Anaemia occurs when the amount of haemoglobin (found in the red blood cells) drops below normal. Haemoglobin is necessary for the transportation of oxygen throughout the body. There are many different types of anaemia, but we will limit this page to the most common ones.
Iron and Vitamin Deficiencies
Iron deficiency anaemia is the most common of the anaemias and is usually due to bleeding. In women, iron deficiency may be due to heavy menstrual periods, but in older women and in men, the bleeding is usually from disease of the intestines. In children and in pregnant women, the body needs more iron, and iron deficiency may be due simply to not eating enough iron in the diet. Iron deficiency may also result from some extreme diets. Treatment of iron deficiency usually involves iron supplements. In older women and in men, there is usually also some further testing to determine why the person is iron deficient.
Pregnant and nursing women frequently develop this deficiency since the baby requires large amounts of iron for growth. Lack of iron can lead to low birth weight babies and premature delivery. Pre-pregnant and pregnant women are routinely given iron supplements to prevent these complications. Newborns who are nursing from deficient mothers tend to have iron deficiency anaemia as well.
Blood tests may show a normal or low haemoglobin, decreased iron, ferritin, and all red blood cell indices. The total iron-binding capacity (TIBC) or transferrin will be increased. The ferritin test is considered to be the most specific for identifying iron deficiency anaemia.
Vitamin B12 deficiency is less common than iron deficiency and is usually not due to dietary deficiency of vitamin B12. The most common cause is a disease called pernicious anaemia, in which the body stops making a substance (called "intrinsic factor") that is needed to absorb vitamin B12 from the diet. Vitamin B12 deficiency can also cause nerve problems, often causing numbness and tingling that start first in the hands and feet. Haemoglobin is low, but the MCV is increased.
Folic acid deficiency can cause the same pattern of changes in haemoglobin and the red cell indices as seem with vitamin B12 deficiency. Folic acid is found in many foods, especially in green, leafy vegetables. During pregnancy, however, there is an increased need for folic acid so deficiency can develop during this time. This is especially dangerous because a deficiency in folic acid can cause problems in the development of the brain and spinal cord of the baby. Pregnant women usually need folic acid supplements.
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