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Anaemia means decrease in oxygen carrying capacity of blood as a result of significant reduction in red blood cells (RBCs). Decrease in red cell concentration in peripheral blood or decrease of hemoglobin is the main indicator of anaemia. Decrease in hemoglobin concentration by more than 10% below the average values signifies anaemia.
What are the signs and symptoms of anaemia ?
The anaemia is characterised by weakness, fatigue, palpitation, light headedness, pica (habit of eating mud), difficulty in swallowing, loss of appetite, nausea, constipation, diarrhea, stomatitis etc. The patient is pale, the nail may be dry and brittle, and tongue may be inflammed. In severe anaemia, heart failure and edema can occur. Gastointestinal symptoms are more common in megaloblastic anaemia. Severe anaemia in young children may cause growth retardation.
What is the importance of Red Blood Cells (RBCs, Erythrocytes) ?
The blood performs the function of transporting the oxygen with the help of Red Blood Cells (RBCs). Mature human RBC is a circular, biconcave cell without a nucleus. The average diameter of RBC is 7.2 micron. RBCs bigger than normal size are known as macrocytes and smaller than normal size as microcytes,. The RBCs are filled with hemoglobin (Hb) which imparts red colour to these cells. Normal average RBC count is 4.8 and 5.2 million/cubic mm. in females and males, respectively. The absence of nucleus gives RBC biconcave shape and allows more room for haemoglobin.
Where are the RBCs produced in the body ?
RBCs are produced in the bone marrow. The cells of the bone marrow undergo multiplication and maturation producing and realeasing the RBCs in the blood. Immature RBCs are larger than the mature RBCs.
What factors are responsible for the production of RBCs ?
1. Dietary components, such as iron, Vitamin. B12, Folic acid, trace elements, proteins, and Vitamin C & B complex are essential for the production of RBCs. These vital substances are obtained from the food articles like meat, fish, eggs, green vegetables and fruits. 2. Lack of oxygen (Hypoxia) stimulates release of a hormone- erythropoietin - from the kidney. Erythropoietin is the most potent stimulant of RBC production and causes substantial increase in RBC count and haemoglobin concentration in the blood.
Do the RBCs remain in the blood throughout the life time of an individual ?
No. The RBCs survive in the blood for an average of 120 days and are replaced by the fresh cells from the bone marrow. The destruction of RBCs occur in the reticuloendothelial system. Haemoglobin is released from the disintegrated RBCs. The released haemoglobin is
peas. Green leafy vegetables. The availability of iron from vegetarian diet is poor due to various factors. lentils. Meats like liver and heart. pregnancy. behavioral and learning problems in children due to disturbances in brain functions. What is normal Haemoglobin level in the blood ? The average adult male has about 14. Deficiency of iron is well known to cause anaemia because of inadequate synthesis of haemoglobin.8 gm Hb/100 ml of blood.5 to 5 gram of which about 70-75% is an essential component of hemoglobin.5 mg daily. However. What are the sources of iron ? The iron is available in vegetarian and non-vegetarian foods.broken into protein (globin) and haem.4 Gm Hb/100 ml of blood in adult females. A normal diet contains about 10-15 mg iron which is sufficient for daily requirement. egg yolk. What is Iron deficiency ? Iron deficiency is common in human beings and its victims are in millions. worm infestations. The most important property of hemoglobin is to transport oxygen by combining with it to form oxyhaemoglobin in lungs and to dissociate from it in the tissues. or increased requirement due to increased loss. The iron in meats is known as haem iron and it is better absorbed than non-haem iron.34%. malabsorption. Iron deficiency is mainly due to dietary deficiency. in addition to anaemia. It is about 13. In menstruating females the additional requirement due to blood loss is about 0. Normally the loss of iron is 1 mg daily. or disease like cancer. it leads to reduced muscular stamina and endurance. The total body iron is about 3. How is Iron balance maintained ? Under normal conditions iron balance is strictly maintained. What is the role of Iron in human body ? Iron is a very important element of the body. crab and oysters are rich in iron. Prevalence of iron deficiency in females is very high in developing countries like India. fish. The amount of iron obtained from diet replaces the iron lost from the skin. Iron.g. cereals and some fruits contain iron in ferric form. Some 20-40% of population is particularly prone to iron deficiency e. gastrointestinal tract. It consists of two parts : 96% of it is a protein known as globin and 4% is an iron containing pigment called haem. What is Haemoglobin ? Hemoglobin is the red pigment of RBCs. and genitourinary tract. Iron from vegetarian diet is poorly absorbed. The iron present in haem is utilized again and rest of the haem molecule is converted into bilirubin (bile pigment). and abnormalities of body temperature regulation. is very . therefore. and about 5 to 10% of dietary iron is absorbed. The iron content of hemoglobin is 0. infants and pregnant females.
worm infestations and surgical procedures. Reduced production of RBCs due to bone marrow failure due to variety of this orders including drug toxicities. vitamin. abnormal hemoglobin (thalassaemia). pregnant women. 1. Additionally. On the basis of the appearance of RBCs under the microscope. 3. Megaloblastic anaemia: The RBC are macrocytic (bigger than normal) because of imcomplete maturation in the bone marrow due to the deficiency of vitamin B12 and Folic acid. 2. and abnormal shape of RBCs as in hereditary spherocytosis. particularly in the developing countries among women. . doctors classify anaemia as : Microcytic. Iron deficiency anaemia is the commonest deficiency disease all over the world. abnormal catecholamine metabolism. What are the types of anaemia ? Based on the causes of anaemia listed above. bleeding disorders of gastrointestinal tract.B12 and Folic acid. and in menstruating women. Aplastic anaemia .g.importantly involved in the oxygen carrying activity of red blood cells. the anaemia is classified as: 1.It occurs due to increased destruction of RBCs as described above. myoglobin and several enzymes.Iron deficiency anaemia is the most common deficiency anaemia the world. less hemoglobin) e. 3. Dimorphic anaemia : In this anaemia both small and large RBCs appear in the circulation due to combined iron. 1. lactation and menstrual blood loss in women. Haemolytic anaemia . and vitamin B12 deficiency. 2. It is often associated with other deficiencies and is a major cause of morbidity and mortality. behavioral and learning problems in children. reduced muscular stamina. hypochromic anaemia (small RBC. What are the causes of anaemia ? Anaemia is caused by one or a combination of more than one of the following factors: Dietary deficiency of iron. antigen antibody reactions (autoimmune anaemia).g. Increased demand of the above nutrients due to growth in children.It occurs due to bone marrow failure as described above. in Deficiency anaemia . and disturbances in heat regulating mechanisms. Folic acid. 2. Deficiency anaemia also occurs due to increased demands as in case of growing children. Chronic blood loss due to heavy menstrual bleeding in women. pregnancy. Increased destruction of RBCs as in case of haemolytic disorders that occur due to various factors e. 3. 5. lactating mothers. What happens in case of Iron deficiency ? Deficiency of iron leads to microcytic hypochromic (iron deficiency) anaemia. it is an essential component of the muscle protein. iron deficiency. 4.
surgery. Please consult your doctor for the treatment of anaemia. B12. Folic acid etc. Decreased absorption: Chronic diarrhea and dysentery. increased motility of intestine and interfering substance in food or drugs decrease iron absorption. Iron is also present in breast milk which increases the requirement of iron in lactating mothers. Worms not only suck blood but they also compete for dietary proteins.What are the causes of iron deficiency anaemia ? Increased requirements: Iron requirements are increased during the period of growth e. How can anaemia be treated ? For the treatment of anaemia. is most responsible for iron deficiency. as in case of growing children. piles or cancer are other cause of anaemia.g. Increased blood loss: It is an important cause in adults. Although some iron is conserved during pregnancy this is offset by increased requirement for fetus and loss of blood during delivery. Intestinal parasites are very important cause of blood loss.maximum deficiency occurs at the age of 1 to 2 because the children mainly depend on milk diet which is the poorest source of iron. Inadequate intake: Although the average diet contains sufficient iron for daily requirements its bioavailability is poor specially with vegetarian diets. vitamins and other minerals would be of utmost importance in treating the anaemia. specially in children and elderly. it is important to determine its underlying cause. Chronic blood loss from peptic ulcer. worm infestations and a disease like malaria which causes destruction of RBCs. Treatment of these diseases will naturally lead to the correction of anaemia. In preschool children.5 to 2 mg of elemental iron per day in comparison to 1 mg daily in an adult male. However. minerals and also damage the intestinal mucosa or cause diarrhea. Daily iron requirements in pregnancy are about three times higher and more than 50% of pregnant women have iron deficiency. in situations of increased demand. lactating mothers or it may be due to chronic blood loss due to menstruation or certain bleeding disorders. biliary disorders. in infancy and during adolescence. . Elderly patients often have poor appetite which leads to iron deficiency. The average iron requirement in menstruating female is 1. Most frequent cause in females is menstrual loss. Hookworm anaemia is a very well recognized condition. Unbalanced diet. Usually there is also a deficiency of other dietary constituents like Vitamin. The underlying cause may be a situation of increased demand for nutrients. malabsorption. pregnant women. administration of supplemental iron. Pregnancy imposes a requirement of about 500 to 750 mg elemental iron.
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