Anemia

Anemia or anemia is a condition when the body lacks healthy red blood cells or when red blood cells do not function properly. As a result, the body’s organs do not get enough oxygen, making the sufferer of anemia pale and easily tired.

Anemia can occur temporarily or in the long term with mild to severe severity. Anemia is a blood disorder or hematologic abnormality that occurs when the level of hemoglobin (the main part of red blood cells that binds oxygen) is below normal.

Adults are said to suffer from anemia when their hemoglobin level is below 14 grams per deciliter for men and less than 12 grams per deciliter for women. Anemia with a hemoglobin level below 8 grams per deciliter is classified as severe. This condition is called anemia gravis

The treatment of anemia depends on the underlying cause, ranging from consumption of iron supplements, blood transfusions, to surgery.

Causes of Anemia

Anemia occurs when the body lacks healthy red blood cells or hemoglobin. As a result, the cells in the body do not get enough oxygen and do not function normally (hypoxemia).

Broadly speaking, anemia occurs due to the following three conditions:

• Less production of red blood cells
• Excessive blood loss
• The rapid destruction of red blood cells

The following are the types of anemia that commonly occur based on the cause:

1. Anemia due to iron deficiency

Iron deficiency makes the body unable to produce hemoglobin (Hb). This condition can occur due to a lack of iron intake in food, or because the body is unable to absorb iron, for example due to celiac disease.

2. Anemia during pregnancy

Pregnant women have lower hemoglobin values, but this is normal. However, the need for hemoglobin increases during pregnancy so more hemoglobin-forming substances are needed, namely iron, vitamin B12, and folic acid.

If the intake of these three nutrients is low, then anemia can occur which can harm the pregnant mother and the fetus.

3. Anemia due to bleeding

Anemia can be caused by heavy bleeding that occurs slowly over a long period of time or occurs suddenly. The cause can be injury, menstrual disorders, hemorrhoids, inflammation of the stomach, colon cancer, or side effects of drugs, such as nonsteroidal anti-inflammatory drugs (NSAIDs) .

Anemia due to bleeding can also be a symptom of hookworm infection that sucks blood from the intestinal wall.

4. Aplastic anemia

Aplastic anemia occurs when damage to the bone marrow makes the body no longer able to produce red blood cells optimally. This condition is suspected to be triggered by infections, autoimmune diseases, exposure to toxic chemicals, as well as side effects of antibiotics and drugs to overcome rheumatoid arthritis.

5. Hemolytic anemia

Hemolytic anemia occurs when the destruction of red blood cells is faster than their formation. This condition can be inherited from parents, or acquired after birth due to blood cancer, bacterial or viral infections, autoimmune diseases, as well as side effects of drugs, such as paracetamol, penicillin, and antimalarial drugs.

6. Anemia due to chronic disease

Some diseases can affect the process of red blood cell formation, especially if it lasts for a long time. Some of them are Crohn’s disease, kidney disease, cancer, rheumatoid arthritis, and HIV/AIDS.

7. Sickle cell anemia

Sickle cell anemia is caused by a genetic mutation (change) in hemoglobin. As a result, hemoglobin becomes sticky and abnormally shaped, which is like a crescent moon. A person can get sickle cell anemia if both parents have the same genetic mutation.

8. Thalassemia

Thalassemia is caused by a gene mutation that affects the production of hemoglobin. A person can suffer from thalassemia if one or both parents have the same condition.

Symptoms of Anemia

Symptoms of anemia vary greatly, depending on the cause. Anemic patients can experience symptoms in the form of:

• Weak and tired quickly
• Headache and dizziness
• Often sleepy, for example sleepy after eating
• The skin looks pale or yellowish
• Irregular heartbeat
• Short breath
• Chest pain
• Cold hands and feet

The symptoms above are often not noticed by the sufferer at first, but will become more noticeable as the condition of anemia worsens.

When should you go to the doctor?

Check yourself with a doctor if you feel tired quickly or experience symptoms of anemia that get worse over time.

If you suffer from anemia that requires long-term treatment or even routinely receive blood transfusions, then do a routine check-up with a doctor to monitor the progress of the disease.

Consult a doctor if you experience conditions that can cause anemia, such as kidney disease, menstrual disorders, colon cancer, or hemorrhoids .

For pregnant women, a drop in Hb is normal. To take care of the health of the mother and the fetus, check the pregnancy routinely to the obstetrician . Obstetricians will give supplements to prevent anemia during pregnancy.

If you suffer from a genetic disorder that can cause anemia, such as thalassemia, or have a family member suffering from the disease, it is recommended to consult a doctor before planning to have offspring.

Diagnosis of Anemia

To determine if the patient suffers from anemia, the doctor will perform a complete blood count. Through a blood test, the doctor will measure the level of iron, hematocrit, vitamin B12, and folic acid in the blood, as well as check kidney function. The purpose of the test is to find out the cause of anemia.

In addition to blood tests, the doctor will perform other advanced examinations to find the cause of anemia, such as:

• Endoscopy, to see if the stomach or intestines are bleeding
• Pelvic ultrasound, to find out the cause of menstrual disorders that cause anemia
• Examination of bone marrow aspiration, in order to find out the rate, shape, and level of maturity of blood cells directly from the ‘factory’
• Examination of amniotic fluid samples during pregnancy to determine the possibility of the fetus suffering from genetic abnormalities that cause anemia

Treatment of Anemia

The treatment method for anemia depends on the type of anemia the patient suffers from. Be aware that treatment for one type of anemia can be dangerous for another type of anemia. Therefore, doctors will not start treatment before knowing the cause for sure.

Some examples of anemia treatment or anemic drugs based on the type are:

• Anemia due to iron deficiency
  This condition is overcome by consuming food and iron supplements. In severe cases, a blood transfusion is required .
• Anemia during pregnancy
  This condition is dealt with by giving supplements of iron , folic acid, and vitamin B12, the dosage of which is determined by the doctor.
• Anemia due to bleeding
  This condition is treated by stopping the bleeding. When necessary, the doctor will also give iron supplements or blood transfusions.
• Aplastic anemia
  The treatment is with blood transfusion to increase the number of red blood cells, or bone marrow transplantation (transplantation) when the patient’s bone marrow can no longer produce healthy red blood cells.
• Hemolytic anemia
  The treatment is by stopping the consumption of drugs that trigger hemolytic anemia, treating infections, taking immunosuppressant drugs, or removing the spleen.
• Anemia due to chronic disease
  This condition is overcome by treating the underlying disease. In certain conditions, blood transfusions and erythropoietin hormone injections are required to increase red blood cell production.
• Sickle cell anemia
  This condition is treated with iron and folic acid supplements, bone marrow transplants, and the administration of chemotherapy, such as hydroxyurea. In certain conditions, the doctor will give pain relievers and antibiotics.
• Thalassemia
  In dealing with thalassemia, doctors can perform blood transfusions, folic acid supplements, spleen removal, and bone marrow transplants.

Complications of Anemia

If left untreated, anemia risks causing serious complications, such as:

• Difficulty doing activities due to fatigue
• Heart problems, such as heart rhythm disorders (arrhythmias) and heart failure
• Disorders of the lungs, such as pulmonary hypertension
• Pregnancy complications, including premature birth or low birth weight babies
• Disruption of the growth process if anemia occurs in children or babies
• Susceptible to infection

Prevention of Anemia

Some types of anemia, such as anemia during pregnancy and anemia due to iron deficiency, can be prevented with a nutrient-rich diet, especially:

• Foods rich in iron and folic acid, such as meat, cereals, nuts, dark green leafy vegetables, bread, and fruits
• Foods rich in vitamin B12, such as milk and its derivatives, as well as soybean-based foods, such as tempeh and tofu
• Fruits rich in vitamin C, such as oranges, melons, tomatoes, and strawberries

In addition to food, iron deficiency anemia can also be prevented by taking iron supplements routinely.

The normal level of Hb varies from person to person, depending on their age and gender. Here is the range of normal Hb values:

• Adult male: 13 g/dL (grams per deciliter)
• Adult women: 12 g/dL
• Pregnant women: 11 g/dL.
• Infants: 11 g/dL
• Children aged 1–6 years: 11.5 g/dL
• Children and adolescents aged 6—18 years: 12 g/dL

To find out if your nutritional intake is enough, discuss it with a nutrition specialist. If your family suffers from anemia due to genetic abnormalities, such as sickle cell anemia or thalassemia, consult a doctor before planning pregnancy so that this condition does not occur in children.

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