November 27, 2016

Anemia as We Age – Part 1

As we age, anemia can become a fact of life. Many people fail to realize that some types of food plans can promote anemia at any age.

Anemia is often more serious than even many doctors are willing to admit. Three friends of mine had anemia and when taken to the emergency room were treated as having something contagious and were admitted under quarantine while several of us repeatedly asked for them to be checked for anemia.

We were politely ushered out of the hospital after being thoroughly checked and rechecked for the same symptoms the other three had. Yet no one would believe us about anemia until three days later when none of the other symptoms of the disease they were expecting developed. Then they were tested and retested for anemia and severe anemia was determined.

My final thoughts: If you have diabetes, be extra cautious and make sure your doctor does all the tests to determine the correct cause of any anemia diagnosed. Also read my blog about anemia. Another of my blogs on vitamin deficiency anemia can be read here.

The following information on anemia is excerpted from “Anemia in the Older Adult: 10 Common Causes & What to Ask,” originally written and published by Leslie Kernisan, MD, on Better Health While I am reposting this with her permission and am sharing it to educate readers about anemia.

Defining and detecting anemia

Anemia means having a lower-than-normal count of red blood cells circulating in the blood.

Red blood cells are always counted as part of a “Complete Blood Count” (CBC) test, which is a very commonly ordered blood test. To determine your general health status; to screen for, diagnose, or monitor any one of a variety of diseases and conditions that affect blood cells, such as anemia, infection, inflammation, bleeding disorder, or cancer

A CBC test usually includes the following results:
  • White blood cell count (WBCs): the number of white blood cells per microliter of blood
  • Red blood cell count (RBCs): the number of red blood cells per microliter of blood
  • Hemoglobin (Hgb): how many grams of this oxygen-carrying protein per deciliter of blood
  • Hematocrit (Hct): the fraction of blood that is made up of red blood cells
  • Mean corpuscular volume (MCV): the average size of red blood cells
  • Platelet count (Plts): how many platelets (a smaller cell involved in clotting blood) per microliter of blood

(For more information on the CBC test, see this Medline page.)

By convention, to detect anemia clinicians rely on the hemoglobin level and the hematocrit, rather than on the red blood cell count.

A “normal” level of hemoglobin is usually in the range of 14-17gm/dl for men, and 12-15gm/dl for women. However, different laboratories may define the normal range slightly differently.

A hemoglobin level below normal can be used to detect anemia. Clinicians often confirm the lower hemoglobin level by repeating the CBC test.

If clinicians detect anemia, they usually will review the mean corpuscular volume measurement (included in the CBC) to see if the red cells are smaller or bigger than normal. This is because the size of the red blood cells can help point doctors towards the underlying cause of anemia.

Hence anemia is often described as:
  • Microcytic: red cells smaller than normal
  • Normocytic: red cells of a normal size
  • Macrocytic: red cells larger than normal

Symptoms of anemia

The red blood cells in your blood use hemoglobin to carry oxygen from your lungs to every cell in your body. So when a person doesn’t have enough properly functioning red blood cells, the body begins to experience symptoms related to not having enough oxygen.

Common symptoms of anemia are:
  • fatigue
  • weakness
  • shortness of breath
  • high heart rate
  • headaches
  • becoming paler, which is often first seen by checking inside the lower eye lids
  • lower blood pressure (especially if the anemia is caused by bleeding)

However, it’s very common for people to have mild anemia — meaning a hemoglobin level that’s not way below normal — and in this case, symptoms may be barely noticeable or non-existent.

That’s because how bad the symptoms depends on two crucial factors:
  • How far below normal is the hemoglobin level?
  • How quickly did the hemoglobin drop to this level?

This second factor is very important to keep in mind. The human body does somewhat adapt to lower hemoglobin levels, but only if it’s given enough time to do so.

So this means that if someone’s hemoglobin drops from 12.5gm/dL to 10gm/dL (which we’d generally consider a moderate level of anemia), they are likely to feel pretty crummy if this drop happened over a two days, but much less so if it developed slowly over two months.

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