What is anaemia?
Anaemia is a condition caused by a lack of
red blood cells. It means that the body’s tissues and organs cannot get enough
Red blood cells are given their colour by a
red pigment called haemoglobin – this pigment is also responsible for transporting
oxygen around the body. So when there is a lack of red blood cells, there is also
a shortage of haemoglobin – and not enough oxygen is delivered to the various tissues
What are the symptoms of anaemia?
General symptoms of anaemia may include:
- Fatigue, tiredness, lethargy
- Breathing difficulties on exercise
- Angina (chest tightness on exercise)
- Leg pains
- Pale complexion.
Depending on the underlying cause of the
anaemia, other symptoms may also develop and can include:
- Unusual cravings for specific foods
- Painful cracks at the corners of the mouth
- Difficulty swallowing
- Brittle and spoon shaped nails
- Loss of sense of touch, ‘pins and needles’
- Jaundice (yellow colouring of the skin)
- Abdominal pain
- Spontaneous bleeding under the skin or from
the gums, nose, vagina or anus
- Black stools, or blood present in your
One or more of these symptoms or signs may
indicate anaemia. However, the only way to establish whether you have anaemia
for certain is to consult your GP and have a blood test to measure your
How can you become anaemic?
Anaemia occurs when the normal balance
between red blood cell production in the bone marrow and red blood cell
destruction in the spleen is disrupted – resulting in an overall loss of red
blood cells. This can be due to:
- Inadequate red cell production – this may
be due to an inadequate supply of the necessary "ingredients",
particularly iron, folic acid and vitamin B12, or problems with the
"manufacturing plant" – the bone marrow.
- Bleeding from any source, such as the bowel
or womb – red cells may be lost from the body at a faster rate than they can be
- Premature or excessive destruction of blood
cells in the spleen.
There are many different types of anaemia. These
This is by far the
most common form of anaemia in Ireland – it can affect up to one in five women
of child-bearing age and 2% of adult men. Iron deficiency anaemia commonly
results from inadequate dietary intake of iron, from excessive blood loss from
ulcers or other problems in the bowel, or due to heavy periods. The cause of
the iron deficiency needs to be identified and treated. Iron tablets and
improvements in the diet are important elements of treatment (foods rich in
iron include lean meat, green vegetables, fruit, wholemeal bread and beans.) In
severe cases, a blood transfusion may be required to bring haemoglobin levels
back to normal levels.
Megaloblastic anaemia - so called because
of the large, deformed cells seen in the blood – is caused by a lack of folic
acid or vitamin B12. The body needs both of these substances to manufacture red
Folic acid cannot be stored in the body;
therefore a constant supply is needed from the diet (foods rich in folic acid
include green vegetables, lean meat and fortified bread etc). Anaemia due to
folic acid deficiency is most commonly seen in pregnant women, whose folic acid
requirement increases during the pregnancy. An uncorrected folic acid
deficiency in the mother increases the risk of neural tube defects (such as
spina bifida) or low birth weight in her baby. For this reason, doctors
recommend that pregnant women take folic acid supplements during early
pregnancy. Folic acid deficiency may also be a consequence of diseases which
interfere with the absorption process in the bowel, such as coeliac disease or
Crohn’s disease. If these diseases are found to be present, they will need to
Vitamin B12 is found in foods of animal
origin only and must combine with a chemical called intrinsic factor in the gut
before it can be absorbed. Excess vitamin B12 can be stored in the liver;
therefore inadequate dietary intake is relatively uncommon – although a strict
vegetarian diet may result in vitamin B12 deficiency. The common cause of this
type of anaemia is failure of the body to produce intrinsic factor in the
stomach lining, preventing the body from absorbing the vitamin. This is known
as pernicious anaemia. Eggs and liver provide good sources of vitamin B12.
Patients who are found to be deficient in vitamin B12 may need to have
This is a disorder in which the
body's red blood cells are destroyed prematurely. This may be caused by a defect
within the red cells themselves, which is usually inherited and causes the
cells to rupture spontaneously – or by an external trigger – such as an
infection, drug or toxin.
Sickle cell anaemia
Sickle cell anaemia is a genetically
inherited disorder that affects the red blood cells’ ability to carry oxygen to
the body’s tissues. It primarily affects black Africans and their descendants
Thalassemia is also a genetically inherited
anaemia. It affects the synthesis of haemoglobins, which carry oxygen around
the body. It is also known by the alternative name of Mediterranean Disease as
it primarily affects people of Mediterranean origin.
Aplastic anaemia is a rare and serious
disease which affects the body's ability to produce red blood cells in the bone
marrow. Sometimes, a bone marrow transplant is the only remedy. This type of
anaemia may be inherited, or it may be caused by damage to the bone marrow from
certain medications, infection or radiation.
Anaemia can also be associated with some
other conditions, such as autoimmune disorders, cancer and infection – which
may reduce red blood cell production.
Who should be especially careful of
Some people should be especially concerned
about becoming anaemic. If you have a complaint which makes demands on your
blood cell production already, anaemia will make things worse:
- Cancer can cause a reduction of red blood
cells in the body, and patients may find that their red blood cells are
affected by chemotherapy. Unfortunately, around half of all cancer patients
will suffer a bout of anaemia, but on the other hand, treating the anaemia can
improve recovery from cancer.
- HIV and AIDS can cause anaemia, either
directly as a result of the disease, or else as a result of treatment. Anaemia
increases the risk of death among people with AIDS and HIV. Equally, treating
the anaemia will improve the patient’s energy levels, enabling them to combat
- People with kidney disease often find that
their bodies do not produce enough of a substance called erythropoietin. This
substance is crucial in maintaining the body’s red blood cell level. As a
result, the anaemia that ensues can sometimes be difficult to treat.
- Anyone who has recently had surgery may be
at risk of contracting anaemia, due to blood loss.
- Pregnant women are likely to become anaemic
because of the nutritional needs of the developing baby. Women may develop
anaemia after the birth of a baby due to persistent blood loss during labour
and for a number of weeks afterwards.
How is anaemia treated?
For iron-deficiency anaemia, your doctor
may recommend changes to your diet to increase your iron intake – or iron
supplements may be required if you are not getting enough from your diet. Similarly,
folic acid and vitamin B-12 supplements may be required if you are found to be deficient
in one of these substances.
If you have haemolytic anaemia, you may
need surgery to remove the spleen (a splenectomy), while someone with aplastic anaemia may require a bone marrow
Anaemia can be a life-threatening
condition, since the heart, lungs and brain rely on the body’s red blood cells
to bring oxygen to them. If you suspect you may be anaemic, you should consult