By Dr Amrish Kamboj, MD (Pathology )
With every breath we take, oxygen is picked up by haemoglobin, an iron-rich protein in the red blood cells, and carried to tissues throughout the body. Women who have insufficient levels of haemoglobin or red blood cells can’t get all the oxygen they need. This condition, called anaemia, can result in weakness, fatigue, headaches, heart palpitations, difficulty in concentrating, and other symptoms. With severe anaemia, other symptoms, such as shortness of breath and rapid heartbeat, may be experienced.
Anaemia is a very common finding in a large number of patients. It affects an estimated 400 million women throughout the world. Women and people with chronic diseases are at the greatest risk for anaemia.
Anaemia can cause serious health problems for women, and has to be taken seriously to find out what is it that is causing haemoglobin or red blood cells to decline. If anaemia remains undiagnosed, it can lead to infertility in women of childbearing age, premature delivery in pregnant women, and in severe cases – fainting, and mental confusion in women of any age.
Heavy menstrual bleeding or insufficient iron intake in the diet is often a major cause of anaemia. The other reasons resulting in anaemia in women include chronic internal bleeding due to stomach ulcers or some forms of bowel cancer. Women in the childbearing years are particularly susceptible to iron-deficiency anaemia because of the blood lost during menstruation and the increased blood supply demands during pregnancy.
Women who are vegetarians sometimes get anaemia because the iron in plant foods is not as easy for the body to absorb as the iron found in meat. Pregnancy also affects iron levels, which is why women are advised to take iron-containing prenatal supplements.
Most cases of anaemia due to dietary deficiency are caused by insufficient iron in the diet, but there are other forms of this condition as well. A deficiency of vitamin B12 can result in a decrease in red blood cells that may lead to anaemia. This nutrient is found only in animal foods, so strict vegetarians may not get enough. Pernicious anaemia, which often affects elderly adults, is caused by the lack of a stomach protein that is needed for adequate absorption of vitamin B12 in the small intestine.
Some frequently asked questions
How is anaemia diagnosed? How do I find out if I have anaemia?
Anaemia is identified by doing a complete blood count. The normal range of haemoglobin values is 12.3 g/dL to 15.3 g/dL for non-pregnant women. The World Health Organization defines anaemia as less than 12 g/dL for non-pregnant women.
What is the treatment for anaemia?
With any type of anaemia, there are two treatment goals:
– to get red blood cell counts or haemoglobin levels back to normal so that your organs and tissues can get enough oxygen
– to treat the underlying cause of the anaemia
The treatment your doctor prescribes for you will depend on the cause of the anaemia. The treatment of anaemia involves treating its cause, but severe anaemia is life threatening and can only be treated in the hospital with a transfusion of red blood cells.
What can I do to prevent anaemia?
There are various things women can do to prevent anaemia.
Increase iron intake: Women between the ages of 18 and 50 should take 18 milligrams of iron daily. During pregnancy, this amount should be increased to 27 milligrams. Women who are fifty and above need only about 8 milligrams of iron daily.
Eat red meats: They help in preventing or reversing anaemia in two ways: They are rich in dietary iron, and the form of iron that they contain, called haeme iron, is easy for the body to absorb. Lean red meat is a more healthy dietary meat source.
Enjoy iron-rich greens and beans: Most green leafy vegetables provide iron in our diet. Beans and lentils are also good sources of iron.
Drink orange juice with meals: or finish off your meal with a few slices of orange or grapefruit. Citrus fruits are very high in Vitamin C, which enhances iron absorption.
Save the coffee or tea for later. Along with tea, coffee reduces the body’s capacity to absorb iron. It is fine to enjoy these beverages as long as you have them a few hours after meals.
Take advantage of breakfast cereals: Especially those eating less or no meat should opt for fortified breakfast cereals which contain added iron: for example, taking fortified oats instead of the regular instant oats.
Take iron supplements after consulting your doctor: These can help your body keep pace with the normal iron losses, for example, during menstruation.
Do birth control pills reduce the risk of anaemia?
They could. Some women who take birth control pills have less bleeding during their periods. This would lower their risk for anaemia. But women who use an intrauterine device (IUD) may have more bleeding and increase their chances of getting anaemia. Talk to your doctor.
In conclusion, the ‘take home’ message
on anaemia for a woman is:
– Don’t treat it entirely on your own: Many women know the signs of anaemia – such as fatigue around their menstrual periods – and they assume that getting extra iron is all that they need to do. Iron will certainly improve your levels of red blood cells, but it won’t correct the underlying problem. It’s essential that you consult a doctor, who will run laboratory tests to determine what is causing your symptoms.
– Tell your doctor if iron supplements are causing side effects. Many women with anaemia quit taking iron supplements because they can’t handle the diarrhoea, nausea, or other unpleasant symptoms that sometimes occur with iron pills. Your doctor can try a different type of supplement that can be tolerated better.
– Be patient. It usually takes weeks or months for supplemental iron, either from food or pills, to correct anaemia. In the meantime, you should take adequate rest when you feel tired.
Anaemia happens when:
• the body loses too much blood (such as with heavy periods, certain diseases, and trauma); or
• the body has problems making red blood cells (like with iron and vitamin deficiencies); or
• red blood cells break down or die faster than the body can replace them with new ones; or
more than one of the above problems happen at the same time.
