Understanding Anemia - The Basics

Understanding Anemia -- the Basics
In this Article
In this Article
In this Article
 What Is Anemia?
 What Causes Anemia?
What Is Anemia?
Anemia is a condition that develops when your blood lacks enough healthy red blood cells or
hemoglobin. Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or
abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get
enough oxygen. Symptoms of anemia -- like fatigue -- occur because organs aren't getting what
they need to function properly.
Anemia is the most common blood condition in the U.S. It affects about 3.5 million Americans.
Women, young children, and people with chronic diseases are at increased risk of anemia.
Important factors to remember are:
 Certain forms of anemia are hereditary and infants may be affected from the time of birth.
 Women in the childbearing years are particularly susceptible to iron-deficiency anemia
because of the blood loss from menstruation and the increased blood supply demands during
pregnancy.
 Older adults also may have a greater risk of developing anemia because of poor diet and
other medical conditions.
There are many types of anemia. All are very different in their causes and treatments. Iron-
deficiency anemia, the most common type, is very treatable with diet changes and iron supplements.
Some forms of anemia -- like the mild anemia that develops during pregnancy -- are even
considered normal. However, some types of anemia may present lifelong health problems.
What Causes Anemia?

There are more than 400 types of anemia, which are divided into three groups:
 Anemia caused by blood loss

 Anemia caused by decreased or faulty red blood cell production
 Anemia caused by destruction of red blood cells
Anemia Caused by Blood Loss

Red blood cells can be lost through bleeding, which often can occur slowly over a long period of
time, and can go undetected. This kind of chronic bleeding commonly results from the following:
 Gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of

the stomach), and cancer
 Use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, which
can cause ulcers and gastritis
 Menstruation and childbirth in women, especially if menstrual bleeding is excessive and if
there are multiple pregnancies
Continued
Anemia Caused by Decreased or Faulty Red Blood Cell Production
With this type of anemia, the body may produce too few blood cells or the blood cells may not
function correctly. In either case, anemia can result. Red blood cells may be faulty or decreased due
to abnormal red blood cells or a lack of minerals and vitamins needed for red blood cells to work
properly. Conditions associated with these causes of anemia include the following:
 Sickle cell anemia

 Iron-deficiency anemia
 Vitamin deficiency
 Bone marrow and stem cell problems
 Other health conditions
Sickle cell anemia is an inherited disorder that, in the U.S. affects mainly African-Americans and
Hispanic Americans. Red blood cells become crescent-shaped because of a genetic defect. They
break down rapidly, so oxygen does not get to the body's organs, causing anemia. The crescent-
shaped red blood cells can also get stuck in tiny blood vessels, causing pain.
Iron-deficiency anemia occurs because of a lack of the mineral iron in the body. Bone marrow in
the center of the bone needs iron to make hemoglobin, the part of the red blood cell that transports
oxygen to the body's organs. Without adequate iron, the body cannot produce enough hemoglobin
for red blood cells. The result is iron-deficiency anemia. This type of anemia can be caused by:
 An iron-poor diet, especially in infants, children, teens, vegans, and vegetarians

 The metabolic demands of pregnancy and breastfeeding that deplete a woman's iron stores
 Menstruation
 Frequent blood donation
 Endurance training
 Digestive conditions such as Crohn's disease or surgical removal of part of the stomach or
small intestine
 Certain drugs, foods, and caffeinated drinks
Vitamin-deficiency anemia may occur when vitamin B12 and folate are deficient. These
two vitamins are needed to make red blood cells. Conditions leading to anemia caused by vitamin
deficiency include:
 Megaloblastic anemia: Vitamin B12 or folate or both are deficient

 Pernicious anemia: Poor vitamin B12 absorption caused by conditions such as Crohn's
disease, an intestinal parasite infection, surgical removal of part of the stomach or intestine,
or infection with HIV
 Dietary deficiency: Eating little or no meat may cause a lack of vitamin B12, while
overcooking or eating too few vegetables may cause a folate deficiency.
 Other causes of vitamin deficiency: pregnancy, certain medications, alcohol abuse, intestinal
diseases such as tropical sprue and celiac disease
Continued
During early pregnancy, sufficient folic acid can help prevent the fetus from developing neural tube
defects such as spina bifida.
Bone marrow and stem cell problems may prevent the body from producing enough red blood
cells. Some of the stem cells found in bone marrow develop into red blood cells. If stem cells are
too few, defective, or replaced by other cells such as metastatic cancer cells, anemia may result.
Anemia resulting from bone marrow or stem cell problems include:
 Aplastic anemia occurs when there's a marked reduction in the number of stem cells or
absence of these cells. Aplastic anemia can be inherited, can occur without apparent cause,
or can occur when the bone marrow is injured by medications, radiation, chemotherapy, or
infection.
 Thalassemia occurs when the red cells can't mature and grow properly. Thalassemia is an
inherited condition that typically affects people of Mediterranean, African, Middle Eastern,
and Southeast Asian descent. This condition can range in severity from mild to life-
threatening; the most severe form is called Cooley's anemia.
 Lead exposure is toxic to the bone marrow, leading to fewer red blood cells. Lead poisoning
occurs in adults from work-related exposure and in children who eat paint chips, for
example. Improperly glazed pottery can also taint food and liquids with lead.
Anemia associated with other conditions usually occurs when there are too few hormones
necessary for red blood cell production. Conditions causing this type of anemia include the
following:
 Advanced kidney disease
 Hypothyroidism
 Other chronic diseases, such as cancer, infection, lupus, diabetes, and rheumatoid arthritis
 Old age
Anemia Caused by Destruction of Red Blood Cells

When red blood cells are fragile and cannot withstand the routine stress of the circulatory system,
they may rupture prematurely, causing hemolytic anemia. Hemolytic anemia can be present at birth
or develop later. Sometimes there is no known cause. Known causes of hemolytic anemia may
include:
 Inherited conditions, such as sickle cell anemia and thalassemia

 Stressors such as infections, drugs, snake or spider venom, or certain foods
 Toxins from advanced liver or kidney disease
 Inappropriate attack by the immune system (called hemolytic disease of the newborn when
it occurs in the fetus of a pregnant woman)
 Vascular grafts, prosthetic heart valves, tumors, severe burns, exposure to certain chemicals,
severe hypertension, and clotting disorders
 In rare cases, an enlarged spleen can trap red blood cells and destroy them before their
circulating time is up.

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Understanding Anemia -- the Basics

What Causes Anemia?

 Anemia caused by blood loss

Anemia Caused by Blood Loss

 Gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of

 Sickle cell anemia

 An iron-poor diet, especially in infants, children, teens, vegans, and vegetarians

 Megaloblastic anemia: Vitamin B12 or folate or both are deficient

Anemia Caused by Destruction of Red Blood Cells

 Inherited conditions, such as sickle cell anemia and thalassemia

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