Variety of causes to be explored when treating anemia

Q: I am a 45-year-old woman. The last time I went for routine blood tests, my doctor noticed that I am anemic. He has ordered more tests to see what caused this. He thinks it may be from my periods, which have been a little heavier recently. What else do you think may be causing my anemia?

A: Anemia can be detected if the hemoglobin levels in the blood are low. This happens if the body makes insufficient red blood cells or it destroys them quicker than they can be made.

Bleeding for any reason may lead to more red blood cells being lost than are being made. This results in the blood having less oxygen-carrying capacity, and the person will feel tired and weak. In more severe cases, paleness of the skin is obvious.

The best places to check are the insides of your eyelids and the palms of your hands. Compare them to another person. You can also have shortness of breath, headaches, chest pains, low blood pressure leading to dizzy spells and an irregular heartbeat.

Heavy menstrual flow is one of the leading causes of anemia in women of your age or younger, but there are other medical conditions that should be ruled out before jumping to this conclusion. Many chronic illnesses, including chronic inflammation such as rheumatoid arthritis, cancer and Crohn’s disease, can also cause anemia, so these should be looked into and treated appropriately.

Iron deficiency anemia is the most common situation in both men and women. Apart from menstruation and pregnancy, stomach ulcers or trauma may cause bleeding, as well as some medications that irritate the stomach lining, such as aspirin and ibuprofen. Iron deficiency anemia is managed by treating the cause of bleeding and taking iron medications. Occasionally blood transfusions are necessary.

Lack of vitamin B12 and/or folic acid can lead to anemia from decreased red cell production. Some vegetarians and vegans may need to supplement their diets to prevent this from happening. Also, many older people have trouble absorbing dietary vitamin B12, even if they are meat eaters, and may require regular or occasional injections.

Anemia can also begin in the bone marrow, which affects the production of blood cells. This could be due to serious illnesses such as leukemia or aplastic anemia.

Other serious conditions include the inherited sickle cell disease, which affects mainly Africans or people of African descent. In this case distorted, immature and thin red blood cells are great for protection against the malaria parasite, but are not very good at carrying oxygen because there is less room for hemoglobin.

Hemolytic anemia may also be inherited and usually occurs in older people. In this case, the body destroys cells faster than they can be replaced.

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