Anemia,
also Known as 'low blood", means less than normal amount of red blood
cell in a person.
It is
diagnosed by taking a sample of blood and measuring the relative amount of red
cell substance in it.
Red blood
cells normally live about 120 days in the circulation and they then die.
The human body is remarkably efficient in reusing major parts and discarding
only a small portion of the cells. Under normal circumstances, a person
replaces slightly less than 1% of cells daily. He or she has the capacity to
make many times that number when needed but requires some time to assemble the
elements and start production.
Anemia
results from:
-
Decreased
production;
-
Increased
destruction;
-
Loss from
the body (hemorrhage);
-
Combinations
of the above.
If a person
stops production or markedly slows production, then normal attrition will
gradually reduce the number of red cells in the body. This most commonly
occurs when a person is very ill and all resources are needed to deal with the
total body illness. Most of the time the person recovers before the loss
becomes noticeable. In long standing severe illness, the problem
persists long enough for detection, such as in chronic kidney failure,
smoldering infections like Tb, chronic bone infections, etc. Other
times, a critical component for blood cell formation is missing,
production is defective and fails to keep up with attrition.
Increased
destruction may be either mechanical or biological. Extensive and severe
burns and artificial heart valves are examples of mechanical or physical
destruction of red cells.
Biological
destruction may be inherited or acquired. Many inherited defects
predispose a person to red cell destruction under specific circumstances.
One example
is sickle cell anemia [frequent in Blacks] where cells are vulnerable
to trauma while traveling at high velocity and pressure in the blood
vessels.
A common but
little known disease is 'glucose 6 phosphate dehydrogenase deficiency'. About
10% of black men have it and their red cells are easily destroyed by
certain drugs.
Some acquired
problems render red cells prone to destruction. Sometimes certain germs
weaken red cells or the person's own body attacks itself by making antibodies
which destroys the red cells.
By far, the
most common form of anemia is due to loss of blood from the body. Nearly
one half of the people in the world between 11 and fifty of age bleed
monthly...women.
If a blood
loss continues excessively or for a long time, the body's raw material for red
cell production can be used up.. This is often true of iron. Iron
deficiency anemia occurs when loss exceed the ability to absorb iron or there
is insufficient iron in the diet to keep up with the loss.
In older
individuals anemia may be the first sign of colon cancer. As a matter of
fact, colon cancer is the most common cause of anemia in people over the age
of 60. Other sneaky (unknown the persons causes of intestinal bleeding
are worms.
Diet without
red meat and green leafy vegetables may lead to iron deficiency but the anemia
in this case may be due to decreased production. Many young women eat
starch, ice clay, paper, cloth or other substances and develop iron deficiency
by this mechanism. It is called PICA.
Dr. Esly
S. Caldwell, II, M.D., MPH, FRCP (C), FAAFP, FACP, is an internist in private
practice in Cincinnati, Ohio. Please use the feedback
form for addressing any comments or questions to him.
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