Anaemia is a medical condition characterized by a decrease in the number of red blood cells (RBCs) or a lack of hemoglobin in the blood. This results in reduced oxygen-carrying capacity, leading to symptoms like fatigue, weakness, shortness of breath, and pallor. It originates when there is a disruption in one or more of the processes required for maintaining healthy red blood cells. Its main components include: a. Production of Red Blood Cells: Occurs in the bone marrow, primarily within flat bones like the pelvis, skull, and ribs. Requires essential nutrients such as iron, vitamin B12, and folate. Hormones like erythropoietin (produced by the kidneys) stimulate RBC production. b. Hemoglobin Formation: Hemoglobin, the oxygen-carrying component of RBCs, is synthesized using iron. Any deficiency in iron, or conditions affecting hemoglobin synthesis (e.g., thalassemia), can lead to anemia.
Lifespan of Red Blood Cells: Normal RBC lifespan is about 120 days. Premature destruction of RBCs, as seen in hemolytic anemia, disrupts balance. d. Blood Loss: Chronic or acute blood loss (e.g., from heavy menstruation, gastrointestinal bleeding, or trauma) reduces RBC count. e. Immune or Bone Marrow Disorders: Diseases like aplastic anemia, leukemia, or autoimmune conditions can impair RBC production. In this context, the condition of anemia causes: a. Nutritional Deficiency: Lack of iron, vitamin B12, or folate. b. Chronic Diseases: Kidney disease, cancer, or infections. c. Genetic Conditions: Sickle cell disease, thalassemia. d. Blood Loss: From injury, surgery, or internal bleeding. At large, its treatment depends on identifying and addressing the underlying cause.
The symptoms of anemia vary depending on its severity and the underlying cause. Common signs and symptoms are divided into two parts which include: a. General Symptoms: Fatigue: A persistent feeling of tiredness or lack of energy. Weakness: Difficulty performing everyday activities due to reduced strength. Pallor: Pale skin, especially noticeable on the face, inner eyelids, or nails. Shortness of Breath: Feeling breathless even with minimal exertion. Dizziness or Light-headedness: A spinning sensation or feeling faint. Cold Hands and Feet: Poor oxygen delivery to extremities. Headaches: Frequent or persistent headaches due to reduced oxygen supply to the brain.
Rapid or Irregular Heartbeat: The heart works harder to compensate for low oxygen levels. b. Specific Symptoms (Based on Cause): Iron-Deficiency Anaemia: Craving for non-food items like ice, dirt, or clay (pica). Brittle nails or spoon-shaped nails. Cracks or sores at the corners of the mouth. Hair thinning or loss. Vitamin B12 or Folate Deficiency Anaemia: Numbness or tingling in hands and feet. Difficulty walking or maintaining balance. Memory problems or cognitive difficulties. A swollen, red tongue (glossitis). Hemolytic Anaemia: Jaundice (yellowing of the skin and eyes). Dark-coloured urine. Pain in the abdomen or back. Sickle Cell Anaemia: Episodes of severe pain, known as sickle cell crises. Swelling in the hands and feet. Delayed growth in children. Anemia of Chronic Disease: Symptoms related to the underlying condition, such as joint pain or swelling in inflammatory conditions. In the circumstances, when we experience persistent fatigue, pallor, or any of the symptoms listed above, especially with rapid heartbeats or shortness of breath, we must consult a healthcare professional for evaluation and appropriate treatment.
A balanced diet rich in essential nutrients helps in preventing and managing anaemia. a. Iron-Rich Foods: Heme Iron (easily absorbed): Found in animal products like: Red meat (beef, lamb). Poultry (chicken, turkey). Fish and shellfish. Non-Heme Iron (plant-based): Found in: Dark leafy greens (spinach, kale). Legumes (lentils, chickpeas, beans). Tofu and fortified cereals. Nuts and seeds (pumpkin seeds, sunflower seeds). b. Vitamin C-Rich Foods: Vitamin C enhances iron absorption. Include: Citrus fruits (oranges, lemons). Strawberries, kiwi, and guava. Bell peppers, tomatoes, and broccoli.
Vitamin B12-Rich Foods: Important for red blood cell production: Animal products like eggs, dairy, fish, and meat. Fortified plant-based milk or cereals for vegans. d. Folate-Rich Foods: Folate is essential for red blood cell formation: Leafy greens (spinach, asparagus). Avocados, bananas. Whole grains and fortified bread. e. Avoid Iron Absorption Inhibitors: Limit intake of: Tea and coffee (contain tannins). High-calcium foods or supplements with iron-rich meals. Other Precautions include: a. Regular Health Check-ups: Monitor hemoglobin and red blood cell levels, especially if you have a history of anaemia or chronic conditions. b. Address Underlying Conditions: Treat chronic diseases like kidney issues or gastrointestinal disorders, as they can contribute to anaemia. c. Maintain Hygiene: Prevent parasitic infections (e.g., hookworm) by practicing good hygiene and drinking clean water. d. Avoid Excessive Blood Loss: Seek medical advice for heavy menstrual bleeding or unexplained bleeding. e. Prenatal Care for Pregnancy: Regular iron and folate supplementation, as recommended by a doctor.
Advancements in the treatment of anaemia focus on improving diagnostics, enhancing treatment options, and addressing underlying causes more effectively. An overview of recent developments include: a. Advances in Treating Chronic Disease-Related Anaemia: Hepcidin Modulators: Drugs targeting hepcidin (a hormone that regulates iron absorption) are under development to treat anaemia of chronic inflammation. Example: Rusfertide is in clinical trials for conditions like polycythemia vera and anaemia of inflammation. Hypoxia-Inducible Factor (HIF) Stabilizers: Approved in some countries for treating anaemia in chronic kidney disease (CKD). Drugs like roxadustat and daprodustat stimulate endogenous erythropoietin production, improving red blood cell formation.
Gene Therapy for Genetic Anaemias: Sickle Cell Disease and Thalassemia: Gene-editing technologies like CRISPR-Cas9 show promise in correcting genetic mutations. Bluebird Bio’s Zynteglo: A gene therapy for beta-thalassemia that allows patients to produce functional hemoglobin. Excel: A CRISPR-based therapy for sickle cell disease, currently in advanced clinical trials. c. Advances in Blood Transfusion Therapy: Extended Blood Typing: Reduces complications from transfusions by matching minor blood group antigens. Synthetic Blood Substitutes: Research into oxygen-carrying substitutes aims to address blood shortages and reduce risks associated with transfusions. d. Erythropoiesis-Stimulating Agents (ESAs) Second-Generation ESAs: Longer-acting formulations, such as darbepoetin alfa and methoxy polyethylene glycol-epoetin beta, reduce the frequency of injections. e. Nutritional and Preventive Advances: Fortified Foods: Innovative food fortification strategies for regions with high anemia prevalence (e.g., iron-fortified rice or wheat).
Nanotechnology: Nano-encapsulated iron supplements that improve bioavailability while reducing gastrointestinal side effects. f. Enhanced Management of Autoimmune and Hemolytic Anaemias: Targeted Therapies: Monoclonal antibodies like eculizumab (for paroxysmal nocturnal hemoglobinuria) and rituximab (for autoimmune hemolytic anemia) provide precision treatment. Complement Inhibitors: Drugs like pegcetacoplan target the complement system to treat hemolytic anemias. g. Future Directions: Artificial Intelligence (AI): AI tools assist in early detection and risk assessment of anemia, enabling timely intervention. Combination Therapies: Exploring the synergistic effects of combining novel drugs to address complex causes of anemia. These advancements aim to improve patient outcomes, reduce treatment side effects, and address the global burden of anemia effectively.
Dr. Rajkumar Singh is a youth motivator and former Head of the University Department of Political Science, B.N. Mandal University, Madhepura, Bihar, India.
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