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Definition of Anemia
Anemia occurs when blood does not have enough red blood cells or when the blood does not have enough hemoglobin. Hemoglobin is the oxygen-carrying pigment found in red blood cells. Anemia can be life-threatening.
Although there are over 400 different forms of anemia. Anemias can also be caused by such conditions as external bleeding, chronic disease, pregnancy, alcoholism,bleeding disorders, infection and hereditary conditions.
Other Causes of Anemia

1. Blood loss: excessive bleeding such as hemorrhages or abnormal menstrual bleeding
2. Chronic illness secondary to refractory anemia: inflammatory GI/GU diseases, malignancies (cancer), arthritis, kidney or liver failure, and acute and chronic infections
3. Cancer therapy: surgery, radiotherapy, chemotherapyand/or immunotherapy
4. Infiltration (replacement) of bone marrow with cancer
5. Hemolysis: Breakdown or destruction of red blood cells
6. Decreased red cell production due to low levels of erythropoietin (a hormone produced by the kidney {90%} and liver {10%}) which promotes red blood cell production

Causes and Risk Factors of Anemia
Iron deficiency anemia
Iron deficiency anemiaarises from too little iron in the body to make sufficient hemoglobin. There are three causes of iron deficiency anemia:
1. Loss of iron at a greater rate than normal (blood loss).
2. Poor absortion of iron from the diet.
3. Eating a low iron diet.
Vitamin B12 anemia
Vitamin B12 anemia is the result of an impaired ability of the digestive tract to absorb the B12 that is a normal part ofdiet. B12 is essential for the production of red blood cells, as well as the maintenance of the nervous system, and is found in food of animal origin such as meat, fish and dairy products. There are four causes.
1. Failure of the stomach lining to produce intrinsic factor.
2. Removal of small intestine where vitamin B12 is absorbed
3. Crohn’s disease - a chronic inflammatory disease thataffects any part of the gastrointestinal tract
4. Eating a vegan diet which excludes eggs, dairy products, meat and fish
Folic acid deficiency
Folic acid deficiency is usually caused by an inadequate intake of folic acid, a vitamin mainly supplied by the fresh green leafy vegetables, mushrooms, lima beans and kidney beans. This disorder is most common in the poor and elderly (due to pooreating habits), in heavy alcohol drinkers, and in persons afflicted with intestinal disorders such as Crohn’s disease or celiac sprue.
Anemia´s Symptoms
The symptoms of iron deficiency anemia (if any) are:
• Paleness
• Weakness
• Tiredness
• Chest pains (in severe cases)
• Shortness of breath (in severe cases)
• Heart palpitations (in severe cases)
• An increased heart rate especiallyduring exertion (in severe cases)
• Rapid breathing
• Low blood pressure
The symptoms of vitamin B12 anemia are similar to those of iron deficiency anemia but can also cause:
• Jaundice
• Numbness and tingling in the hands and feet
• Equilibrium difficulties
• Confusion
• Personality changes and depression
The symptoms of folic acid deficiency are similar to vitamin B12 anemia.Symptoms of anemia may also include:
• Back, maroon or bloody stool
• Abdominal pain
• Weight loss
• Fatigue
• Chest pain

Diagnosis of Anemia
Anemia is diagnosed from the patient's symptoms and by a blood test that measures the level of hemoglobin in the blood, as well as substances such as folic acid, bilirubin and vitamin B12. Additionally, the size of the red cells providefurther clues to the type of anemia.
Other methods of diagnosis may include a bone marrow biopsy, which is the removal of bone marrow for further examination under a microscope.
Bone marrow biopsy is helpful in diagnosing vitamin B12 anemia. Some dietitians suggest that the doctor also check for levels of ferritin in the blood of premenopausal women. Ferritin is a protein that stores iron before...
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