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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

When it comes to anemia, causes, symptoms are vast, varied

Dr. Alisa Hideg

Anemia is a common condition and you may have heard of pregnant women, children or the elderly being anemic. When I was undergoing chemotherapy, I became anemic, too. This means I did not have enough good red blood cells to carry oxygen from my lungs to my body.

Anemia happens for many reasons. It can be caused by a lack of vitamin B-12, folate (also called folic acid) or iron, important building blocks needed to make red blood cells. Damaged kidneys make less erythropoietin, the hormone that stimulates bone marrow to make red blood cells. Red blood cells last about 120 days, so a healthy, non-anemic person is constantly making new red blood cells. Blood loss or a condition that increases destruction of red blood cells also causes anemia.

Many symptoms of anemia – fatigue, pale skin, fast or irregular heartbeat, shortness of breath, chest pain, dizziness, confusion, cold hands and feet and headache – are also caused by other diseases and conditions. If you suspect anemia, see your health-care provider. Some causes of anemia, such as bleeding from colon cancer or lack of red blood cell production as happens in leukemia, can be life-threatening. If you have some anemia symptoms, your health-care provider may perform a physical exam and order blood tests to look for the cause.

If you are significantly anemic, additional tests may be needed to determine what kind, of the more than 400 types of anemia, you have. All of these anemias can be classified as due to one of three causes: blood loss, decreased or faulty red blood cell production or destruction of red blood cells.

The most common type is iron-deficiency anemia, which can be treated with dietary changes and supplements, as can anemia caused by folate deficiency. Anemia caused by vitamin B-12 deficiency is treated with dietary changes and supplements as well, but if your digestive system cannot absorb vitamin B-12 properly, you may need vitamin B-12 injections periodically.

Treatments for other types of anemia can vary greatly, and treatment for one type may be dangerous if used for another type of anemia, which is why it is so important to see a health care provider about it. When anemia is caused by an underlying disease, that disease must be treated. Some anemias may require steroids, immune suppressants, surgery to stop bleeding, blood transfusions, a bone marrow transplant, injections of erythropoietin, avoidance of certain medications, or some combination of treatments.

Anyone can become anemic, but women of childbearing age, pregnant women, infants and older adults should be especially on the lookout for iron-deficient or vitamin-deficient anemia. Other risk factors for anemia include a poor diet, blood loss from surgery or injury, chronic diseases, long-term infection and family history of anemia.

Eating a healthy, well-balanced diet usually prevents anemia caused by vitamin and iron deficiencies. Make an appointment to be seen by your health care provider if you suspect anemia. No matter what you think the cause might be for your symptoms, it is good to know for certain to ensure any underlying conditions are detected and treated early.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section. Send your comments and column suggestions to drhideg@ghc.org.