Haemoglobin (MCH) - refers to the average amount of haemoglobin per red blood cell; low amounts may be found in individuals with iron deficiency anaemia.
Serum ferritin test	Measures the amount of iron in the body. Low ferritin level is a reliable marker of iron deficiency.
Serum iron test	Measure how much iron is in the blood serum. Low level suggests iron deficiency.
Total iron-binding capacity (TIBC) test	Evaluates the blood’s ability to attach iron with transferrin. High TIBC levels typically indicate iron deficiency.
Transferrin saturation test	Measures the percentage of transferrin (iron transport protein) that is saturated with iron. A low percentage may be a sign of iron deficiency anaemia.

Other tests might be necessary if the cause of iron deficiency anaemia is unknown, including:

Endoscopy or colonoscopy	Identify the bleeding sources or gastrointestinal conditions.
Stool occult blood test	Check for hidden blood loss in the gastrointestinal tract.
Celiac disease screening	Might be necessary if poor absorption is suspected.
Bone marrow biopsy	May be done to evaluate the iron stores in the bone marrow under rare circumstances where the diagnosis is unclear.

Treatment and Prevention Of Anaemia

Both the underlying cause and the iron deficiency itself will be addressed during the treatment of iron deficiency anaemia.

Dietary changes	Eat more iron-rich foods such as fish, poultry, red meat, beans, tofu, spinach, lentils, and fortified cereals. Include foods rich in vitamin C (citrus fruits, tomatoes, and bell peppers) alongside iron-rich foods in your diet to improve iron absorption. Substances or foods that can hinder iron absorption, such as high-fibre foods, tea, coffee, and calcium supplements, should not be consumed around the time of iron-rich meals.
Iron administration	Oral iron supplements The recommended treatment for the majority of cases of iron deficiency anaemia and iron deficiency without anaemia. However, some people may experience side effects from iron tablets, including heartburn, stomach pain, constipation or diarrhoea, nausea, vomiting, and darker-than-usual stools. For individuals who may find it difficult to remember to take iron supplements daily, taking them every other day or on specific days of the week can still be beneficial. To improve iron absorption, it is recommended to take Vitamin C supplements on an empty stomach. Intravenous (IV) iron May be administered if oral iron is ineffective, poorly tolerated, or if rapid replenishment is necessary, such as in cases of severe anaemia, malabsorption conditions, or chronic kidney disease.
Treating underlying causes	Managing severe menstrual bleeding, gastrointestinal bleeding, and other causes of chronic blood loss, as well as chronic diseases like Crohn's disease, celiac disease, or chronic kidney disease that may reduce iron absorption, are some possible treatment options.
Blood transfusions	May be required for rapid correction in cases of severe anaemia accompanied by symptoms such as shortness of breath, chest pain, or extreme fatigue. To ensure the treatment is effective, your doctor will perform follow-up blood tests to check your ferritin, haemoglobin, and haematocrit levels.

Schedule an Appointment for Anaemia Treatment at Gleneagles Hospitals

If you're concerned about symptoms of anaemia, whether it’s iron deficiency, vitamin B12 or folate deficiency, or hemolytic anaemia, reach out to us. The experienced haematology specialists are here to guide you through a proper diagnosis and create a treatment plan that works for you. Whether you're feeling tired, weak, or experiencing other symptoms, we’re here to help. Contact us to make an appointment today for a consultation, or stop by our Haematology Department at your nearest Gleneagles Hospitals.

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