Anemia, Frequently Asked Questions

WHAT ARE THE SYMPTOMS OF ANEMIA?

  • Headache.

  • Difficulty thinking.

  • Fatigue.

  • Shortness of breath.

  • Weakness.

  • Rapid heartbeat.

AT WHAT POINT ARE PEOPLE CONSIDERED ANEMIC?

This varies with gender and age.

  • Both hemoglobin (Hgb) and hematocrit values are used to define anemia. These lab values are obtained from a complete blood count (CBC) test. This is performed at a caregiver's office.

  • The normal range of hemoglobin values for adult men is 14.0 g/dL to 17.4 g/dL. For nonpregnant women, values are 12.3 g/dL to 15.3 g/dL.

  • The World Health Organization defines anemia as less than 12 g/dL for nonpregnant women and less than 13 g/dL for men.

  • For adult males, the average normal hematocrit is 46%, and the range is 40% to 52%.

  • For adult females, the average normal hematocrit is 41%, and the range is 35% to 47%.

  • Values that fall below the lower limits can be a sign of anemia and should have further checking (evaluation).

GROUPS OF PEOPLE WHO ARE AT RISK FOR DEVELOPING ANEMIA INCLUDE:

  • Infants who are breastfed or taking a formula that is not fortified with iron.

  • Children going through a rapid growth spurt. The iron available can not keep up with the needs for a red cell mass which must grow with the child.

  • Women in childbearing years. They need iron because of blood loss during menstruation.

  • Pregnant women. The growing fetus creates a high demand for iron.

  • People with ongoing gastrointestinal blood loss are at risk of developing iron deficiency.

  • Individuals with leukemia or cancer who must receive chemotherapy or radiation to treat their disease. The drugs or radiation used to treat these diseases often decreases the bone marrow's ability to make cells of all classes. This includes red blood cells, white blood cells, and platelets.

  • Individuals with chronic inflammatory conditions such as rheumatoid arthritis or chronic infections.

  • The elderly.

ARE SOME TYPES OF ANEMIA INHERITED?

  • Yes, some types of anemia are due to inherited or genetic defects.

  • Sickle cell anemia. This occurs most often in people of African, African American, and Mediterranean descent.

  • Thalassemia (or Cooley's anemia). This type is found in people of Mediterranean and Southeast Asian descent. These types of anemia are common.

  • Fanconi. This is rare.

CAN CERTAIN MEDICATIONS CAUSE A PERSON TO BECOME ANEMIC?

Yes. For example, drugs to fight cancer (chemotherapeutic agents) often cause anemia. These drugs can slow the bone marrow's ability to make red blood cells. If there are not enough red blood cells, the body does not get enough oxygen.

WHAT HEMATOCRIT LEVEL IS REQUIRED TO DONATE BLOOD?

The lower limit of an acceptable hematocrit for blood donors is 38%. If you have a low hematocrit value, you should schedule an appointment with your caregiver.

ARE BLOOD TRANSFUSIONS COMMONLY USED TO CORRECT ANEMIA, AND ARE THEY DANGEROUS?

They are used to treat anemia as a last resort. Your caregiver will find the cause of the anemia and correct it if possible. Most blood transfusions are given because of excessive bleeding at the time of surgery, with trauma, or because of bone marrow suppression in patients with cancer or leukemia on chemotherapy. Blood transfusions are safer than ever before. We also know that blood transfusions affect the immune system and may increase certain risks. There is also a concern for human error. In 1/16,000 transfusions, a patient receives a transfusion of blood that is not matched with his or her blood type.

WHAT IS IRON DEFICIENCY ANEMIA AND CAN I CORRECT IT BY CHANGING MY DIET?

Iron is an essential part of hemoglobin. Without enough hemoglobin, anemia develops and the body does not get the right amount of oxygen. Iron deficiency anemia develops after the body has had a low level of iron for a long time. This is either caused by blood loss, not taking in or absorbing enough iron, or increased demands for iron (like pregnancy or rapid growth).

Foods from animal origin such as beef, chicken, and pork, are good sources of iron. Be sure to have one of these foods at each meal. Vitamin C helps your body absorb iron. Foods rich in Vitamin C include citrus, bell pepper, strawberries, spinach and cantaloupe. In some cases, iron supplements may be needed in order to correct the iron deficiency. In the case of poor absorption, extra iron may have to be given directly into the vein through a needle (intravenously).

I HAVE BEEN DIAGNOSED WITH IRON DEFICIENCY ANEMIA AND MY CAREGIVER PRESCRIBED IRON SUPPLEMENTS. HOW LONG WILL IT TAKE FOR MY BLOOD TO BECOME NORMAL?

It depends on the degree of anemia at the beginning of treatment. Most people with mild to moderate iron deficiency, anemia will correct the anemia over a period of 2 to 3 months. But after the anemia is corrected, the iron stored by the body is still low. Caregivers often suggest an additional 6 months of oral iron therapy once the anemia has been reversed. This will help prevent the iron deficiency anemia from quickly happening again. Non-anemic adult males should take iron supplements only under the direction of a doctor, too much iron can cause liver damage.

MY HEMOGLOBIN IS 9 G/DL AND I AM SCHEDULED FOR SURGERY. SHOULD I POSTPONE THE SURGERY?

If you have Hgb of 9, you should discuss this with your caregiver right away. Many patients with similar hemoglobin levels have had surgery without problems. If minimal blood loss is expected for a minor procedure, no treatment may be necessary.

If a greater blood loss is expected for more extensive procedures, you should ask your caregiver about being treated with erythropoietin and iron. This is to accelerate the recovery of your hemoglobin to a normal level before surgery. An anemic patient who undergoes high-blood-loss surgery has a greater risk of surgical complications and need for a blood transfusion, which also carries some risk.

I HAVE BEEN TOLD THAT HEAVY MENSTRUAL PERIODS CAUSE ANEMIA. IS THERE ANYTHING I CAN DO TO PREVENT THE ANEMIA?

Anemia that results from heavy periods is usually due to iron deficiency. You can try to meet the increased demands for iron caused by the heavy monthly blood loss by increasing the intake of iron-rich foods. Iron supplements may be required. Discuss your concerns with your caregiver.

WHAT CAUSES ANEMIA DURING PREGNANCY?

Pregnancy places major demands on the body. The mother must meet the needs of both her body and her growing baby. The body needs enough iron and folate to make the right amount of red blood cells. To prevent anemia while pregnant, the mother should stay in close contact with her caregiver.

Be sure to eat a diet that has foods rich in iron and folate like liver and dark green leafy vegetables. Folate plays an important role in the normal development of a baby's spinal cord. Folate can help prevent serious disorders like spina bifida. If your diet does not provide adequate nutrients, you may want to talk with your caregiver about nutritional supplements.

WHAT IS THE RELATIONSHIP BETWEEN FIBROID TUMORS AND ANEMIA IN WOMEN?

The relationship is usually caused by the increased menstrual blood loss caused by fibroids. Good iron intake may be required to prevent iron deficiency anemia from developing.