Anemia - symptoms and treatment, causes, types, prevention. Anemia: causes, types, diagnosis, prevention Chronic anemia symptoms

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Anemia (or anemia) is a hematological syndrome characterized by a lack of red blood cells and a low level of hemoglobin in the blood. Due to a deficiency of red blood cells, the body's ability to exchange gases (carbon monoxide and oxygen) deteriorates. Weakness, pale skin, tachycardia and other signs of fatigue are the initial manifestations of anemia, and let’s take a closer look at what it is and why it’s dangerous.

Causes

Anemia rarely develops as an independent disease. The provoking mechanism is unfavorable factors that affect the quality of the blood composition. The main causes of anemia are bleeding, poor nutrition, insufficient production of red blood cells, concomitant diseases, tissue hypoxia, hereditary anemic syndrome.

The danger is represented by a large loss of blood by the body, its causes:

• injuries;
• abdominal operations;
• heavy periods (for women);
• diseases associated with increased bleeding (stomach ulcer, hemorrhoids);
• uncontrolled use of blood-thinning drugs (Aspirin, Trental, Thrombo ACC, Curantil, etc.).

Reasons leading to damage to red blood cells:

• stress;
• malnutrition, poor diet, diets;
• hypovitaminosis caused by a lack of iron, folic acid, cobalamin;
• hypervitaminosis (for example, excess ascorbic acid);
• physical exercise;
• bad habits;
• caffeinated drinks;
• poisoning of the body with various poisons and toxins.

How often do you get your blood tested?

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Only as prescribed by the attending physician 31%, 1908 votes

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More than twice a year but less than six times 11%, 706 votes

I take care of my health and donate once a month 6%, 371 voice

I'm afraid of this procedure and try not to pass 4%, 248 votes

21.10.2019

There are pathologies that cause red blood cell deficiency:

• past infections (acute respiratory infections, chickenpox, etc.);
• renal and liver failure;
• rheumatoid arthritis;
• arterial hypertension;
• celiac disease (pathology of the digestive system);
• hypothyroidism (thyroid hormone deficiency);
• HIV infections;
• oncology;
• cirrhosis;
• hereditary pathologies (granulomatosis, sickle cell anemia, thalassemia, etc.);
• hypoplastic anemia of the spinal cord caused by stem cell deficiency.

A human condition characterized by a low level of hemoglobin in the blood is called anemia. We will consider the symptoms, causes and principles of treatment of this pathology in the article.

General information

This disease, anemia (another name is anemia), can be independent, or it can act as a concomitant symptom or complication of other ailments or conditions. The provoking factors and the mechanism of development of pathology in each specific case are different. Anemia occurs due to insufficient oxygen supply to internal organs. The supply of oxygen is disrupted due to insufficient production of red blood cells.

If we look at specific numbers, anemia is diagnosed when the amount of hemoglobin decreases to below 120 g/l in women and children from 6 to 14 years old, 130 g/l in men, 110 g/l in children from 6 months to 6 years.

There are also different degrees of anemia (depending on the level of the same hemoglobin):

Mild - hemoglobin level is 90 g/l.

Severe - hemoglobin level drops below 70 g/l.

Causes of anemia

The most common provoking factors for the development of this pathology are:

Growth of the body against the background of intense physical activity (sports) associated with sun deficiency and unbalanced nutrition.

The appearance of a girl's first menstruation. During this period, the body adapts to a new mode of operation.

The presence of gastritis with low acidity, intestinal diseases, previous operations on the gastrointestinal tract.

Helminthic intoxications that inhibit the production of red blood cells and hematopoiesis. Children are more susceptible to this condition.

Pregnancy, during which the metabolism changes, and the woman’s body’s need for iron, as well as carbohydrates, fats, proteins, calcium and vitamins increases several times.

Periodic bleeding: heavy menstruation (occurs with uterine fibroids, inflammation of the appendages), internal blood loss (with hemorrhoids, stomach ulcers). In this case, relative anemia occurs, in which the level of formed elements in the blood, which include hemoglobin and iron, proportionally decreases.

How effective the treatment will be depends on the correct identification of the causes of the pathology. Anemia is a serious condition that requires timely and adequate treatment.

Symptoms

Most often, a person is not aware of the development of anemia. You can suspect it if you have the following symptoms:

What else is characteristic of anemia? Signs may be supplemented by the following disorders:

hair loss, lack of shine;

brittle nails;

cracks in the corners of the mouth;

the emergence of strange addictions (for example, people like to eat chalk, inhale the smell of paint and varnish, etc.).

Classification of anemia

Depending on the causes of the pathology, there are several types of anemia. Let's take a closer look at each of them.

Iron-deficiency anemia

This form of the disease is the most common. The disease develops as a result of impaired hemoglobin synthesis due to iron deficiency. The causes of this form of anemia are chronic blood loss, impaired absorption of iron in the intestines, and insufficient intake of this substance from food. Young children, women of reproductive age and pregnant women are more susceptible to this pathology.

In this case, anemia has the following symptoms: dizziness, spots flashing before the eyes, tinnitus. The disease also manifests itself as dry and pale skin. Nails become brittle, layered, flat. Some patients feel a burning sensation on their tongue.

Therapy consists, first of all, in eliminating the cause of iron deficiency (treatment of pathologies of the digestive tract, surgical treatment of intestinal tumors, uterine fibroids). In order to normalize hemoglobin levels, iron supplements are prescribed in combination with vitamin C (Actiferrin, Iradian, Tardiferon, Ferromed, Ferrum Lek, Ferroplex).

B12 deficiency anemia

In this case, anemia causes insufficient intake of vitamin B12 into the body or impaired absorption. Most often, this phenomenon occurs in older people. Provoking factors for the development of B12-deficiency anemia are the presence of gastritis, severe enteritis, infection with worms, and previous gastric surgery.

Anemia (anemia) of this type is manifested by weakness, fatigue, and palpitations during physical activity. The tongue becomes “polished” and a burning sensation occurs in it. The skin takes on a jaundiced tint. Often, B12 deficiency anemia can only be detected through a blood test. Over time, the nervous system is affected. In addition to red blood cells, the disease also affects white blood cells and platelets - their levels in the body decrease. What treatment is needed? In this case, they try to overcome anemia by taking vitamin B12 preparations (“Cyanocobalamin”, “Hydroxycobalamin”) and enzyme medications (“Pancreatin”).

Posthemorrhagic anemia

Anemia of a posthemorrhagic nature develops due to the loss of a large amount of blood. As a result, a lack of oxygen occurs in the tissues. Posthemorrhagic anemia, depending on the rate of blood loss, can be acute or chronic. Acute causes include injuries, bleeding from internal organs, most often due to damage to the lungs, gastrointestinal tract, uterus, heart cavities, complications of pregnancy and childbirth. The development of chronic anemia is associated with an increasing lack of iron in the body due to prolonged, often recurring bleeding due to rupture of the vascular walls.

Posthemorrhagic anemia has the following symptoms: pallor of the skin and mucous membranes, fatigue, ringing in the ears, shortness of breath, dizziness, palpitations even with little physical activity. A decrease in blood pressure is often observed. Severe blood loss can cause fainting and collapse. Gastric bleeding is usually accompanied by vomiting (the vomit is bloody or coffee-colored).

Therapy for posthemorrhagic anemia consists, first of all, of stopping bleeding; in case of large blood losses, an urgent blood transfusion is necessary. After this, long-term use of iron preparations (“Ferro-gradument”, “Hemofer”) and combined agents (“Aktiferrin”, “Irovit”, “Heferol”) is indicated.

Folate deficiency anemia

Folic acid is a complex compound that is directly involved in DNA synthesis and hematopoiesis. Absorption of this substance occurs in the upper part of the small intestine. The causes of folate deficiency anemia are divided into two groups: lack of folic acid intake from food; violation of its digestibility and transportation to the hematopoietic organs. Pregnant women, children, alcoholics, people who have undergone surgery on the small intestine are more susceptible to a pathology such as folate deficiency anemia.

Symptoms of the disease are expressed in damage to the hematopoietic tissue, digestive (“polished” tongue, burning sensation in it, decreased gastric secretion) and nervous (increased fatigue, weakness) systems. There is also an enlargement of the liver and spleen, and mild jaundice is noted.

For the treatment of the disease, folic acid and combination products with vitamin B and iron supplements are prescribed (Ferretab comp, Gyno-Tardiferon, Ferro Folgamma, Maltofer Fol).

Traditional methods of treating anemia

If you notice the first signs of anemia, you should immediately consult a doctor. Based on the results of the examination and blood test, the specialist will prescribe the necessary treatment. Therapeutic methods depend on the type and degree of anemia. Alternative medicine recipes can be used as additional methods of treatment (but not the main ones!).

The most effective of them are:

Grate radishes, carrots, beets. Squeeze the juice from the root vegetables and combine in equal quantities in a dark glass container. Cover the dish with a lid (not tightly). Place the container in the oven to simmer over low heat for three hours. Take the resulting product three times a day, a tablespoon before meals. The treatment course lasts three months.

To normalize the condition in case of severe loss of strength, it is recommended to mix garlic with honey and take the resulting mixture before meals.

Mix fresh aloe juice (150 ml), honey (250 ml), Cahors wine (350 ml). Drink a tablespoon before meals three times a day.

Place peeled garlic (300 g) in a half-liter bottle, add alcohol (96%) and leave for three weeks. Three times a day, take 20 drops of the resulting tincture mixed with ½ glass of milk.

Pour oats or oatmeal (1 cup) with water (5 cups) and cook until the consistency of liquid jelly. Strain the broth and combine with the same amount of milk (about 2 glasses) and boil again. Drink the resulting drink, warm or cooled, during the day in 2-3 doses.

Prevention of anemia

Diet for anemia plays no less a role than proper treatment. Also, good nutrition is the basis for the prevention of anemia. It is very important to regularly consume foods that contain vitamins and microelements necessary for the hematopoiesis process.

The most iron is found in beef tongue, pork and beef liver, rabbit and turkey meat, sturgeon caviar, buckwheat, wheat, oatmeal, barley, blueberries, and peaches.

There is less iron in chicken, lamb, beef, eggs, semolina, pink salmon, mackerel, apples, persimmons, pears, spinach, sorrel.

In addition, you need to include in your daily diet foods that promote the absorption of this microelement: eggplant, broccoli, zucchini, corn, cabbage, beets, pumpkin, herbs, dried fruits.

Anemia is considered one of the most common pathological conditions among the world's population. Among the types of anemia, several main conditions are distinguished, classifying them according to the causes of anemia:

• Iron-deficiency anemia;
• hemolytic anemia;
• aplastic anemia;
• sideroblastic type of anemia;
• B12 deficiency, resulting from a deficiency of vitamin B12;
• posthemorrhagic anemia;
• sickle cell anemia and other forms.

Approximately every fourth person on the planet, according to expert research, suffers from iron deficiency anemia due to a decrease in iron concentration. The danger of this condition lies in the blurred clinical picture of iron deficiency anemia. Symptoms become pronounced when the level of iron and, accordingly, hemoglobin, decreases to a critical level.

The risk groups for developing anemia among adults include the following categories of the population:

• followers of vegetarian nutrition principles;
• people suffering from blood loss due to physiological reasons (heavy menstruation in women), diseases (internal bleeding, severe stages of hemorrhoids, etc.), as well as donors who donate blood and plasma on a regular basis;
• pregnant and lactating women;
• professional athletes;
• patients with chronic or acute forms of certain diseases;
• categories of the population experiencing nutritional deficiencies or limited diets.

The most common form of iron deficiency anemia is a consequence of iron deficiency, which, in turn, can be triggered by one of the following factors:

• insufficient intake of iron from food;
• increased need for iron due to situational or individual characteristics (developmental pathologies, dysfunctions, diseases, physiological conditions of pregnancy, lactation, professional activity, etc.);
• increased loss of iron.

Mild forms of anemia, as a rule, can be cured by adjusting the diet, prescribing vitamin and mineral complexes, and iron supplements. Moderate and severe forms of anemia require specialist intervention and a course of appropriate therapy.

Causes of anemia in men

Anemia in women

Anemia in women is diagnosed when hemoglobin levels are below 120 g/l (or 110 g/l during pregnancy). Physiologically, women are more prone to anemia.
During monthly menstrual bleeding, the female body loses red blood cells. The average volume of monthly blood loss is 40-50 ml of blood, however, with heavy menstruation, the amount of discharge can reach 100 ml or more over a period of 5-7 days. Several months of such regular blood loss can lead to the development of anemia.
Another form of hidden anemia, common among the female population with a high frequency (20% of women), is triggered by a decrease in the concentration of ferritin, a protein that functions to store iron in the blood and release it when hemoglobin levels decrease.

Anemia in pregnancy

Anemia in pregnant women occurs under the influence of various factors. The growing fetus removes from the maternal bloodstream substances necessary for development, including iron, vitamin B12, folic acid, necessary for the synthesis of hemoglobin. With insufficient intake of vitamins and minerals from food, disturbances in its processing, chronic diseases (hepatitis, pyelonephritis), severe toxicosis of the first trimester, as well as during multiple pregnancy, the expectant mother develops anemia.
Physiological anemia of pregnant women includes hydremia, “thinning” of the blood: in the second half of the gestational period, the volume of the liquid part of the blood increases, which leads to a natural decrease in the concentration of red blood cells and the iron they transport. This condition is normal and is not a sign of pathological anemia if the hemoglobin level does not fall below 110 g/l or is restored on its own in a short time, and there are no signs of deficiency of vitamins and microelements.
Severe anemia in pregnant women threatens miscarriage, premature birth, third trimester toxicosis (preeclampsia, preeclampsia), complications of the delivery process, as well as anemia in the newborn.
Symptoms of anemia in pregnant women include a general clinical picture of anemia (fatigue, drowsiness, irritability, nausea, dizziness, dry skin, brittle hair), as well as perversion of smell and taste (desire to eat chalk, plaster, clay, unprocessed meat, sniff substances with a strong smell among household chemicals, building materials, etc.).
Minor anemia of pregnant and lactating women is restored after childbirth and the end of the lactation period. However, with a short interval between repeated births, the body’s recovery process does not have time to complete, which leads to increased signs of anemia, especially pronounced when the interval between births is less than 2 years. The optimal recovery period for the female body is 3-4 years.

Anemia during lactation

According to research by specialists, lactation anemia is most often diagnosed at a fairly advanced stage of the disease. The development of anemia is associated with blood loss during delivery and lactation against the background of a hypoallergenic diet for nursing mothers. The production of breast milk itself does not contribute to the development of anemia, but if certain important food groups are excluded from the diet, for example, legumes (due to the risk of increased gas formation in the baby), dairy and meat products (due to allergic reactions in the infant) the likelihood of developing anemia increases significantly.
The reason for the late diagnosis of postpartum anemia is considered to be a shift in the focus of attention from the condition of the mother to the child, primarily in the youngest mother. The baby's health concerns her more than her own well-being, and the symptom complex of anemia - dizziness, fatigue, drowsiness, decreased concentration, pale skin - is most often perceived as a consequence of overwork associated with caring for a newborn.
Another reason for the prevalence of iron deficiency anemia in nursing is associated with an incorrect opinion about the effect of iron supplements that pass into breast milk on the functioning of the infant’s gastrointestinal tract. This opinion is not confirmed by specialists, and when diagnosing iron deficiency anemia, medications and vitamin-mineral complexes prescribed by a specialist must be taken.

Anemia of menopause

Anemia during female menopause is a fairly common phenomenon. Hormonal changes, the consequences of menstruation, gestation, childbirth, various dysfunctional conditions and surgical interventions cause chronic anemia, which worsens against the background of menopausal changes in the body.
Dietary restrictions and unbalanced diets, which are resorted to by women seeking to reduce the rate of weight gain caused by fluctuations in hormonal balance during the premenopausal period and directly during menopause, also play a provocative role.
By the age of menopause, there is also a decrease in ferritin reserves in the body, which is an additional factor in the development of anemia.
Fluctuations in well-being, fatigue, irritability, and dizziness are often perceived as symptoms of the onset of menopause, which leads to a late diagnosis of anemia.

Anemia of childhood

According to research by the World Health Organization (WHO), 82% of children suffer from anemia of varying severity. Low hemoglobin levels and iron deficiency conditions of various etiologies lead to disturbances in the mental and physical development of the child. The main causes of anemia in childhood include:

The need for iron varies in children depending on age, and upon reaching puberty it correlates with gender. Treatment of deficiency anemia in children with a balanced diet is not always effective, so experts prefer regulation with the help of medications that ensure the required dose of microelements enters the child’s body.

Anemia of infancy

A newborn baby is born with a certain supply of iron obtained from the mother’s body during intrauterine development. The combination of imperfection of one's own hematopoiesis and rapid physical growth leads to a physiological decrease in the level of hemoglobin in the blood in healthy children born on time, by 4-5 months of life, and in premature infants - by the age of 3 months.
Artificial and mixed feeding are considered risk factors that increase the likelihood of developing anemia. Hemoglobin deficiency develops especially rapidly when replacing breast milk and/or artificial formulas with cow's, goat's milk, cereals and other products for a period of up to 9-12 months.
Symptoms of anemia in children under one year old include:

• pallor of the skin, since the skin is still very thin, there is increased “transparency” and “bluishness” of the skin;
• anxiety, causeless crying;
• sleep disorders;
• decreased appetite;
• hair loss outside the physiological framework of hair growth;
• frequent regurgitation;
• low weight gain;
• lag first in physical, then in psycho-emotional development, decreased interest, lack of expression of the revitalization complex, etc.

A peculiarity of children of this age is the ability to absorb iron from food at a high level (up to 70%), therefore, not in all cases of anemia, pediatricians see the need to prescribe medications, limiting themselves to correcting the child’s diet, switching to full breastfeeding, and selecting a substitute formula that meets the needs. In cases of severe anemia, iron supplements are prescribed in age-specific dosages, for example, Ferrum Lek or Maltofer in the form of syrup drops.
When diagnosing a severe degree of anemia, the reasons may not be in the diet, but in diseases, pathologies and dysfunctions of the child’s body. Anemia can also be caused by hereditary diseases; some hereditary developmental disorders and diseases are characterized by a decrease in iron concentration, ritrocytopenia, insufficiency of the hematopoietic system, etc. With persistent low hemoglobin levels, mandatory examination of children and correction of the primary disease is necessary.

Anemia in preschool children

A large-scale study conducted in 2010 revealed a high incidence of iron deficiency anemia in preschool children: every second child suffers from a lack of hemoglobin due to low iron levels. The etiology of this phenomenon may involve various factors, but the most common is the consequences of uncorrected anemia in the first year of life.
The second factor that provokes anemia in preschool children is often combined with the first. An insufficiently balanced diet, lack of protein (meat products) and vitamins (vegetables) is often explained by the child’s reluctance to eat meat and vegetables, preferring semi-finished products and sweets. This is solely a matter of parental education and attention to a healthy diet without providing alternative foods from an early age, which also requires transferring family members to a rationally formulated diet.
In the case when nutrition corresponds to age standards, and the child shows signs of anemia (pallor, dry skin, fatigue, decreased appetite, increased fragility of the nail plates, etc.), examination by a specialist is necessary. Despite the fact that in 9 out of 10 preschoolers with diagnosed anemia it is caused by iron deficiency, in 10% of anemia the cause is diseases and pathologies (celiac disease, leukemia, etc.).

Anemia in children of primary school age

The norms for hemoglobin content in the blood of children 7-11 years old are 130 g/l. Manifestations of anemia in this age period increase gradually. Signs of developing anemia include, in addition to symptoms of anemia in preschoolers, decreased concentration, frequent acute respiratory viral and bacterial diseases, increased fatigue, which can affect the results of educational activities.
An important factor in the development of anemia in children attending general education institutions is the lack of ability to control their diet. In this age period, there is still a sufficient level of absorption of iron from food entering the body (up to 10%, decreasing by the age of an adult to 3%), therefore, the prevention and correction of iron deficiency type of anemia is a properly organized meal with dishes rich in vitamins and microelements at its basis. .
Physical inactivity, limited exposure to fresh air, preference for playing games in the house, especially with tablets, smartphones, etc., which dictate a long stay in a static position, also provoke anemia.

Anemia of puberty

The teenage period is dangerous for the development of anemia, especially in girls with the onset of menstruation, characterized by a periodic decrease in hemoglobin with blood loss. The second factor that provokes the onset of anemia in teenage girls is associated with a concentration on one’s own appearance, the desire to follow various diets and a reduction in the daily diet, excluding foods necessary for health.
Rapid growth rates, intense exercise, poor diet and previous anemia also affect adolescents of both sexes. Symptoms of anemia in adolescence include a blue tint to the sclera of the eyes, changes in the shape of the nails (cup-shaped nail plate), dysfunction of the digestive system, disturbances of taste and smell.
Severe forms of the disease in adolescence require medication therapy. A change in the blood formula is observed, as a rule, no earlier than 10-12 days after the start of the course of treatment; signs of clinical recovery, provided that the specialist’s prescriptions are followed, are observed after 6-8 weeks.

Causes of anemia

Anemia is characterized by a decrease in the concentration of hemoglobin and red blood cells per unit of blood. The main purpose of red blood cells is to participate in gas exchange, transport oxygen and carbon dioxide, as well as nutrients and metabolic products to cells and tissues for further processing.
The red blood cell is filled with hemoglobin, a protein that gives the red blood cell and blood its red color. Hemoglobin contains iron, and therefore its lack in the body causes a high incidence of iron deficiency anemia among all types of this condition.
There are three main factors for the development of anemia:

• acute or chronic blood loss;
• hemolysis, destruction of red blood cells;
• decreased production of red blood cells by the bone marrow.

According to the variety of factors and causes, the following types of anemia are distinguished:

The classification of an anemic condition is based on various signs that describe the etiology, mechanisms of disease development, stage of anemia, and diagnostic indicators.

Classification according to the severity of the condition

The severity of anemia is based on blood test results and depends on age, gender and physiological period.
Normally, in a healthy adult man, hemoglobin levels are 130-160 g/l of blood, in women - from 120 to 140 g/l, during gestation - from 110 to 130 g/l.
A mild degree is diagnosed when the hemoglobin concentration level decreases to 90 g/l in both sexes, with an average level corresponding to the range from 70 to 90 g/l, a severe degree of anemia is characterized by a decrease in the hemoglobin level below the limit of 70 g/l.

Classification of varieties according to the mechanism of development of the condition

In the pathogenesis of anemia, three factors are observed that can act separately or together:

• blood loss of an acute or chronic nature;
• disorders of the hematopoietic system, production of red blood cells by the bone marrow (iron deficiency, renal, aplastic anemia, deficiency anemia due to lack of vitamin B12 and/or folic acid);
• increased destruction of red blood cells before the end of their functioning period (120 days) due to genetic factors, autoimmune diseases.

Classification by color index

The color indicator serves as an indicator of the saturation of red blood cells with hemoglobin and is calculated using a special formula during the blood test.
The hypochromic form with weakened erythrocyte coloring is diagnosed when the color index is below 0.80.
The normochromic form, with a color index within the normal range, is determined by the range of 0.80-1.05.
The hyperchromic form, with excessive saturation with hemoglobin, corresponds to a color index above 1.05.

Classification according to morphological characteristics

The size of red blood cells is an important indicator in diagnosing the cause of anemia. Different sizes of red blood cells may indicate the etiology and pathogenesis of the condition. Normally, red blood cells are produced with a diameter of 7 to 8.2 micrometers. The following varieties are distinguished based on determining the size of the prevailing number of red blood cells in the blood:

• microcytic, red blood cell diameter less than 7 microns, indicates a high probability of iron deficiency;
• normocytic variety, the size of red blood cells is from 7 to 8.2 microns. Normocytosis is a sign of the posthemorrhagic form;
• macrocytic, with a red blood cell size of more than 8.2 and less than 11 microns, as a rule, indicates a deficiency of vitamin B12 (pernicious form) or folic acid;
• megalocytosis, megalocytic (megaloblastic) form, in which the diameter of erythrocytes is more than 11 microns, corresponds to severe stages of some forms, disturbances in the formation of red blood cells, etc.

Classification based on assessment of the bone marrow's ability to regenerate

The degree of erythropoiesis, the ability of red bone marrow to form red blood cells, is assessed by the quantitative indicator of reticulocytes, progenitor cells or “immature” red blood cells, which is considered the main criterion in assessing the ability of bone marrow tissue to regenerate and is an important factor for predicting the patient’s condition and choosing therapy methods . The normal concentration of reticulocytes is 0.5-1.2% of the total number of red blood cells per unit of blood.
Depending on the level of reticulocytes, the following forms are distinguished:

• regenerative, indicating the normal ability of the bone marrow to recover. Reticulocyte level 0.5-1.2%;
• hyporegenerative, with a concentration of immature red blood cells below 0.5%, which indicates a reduced ability of the bone marrow to recover independently;
• hyperregenerative, reticulocyte count more than 2%;
• aplastic anemia is diagnosed when the concentration of immature red blood cells decreases to less than 0.2% among the mass of all red blood cells and is a sign of a sharp suppression of the ability to regenerate.

Iron deficiency anemia (IDA)

The iron deficiency form accounts for up to 90% of all types of anemic conditions. According to research by the World Health Organization, this form affects one in 6 men and every third woman in the world.
Hemoglobin is a complex protein compound containing iron that is capable of reversible communication with oxygen molecules, which is the basis for the process of transporting oxygen from the lungs to the body’s tissues.
The iron deficiency form is hypochromic anemia, with signs of microcytosis, the presence in the blood formula of red blood cells with a diameter less than normal, which is associated with a deficiency of iron, the basic element for the formation of hemoglobin, which fills the cavity of the red blood cell and gives it a red color.
Iron is a vital trace element involved in many metabolic processes, nutrient metabolism, and gas exchange in the body. During the day, an adult consumes 20-25 mg of iron, while the total reserve of this element in the body is about 4 g.

Reasons for the development of IDA

The reasons for the development of this form of the condition include factors of various etiologies.
Iron deficiency:

• unbalanced diet, strict vegetarianism without compensation for iron-containing foods, fasting, dieting, taking medications, drugs and other substances that suppress hunger, appetite disturbances due to diseases of physical or psycho-emotional etiology;
• socio-economic causes of malnutrition, food shortages.

Disturbances in the process of absorption and assimilation of iron:

• diseases of the gastrointestinal tract (gastritis, colitis, gastric ulcer, resection of this organ).

Imbalance of iron consumption and intake due to increased need of the body:

• pregnancy, lactation period;
• age of pubertal growth spurts;
• chronic diseases that provoke hypoxia (bronchitis, obstructive pulmonary disease, heart defects and other diseases of the cardiovascular system and respiratory organs);
• diseases accompanied by purulent-necrotic processes: sepsis, tissue abscesses, bronchiectasis, etc.

Loss of iron by the body, acute or chronic posthemorrhagic:

• for pulmonary bleeding (tuberculosis, tumor formations in the lungs);
• for gastrointestinal bleeding accompanying gastric ulcer, duodenal ulcer, cancer of the stomach and intestines, severe erosion of the gastrointestinal mucosa, varicose veins of the esophagus, rectum, hemorrhoids, helminthic infestation of the intestine, ulcerative colitis and others;
• with uterine bleeding (heavy menstruation, cancer of the uterus, cervix, fibroids, placental abruption during the gestational period or during childbirth, ectopic pregnancy during expulsion, birth injuries of the uterus and cervix);
• bleeding localized in the kidneys (tumor formations in the kidneys, tuberculous changes in the kidneys);
• bleeding, including internal and hidden, due to injuries, blood loss due to burns, frostbite, during planned and emergency surgical interventions, etc.

Symptoms of IDA

The clinical picture of the iron deficiency form consists of anemic and sideropenic syndrome, caused primarily by insufficient gas exchange in the tissues of the body.
Symptoms of anemic syndrome include:

• general malaise, chronic fatigue;
• weakness, inability to tolerate prolonged physical and mental stress;
• attention deficit disorder, difficulty concentrating, rigidity;
• irritability;
• headache;
• dizziness, sometimes fainting;
• drowsiness and sleep disturbances;
• shortness of breath, increased heart rate both during physical and/or psycho-emotional stress and at rest;
• black color of stool (with bleeding of the gastrointestinal tract).

Sideropenic syndrome is characterized by the following manifestations:

• perversion of taste preferences, craving for eating chalk, clay, raw meat, etc.;
• distortion of the sense of smell, the desire to smell paint, household chemicals, substances with a strong odor (acetone, gasoline, washing powder, etc.);
• fragility, dry hair, lack of shine;
• white spots on the nail plates of the hands;
• dry skin, peeling;
• pallor of the skin, sometimes blue sclera;
• the presence of cheilitis (cracks, “jams”) in the corners of the lips.

In severe stages of IDA, neurological symptoms are noted: “pins and needles” sensations, numbness of the limbs, difficulty swallowing, weakened bladder control, etc.

Diagnosis of IDA

The diagnosis of iron deficiency anemia is based on external examination data, assessment of the results of laboratory blood tests and instrumental examination of the patient.
During an external medical examination and history taking, attention is paid to the condition of the skin, mucous surfaces of the mouth, corners of the lips, and also the size of the spleen is assessed upon palpation.
A general blood test in the classic clinical picture of IDA shows a decrease in the concentration of red blood cells and hemoglobin relative to age and gender norms, the presence of red blood cells of different sizes (poikilocytosis), reveals microcytosis, the presence, in severe forms, the predominance of red blood cells with a diameter of less than 7.2 microns, hypochromic , weakly expressed color of erythrocytes, low color index.
The results of a biochemical blood test for IDA have the following indicators:

• the concentration of ferritin, a protein that acts as an iron depot in the body, is reduced relative to normal limits;
• low serum iron levels;
• increased iron-binding capacity of blood serum.

Diagnosis of IDA is not limited to identifying iron deficiency. To effectively correct the condition, after collecting an anamnesis, the specialist, if necessary, prescribes instrumental studies to clarify the pathogenesis of the disease. Instrumental studies in this case include:

• fibrogastroduodenoscopy, examination of the condition of the mucous membrane of the esophagus, walls of the stomach, duodenum;
• ultrasound examination of the liver, kidneys, female reproductive organs;
• colonoscopy, examination of the walls of the large intestine;
• computed tomography methods;
• X-ray examination of the lungs.

Treatment of anemia of iron deficiency etiology

Depending on the stage and pathogenesis of IDA, therapy is chosen by adjusting the diet, medication, surgery to eliminate the causes of blood loss, or a combination of methods.

Therapeutic diet for iron deficiency

Iron that comes into the body from food is divided into heme iron, which is of animal origin, and non-heme iron, which is of plant origin. The heme variety is absorbed much better and its lack of nutrition, for example, in vegetarians, leads to the development of IDA.
Products recommended for correcting iron deficiency include the following:

• heme group in descending order of iron amount: beef liver, beef tongue, rabbit, turkey, goose, beef, some types of fish;
• non-heme group: dried mushrooms, fresh peas, buckwheat, rolled oats and oats, fresh mushrooms, apricots, pears, apples, plums, cherries, beets, etc.

Despite the seemingly high iron content in vegetables, fruits, and products of plant origin when studying the composition, the digestibility of iron from them is insignificant, 1-3% of the total volume, especially when compared with products of animal origin. Thus, when eating beef, the body is able to absorb up to 12% of the essential element contained in the meat.
When correcting IDA using diet, you should increase the content of foods rich in vitamin C and protein (meat) in the diet and reduce the consumption of eggs, table salt, caffeinated drinks and foods rich in calcium due to the effect on the absorption of dietary iron.

Drug therapy

In moderate and severe forms, the therapeutic diet is combined with the prescription of medications that supply iron in an easily digestible form. Medicines differ in the type of compound, dosage, release form: tablets, dragees, syrups, drops, capsules, injection solutions.
Preparations for oral use are taken one hour before meals or two hours after due to the nature of iron absorption, while it is not recommended to use caffeine-containing drinks (tea, coffee) as a liquid to facilitate swallowing, as this impairs the absorption of the element. The interval between taking doses of drugs should be at least 4 hours. Self-prescription of medications can cause both side effects from an incorrectly selected form or dosage, as well as iron poisoning.
The dosage of drugs and the form of release are determined by a specialist, focusing on the age, stage of the disease, causes of the condition, general clinical picture and individual characteristics of the patient. Doses may be adjusted during the course of treatment based on the results of intermediate or control blood tests and/or the patient’s well-being.
Iron supplements in the course of treatment are taken from 3-4 weeks to several months with periodic monitoring of hemoglobin levels.
Among the iron-supplying drugs taken orally, there are medications with di- and trivalent forms of iron. At the moment, according to research, ferrous iron is considered the more preferable form for oral administration due to its higher ability to be absorbed in the body and its gentle effect on the stomach.
For children, iron-containing products are produced in the form of drops and syrups, which is determined both by the age-related characteristics of taking the drugs and by a shorter course of therapy than in adults, due to the increased absorption of iron from food. If it is possible to take capsules, dragees and tablets, as well as for long courses, preference should be given to solid forms of medicines containing iron, since liquid ones with prolonged use can have a negative effect on tooth enamel and cause its darkening.
The most popular tablet forms include the following medications: Ferroplex, Sorbifer, Actiferrin, Totema (ferrous form of iron) and Maltofer, Ferrostat, Ferrum Lek with ferric iron.
Oral forms are combined with vitamin C (ascorbic acid) in the dosage prescribed by the doctor for better absorption.
Intramuscular and intravenous injections of iron supplements are prescribed in limited situations, such as:

• severe stage of anemia;
• ineffectiveness of a course of taking oral forms of drugs;
• the presence of specific diseases of the gastrointestinal tract, in which taking oral forms can worsen the patient’s condition (acute gastritis, gastric ulcer, duodenal ulcer, nonspecific ulcerative colitis, Crohn’s disease, etc.);
• with individual intolerance to oral forms of iron-containing drugs;
• in situations where there is a need to urgently saturate the body with iron, for example, with significant blood loss due to injury or before surgery.

The administration of iron preparations intravenously and intramuscularly can lead to an intolerance reaction, which is why such a course of therapy is carried out exclusively under the supervision of a specialist in a hospital or clinical setting. Negative side effects of intramuscular administration of iron-containing liquids include deposition of hemosiderin subcutaneously at the injection site. Dark spots on the skin at the injection sites can last from one and a half to 5 years.
Iron deficiency anemia responds well to drug therapy, provided the prescribed dose and duration of treatment are followed. However, if the etiology of the condition involves primary serious diseases and disorders, therapy will be symptomatic and have a short-term effect.
To eliminate causes such as internal bleeding, in the hemorrhagic form, iron deficiency anemia is treated with surgical methods. Surgical intervention eliminates the main factor of acute or chronic bleeding and stops blood loss. For internal bleeding of the gastrointestinal tract, fibrogastroduodenoscopic methods or colonoscopy are used to identify the area of ​​bleeding and measures to stop it, for example, cutting off a polyp, coagulating an ulcer.
For internal bleeding of the peritoneal and reproductive organs in women, a laparoscopic intervention method is used.
Emergency treatment methods include transfusion of donor red blood cells to quickly restore the concentration of red blood cells and hemoglobin per unit of blood.
Prevention of iron deficiency is considered to be a balanced diet and timely diagnostic and therapeutic measures to maintain health.

Anemia due to cobalamin or vitamin B12 deficiency

Deficiency forms are not limited to iron deficiency anemia. Pernicious anemia is a condition that occurs against the background of malabsorption, insufficient intake, increased consumption, abnormalities in the synthesis of protective proteins, or liver pathologies that prevent the accumulation and storage of cobalamin. In ptogenesis of this form, a frequent combination with folic acid deficiency is also noted.
Among the reasons for this deficiency form are the following:

The clinical picture of vitamin B12 and folic acid deficiency includes anemic, gastrointestinal and neuralgic syndromes.
Particularly the anemic symptom complex for this type of deficiency includes such specific symptoms as jaundice of the skin and sclera and increased blood pressure. Other manifestations are also characteristic of IDA: weakness, fatigue, dizziness, shortness of breath, rapid heartbeat (situational), tachycardia, etc.
Manifestations associated with the functioning of the gastrointestinal tract include the following symptoms of atrophy of the mucous membranes of the gastrointestinal tract and oral cavity:

• red, “glossy” tongue, often with complaints of a burning sensation on its surface;
• phenomena of aphthous stomatitis, ulceration of the oral mucosa;
• Appetite disturbances: decrease to complete absence;
• feeling of heaviness in the stomach after eating;
• the patient's immediate history of weight loss;
• disturbances, difficulties in defecation, constipation, pain in the rectum;
• hepatomegaly, enlarged liver.

Neuralgic syndrome due to vitamin B12 deficiency consists of the following manifestations:

• feeling of weakness in the lower extremities with severe physical activity;
• numbness, tingling, “goosebumps” on the surface of the arms and legs;
• decreased peripheral sensitivity;
• atrophy of muscle tissue of the legs;
• convulsive manifestations, muscle spasms, etc.

Diagnosis of cobalamin deficiency

Diagnostic measures include a general medical examination of the patient, medical history, laboratory blood tests and, if necessary, instrumental examination methods.
During a general blood test, the following changes are noted:

• lower levels of red blood cells and hemoglobin relative to the age norm;
• hyperchromia, increased color index of red blood cells;
• macrocytosis of erythrocytes, their size exceeding 8.0 microns in diameter;
• poikilocytosis, the presence of red blood cells of different sizes;
• leukopenia, insufficient concentration of leukocytes;
• lymphocytosis, exceeding the normal level of lymphocytes in the blood;
• thrombocytopenia, an insufficient number of platelets per unit of blood.

Biochemistry studies of blood samples reveal hyperbilirubinemia and vitamin B12 deficiency.
To diagnose the presence and severity of atrophy of the mucous membranes of the stomach and intestines, as well as to identify possible primary diseases, instrumental methods of examining patients are used:

• fibrogastroduodenoscopic examination;
• analysis of biopsy material;
• colonoscopy;
• irrigoscopy;
• Ultrasound of the liver.

Treatment methods

In most cases, B12 deficiency anemia requires hospitalization or treatment in a hospital setting. For therapy, first of all, a diet with foods rich in cobalamin and folic acid (liver, beef, mackerel, sardines, cod, cheese, etc.) is prescribed; secondly, drug support is used.
In the presence of neurological symptoms, injections of Cyanocobalamin are prescribed intramuscularly at an increased dose: 1000 mcg daily until the neurological signs of deficiency disappear. Subsequently, the dosage is reduced, however, if a secondary etiology is diagnosed, the drugs are most often prescribed on a lifelong basis.
After discharge from a medical institution, the patient is required to undergo regular preventive examinations with a therapist, hematologist and gastrologist.

Aplastic anemia: symptoms, causes, diagnosis, treatment

Aplastic anemia can be either a congenital or acquired disease, developing under the influence of internal and external factors. The condition itself occurs due to bone marrow hypoplasia, a decrease in the ability to produce blood cells (erythrocytes, leukocytes, platelets, lymphocytes).

Reasons for the development of aplastic form

In aplastic, hypoplastic forms of anemia, the causes of this condition may be the following:

• stem cell defect;
• suppression of the process of hematopoiesis (blood formation);
• insufficiency of factors stimulating hematopoiesis;
• immune, autoimmune reactions;
• deficiency of iron, vitamin B12 or their exclusion from the process of hematopoiesis due to dysfunction of hematopoietic tissues and organs.

The development of disorders that provoke the aplastic or hypoplastic form include the following factors:

• hereditary diseases and genetic pathologies;
• taking certain medications from the groups of antibiotics, cytostatics, non-steroidal anti-inflammatory drugs;
• poisoning with chemicals (benzenes, arsenic, etc.);
• infectious diseases of viral etiology (parvovirus, human immunodeficiency virus);
• autoimmune disorders (systemic lupus erythematosus, rheumatoid arthritis);
• severe deficiencies of cobalamin and folic acid in the diet.

Despite the extensive list of causes of the disease, in 50% of cases the pathogenesis of the aplastic form remains unidentified.

Clinical picture

The severity of pancytopenia, a decrease in the number of basic types of blood cells, determines the severity of symptoms. The clinical picture of the aplastic form includes the following signs:

• tachycardia, rapid heartbeat;
• pallor of the skin, mucous membranes;
• headache;
• increased fatigue, drowsiness;
• shortness of breath;
• swelling of the lower extremities;
• bleeding gums;
• petechial rash in the form of small red spots on the skin, a tendency to bruise easily;
• frequent acute infections, chronic diseases as a result of decreased general immunity and leukocyte deficiency;
• erosions, ulcers on the inner surface of the oral cavity;
• yellowness of the skin and sclera of the eyes as a sign of incipient liver damage.

Diagnostic procedures

To establish a diagnosis, laboratory methods for studying various biological fluids and tissues and instrumental examination are used.
A general blood test reveals a reduced number of red blood cells, hemoglobin, reticulocytes, leukocytes, platelets, while the color index and hemoglobin content in red blood cells correspond to the norm. The results of a biochemical study indicate an increase in serum iron, bilirubin, lactate dehydrogenase, and saturation of transferrin with iron by 100% of the possible level.
To clarify the diagnosis, a histological examination of the material removed from the bone marrow during puncture is carried out. As a rule, the results of the study indicate underdevelopment of all sprouts and replacement of bone marrow with fat.

Treatment of aplastic form

Anemia of this type cannot be treated by correcting the diet. First of all, a patient with aplastic anemia is prescribed selective or combined use of drugs from the following groups:

• immunosuppressants;
• glucocorticosteroids;
• immunoglobulins of antilymphocyte and antiplatelet action;
• anti-metabolic drugs;
• stimulators of erythrocyte production by stem cells.

If drug therapy is ineffective, non-drug treatment methods are prescribed:

• bone marrow transplantation;
• transfusion of red blood cells and platelets;
• plasmaphoresis.

Aplastic anemia is accompanied by a decrease in general immunity due to a deficiency of leukocytes, therefore, in addition to general therapy, an aseptic environment, antiseptic surface treatment, and no contact with carriers of infectious diseases are recommended.
If the listed treatment methods are insufficient, the patient is prescribed splenectomy and removal of the spleen. Since it is in this organ that the breakdown of red blood cells occurs, its removal can improve the general condition of the patient and slow down the development of the disease.

Anemia: methods of prevention

The most common form of the disease, iron deficiency anemia, can be prevented through a balanced diet with an increase in the amount of iron-containing foods during critical periods. An important factor is also the presence of vitamin C, cobalamin (vitamin B12), and folic acid in food products.
If you are at risk of developing this form of anemia (vegetarianism, age-related growth periods, pregnancy, lactation, prematurity in infants, heavy menstrual bleeding, chronic and acute diseases), regular medical examination, blood tests for quantitative and qualitative indicators of hemoglobin, red blood cells and additional taking medications as prescribed by specialists.

How dangerous is anemia and what are its consequences? This is a question asked by many people who are faced with pale skin and weakness. is a common disease that, at first glance, does not pose any danger. In fact, with anemia, death is also possible. Therefore, it is necessary to promptly pay attention to the symptoms of the disease and identify the cause.

Why is anemia dangerous?

The blood fluid of the human body contains platelets, leukocytes and red blood cells that perform specific functions. Anemia is characterized by pathological disorders in blood cells (red blood cells), which in turn consist of an important substance - hemoglobin. It gives not only the red color, but is also responsible for gas exchange (saturates internal organs with oxygen and removes carbon dioxide). With a lack of hemoglobin, anemia develops. Hemoglobin contains iron and protein parts, and if they are deficient, the substance is not produced in sufficient quantities. Thus, the whole danger lies in a decrease in the level of red blood cells, which leads to the development of diseases of many body systems.

Anemia is more a female disease, since in men it occurs only in 10 cases out of 100. Based on statistical data, every fourth inhabitant of the globe suffers from anemia. This is especially true for pregnant women.

The “Live Healthy” program examines in detail the reasons for low hemoglobin levels and offers 3 interesting tests. You can see this in the presented video.

If anemia is not detected and treated in a timely manner, irreversible processes occur that lead to serious pathological diseases. This is facilitated by a decrease in hemoglobin levels, which weakens the immune system, that is, the body’s protective functions are lost. And this leads to frequent infection with viruses, bacteria and other harmful microorganisms.

At the same time, the body launches compensatory functions, which enhances the functioning of the heart and circulatory system. Frequent contractions of the heart muscle lead to tissue wear, which causes heart failure. Against the background of a weakened body, the patient becomes overly irritable, an imbalance in the psycho-emotional background is detected, and pathologies of a neurological nature develop. In addition, concentration and memory are impaired, the sense of smell and taste changes, the structure of the skin and all mucous membranes is deformed.

Possible complications:

• decreased immunity and, as a result, frequent morbidity;
• increased heart rate leads to heavy stress, resulting in the development of diseases of the cardiovascular system;
• during pregnancy there is a risk of miscarriage, and the fetus stops developing;
• in childhood, growth and mental development stops;
• pathologies of the gastrointestinal tract, visual apparatus, and respiratory system develop;
• hypoxic coma occurs, which can be fatal. More details about anemic coma - this is one of the types of hypoxic coma.

Consequences of grade 3 anemia

Anemia has three main degrees of severity. The 3rd is considered the heaviest. In a healthy person, the hemoglobin level should be 120-180 g/l, with grade 3 - only 70 g/l. And this condition is already life-threatening for the patient, since the functionality of almost all body systems is disrupted. The most severe consequences for grade 3 anemia:

• cardiogenic shock;
• acute renal failure;
• blood loss;
• heart failure and subsequent stroke, heart attack, etc.

With advanced stage 3 anemia, there is a high risk of death, so it is important to contact the clinic at the slightest suspicion of anemia for examination and identification of pathology.

Consequences of anemia for women

The consequences of anemia in women are associated with organs that are considered sensitive to oxygen deprivation. So, the following occurs:

• Digestive disorders and damage to the mucous organs of the gastrointestinal tract.
• Deterioration of the excretory and detoxifying properties of the renal system and liver.
• Pathological changes in the central nervous system, heart, blood vessels.
• The woman's reproductive system and genitourinary system are affected due to frequent infection.
• The condition of the hair follicles and nail plate worsens.
• The structure of the mucous membranes and teeth changes.
• Skin diseases appear.

Causes of anemia

In medicine, there are only 3 main reasons for the development of anemia - the loss of a large amount of blood, the rapid breakdown of red blood cells (hemolysis) and a decrease in the production of blood cells. However, there are factors that influence the causes of occurrence:

1. Genetic abnormalities:

• disturbances in the production of congenital red blood cells;
• abnormal structure of cells (erythrocytes);
• spherocytosis;
• Bassen-Kronzweig syndrome;
• enzymatic abnormalities.

2. Malnutrition:

• frequent strict diets;
• lack of a balanced diet, which leads to a deficiency of vitamin C, B, microelements (iron, folic acid, etc.).

3. Impact of chronic diseases:

• pathologies of the renal and cardiovascular systems;
• liver diseases;
• disorders in the autoimmune apparatus;
• neoplasms of benign and malignant nature.

4. Presence of infectious pathologies:

• hepatitis virus;
• malarial pathogenic microorganisms;
• cytomegalovirus;
• toxoplasmosis;
• obstructive bronchitis;
• tuberculosis bacillus.

Another important factor leading to the development of anemia is intoxication of the body (through pesticides and medications) and injury (burn, frostbite, fractures).

General symptoms of anemia for any age and gender:

• pallor of the skin and lips, further cyanosis;
• weakness and fatigue;
• shortness of breath with little physical activity;
• cramps and numbness in the limbs;
• brittleness and splitting of nails, hair loss;
• plaque and cracks in the corners of the lips;
• trembling of the limbs and changes in taste and smell;
• pain in the gastrointestinal tract;
• dryness and cracking of the skin (particularly on the legs and arms).

In adults and in old age:

• dizziness, fainting, loss of consciousness;
• sensations of tinnitus, headache and insomnia;
• disruption or cessation of the menstrual cycle in women;
• weakening of potency in men;
• aversion to food, resulting in anorexia;
• increased angina pectoris, dementia.

IN childhood the following is added:

• loss of interest in studying, as concentration decreases and memory deteriorates;
• lethargy in games;
• increased bleeding in the gums;
• retarded physical and mental development;
• disproportionality of appearance.

Anemia in newborns and adolescents

Anemia is also observed in newborn children. This is due, first of all, to the presence of anemia in the mother. This often happens when you neglect your own health during pregnancy. The disease is usually diagnosed immediately after birth. If not treated in a timely manner, the disease develops into severe childhood anemia. There are features of childhood anemia. The child begins to intensively chew paper (most often with a stamp), chalk, sand and even earth. In addition, children prefer specific smells. For example, paints, acetone, glue and the like.

Childhood and adolescence are characterized by depression of the heart and blood vessels, which is manifested by irregular breathing, rapid heartbeat, and changes in blood pressure. Metabolism in all tissues and cells is disrupted, the child suffers from jaundice and frequent colds.

Learn about the features of anemia in childhood from this video in Dr. Komarovsky’s program.

Anemia in pregnant women

During pregnancy, a woman’s body requires more vitamins and minerals, since beneficial substances enter not only her internal systems, but also the fetus. Therefore, almost all pregnant women suffer from. If this is the 1st degree (mild), then it will be enough to follow a certain diet, which includes a number of necessary substances. But in more severe forms, drug therapy will be required, which can negatively affect the development of the unborn child. Read more about anemia during pregnancy -.

The peculiarity is that in a mild form of anemia, only the mother’s body suffers, since all the nutrients in the required quantity are supplied to the child.

During pregnancy, the following unpleasant consequences may occur:

• varicose veins and thrombosis;
• threat of miscarriage and bleeding;
• harm to the unborn child: anemia, mental and physical underdevelopment, lack of immunity, frequent morbidity after birth.

A huge number of people suffer from anemia, but not every person knows about it, which leads to the development of many pathological abnormalities. Therefore, it is extremely important to periodically visit doctors and take appropriate blood tests to determine the level of red blood cells. In the early stages of the disease, it is much easier to get rid of anemia than in severe cases of the disease.

Anemia - what kind of disease is it?

When diagnosing posthemorrhagic anemia it is necessary to take into account information about the acute blood loss that has occurred in the presence of external bleeding. After a massive internal diagnosis is based on clinical signs and, without fail, laboratory tests ( Weber , Gregersen ). The basis for diagnosis will also be an increase in the level of residual nitrogen during bleeding from the upper digestive tract.

After the crisis and acute period have passed, the patient is prescribed iron supplements, and. This therapy is carried out for 6 months. If there is a loss of more than 50% of the circulating blood volume, the prognosis is unfavorable.

Folate deficiency anemia

The condition may develop as a result of decreased intake of folic acid or disruption of its absorption processes in the digestive tract. Treatment consists of additional intake of the missing substance.

Unlike the pathology associated with B12 deficiency, folate deficiency anemia is diagnosed much less frequently.

One of the main causes of folate deficiency anemia is insufficient folic acid in the diet. You should remember that you need to include more greens and liver in your daily menu. Also, health is significantly affected by pregnancy, malignant neoplasms, some, .

This type of disease occurs when absorption is impaired (for example, when celiac disease ), under the influence of drugs, , Triamterene , anticonvulsants, barbiturates , etc. The body’s need for folic acid increases significantly after hemodialysis and in liver diseases.

Deficiency also affects health. cyanocobalamin and its coenzyme - methylcobalamin . Under such conditions, there is no transformation of folic acid into the coenzyme form. As a result, the process of normal cell division is disrupted, and the cells of the hematopoietic tissue that were previously actively multiplying begin to suffer. The processes of maturation and reproduction of red blood cells are inhibited, and their life expectancy is reduced. Changes also affect leukocytes, and leukopenia And .

Further, as a result of incorrect mitosis, giant epithelial cells of the alimentary canal appear and inflammatory processes develop in the mucous membrane, enteritis . The primary disturbances in secretion and the process of absorption of internal factor are further aggravated, and vitamin deficiency intensifies. A vicious circle arises.

Due to the resulting lack of cyanocobalamin, metabolic products begin to accumulate in the body, which are toxic to nerve cells. At that time, fatty acids with a distorted structure begin to be synthesized in the fibers. There is a gradual change in the quality of spinal cord cells, peripheral and cranial nerve plexuses are affected, and neurological symptoms develop.

With this type of anemia, as a rule, the patient experiences standard symptoms: high fatigue, rapid heartbeat, pale nails and lips, bright red tongue. In the initial stages, it is almost impossible to track signs of damage to the nervous system and gastrointestinal tract. Based on the results of the examination, it is revealed hyperchromic macrocytic anemia , leukopenia , thrombocytopenia . And treatment with vitamin B12 does not cause improvements in laboratory parameters. The diagnosis can be confirmed by determining the level of serum folic acid and in red blood cells. Normally, its content ranges from 100 to 450 ng/l. In folate deficiency anemia, the concentration of folic acid in red blood cells is significantly reduced.

If a peripheral blood picture is analyzed, hyperchromic (macrocytic) anemia is noted with a general decrease in the level of hemoglobin and red blood cells. Indirect changes rarely.

As a preventative measure and for the treatment of folate deficiency anemia, folic acid should be prescribed at a dose of 1 mg/day, orally. If necessary, the doctor may increase the dose. Improvements should occur within 3-4 days, including neurological symptoms. Otherwise, we have to talk about a deficiency of vitamin B12, and not folic acid.

It is imperative to prevent folic acid deficiency in pregnant women and patients taking certain groups of medications. drugs. For prevention, 5 mg of the substance per day is prescribed.

B12 deficiency anemia

Refers to the species vitamin deficiency (megaloblastic) anemia , which occur when there is insufficient intake into the body ( cyanocobalamin ). As a result of B12 deficiency anemia, the hematopoietic function, nervous and digestive systems are affected. Unlike folate deficiency B12 anemia, it develops in old or senile age, most often in men. The disease manifests itself gradually.

A person suffering from B12 deficiency anemia will experience general symptoms: weakness, decreased performance, dyspnea , burning behind the sternum, pain in the legs and tongue, unsteadiness of gait. Such symptoms will be combined with icteric skin color, slight enlargement of the liver and spleen, low systolic murmur, and muffled heart sounds. The nervous system is often affected and develops combined sclerosis or funicular myelosis , sensitivity is impaired, polyneuritis , muscle atrophy, lower limb paralysis.

Anemia develops due to a lack of vitamin B12, due to an imbalanced diet, fasting, alcoholism and lack of appetite. The syndrome can also be observed against the background malabsorption , celiac disease , changes in the intestinal mucosa, sprue , intestinal lymphoma , Crohn's disease , regional ileitis , due to long-term use of anticonvulsants.

The likelihood of developing B12 deficiency anemia will be higher during pregnancy, hemolytic anemia , exfoliative dermatitis . When taking alcohol, folate antagonist drugs, inborn errors of metabolism and atrophic gastritis this disease may also occur.

As a rule, a diagnosis of B12 deficiency anemia can be made without any problems. It can do hematologist , neurologist , nephrologist or gastroenterologist based on the results of a general and biochemical blood test, the presence methylmalonic acid . An ultrasound of the abdominal cavity and a study of vitamin B12 absorption using radioisotopes . According to indications, it is possible to carry out bone marrow aspiration biopsy .

Treatment is carried out with vitamin B12 intramuscularly. A maintenance dose is used for 1-1.5 months. If the hemoglobin level has dropped to less than 60 g per liter, if hemodynamics are impaired and there is a threat of anemic coma, red blood cell transfusion .

As a preventative measure for diseases accompanied by impaired absorption of vitamin B12, as well as after operations, it is necessary to use preventive and therapeutic courses of vitamin therapy under the control of the content of vitamin B12 in the urine and blood.

Hemolytic anemia

What is this in simple words? This is a process of accelerated destruction red blood cells , it is accompanied by a significant increase in the level of direct bilirubin in blood. The disease is quite rare.

Autoimmune hemolytic anemia is usually caused by genetic defects in the membranes of red blood cells, which causes their increased destruction. Autoimmune disease and hemolysis of red blood cells in acquired anemia occurs under the influence of internal factors or any environmental factors.

Hemolytic anemias can be divided into two broad groups of diseases: acquired And congenital.

Forms of hereditary diseases:

• Erythrocyte membranopathies such as Minkowski-Choffar anemia or Minkowski-Choffard disease ( microspherocytosis ), acanthocytosis , ovalocytosis caused by abnormalities in the structure of red blood cell membranes. Note that spherocytosis is the most common type among pathologies (microspherocytosis).
• Enzymopenia caused by a deficiency of certain enzymes ( pyruvate kinase , glucose-6-phosphate dehydrogenase ).
• Hemoglobinopathies that arise due to qualitative disturbances in the structure of hemoglobin or changes in the ratio of its normal forms.

Acquired hemolytic anemias are divided into:

• Acquired membranopathies ( spur cell anemia , Marchiafava-Micheli disease ).
• Iso- and autoimmune, caused by the action of antibodies.
• Toxic, resulting from exposure to poisons, toxins or other chemicals. agents.
• Anemia associated with mechanical damage to the structure of red blood cells.

An increase in the concentration of residual traces after the breakdown of red blood cells in the body will be externally manifested jaundice lemon shade. There will also be an increase in the concentration of indirect bilirubin and iron in the blood. Noted urobilinuria And pleiochromy feces and bile. With intravascular hemolysis, it additionally develops hyperhemoglobinemia , hemoglobinuria , hemosiderinuria . Indicates an increase in erythropoiesis reticulocytosis And polychromatophilia in peripheral blood, or erythronormoblastosis bone marrow.

If the patient does not have microspherocytic anemia caused by hereditary spherocytosis or elliptocytosis, then it is necessary, first of all, to carry out adequate therapy for the disease that caused the hemolytic anemia.

For treatment usually used:

• medications (for example, Desferal );
• splenectomy ;
• transfusion of red blood cells during a crisis;
• HSC for autoimmune diseases in medium dosage.

Aplastic anemia

Aplastic anemia is a disease that is classified as myelodysplasia . With this disease, there is a sharp inhibition or cessation of growth and maturation of cells in the bone marrow, also called panmyelophthisis .

Typical symptoms of the disease are: leukopenia , anemia , lymphopenia And thrombocytopenia . The term itself first appeared at the beginning of the 20th century. This disease has a fairly severe course and without treatment (including medication Atgam ) has a poor prognosis.

For a very long time, this disease was considered as a syndrome combining various pathological conditions in the bone marrow. Currently, the term “aplastic anemia” is identified as an independent nosological unit. It should be clearly distinguished from hypoplasia syndrome in the hematopoietic system.

Aplastic anemia can be caused by various reasons:

• chemical agents, benzene, salts of heavy metals and so on;
• ionizing radiation;
• taking certain medications cytostatics , NSAIDs, ;
• viruses;
• the presence of other autoimmune diseases.

There is also a form of aplastic anemia that is inherited - Fanconi anemia . Treatment of the disease consists of taking immunosuppressants and undergoing a bone marrow transplant.

Sickle cell anemia

In human sickle cell anemia, the structure of the hemoglobin protein is disrupted; it acquires an atypical crystalline structure, in the form of a sickle. This form is called S-hemoglobin . The disease is associated with a mutation in the HBB gene, due to which an abnormal type of S-hemoglobin begins to be synthesized in the bone marrow; valine is found in the sixth position in the B chain instead of glutamic acid. Polymerization of S-hemoglobin occurs, long strands are formed, and red blood cells take on the shape of a sickle.

The mode of inheritance of sickle cell anemia is autosomal recessive with incomplete dominance. Heterozygous carriers have approximately equal amounts of hemoglobin A and S in their erythrocytes. Carriers themselves do not get sick, and sickle erythrocytes can be detected by chance during a laboratory examination. Symptoms may not appear at all. Sometimes such people begin to feel unwell due to severe dehydration.

Homozygotes have only hemoglobin S in their blood, and the disease is quite severe. Such patients have a high level of destroyed red blood cells in the spleen, a significantly shorter life span, and often show signs of chronic oxygen deficiency.

This type of anemia is quite common in regions where the incidence rate is high. Such patients have higher resistance to different strains of malarial plasmodium. Therefore, such harmful alleles often appear in Africans.

Symptoms vary greatly and can be observed in children as early as 3 months of age. Anemia can lead to loss of consciousness, less stamina, cause jaundice . In infants, thinness, weakness, curvature of the limbs, elongation of the body, changes in the structure of the skull and teeth are observed. Also, sick children have an increased tendency to develop sepsis . In adolescents, developmental delays of 2-3 years are observed. Women, as a rule, are capable of conceiving and giving birth to a child.

Megaloblastic anemia

Megaloblastic anemia ( Addison-Beermer disease , B12 deficiency, pernicious) is a disease caused by a lack of folic acid or vitamin B12. This happens due to a lack of substances in food or diseases of the digestive tract. Also, megaloblastic anemia can occur due to congenital disorders of DNA synthesis processes, acquired pathologies and due to the use of certain medications ( antimetabolites , anticonvulsants).

With a constant lack of folic acid and B12, chronic anemia develops, red blood cells change their shape and size. Milder stages are sometimes asymptomatic, then external signs begin to appear. This deficiency state is often also called pernicious anemia . The disease has received the status of anemia of chronic diseases, as it manifests itself in patients after 60 years of age and in patients who have undergone, with and bowel cancer . This type of anemia is described in more detail above.

Pernicious anemia

Develops as a result of endogenous B12 vitamin deficiency caused by atrophy of the glands of the fundus of the stomach, which normally should produce gastromucoprotein . As a result, the absorption processes of vitamin B12 are disrupted and pernicious anemia of the “pernicious” type occurs. Most often, this diagnosis is made at the age of 50 years.

The disease is accompanied by disorders of the nervous, cardiovascular, hematopoietic and digestive systems. Patients usually complain of shortness of breath, general weakness, swelling of the legs, “pins and needles” on the feet and hands, burning pain in the tongue and unsteadiness of gait. According to laboratory indicators, hyperchromic anemia, leukopenia, and thrombocytopenia are observed.

Sideroblastic anemia

Sideroblastic anemia is also called sideroachrestic anemia (SAA), iron-refractory, iron-saturated or sideroblastic. This is a pathological condition of disturbances in the synthesis of microelements and hematopoiesis, most often iron. Red blood cells contain a small amount of iron, due to the fact that the microelement is actively consumed by the bone marrow and begins to accumulate in the internal organs. The disease develops against the background of insufficient levels of protoporphyrin.

There are two forms of the disease:

• pyridoxine-dependent resulting from pyridoxal phosphate deficiency;
• pyridoxine-resistant , developing due to an enzyme defect (heme synthetase deficiency).

Acquired forms of sideroachrestic anemia are more often observed in old age, but the disease is not inherited from parents. Often this kind of anemia develops as a side effect of treatment with drugs for tuberculosis or depletion of pyridoxal phosphate in case of lead poisoning, myeloproliferative blood diseases, cutaneous porphyria . Idiopathic forms of SAA also occur.

Fanconi anemia

This is a rare, inherited disease. Fanconi anemia occurs in 1 in 350,000 children. The disease is most widespread among Ashkenazi Jews and residents of South Africa.

Nutritional anemia

It occurs due to the presence of defects in protein clusters responsible for the DNA repair process. The disease is characterized by high fragility of chromosomes, the presence in patients over 40 years of age myeloid leukemia And aplastic anemia .

Newborns with this disease are characterized by congenital developmental defects, unusual pigmentation, short stature, skeletal development abnormalities and some neurological symptoms (or underdevelopment of one of the eyes, deafness, mental retardation), and abnormal development of internal organs. Unfortunately, on average such patients live no more than 30 years.

Unspecified anemia

The diagnosis of unspecified anemia has a code according to ICD-10 D64.9. This is a primary diagnosis, which is clarified after examination by a doctor, since it is a secondary sign of any underlying disease. First of all, the possibility of blood loss due to injuries, surgical interventions, internal bleeding should be excluded, then laboratory diagnostics are carried out.

Myelodysplastic syndrome

According to international classification ICD-10 for myelodysplastic syndrome:

• D46.0 Refractory anemia without sideroblasts, so designated;
• D46.1 Refractory anemia with sideroblasts;
• D46.2 Refractory anemia with excess blasts;
• D46.3 Refractory anemia with excess blasts with transformation;
• D46.4 Refractory anemia, unspecified;
• D46.7 Other myelodysplastic syndromes;
• D46.9 Myelodysplastic syndrome, unspecified.

Refractory anemia with excess blasts

The prefix “refractory” means the disease is resistant to taking vitamins, iron supplements, and following a diet. Most often, this type of anemia is the most common type myelodysplastic syndrome . Due to disturbances in the maturation processes of blasts in the blood, the hemoglobin content is significantly reduced, and signs appear. Approximately 40% of patients with myelodysplastic syndrome have refractory anemia. Most often, hemoglobinopathy of this kind develops in patients over 50 years of age.

The disease can be considered an intermediate stage between refractory anemia and acute leukemia. As a rule, the disease is manifested by a decrease in hemoglobin levels and general weakness. If the patient has no other reasons for such changes in the blood picture, then the main task of doctors is to further examine the patient and slow down the onset of acute leukemia as much as possible.

Thalassemia

What kind of disease is thalassemia? This is a recessively inherited disease that develops due to a decrease in the synthesis of polypeptide chains in the structure of hemoglobin. Depending on which monomer has ceased to be synthesized normally, they distinguish alpha- , beta thalassemia And delta thalassemia . The disease is also classified according to the degree of clinical manifestations, divided into severe, mild and moderate.

Alpha thalassemia is associated with mutations in genes HBA2 And HBA1. The alpha chain is encoded by four loci and, depending on the number of abnormal ones, different degrees of severity of the disease are distinguished. The symptoms and course of hemoglobinopathy range from mild to severe hypochromic microcytic anemia.

Beta thalassemia exists in two most common variants: minor and CD8(-AA) major (the most severe form of the disease). Anemia develops due to mutations in both beta-globin alleles, when hemoglobin A begins to be replaced by hemoglobin F. Thalassemia minor is usually mild and no treatment is required.

Diamond-Blackfan anemia

According to Wikipedia, Diamond-Blackfan anemia is a hereditary form of red cell aplasia with an unclear mode of inheritance. It is assumed that the disease has an autosomal dominant mode of inheritance, which occurs in one fourth of all patients. Such patients usually exhibit symptoms of anemia during the first year of life, weakness, pallor, increased fatigue, and a decrease in the number of red blood cells in the blood plasma.

Diagnosis is made by complete blood count, erythropoietin levels, microscopy and bone marrow biopsy. The disease is difficult to treat; corticosteroids and blood transfusions are prescribed.

Hemoglobinemia

Causes of anemia

What are the causes of anemia?

There are so many different causes of the disease that some of them can only be identified after laboratory tests. It often happens that hemoglobin levels are normal, but iron is low. The disease can occur with a lack of B vitamins and folic acid. Anemia in humans occurs as a result of various injuries and abundant internal or external bleeding .

What causes anemia, the most common causes of anemia in women

A woman can be diagnosed with this if her hemoglobin level in the blood drops below 120 g per liter. In general, women, due to certain physiological characteristics, have a higher tendency to this disease. Monthly blood loss during menstruation, when a woman can lose up to 100 ml of blood within a week, pregnancy, lactation and decreased concentration ferritin – the most common causes of anemia. The disease often develops due to psychosomatics , when a woman is depressed, she eats poorly, rarely goes out into the fresh air, does not exercise, or during menopause, when global changes occur in a woman’s physiology.

Causes of anemia in men

Symptoms of anemia

Anemia manifests itself in different ways, depending on the specific type of disease. It is known that with anemia in a person, the number of red blood cells decreases, their structure changes, the iron content in the blood changes, and hemoglobin decreases. Human tissues lack oxygen and this affects the general condition and appearance of a person.

Common signs of anemia are as follows:

• significantly reduced performance, general weakness;
• irritability, increased fatigue, severe drowsiness;
• and headaches, spots before the eyes, dizziness;
• dysuria ;
• an irresistible desire to eat chalk or lime;
• constant shortness of breath;
• thin and brittle hair, nails, dry, inelastic skin;
• angina pectoris , low blood pressure;
• tinnitus and frequent fainting;
• change in stool color, jaundice, pallor;
• aches in the body and joints, muscle weakness.

There are also specific symptoms of anemia that are characteristic of a particular type:

• Iron-deficiency anemia. Characteristic for this diagnosis parorexia , the patient has a strong desire to chew chalk, earth, papers and other inedible materials. You can also highlight koilonychia , cracks in the corners of the mouth, sore tongue. Sometimes the temperature may rise to low-grade fever.
• Main symptom B12 deficiency anemia can be called tingling in the limbs, instability of gait, stiffness and tightness in movements, low sense of touch. The patient's cognitive abilities decrease and symptoms may occur. In extremely severe cases, it may develop paranoia or .
• A characteristic symptom sickle cell anemia There may be weakness, paroxysmal pain in the abdominal cavity and joints.
• When poisoned by lead waste, the victim experiences characteristic dark blue lines on the gums, nausea and pain in the abdomen.
• Chronic destruction of red blood cells can be a symptom of a malignant tumor. In this condition, emerging jaundice, ulcers and abrasions on the legs, and redness of the urine develop. Gallstones often form in the gallbladder.

Anemia, differential diagnosis, table

An accurate diagnosis of hemolytic, megaloblastic or aplastic anemia can be made after differential diagnosis. Diff. Diagnosis is carried out using appropriate tables and laboratory results.

Diseases	ZhDA	Chronic inflammatory diseases. Tumors	Thalassemia	Porphyrin metabolism disorder
Criterion	Iron deficiency	Impaired iron recycling	Impaired synthesis of globin chains	Chronic lead intoxication. Shortage vitamin B6
Degree of anemia	any	rarely Hb< 90 г/л	moderate	any
Reticulocyte count	various	usually normal	increased	increased
Average red blood cell volume	demoted	N or reduced	sharply reduced	N
Serum iron	downgraded	downgraded	increased	increased
OZhSS	increased	N or reduced	N	N or reduced
Ferritin	downgraded	N or increased	N	elevated
Iron in bone marrow	absent	present in macrophages	present	present

Symptoms of anemia in adults may also vary depending on gender and age. Often, signs of anemia in women are most pronounced in their psycho-emotional state.

Signs of anemia in adult women:

• general weakness;
• fatigue;
• low ability to work;
• perversion and loss of appetite;
• bad mood and depression.

You can also note the characteristic external signs of anemia, which can be more difficult to recognize in men:

• pale, thin, dry skin;
• haggard appearance;
• trophic changes;
• dull and brittle nails and hair.

Signs of anemia in men:

• muscle weakness;
• trembling of the lower extremities;
• distortion of taste and smell;
• And glossitis ;
• shortness of breath and;
• hypotension etc.

Tests and diagnostics

When visiting a doctor, the specialist must first collect anamnesis and listen to the patient’s complaints. But a diagnosis of “anemia” can only be made after laboratory diagnostics. The doctor must prescribe a general blood test and, if necessary, additional studies depending on the cause. Except low level hemoglobin it is important to determine the number red blood cells , quantity reticulocytes , platelets And leukocytes , their shape and size, percentage of immature blood cells, level, erythrocyte volume distribution width (RDW), mean erythrocyte volume (MCV), mean hemoglobin content in erythrocyte (MCH),

General blood analysis – the main diagnostic method. Next, a series of specific tests are prescribed: ferritin, serum iron, total iron-binding capacity of serum, transferrin. Such additional studies can help diagnose the disease before its clinical manifestations appear.

Blood test results for aplastic anemia show low levels of red blood cells and hemoglobin, normal or increased mean erythrocyte volume, few platelets and increased ESR, low reticulocyte levels. To assess the condition of the bone marrow, it is further recommended to perform a sternal puncture or trepanobiopsy.

For diagnostics B12 deficiency anemia Most often, a general blood test is sufficient. With B12 deficiency anemia, there is usually a drop in the level of red blood cells, an increase in the average volume to 110-160 µm3, poikilocytosis, reticulopenia and anisocytosis are noted. The ESR will most likely be increased.

When diagnosing hemolytic anemia First of all, they look at the general blood test: low hematocrit, level of red blood cells and hemoglobin, increase in the number of reticulocytes. Biochemical blood test shows high indirect bilirubin, ferritin and iron, drop haptoglobin . Significantly elevated in urinalysis urobilinogen .

Despite the fact that the term “hypochromia” in a general blood test is somewhat outdated, the color of red blood cells usually indicates the iron content in the red blood cell and the body as a whole. For the color indicator of blood, numerical parameters were introduced, so normochromia they say if the amount of iron ranges from 0.8 to 1.15 g per liter, hypochromia – when the content is below 0.8 g/l, hyperchromia – if the amount of Fe is above 1.15.

Treatment of anemia

For those who are interested in how to treat anemia, the answer depends on the type of disease. Tactics should be determined by the attending physician depending on the causes of the disease and the type of anemia. However, in any case, you will most likely be prescribed medication. iron supplements . Mild forms are treated at home, strictly following the doctor’s recommendations; severe cases may require hospitalization.

If iron deficiency anemia occurs due to insufficient intake of the microelement from food, then iron tablets or injections are prescribed. After prolonged and heavy blood loss, a blood transfusion or red blood cell transfusion is required. At the same time, it is necessary to eliminate the cause of blood loss.

Treatment pernicious anemia also carried out using tablets. It is necessary to replenish the content and folic acids . Treatment of B12-deficiency anemia is often carried out with vitamin injections, due to impaired absorption of the substance in the intestine.

All other types of disease are treated with specific drugs. Drug treatment of anemia is carried out strictly as prescribed by a specialist. And, unfortunately, for some hereditary diseases there is currently no specific therapy.

For example, treatment hemolytic anemia , regardless of the form, is based on eliminating the influence of hemolyzing factors. Patients are prescribed blood plasma infusions, vitamin therapy, treatment and, immunosuppressants . Also carry out splenectomy .

Which doctor treats anemia?

If alarming symptoms appear, it is recommended to seek help from a specialist. Since anemia is a blood disease, treatment should be hematologist . A referral to a specialized specialist will be given by a regular local doctor or local therapist. The doctor will most likely prescribe a general blood test, a test for iron, vitamin B12 and folic acid.

The doctors

Medicines

What to drink to increase hemoglobin?

In order to enhance the effectiveness of treatment, combination drugs can be prescribed, including various vitamins, amino acids, and ascorbic acid. The best iron supplements for anemia have a prolonged effect and may contain folic acid. Considering the fact that about 10-12% of the active substance is absorbed from the drug, various supplements and vitamins can significantly increase bioavailability. Many tablets have a slow release of iron and this significantly reduces the risk of adverse reactions.

During treatment with such medications you should remember:

• The tablets should be taken exclusively with water. Do not use milk, tea or coffee.
• With caution, medications are combined with calcium supplements, antacids (, ), antibiotics. If it was not possible to avoid this combination, then it is better to use iron injections or space out the intake as much as possible over time.
• Liquid medications are recommended for young children. forms.
• Do not take a double dosage of the drug or otherwise violate the instructions for use.
• Some people are worried about what to do if the treatment turns their stool black. This is absolutely normal for therapy of this kind.
• In patients with inflammation and ulcers on the intestinal or stomach mucosa (especially with B12-deficiency anemia), gastroenterological diseases may worsen. In this case, treatment should be carried out strictly under the supervision of the attending physician, taking into account the risk-benefit ratio. The dosage of the medication is reduced or injections are prescribed.

List of iron-containing drugs for anemia

The best iron supplements:

• Ferlatum Foul
• Ferro-Folgamma

The medications are well suited for adults without underlying chronic diseases.

Names of iron supplements in Russia for pregnant women:

• Maltofer
• Totema

List of drugs for children:

• Maltofer Fall
• Ferrum Lek

The medicine is also very popular Totema , reviews of which are usually very good.

Trade names of the drug	Price range (Russia, rub.)	Features of the drug that are important for the patient to know about
iron sulfate + serine
(Teva, Ratiopharm)	50 – 390	The α-amino acid included in the drug for anemia stimulates more efficient absorption of iron. There is lek for children and newborns. shape - drops. For children from 2 to 6 years old - syrup; from 6 years of age you can take capsules.
iron protein succinylate
(Italpharmaco)	460 – 780	The medicine is produced in the form of a solution for internal use. As part of the drug, ferric iron is surrounded by a special protein carrier so as not to harm the gastric mucosa. The medicine can be prescribed even to newborn children.
iron sulfate		Slow-release iron tablets. Applicable only from 12 years of age.
(GlaxoSmithKline)	60 – 130
iron sulfate + ascorbic acid
(Aegis, Astra Zeneca)	240 – 370
ferric hydroxide polymaltosate
(Vifor), (Lek d.d.)	250 – 320	The medicine contains ferric iron with a special complex, which will greatly reduce the risk of adverse reactions from the digestive tract. For children, the drug is usually prescribed in the form of syrup or drops. Drops are better suited for premature babies and infants. For children over 12 years old - syrup.

Procedures and operations

If necessary, they can assign physiotherapy , visiting a sauna or bath. In severe cases, with a malignant course of the disease, bone marrow transplants are performed.

Treatment of anemia with folk remedies at home

Treatment at home for mild forms of anemia involves turning to traditional medicine recipes.

Various procedures can also be very effective folk remedies:

• drinking hydrotherapy with mineral water;
• herbal treatment;
• swimming pool, sauna and other wellness treatments;
• Nordic walking;
• conducting physiotherapy with the help of;
• coniferous, salt, bischofite, iodine-bromine baths;
• collar area massage and foot massage.

How to treat anemia in adults using herbs and settings?

It may be quite effective, including for older people. chicory drink with milk. Add a spoonful of ground chicory to a glass of medium-fat milk and take it three times a day.

Treatment of anemia in women does not differ significantly from the treatment tactics in men. Patients are prescribed vitamins, iron supplements, procedures, and the body requires special support during menstruation or menopause.

Treatment of anemia in pregnant women is carried out under the supervision of the attending physician using the recommended medications listed above. If we talk about the treatment of anemia in pregnant women, we can recommend the following folk recipes:

Rosehip tea with blackcurrant

Strawberry tincture

Another popular recipe for anemia in adults. You need to take fresh or dried strawberry leaves and crushed berries. For one tablespoon of the mixture you need to pour one glass of hot water. Infuse the decoction for 3-4 hours and then strain thoroughly. You need to drink the tincture immediately, one glass, 3 times a day.

You can also make tinctures and decoctions for the treatment of adults and children from the following herbs:

• horsetail;
• stinging nettle;
• series;
• water pepper;
• dandelion;
• viburnum bark;
• burnet;
• medicinal lungwort;
• barberry leaves;
• water pepper;
• viburnum bark;
• shepherd's purse.

Prevention

Prevention of anemia in adults and children includes following these recommendations:

After 60 years, in men, the disease manifests itself due to chronic diseases, heart disease, malfunction of the immune system, tumors, poor ecology, and insufficient nutrition.

Anemia in women

Anemia in women is diagnosed when hemoglobin levels are below 120 g/l (or 110 g/l during pregnancy). Physiologically, women are more prone to developing anemia.

Why is it dangerous for women?

Every month during menstruation, a woman’s body loses a lot red blood cells . On average, the volume of blood loss is about 40-50 ml, but with fairly heavy menstruation, the number of discharges can reach 100 or more ml in 5-7 days. Just a few months in this mode will lead to the development of an anemic state.

There is also another hidden form of the disease. It is quite common (up to 20%). This type of anemia occurs due to a drop in concentration ferritin , a protein that replenishes the storage function of iron in the blood and releases it when hemoglobin levels decrease.

Anemia in children

This is a very common disease in children of all ages. In approximately 40% of cases, this diagnosis is made in children under the age of 3 years, 30% in adolescence, and the rest in other periods of life. The fact is that the mechanism of hematopoiesis at this age has not yet been adjusted and is actively influenced by even the most insignificant factors. Affects the child's condition and active growth, which requires a large amount of nutrients.

Premature birth can lead to anemia in premature babies. In premature infants, the disease can appear either immediately or upon reaching 3 months of age. From birth it is also noted aplastic anemia , Minkowski-Choffar anemia , iron deficiency 1 or 2 degrees, hemolytic anemia .

Signs in children

To accurately diagnose anemia, you need to consult a doctor and, first of all, take a general blood test.

Along with the general signs of anemia, there are also specific symptoms of anemia in children:

• cracks on the palms and soles of the feet;
• frequent colds and gastrointestinal infections;
• the child’s tearfulness, lethargy and drowsiness, poor sleep, fatigue;
• diarrhea, vomiting and nausea;
• Children often complain of headaches and tinnitus.

Treatment of anemia in children

Doctor Komarovsky believes that anemia in infants can be associated with. In children under one year of age, movements are often constrained due to tight swaddling, the child is deprived of freedom of movement, sleeps a lot, and the body slows down the production of red blood cells. It turns out that a lack of physical activity leads to a drop in hemoglobin and the development of anemia in an infant.

There are three degrees of the disease in children:

• if hemoglobin is from 90 to 110 g per liter, then a mild degree is diagnosed;
• if from 70 to 90 g per liter – average;
• An infant with a hemoglobin level below 70 g per liter is diagnosed with severe anemia.

Both in young children and schoolchildren, therapy requires an integrated approach. It is very important to review your diet and daily routine. It is necessary for children to spend a lot of free time outdoors and play outdoor games. It is important to go to bed and get up at the same time.

Your daily diet should include fresh and high-quality foods rich in iron, beans, red meat, organ meats, eggs, cereals, seaweed and dried fruits. It is necessary to enrich the diet with vitamin C, B12 and folic acid. For severe iron deficiency anemia, your doctor will prescribe precisely dosed iron supplements. The reception gives a good effect.

Anemia during pregnancy

It is extremely important for pregnant women to maintain hemoglobin levels at physiological levels. This is why doctors recommend pregnant women to get tested regularly. Anemia during pregnancy is diagnosed if the iron level is reduced to less than 110 g per liter (grade 1). Moreover, the process of blood thinning and a drop in this indicator to 110 is considered normal, as is the fall hematocrit and quantities red blood cells . But, if the value decreases significantly, then they talk about the development of anemia. Many people write entire essays on this topic.

The disease has a code according to ICD-10:

• O00-O99 CLASS XV PREGNANCY, BIRTH AND POSTPARTUM;
• O95-O99 OTHER OBSTETRIC CONDITIONS NOT CLASSIFIED OTHERWISE;
• O99 Other maternal diseases, not classified elsewhere, but complicating pregnancy, childbirth and the puerperium;
• O99.0 Anemia complicating pregnancy, childbirth and the postpartum period.

Mild pregnancy anemia can be diagnosed by hemoglobin at the level of 90-110 g per liter, 2nd degree - from 70 to 90 g per liter, third - below 70 g per liter. Very rarely the figure drops below 70 g/l, because in this condition it is difficult to conceive and bear a child. It should be noted that grade 1 anemia during pregnancy is highly treatable. You just need to strictly follow all the doctor’s instructions, adjust your diet, and after a week, the condition can return to normal.

Characteristic symptoms of anemia during pregnancy, indicating hypoxia :

• fatigue and increased weakness;
• dizziness and headache, tinnitus;
• palpitations and shortness of breath;
• fainting, drowsiness or insomnia.

Signs during pregnancy, anemia associated with iron deficiency:

• jamming, cracking and dry skin;
• cracks, inflamed lip edges, brittle hair;
• severe hair loss.

It should be noted that of all types gestational anemia the most common is iron deficiency . The expectant mother's need for iron increases to 3.5 ml per day, and this is higher than what can be absorbed from food (1.8-2 mg per day). Iron will be actively consumed in the placenta and fetal tissue, which contains many vessels.

Forums for expectant mothers often discuss treatment tactics for this condition, the dangers of anemia for the mother and the possible consequences for the child.

The following consequences of anemia during pregnancy for a child can be identified:

• Insufficient supply of oxygen to the fetus, necessary for normal development, especially of the nervous system.
• Poor health of the mother during pregnancy.
• High probability of premature birth.
• Increased risk of developing postpartum infection .
• The likelihood of bleeding and placental abruption .

Also, women are characterized by anemia after childbirth, when after 1-2 months the blood counts have not returned to normal. In this case, we most often have to talk about iron deficiency anemia . Fatigue and drowsiness, palpitations and shortness of breath, heart failure and distortion of taste in this case do not go away after childbirth. Additional treatment may be needed, especially if the woman lost a lot of blood during childbirth.

Diet, nutrition for anemia

Anyone who is faced with a problem such as anemia is wondering what to eat to increase hemoglobin without pills?

It is known that a properly balanced diet is the main rule of well-being and good health. There is a special , which indicates what foods you should eat if you have anemia in order to quickly normalize your condition.

Ideally, the diet should be balanced, it should contain all the necessary products, but in moderation. You shouldn’t immediately rush to foods rich in iron; it’s important to follow the right combinations of foods.

What to eat to treat and prevent disease?

• Be sure to include one piece (170 g) of lean meat in your diet, which is equivalent to 6 mg of iron. It is recommended to follow the principles of separate nutrition. The best side dish for meat is vegetables and cereals.
• Don't forget about legumes. Beans and peas also make a good side dish.
• Nutritionists do not recommend getting carried away with coffee and tea, especially immediately after meals. Tannin will interfere with the absorption of beneficial microelements. It is better to make yourself weak tea with honey half an hour to an hour after eating.
• Eat a lot of nuts: walnuts, pine, almonds.
• Many vegetables and fruits are excellent sources vitamin C , which will help the iron be absorbed. Be sure to include citrus fruits, garden berries, apples and pineapples, green onions, bell peppers, cabbage, beets, zucchini and carrots in your diet.
• Drink mineral water from sources rich in iron.

Below is a list of iron-containing products that you cannot do without during the course of treatment:

• fresh pomegranate or pomegranate juice;
• rose hip;
• black currant;
• oatmeal and muesli;
• buckwheat porridge;
• strawberries, blackberries or keyberries;
• green salad and onions;
• dried legumes and eggplants;
• bell pepper and garlic;
• green apples;
• plums, plum juice, cranberries and viburnum;
• meat, poultry, dark meat fish;
• cherries and apricots;
• potato;
• spinach;
• grapes and gooseberries;
• various citrus fruits;
• tomatoes and carrots.

Also, nutrition for anemia in women and adult men may involve additional intake of small doses of alcohol. It will be useful to drink about 150 ml of red wine or 45 ml of strong drink at dinner. Don't abuse alcohol! Women can afford 1, and men - 2 servings of alcohol. Otherwise, ethyl alcohol may interfere with the absorption of beneficial microelements.

As for nutrition for anemia in elderly patients, there are no significant differences. It is recommended to prescribe a diet taking into account age needs and lifestyle. If an elderly person has problems chewing food, it is recommended to grind it.

Consequences of anemia and complications

Is it possible to cure anemia forever and what are the consequences of neglecting treatment?

Despite the fact that treatment of the disease in the current realities is quite simple and quick, many are too lazy to seek help in time. Even in large cities, with a powerful diagnostic base, patients often wait until the last minute, until general malaise and pain throughout the body become unbearable. According to the data World Health Organization, in the Russian Federation, every fourth resident, 30% of children and every third woman over 25 years old suffer from this disease. This figure is naturally much higher among older people.

Many people are interested in whether it is possible to die if anemic syndrome is not treated? With improper or delayed treatment, as well as in its absence, the following consequences of anemia may occur in women, men and children:

• Decreased immunity. During illness, not only the number of red blood cells decreases, but also the blood cell count. Ultimately, the body's resistance to infections decreases significantly, the person begins to get sick often and ends up in a vicious circle.
• The patient is plagued by constant fatigue, fatigue and various neurological disorders.
• Problems with the nervous system. Tearfulness and irritability, impaired coordination of movements and attention, memory disorders, decreased level of intellectual development.
• The process involves tissues covering vital organs, especially the cardiovascular and digestive systems. The skin becomes dry and dehydrated, nails and hair become dull and brittle.
• More severe consequences may also occur - swelling of the lower extremities and enlargement of the liver.
• A drop in the number in the blood leads to wear and tear of the heart muscle, it begins to work for two. And in the absence of proper treatment, there is a threat of death.

Is it possible to play sports?

It's no secret that if a person leads a healthy lifestyle and plays sports, then the risk of developing many diseases is significantly reduced. Sports are useful for improving the circulation of oxygen and supplying it to all tissues and organs in the body. However, if hemoglobin has already decreased significantly, then physical activity becomes much more difficult to endure, and the load on the heart and blood vessels increases. Hematologists insist that if organs suffer from hypoxia , then it is better to postpone sports activities. It will be possible to resume training only after normalization of hemoglobin levels.

Complications

Without proper treatment, the consequences of severe anemia may occur:

• Excessive fatigue. Sometimes, the patient can get to such a state that he cannot perform normal daily activities.
• Heart diseases. Developing. The heart is forced to pump large volumes of blood to compensate for the lack of oxygen. As a result, chronic heart failure .
• There are types, for example, particularly neglected or hereditary ones, which can lead to death. Also, large blood loss will lead to the development of acute anemia and can be life-threatening.

Forecast

Almost all types of anemia, provided timely treatment, have an optimistic prognosis. Normalization of the condition occurs within several months.

Survival rate aplastic anemia will depend on various factors:

• on the age of the patient;
• on the degree of inhibition of hematopoietic function;
• on the nature and tolerability of the prescribed treatment.

Life expectancy is higher in patients under 30 years of age, the situation becomes more complicated in severe and super-severe forms of the disease. When prescribing exclusively symptomatic treatment, the probability of surviving a year is no more than 10%. When conducting pathogenetic therapy And TCM , life expectancy increases many times. In some cases, recovery is even possible.

List of sources

• Vorobyov A.I. Guide to hematology. Moscow., “Medicine”. 1985.
• Dvoretsky L.I. Iron deficiency anemia. Moscow., "Newdiamed", 1998, p. 37.
• Abdulkadyrov K. M., Bessmeltsev S. S. Aplastic anemia. - M-SPb.: Science - KN Publishing House. - 1995. - 232 p.
• Hematological diseases in children / Ed. prof. M. P. Pavlova. - Minsk: “Higher School”, 1996. - P. 22-114.
• Shulutko B. I., Makarenko S. V. Standards for diagnosis and treatment of internal diseases. 3rd ed. - SPb.: ECOLOGY BUSINESS INFORMATICS - SPB, 2005.