Blood or lack of it

Anemia, the most common disorder when it comes to females in the reproductive age group, has always been considered a disease of iron deficiency. Not quite so…. it is actually a condition in which the total quantity of hemoglobin in the circulating blood is less than normal. And this can be due to a number of factors. To cure the condition it is important to know the root cause of anemia.  

Aplastic Anemia: is caused by aplasia, a retardation or incomplete development of bone marrow or its destruction.  by chemical agents like arsenic or by physical factors such as x-rays. In this type of anemia , not only are red blood cells reduced in numbers, so too are the white cells. Resistance to infection is reduced, blood platelet count drops as well, and there may be bleeding.

Folacin Anemia: Folacin is a vitamin necessary for normal red blood cell production. This condition occurs in individuals who rarely eat uncooked vegetables or fruits and in pregnant women or alcoholics. Folic acid requirements are increased during pregnancy, so pregnant women may develop the characteristic megaloblastic anemia while ingesting an adequate diet. The anemia symptoms of folic acid and cobalamin deficiencies are similar.

Hemolytic Anemia: If the red blood cells are broken down at a faster rate than normal and before they can be replaced , hemolytic anemia results . Sometimes this is due to a hereditary condition called spherocytosis, in which the red blood cells are small and round, but it may also be caused by antibodies in the blood which attack the red cells or by various drugs  or by a variety of inherited disorders such as sickle cell anemia and thalassemia. hemolytic anemia has the same symptoms as other anemias and may also produce jaundice. The breakdown of the red blood cells releases hemoglobin which is converted into the pigment bilirubin, which turns the tissues of the skin and whites of the eyes yellow,a condition known as jaundice. The spleen where most red blood cells are normally destroyed, may become enlarged from an over accumulation of dead cells and can be detected on physical examination of the upper left part of the abdomen. Signs of  heart failure and an enlarged liver may indicate that the anemia is severe.

Pernicious Anemia: An anemia caused by the deficiency or failure to absorb cobalamin (vitamin B12). The gastric mucosa (stomach lining) fails to excrete mucoproteins , called intrinsic factor, required for absorption. Pernicious anemia is characterized by giant red cells (macrocytes) and each red cell appears to be overloaded with hemoglobin (hyperchromic) while the total number of red blood cells is decreased (anemia). Numbness in the fingers and toes is common .The disease occurs generally in males between the ages of 40 and 65 years. Treatment and maintenance usually involves intramuscular injection of a vitamin B 12 derivative, and the prognosis is excellent. The administration of microgram quantities of cobalamin daily by mouth is sufficient to overcome vitamin B 12 deficiencies when there is normal production of intrinsic factor. Vitamin B 12 is required to remove methyl groups from folic acid . Unmethylated  folacin is required for the production of red blood cells.

Iron Deficiency Anemia: A group consisting of a number of chronic anemias which are characterized by small pale erthrocytes. The basic cause is depletion of iron stores due to a discrepancy between iron intake and iron requirements. In adults, chronic blood loss is the most common cause of iron deficiency anemia.it may be physiologic, as in excessive or prolonged menstruation or pathologic as in occult intestinal blood loss due to ulcerations, parasites or malignancy. Disorders of the gastrointestinal tract such as achlorhydria or chronic diarrhea may also lead to iron deficiency anemia because of impaired iron absorption.. The symptoms of iron deficiency are similar to those of other types of anemia and include easy fatigability, pallor, dyspnea on exertion and a constant feeling of tiredness. The skin,mucous membranes and nails are pale in proportion to the reduction in the circulating hemoglobin. Nails may be brittle; individual blood cells are pale (hypochromic) and smaller than normal (microcytic).

Megaloblastic Anemia: The anemias caused by deficiencies of the vitamins B 12 and folic acid show identical bone marrow and peripheral blood changes. This is because both vitamins are essential for normal deoxyribonucleic acid synthesis. In each case, the marrow is hyperplastic and the precursor erythroid and myeloid cells are large and bizarre ;some are multinucleated. But many of these cells die within the marrow, so that the mature cells which leave the marrow are decreased in number. Thus a pancytopenia ( a reduction in all cellular elements of the blood) develops. After the body stores of vitamin B 12 or folate are used up, signs of anemia begin to appear. The hematologic effects of deficiency are accompanied by effects on other organ systems,particularly the gastrointestinal tract when folate is deficient, and the nervous system when B 12 is deficient.

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