A clinical look at two kinds of Anemia
A clinical look at two kinds of Anemia Anemia is considered to be an anomaly in either the size or number of red blood cells in the body. Depending on how the disease manifests it can have a number of origins, but the most important causative factors are definitely related to nutritional issues. This decrease in either the amount of red blood cells or the reduction in hemoglobin results in a decrease in the amount of oxygen that the blood can carry to the other cells of the body. As a result, aerobic respiration and cellular energy production in the mitochondria is effected. When the cells have less energy to perform normal processes, overall bodily activity tends to slow down and become less efficient, and patients tend to be overly fatigued. Muscular activity can decrease, as can cell repair and regeneration. The brain requires a sufficient constant supply of oxygen and glucose to function. When there is deficient oxygen supply to the brain, mental clarity can be affected and the patient may feel dizzy. Anything that causes a deficiency in the production or formation of red blood cells, or that leads to a rapid destruction of red blood cells can result in anemia. This includes any type of heavy bleeding, hormonal disorders, drug use (recreational or prescription- especially chemotherapeutic compounds), surgery, repeated pregnancy, liver damage, RA, and bone marrow disease. There are some forms of anemia which are related to genetic inheritance, such as sickle cell disease which causes the hemoglobin in oxygen deprived red blood cells to form long chains, distorting the shape of the blood cell and making it difficult for the cell to pass through the capillary bed. The other forms of anemia are hemorrhagic which is related to loss of blood, hypo chromic and microcytic anemia which is related to insufficient hemoglobin, aplastic which is related to decreased production of red blood cells by the marrow, hemolytic which is related to abnormally high destruction of red blood cells, and pernicious or macrocytic-megaloblastic anemia related to B Vitamin deficiency. . Many millions of Americans suffer from anemia. 20 % of anemic patients are women and 50% are children Iron Deficiency Anemia Description and Pathogenesis: Iron deficiency or hypochromic-microcytic anemia is by far the most common type of anemia. Iron is necessary to form hemoglobin which is the component of the red blood cell that attaches to oxygen and transports the oxygen to other cells, as well as binding to carbon dioxide to deliver it to the lungs where it is released. Normally red blood cells have a life cycle of 120 days. After that period of time, or when they are damaged, they are phagocytized in the liver and spleen by macrophages. In the liver, the hemoglobin is split into heme and globin, and then the heme is decomposed into iron and biliverdin. Iron is then returned to the bone marrow via the blood for re-use in the synthesis of new blood cells, or is stored in the liver (and some other tissues such as the spleen and the bones) as ferritin. Although the majority of the iron that is reclaimed from the damaged blood cells is usable by the body, there is some loss that must be made up for by dietary iron intake. Although there can be an abundant supply of iron in many foods, the capacity to absorb available iron from foods in the small intestine is less than optimal, as the mechanism for the absorption involves active transport and consequently occurs slowly. It is estimated that 70-99% of the iron ingested gets excreted in the stools, depending on the tissue stores of iron in the body. If stores are depleted, the body enhances the absorption of available dietary iron. Once iron is absorbed and stored in the body as hemoglobin or ferritin, the principle ways it can be last are through bleeding, menstruation in women or pregnancy. If a patient has inadequate iron leading to hypochromic anemia they may have fatigue, although this has not been completely correlated with decreased hemoglobin levels, and may have to due with depletion of iron-containing enzymes. Other symptoms such as anorexia, weakness and pica can have their roots in either iron deficiency anemia or depletion of iron containing enzymes. Later stage symptoms can include deformation of the epithelial tissues such as the fingernails, mouth, tongue and mouth. Fingernails can become flat, thin or spoon-shaped. The tongue can become shiny and smooth due to atrophy of the tongue papillae. It may also become red and swollen. Paleness of the conjunctiva and angular stomatitis are also possible symptoms. Etiology: There are four major etiologies of iron deficiency anemia: Chronic blood loss, which can occur during heavy periods, bleeding ulcers, hemorrhoids, and possibly malignancies. Faulty iron uptake or absorption Lack of dietary iron Increased iron requirement for growth of blood volume, which usually occurs in children and pre-post pregnancy. Other factors such as copper deficiency, which is required for its transportation into the hemoglobin molecule, or parasitic infection due to intestinal dysbiosis. Diagnosis: Other than signs and symptoms, blood work is one of the best diagnostic tools to determine hypochromic anemia. The parameters to look for in blood work are: Decreased RBC. Below 3.9 million per cu/mm is suspect in females, below 4.2 million in males. This can be decreased in iron deficiency anemia as well as aplastic anemia or macrocytic and B vitamin anemias Hemoglobin. (HGB) Under 13.5 g/dl is below range. Hemoglobin can also be decreased in hemorrhage, digestive inflammation, liver dysfunction or free radical pathology. Hematocrit (HCT) or Packed Cell Volume (PCV) Under 37% in females and 40% in males is low-end. This test measures the volume of RBC’s in a certain amount of plasma by packing the cells together by centrifuge. It can also be low in other diseases. Mean Corpuscular Volume (MCV) Below 85.0 microns is suspect. This test measures the volume a single red blood cell occupies, showing whether they are in
