| Anemia is the condition where there is too little of | | | | chronically and in excessive amounts can |
| the biologic molecule called hemoglobin in the blood. | | | | adversely affect the marrow, as can certain |
| Hemoglobin contains the iron which carries oxygen | | | | drugs which cause a low red cell manufacturing |
| from the lungs to the tissues and brings carbon | | | | condition called aplastic anemia. Chemotherapy in |
| dioxide back to the lungs. In a healthy red blood | | | | particular can affect the blood producing capacity |
| cell there are approximately 280 million molecules | | | | of the marrow. Lead, which used to be a major |
| of hemoglobin. Each molecule of hemoglobin can | | | | ingredient in paint, affected the marrow in children. |
| carry four molecules of oxygen to the tissues. If | | | | If one has chronic kidney disease, the kidneys do |
| there is too little hemoglobin, or if the hemoglobin | | | | not make enough of the hormone, erythropoietin, |
| is abnormal, the oxygen-carrying function of the | | | | which stimulates the marrow to make red blood |
| blood is decreased. | | | | cells. |
| The laboratory uses different techniques to | | | | The third type of anemia is when the red cells |
| measure the hemoglobin. One technique is to pass | | | | are manufactured with some condition which |
| a small quantity of electricity through a blood | | | | affects their longevity and structure. Sickle cell |
| specimen, and from alterations in the current | | | | anemia is one example of this. It is an inherited |
| flow, it is possible to calculate hemoglobin content. | | | | disease where there is abnormal hemoglobin which |
| In another test, a small pipette of blood is spun | | | | breaks down and literally causes the cells to take |
| down on a centrifuge. The per cent age of the | | | | on a sickle shape. There is abnormal hemoglobin in |
| total blood which is red blood cells is called the | | | | the diseases called thalassemia, where the red |
| hematocrit. Another test is to look at the red cells | | | | cells are likewise abnormal. The spleen acts as a |
| under a microscope to see if they are too big or | | | | filter and removes these abnormal cells from the |
| too small. The amount of iron in the blood can | | | | circulation causing it to become swollen and |
| also be measured. The normal hemoglobin value | | | | tender. When the hemoglobin is released from the |
| would be 13 to 15, and a normal hematocrit would | | | | cells, it taken up by the liver where it is broken |
| be about 36 to 46. Values tend to run a little | | | | down into bilirubin, which it can be measured under |
| higher in men than in women. Also the values tend | | | | these circumstances. |
| to be higher in people with chronic lung disease | | | | The symptoms of anemia depend on several |
| and certain kinds of heart disease. | | | | factors, including how rapidly the blood is lost. |
| If a doctor finds you to be anemic, there are | | | | Under long term circumstances the person might |
| three possible major causes. One is that you are | | | | have some exertional fatigue and perhaps pale |
| losing, or have lost, blood from somewhere. A | | | | conjunctivae inside the eyelids which are normally |
| second possibility is that you are not making | | | | pink. Under acute circumstances the person might |
| enough blood cells. The third possibility is that the | | | | pant, have chest pain, feel like they are going to |
| red blood cells are breaking down somewhere | | | | faint, and have low blood pressure and an |
| within the body. | | | | elevated pulse. Young people are more tolerant of |
| The first category would include rapid blood loss | | | | anemia than older people. |
| such as through an injury or in childbirth. Some | | | | The most common type of anemia is |
| people can lose a lot of blood through a bleeding | | | | iron-deficiency anemia. Once the underlying |
| stomach ulcer. It usually takes a matter of time | | | | condition is corrected which is causing the |
| to replace the fluid in the blood system so that | | | | deficiency, this is easily treated with supplemental |
| measurements of hemoglobin and hematocrit will | | | | iron. If people either take in too little, or are unable |
| be accurate. In these cases an estimate of blood | | | | to absorb vitamin B12, they become anemic |
| loss would guide the necessity of transfusion | | | | (pernicious anemia) and form red cells which are |
| blood to be given. There are other bleeding | | | | too large. The same is largely true for folic acid, |
| processes which are slower, and more accurately | | | | as seen in chronic alcoholics and some vegetarians. |
| reflect in the hemoglobin and hematocrit values. | | | | Once again, treatment becomes replacing the |
| One might be from a colon polyp or colon cancer. | | | | vitamins which are deficient. The diminished |
| Sometimes stomach ulcers can bleed slowly with | | | | amount of erythropoietin in chronic kidney disease |
| the only evidence being black tarry bowel | | | | can be supplemented with shots of this hormone. |
| movement and abnormal labs. Another might be | | | | Of course, in the case of a large and acute blood |
| heavy menstrual periods. Another clue to this | | | | loss; transfusion of red blood cells can be |
| situation is that under these circumstances the | | | | accomplished. |
| red blood cells are made smaller and with less | | | | So, here’s the bottom line. Anemia is an |
| hemoglobin content, which can be seen under a | | | | abnormal condition. However, it is most often a |
| microscope. | | | | sentinel for other underlying medical conditions |
| The second type of anemia is when the body | | | | which need to be diagnosed and treated. Some |
| just doesn’t manufacture enough red blood | | | | are easily treated, some might require surgery, |
| cells. As most people know, the red blood cells | | | | chemotherapy, or such remedies as treatment of |
| are manufactured in the marrow of bones. | | | | chronic kidney disease. A primary care provider |
| Sometimes the marrow can literally be sick. An | | | | should be able to initiate the evaluation and make |
| example of this is called the anemia of chronic | | | | referrals as necessary. One thing is for sure- |
| disease. Sometimes there can be a cancer in the | | | | you’ll feel a lot better when your anemia is |
| marrow which decreases its ability to | | | | successfully treated. |
| manufacture red blood cells. Alcohol when used | | | | |