“What You Need to Know About Anemia?”

 

WHAT IS ANEMIA? Anemia develops when you don’t have enough robust, healthy red blood cells to carry oxygen throughout your body. The blood cells may lack enough hemoglobin, the protein that gives blood its red color. Anemia affects one in 10 teen girls and women. It also develops in men and children and is linked to some illnesses.

SYMPTOMS OF ANEMIA: If you’re often tired even though you've slept well or you lack the energy for normal activities, you may have anemia. It can be an underlying cause of memory or mood problems. Symptoms range from none to mild to life-threatening and may include:

• Weakness
• Dizziness
• Pale skin
• Headache
• Numbness or coldness in hands and feet
• Low body temperature

HEART-RELATED SYMPTOMS: People with anemia have less oxygen in their blood, which means the heart must work harder to pump enough oxygen to their organs. Cardiac-related symptoms include arrhythmia (an abnormal heart rhythm), shortness of breath, and chest pain.

ANEMIA IN CHILDREN: About one in seven children develop anemia by age 2, most often because they don’t have enough iron in their diet. People who have iron-deficiency anemia may feel the urge to eat inappropriate things like dirt, clay, ice, or starch, a behavior called pica. Pediatricians test all children for anemia at 12 months. Without treatment, a severe case of anemia could permanently affect brain development.

ANEMIA RISK FACTORS: Women and people with chronic diseases have the greatest risk of anemia. When women lose blood in heavy menstrual periods, they may become anemic. Pregnancy also causes changes in a woman’s blood volume that can result in anemia. Chronic diseases such as kidney disease can affect the body’s ability to make red blood cells. A diet low in iron, folate, or vitamin B12 also increases your risk. And some types of anemia are hereditary.

TEENS AND ANEMIA: If your teen often is fatigued, anemia might be a cause. Teens are at risk of iron-deficiency anemia because of their sudden growth spurts. Teen girls also are more prone to anemia because of their menstrual periods.

CAUSE: LOW IRON INTAKE - A diet that's low in iron can cause anemia. Iron from plants and supplements isn't absorbed as well as the iron in red meat. Digestive concerns such as Crohn’s disease, celiac disease, or even having gastric bypass surgery can interfere with iron absorption. And some foods and medicines can hinder iron uptake when taken with iron-rich foods. They include:

• Dairy
• Other calcium-rich foods
• Calcium supplements
• Antacids
• Coffee
• Tea

CAUSE: VITAMIN DEFICIENCY - The body needs both vitamin B12 and folate to make red blood cells. A diet too low in these vitamins sometimes can cause anemia. An autoimmune disorder or digestive problem also can prevent your body from absorbing enough B12. Animal-based foods and fortified breakfast cereals are good sources of B-12. Folate is in leafy green vegetables, fruits, dried beans, and peas, and is added to breads, pastas, and cereals as folic acid.

CAUSE: ILLNESS - Chronic illness or infection can cause the body to make fewer red blood cells. This can result in a mild drop in hemoglobin. If you have significant blood loss, then you may develop iron-deficiency anemia. And some drugs and medical treatments can also put you at risk for anemia. Consult your doctor to see if you need iron or other supplements.

CAUSE: APLASTIC ANEMIA - Aplastic anemia is a rare disorder in which the bone marrow doesn’t make enough blood cells to supply the body. It affects only about three in one million people. It can be caused by high doses of radiation, certain chemical exposures, viruses, or an autoimmune disorder in which your body attacks the bone marrow. About one in five cases is inherited. In severe cases, people need blood transfusions or even a bone marrow transplant.

CAUSE: BLOOD LOSS - Losing too many red blood cells is a common cause of anemia. Heavy menstruation, ulcers, injury, or surgery can cause enough blood loss to lead to iron-deficiency anemia. Women who have heavy menstrual periods should be tested for anemia every year.

CAUSE: FAULTY BLOOD CELL MECHANICS - Inherited disorders can affect your body’s production of red blood cells. Thalassemias cause the body to make fewer healthy red blood cells and less hemoglobin -- and may be treated with blood transfusions. Among people with hemolytic anemia, red blood cells are destroyed and cleaned out of the bloodstream too quickly.

SICKLE CELL ANEMIA: Sickle cell anemia is an inherited disorder in which the body produces an abnormal form of hemoglobin. This causes red blood cells to change from round to a sickle shape and become stuck together. That can make it difficult for them to pass through blood vessels, leading to pain and damage to body tissues. The red blood cells also die more quickly than normal red blood cells. In the U.S., sickle cell anemia is more common among African-Americans and Hispanics.

DIAGNOSIS: COMPLETE BLOOD COUNT - A complete blood count test will check your levels of red blood cells, white blood cells, platelets, and hemoglobin. It will also check other factors such as average size, variability in size, volume, and hemoglobin concentration of red blood cells. If you have iron-deficiency anemia, your red blood cells may be smaller than normal. Your health care provider also may ask about your symptoms, medicines you take, and your family history.

DIAGNOSIS: OTHER BLOOD TESTS - If the complete blood count shows that you have anemia, you may have additional blood tests. Your blood cells may be checked for an abnormal appearance. Hemoglobin electrophoresis detects the type of hemoglobin in your blood. A reticulocyte count tests how well your bone marrow makes new red blood cells. Iron studies may be ordered to measure iron stores in your body, as well as iron levels in your blood.

DIAGNOSIS: BONE MARROW TEST- If your body is producing too few or too many blood cells or their structure appears abnormal, you may need a bone marrow test. Bone marrow, the spongy tissue inside bones, contains stem cells that turn into blood cells. Your doctor will remove a small sample of bone marrow through a needle. The procedure takes about 30 minutes and will cause some soreness.

TREATMENT: IRON - Iron pills are often needed for anemia that's caused by a deficiency in that mineral. Ferrous iron is more easily absorbed than ferric iron. It's best taken with food, especially orange juice and other foods rich in vitamin C. But don't mix your iron pill with calcium, coffee, or tea, which can block absorption. And never take iron without a doctor's order or let children near the pills. An iron overdose can be dangerous. Some people may need folic acid or vitamin B12 supplements, too.

IRON AND PREGNANCY: About half of pregnant women have iron-deficiency anemia. Pregnant women should get about 30milligrams of iron each day in their diet. Your prenatal vitamin also may contain iron. You may be tested for anemia at your first prenatal visit and after delivery.

TREATMENT: MEDICINES - Drugs for anemia often treat the root illness. So in some cases, where the anemia is due to chronic kidney disease, an injection of the hormone erythropoietin (EPO) may be needed. If an autoimmune disorder causes your body to attack its own red blood cells, then a corticosteroid, such as prednisone, can slow the attack and help correct anemia. In sickle cell anemia, a cancer drug called hydroxyurea can lower the number of painful episodes.

TREATMENT: PROCEDURES - If you have severe anemia, you may need a transfusion of blood that matches your type. When the body's production of red blood cells doesn't work right, anemia may be treated or cured with a transplant. In these cases, bone marrow from a donor replaces the person's faulty bone marrow, so the body can start producing healthy blood cells. When blood cells are destroyed too quickly, blood plasma treatments or even removing the spleen may be needed.

PREVENTING ANEMIA: You can prevent some types of anemia with a healthy diet. Foods containing iron include lean red meat, liver, fish, tofu, lentils and beans, dark green leafy vegetables, and dried fruits. Also eat foods with vitamin B12 and folic acid, such as eggs and dairy products, spinach, and bananas. Many breads, cereals, and other foods are fortified with all three key nutrients: iron, B12, and folic acid. Vitamin C, found in citrus, other fruits, and vegetables, will help your body absorb iron.

IRON OVERLOAD: Too much iron can cause serious problems. Iron overload can be a result of repeated blood transfusions or an inherited condition, but taking too much iron also is a risk. The many symptoms of iron overload are related to excess iron depositing into organs and causing problems in the liver, heart, and pancreas. Iron levels can be reduced through phlebotomy (blood removal) or medications.

LIVING WITH ANEMIA: Treating your anemia and eating a well-rounded diet can give you more energy and enhance your life. Most people can manage their anemia through a healthy diet and iron or vitamin supplements, if a doctor says they are deficient in one of the key nutrients. If you have a chronic disease, then good management of your condition also will help you prevent or manage anemia.

Reviewed by Arefa Cassoobhoy, MD, MPH on January 31, 2014

REFERENCES:

National Heart Lung and Blood Institute: “What is Anemia?”
CDC: “Fast Stats: Anemia and Iron Deficiency.”
National Heart Lung and Blood Institute: “Other Names for Anemia.”
Womenshealth.gov: “Anemia Fact Sheet.”
National Heart Lung and Blood Institute: “What Are the Signs and Symptoms of Anemia?”
Baker, R., Greer, F., and the Committee on Nutrition. Pediatrics, November 2010.
American Family Physician: “Anemia in Children.”
Healthy Children: “Anemia and Your Child.”
National Heart, Lung and Blood Institute: “Who Is At Risk For Anemia?”
Children’s Hospital Boston: “Chronic Fatigue.”
National Heart, Lung and Blood Institute: “Living With Anemia.”
Iron Disorders Institute: “Iron Deficiency Anemia.”
Iron Disorders Institute: “Anemia of Chronic Disease.”
National Heart, Lung and Blood Institute: “Causes of Anemia.”
National Marrow Donor Program: “Aplastic Anemia (Severe).”
National Heart, Lung and Blood Institute: “What Causes Hemolytic Anemia.”
National Heart, Lung and Blood Institute: “What Are Thalassemias?”
Cooley’s Anemia Foundation: “What Is Thalassemia?”
American Sickle Cell Anemia Foundation: “Education Material.”
American Sickle Cell Anemia Foundation: “What Is Sickle Cell Anemia?”
American Sickle Cell Anemia Foundation: “How Common Is Sickle Cell Anemia?”
National Heart, Lung and Blood Institute: “Sickle Cell Anemia.”
National Heart, Lung and Blood Institute: “How Is Anemia Diagnosed?”
National Heart, Lung and Blood Institute: “What Are Bone Marrow Tests?”
Aplastic Anemia & MDS International Foundation: “Bone Marrow.”
National Heart, Lung and Blood Institute: “How Is Hemolytic Anemia Treated?”
National Kidney and Urologic Diseases Information Clearinghouse: “Anemia in Kidney Disease and Dialysis.”
National Heart, Lung and Blood Institute: “How Is Anemia Treated?”
Iron Disorders Institute: “Iron Overload.”
Agency for Healthcare Quality and Research: “Evidence Report/Technology Assessment: Hydroxyurea for the Treatment of Sickle Cell Disease.”
National Marrow Donor Program: “Sickle Cell Anemia.”
National Marrow Donor Program: “Aplastic Anemia (Severe).”
National Heart, Lung and Blood Institute: “How is Hemolytic Anemia Treated?”

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“How to Lower Your A1c Level”

When you have diabetes, you probably know you should check your blood sugar regularly. Your doctor will also recommend that you take an A1c blood test a few times a year, with a goal of lowering the results to help protect your health. And there’s a lot you can do to move toward meeting that goal.

Unlike a regular blood sugar test, the A1c test measures the amount of sugar that clings to a protein, called hemoglobin, in your red blood cells. The test shows your average blood sugar levels over the past few months, so you know how well your diabetes is under control.

In general, the goal for your A1c is to be lower than 7%. Exactly how much lower will depend on your individual treatment plan. When you take steps to get your A1c in a healthy range, you lower your risk of complications such as nerve damage, eye problems, and heart disease.

Your doctor will let you know the best target for your A1c. How do you get there? Here are a few tactics to try, in addition to taking any medications your doctor prescribes.

Get some new kitchen gear. You’ll want to get a set of measuring cups and a kitchen scale if you don’t already have them. These will help you with your portion sizes. Your blood sugar will go up if you eat more food than your body needs. Keeping servings in check is a good way to reduce your A1c level.

At first, it’s a good idea to measure your food to give you an idea of what healthy portion sizes look like for different foods. That’s where the measuring cups and scale come in handy. You may be surprised at first to see what one serving looks like, especially of high-carb items like cereal, rice, and pasta. But this will help ensure you don’t eat more than you intend to.

Be carb smart. It’s true that carbohydrates affect your blood sugar more than other nutrients you eat. Chances are that if you overdo starchy carbs on a regular basis, your A1c number will start to creep up. But remember, all carbs aren’t a problem. You want ones that have a lot of fiber and nutrients, more than those that just serve up starch.

Tweak your plate. Experts advise filling about half your plate with vegetables that are low in starch, such as carrots, greens, zucchini, or tomatoes. One-quarter of your plate should be a lean protein like chicken or tofu, and the last quarter should be whole grains like brown rice or quinoa.

Make a plan. The guidelines for what to put on your plate give you a lot of flexibility. But even though it sounds simple, you’ll probably be better off if you plan your meals. Why? If you skip set menus and eat on the fly, it’s easy to end up with calorie-dense, high-carbohydrate food choices -- like fast food, bagels, and frozen pizza -- that will cause your blood sugar and A1c numbers to soar.

Instead, at the start of each week, pencil in a rough plan for what foods you’ll eat at each meal and what groceries you’ll need. This way, you’ll be prepared with plenty of choices that limit post-meal blood sugar spikes. A Mediterranean diet, which is low in saturated fat and high in vegetables and fruit, reliably lowers A1c numbers.

Maybe downsize your weight loss goal. Not everyone with type 2 diabetes is overweight. But if you are, you may not need to drop as much as you think to make a difference in your A1c level.

If you’re overweight, diabetes doctors will often recommend you try to lose just 5% to 10% of your current weight. Here’s why: As you shed extra pounds, the insulin in your body lowers your blood sugar levels more efficiently, which will cause your A1c levels to drop over time. In one study, people with type 2 diabetes who lost 5% to 10% of their body weight were three times as likely to lower their A1c by 0.5%.

You may have a different goal for your weight or other health considerations on your mind. Ask your doctor to help you make a weight loss plan that matches your overall goals.

Rethink your exercise plan. Other than upgrading your nutrition, exercise is one of the most important habit changes you can make to lower your A1c. But don’t just grind it out on the treadmill, or you’ll miss another effective workout: strength training.

No offense to the elliptical machine or your cycling class. You can choose whatever type of exercise you prefer as long as it’s a challenging workout. Both aerobic exercise and resistance (weight) training lower A1c levels if they’re part of a regular routine.

There’s solid science to support how much working out helps you whittle down your A1c level. Since exercise prompts your muscles to take up sugar from your bloodstream, it helps your blood sugar levels drop more quickly after you eat a meal. As you make exercise a regular habit, you’ll see a downward trend in your A1c numbers.

Never miss your meds. You can reliably lower your A1c through diet and exercise. But if your doctor has prescribed medication, such as metformin, miglitol, or insulin, it’s important to take them exactly as prescribed. If you miss doses regularly, your blood sugar numbers may creep up and cause your A1c to rise. But if you follow the medication plan that your doctor recommends and go to every appointment, your blood sugar should stay under control -- and your lower A1c number will reflect that. If your goal is to cut down on, or even stop needing, your meds, tell your doctor that you want to work toward that. But don’t stop them on your own.

Be savvy about supplements. Many dietary supplements say they’ll lower your A1c. But there’s not always much research to back that up. Still, some may have promise. These include berberine, made up of extracts from a variety of plants, and coenzyme Q10 (CoQ10), an antioxidant that reduces inflammation in your body. Cinnamon may also lower A1c levels over time. As with any supplement, it’s best to check with your doctor first.

Put your plan on repeat. Stick with it and give it time. Since your A1c level reflects your average blood sugar over several months, it’s going to take that long for your A1c to drop. You won’t do everything perfectly, and that’s OK. Just keep moving in the direction you want to go in. And rest assured: Your A1c number will come down, and it’ll be worth it.

Reviewed by: Michael Dansinger, MD on September 16, 2019

SOURCES: 

WebMD
Mayo Clinic: “A1C Test,” “Hyperglycemia in Diabetes,” “Diabetes Diet: Create Your Healthy Eating Plan.”
Merck Manual: “Formation of Blood Cells.”
National Institutes of Health: “The A1C Test and Diabetes.”
Harvard T.H. Chan School of Public Health: “Carbohydrates and Blood Sugar.”
Joslin Diabetes Center: “Key to Success: Portion Control.”
Pakistan Journal of Medical Sciences: “Effect of Vitamin D Supplementation on Reduction in Levels of HbA1 in Patients Recently Diagnosed with Type 2 Diabetes Mellitus Having Asymptomatic Vitamin D Deficiency.”
Utah.gov: “How Can You Lower Your A1C To a Healthy Number?”
Diabetology and Metabolic Syndrome: “Resistance Exercise Training Lowers HbA1c More Than Aerobic Training in Adults With Type 2 Diabetes.”
American Diabetes Association: “Medication Management: What Are My Options?”

Much Love, Dr.Shermaine, #InformativeRead #PleaseShare #HealthyBodySoulAndSpirit #IWantYou2LiveWell

The Goal is to Always Make You Aware of What Concerns Your Body, Soul and Spirit, So You Can Have Open, Honest and Frequent Discussions With Your Physicians and Counselors. You Can’t Treat or Cure What You Don’t Know is Sick.

"It's Not Selfish to Love Yourself, Take Care of Yourself and to Make Your Happiness a Priority. It's a Necessity." (Mandy Hale)

"Self-Care is Not Selfish. You Cannot Serve From an Empty Vessel." (Eleanor Brown)

The contents of the WebMD and Self-Care With Dr. Shermaine Sites, such as text, graphics, images, and other material contained on the WebMD and Self-Care With Dr. Shermaine Sites ("Content") are for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on the WebMD and Self-Care With Dr. Shermaine Sites!

If you think you may have a medical emergency, call your doctor or 911 immediately. WebMD and Self-Care With Dr. Shermaine does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that may be mentioned on the Sites. Reliance on any information provided by WebMD, WebMD employees, others appearing on the Site at the invitation of WebMD, and Self-Care With Dr. Shermaine or other visitors to the Sites is solely at your own risk.