Understanding Anaemia
Anaemia occurs when your body does not have enough red blood cells. These cells move oxygen throughout the body by means of the protein haemoglobin, which also gives blood its bright colour.
Main types of anaemia
- Iron-deficiency anaemia (IDA), caused by low iron stores
- Aplastic anaemia, the bone marrow stops creating sufficient new blood cells
- Sickle-cell anaemia, one form of sickle-cell disease
- Thalassaemia, an inherited condition that leaves the body with less haemoglobin than normal
- Vitamin-deficiency anaemia, linked to low vitamin B₁₂, vitamin C or folate; B₁₂-related anaemia is often called pernicious anaemia
Because IDA is by far the most common variant, this article focuses on that form. More than one million Australians live with iron deficiency or anaemia, and women are affected most often: just over 15 % of women aged 18–30 and 13.7 % aged 30–39 have iron deficiency.
Why iron matters?
Red blood cells form in the bone marrow, the soft, spongy core of many bones. Haemoglobin production depends on iron absorbed from food. Although the liver keeps a small backup supply, once that reserve is exhausted the marrow can no longer make enough haemoglobin, so red-cell numbers fall.
Signs and symptoms of IDA
Early iron deficiency may go unnoticed, but as levels drop you may experience:
- continuing tiredness and weakness
- skin that looks pale
- cold hands or feet
- breathlessness after only slight effort
- dizziness or light-headedness
- a rapid or irregular heartbeat
- frequent headaches
- trouble concentrating
- irritability
- unusual cravings for non-food items
- poor appetite
- a sore, red or cracked tongue
Common causes of anaemia
Low iron can stem from:
- too little dietary iron
- malabsorption of iron from food
- blood loss (heavy periods or endometriosis)
- growth spurts such as puberty or pregnancy
- hidden internal bleeding (e.g. stomach ulcers, bowel polyps, colorectal cancer)
- alcohol, antibiotics, anti-inflammatory drugs or anti-coagulants
- chronic illness, autoimmune disease, hormone disorders or bone-marrow disease
Who is most at risk?,
Individuals more likely to develop anaemia include:
- vegetarians and vegans
- people with generally poor diets
- menstruating women, especially with heavy flow
- frequent blood donors
- pregnant women and teenagers in puberty
- anyone with bowel or stomach conditions that cause bleeding (Crohn’s, ulcerative colitis, ulcers, bowel cancer)
- people with nutrient-absorption problems such as coeliac disease
- patients with bone-marrow disorders like leukaemia
How doctors confirm anaemia?
The usual first step is a complete blood count (CBC), which measures the different cells circulating in your blood. Extra tests may look at iron, vitamin B₁₂, folate and kidney function. Other investigations can include:
- urine analysis for blood
- gastroscopy to inspect the upper digestive tract
- colonoscopy to check the bowel
- bone-marrow biopsy
- faecal occult blood test (looking for hidden blood in stool)
Treating anaemia
IDA is typically managed with over-the-counter iron tablets. Follow your doctor’s dosage instructions closely, as excess iron can be harmful. If levels are extremely low or pills do not work, your doctor may suggest an intravenous iron infusion. Addressing any underlying illness that contributes to iron loss is also vital.
Can IDA be prevented?
Lower your risk by eating iron-rich foods such as red meat, turkey, shellfish (oysters, crab, prawns), legumes (beans, lentils, chickpeas) and spinach. Vegetarians or vegans may benefit from tailored advice from a dietitian. Regular check-ups help manage conditions that predispose you to anaemia. When the root cause is treated, anaemia usually resolves; even without a clear cause, people generally do well once symptoms are controlled.