Anemia is a condition characterized by a decrease in the mass of erythrocytes (red blood cells), a decrease in the value of hemoglobin and a decrease in the value of hematocrit, regardless of the etiology. Hemoglobin is found in erythrocytes and serves as the main transporter of oxygen from the lungs to tissues and organs. When our organs do not receive enough oxygen, they are susceptible to various diseases.

types of anemia

Anemia occurs as a consequence of a disbalance between the synthesis and breakdown of erythrocytes. For this reason, it is necessary to precisely determine the cause of this disorder. It affects 40% of the world’s population, which is an impressive number and is more common in women than men. There are more than 400 types of anemia.

According to the cause and mechanism of anemia, they can be classified into three groups:

  • Anemia caused by reduced erythrocyte production
  • Hemolytic anemias – caused by increased breakdown or loss of red blood cells
  • Anemia due to increased need for erythrocytes. It most often occurs during pregnancy, after childbirth and during breastfeeding, and it can also be present in children who are rapidly developing and growing.

According to the size and shape of erythrocytes and the amount of hemoglobin, anemia is divided into:

  • Macrocytic MCV (mean erythrocyte size> 95fl) – macrocytic anemia is most commonly caused by vitamin B12 or folic acid deficiency. Vitamin B12 or folic acid are important factors in erythrocyte maturation.
  • Microcytic MCV <80FL – the most common cause of microcytic anemia is a lack of iron in the diet or iron deficiency caused by reduced absorption of iron from the digestive tract. Increased need for iron in certain conditions, but also various acute or chronic bleeding can be the cause of microcytic anemia. In addition to iron deficiency, microcytic anemia can be caused by various genetic disorders, as well as some hematological diseases.
  • Normochromic (normocytic) when MCV is 85-95fl, and MCH> 26pg – the cause of this type of anemia is most often certain chronic diseases such as: autoimmune diseases, connective tissue diseases, or kidney diseases. All these types of anemia can be divided into inherited and acquired.

Anemia is sometimes difficult to detect because its early symptoms are very mild. It must not be neglected, because the consequences can be serious. How dangerous it depends on its type, degree, severity and speed of occurrence.

Symptoms of anemia

The symptoms of this condition can vary and most often manifest as:

  • fatigue – drowsiness
  • weakness – rapid fatigue
  • dizziness
  • pallor of the skin and mucous membranes of the lips, gums, conjunctiva, nails and palms
  • rapid heart rate
  • feeling cold, especially around the arms and legs
  • sadness and depression
  • reduction of sexual functions
  • sleep disturbance and decreased appetite

The diagnosis of anemia is made with the help of certain biochemical blood tests. A complete blood count should be done first. The result contains information on the number of erythrocytes (RBC), leukocytes (WBC), platelets (PLT) and the amount of hemoglobin. There is also information on the size, shape, as well as descriptions of the physical characteristics of blood elements. Decreased number of erythrocytes, hemoglobin or hematocrit point to anemia.

Extended diagnostics that will help the doctor determine the type of anemia includes the following biochemical tests:

Blood iron and transferrin binding capacity of iron (TIBC and UIBC). Iron is an integral part of hemoglobin, and hemoglobin is an integral part of erythrocytes. Iron deficiency anemias are the most common form of the condition. The level of iron in the blood oscillates during the day, so the most accurate results are obtained when iron is measured in the morning.

Ferritin, which represents the body’s iron deposits and is an important parameter in monitoring the success of the treatment of anemia. Transferrin (a transport protein that transports iron through the blood and delivers it to cells for use) is also an important parameter.

In certain cases, it is necessary to determine vitamin B12 and FOLIC ACID, which are the basic vitamins necessary for the production of erythrocytes.

In some cases, the doctor may also ask for an analysis of bilirubin and its fraction.

Anemia is treated by acting on the underlying condition that causes this to happen. Depending on the cause, it is necessary to compensate for iron, folic acid, vitamin B12, stop bleeding, or treat the chronic underlying disease. Anemia is often a long-term condition that requires supervision and treatment by an internist – hematologist.

Prim.Vera Cvetkovic

Medical Biochemistry Ph.D