Anemia of the brain. Anemia - how to recognize and overcome it. What causes anemia, the most common causes of anemia in women

Cerebral anemia is characterized by insufficient blood flow to the brain. It occurs in acute and chronic forms.
Etiology. An acute form of anemia of the brain can occur due to severe blood loss or its rapid outflow to other organs (for example, to the abdominal organs after the rapid release of gases, after too rapid delivery, after the release of a large amount of exudate or trasudate from body cavities). In addition, acute weakness of the heart, a decrease in vascular tone with a drop in blood pressure, and sometimes a spasm of cerebral vessels due to any irritation can be the cause. These causes usually create a temporary anemia of the brain.
Chronic anemia of the brain is observed with some blood diseases, such as general anemia, leukemia, infectious anemia, as well as with compression of the vessels of the brain and carotid artery. Sometimes this form of anemia can be the result of some pronounced heart defects, in particular stenosis of the left atrioventricular orifice, stenosis of the port orifice, and insufficiency of the aortic semilunar valves, which cause (especially during work) insufficient blood flow to the brain. On the same basis, anemia of the brain can be with myocarditis, heart block and some other heart diseases.
Symptoms. In severe acute anemia of the brain, oppression, weakness, staggering, dizziness, fainting and convulsions are observed. At the same time, anemic mucous membranes, pupil dilation, sometimes cold sweat, weak and small pulse are noted, in small animals (dogs, cats) often vomiting. Breathing is slowed down or, conversely, speeded up.
In chronic anemia of the brain, the symptoms are similar to those above, but differ in their duration. Seizures and convulsions are rare. Lethargy and weakness prevail. In addition, yawning is often observed.
Forecast. The prognosis depends on the causes of brain anemia. Convulsions are often an unfavorable symptom.
Treatment. With an acute form, it is necessary to give a lower position to the head. Warm compresses are applied to the head. In case of fainting, they resort to stimulants: vigorous rubbing of the skin, inhalation of ammonia or mustard alcohol and vinegar. 20% camphor oil 30.0-60.0 or caffeine solution (5.0 per 20.0 distilled water for large animals) is injected subcutaneously. Useful giving alcohol.
In addition, when fainting, if necessary, they resort to skin irritation with faradization, artificial respiration, irritation of the mucous membranes of the nose, and, finally, intravenous or subcutaneous injections of physiological sodium chloride solution (in the amount of 500.0-1000.0 in a dilution of 0.8-0 85 sodium chloride per 100.0 distilled water) or to copious infusions of water into the rectum. In particular, it is necessary to infuse saline solution with heavy blood loss. A good result is also given by a blood transfusion from another healthy animal donor or intravenous injections of Ringer's solutions - Locke and Tyrode.
Treatment for chronic anemia of the brain consists in the treatment of the underlying disease that is the cause of anemia of the brain, such as heart defects, heart weakness, vascular disease, anemia.

Anemia is a decrease in the amount of hemoglobin in the blood, which is characterized by a low content of fully functioning red blood cells in it. This situation with blood is also called anemia. The possibility of anemia is likely in many cases, as a rule, it is one of the symptoms of various diseases.

Causes and factors

Many factors can contribute to anemia, but the main causes are:

impaired performance of erythrocytes with the help of the bone marrow;
hemolysis - destroyed or shortened vital activity of red blood cells, which on average should last up to 4 months;
severe blood loss.

The first reason is the impaired performance of erythrocytes, which, as a rule, is observed during kidney problems, endocrine system disorders, chronic infectious and oncological diseases, lack of protein substances. Also, the development of anemia is facilitated by a lack of substances in the body that are responsible for the formation of red blood cells. such as: folic acid, vitamin B12, iron, vitamin C, and pyridoxine (in children).

The second reason is hemolysis, during which there is a shortage of red blood cells in the blood. This can happen when a program of self-destruction of red blood cells - erythrocytes - is launched with hormonal changes or a violation of hemoglobin. Often this is observed in a patient with a disease of the spleen.

The third reason is the result of the manifestation of anemia only with severe bleeding with a large loss of blood.

Types of anemia

In medicine, there are six types of anemia:
- a condition of the blood caused by a lack of iron in it. This is observed in women as a result of chronic blood loss or insufficient intake of iron in the body.
pernicious anemia or Addison-Birmer disease - a lack of vitamin B12 in the body, which contributes to the work of the brain and the normal functioning of the nervous system. This kind of anemia develops in people whose stomach cannot recreate certain enzymes needed for the absorption of this vitamin.
sickle cell anemia- a deviation in the body, transmitted hereditarily, in which hemoglobin synthesis is disrupted, and red blood cells acquire a pathological sickle shape. In this case, jaundice and slow blood flow occur.
Spherocytic congenital anemia or Minkowski-Choffard disease - a type of anemia, while the normal appearance of red blood cells from a biconcave disc shape changes to a round one. The result of this deviation of the blood is the development of jaundice, enlargement of the spleen and the possibility of formation of stones in the gallbladder.
aplastic anemia- a violation of the hematopoietic system, it develops as a result of the inability to reproduce red blood cells due to a lack or complete absence of brain tissue that is responsible for this function. This happens when the brain is exposed to radiation.
drug anemia develops as a consequence of taking antimalarial drugs, aspirin and some sulfonamides.

To determine the type of anemia, tests are required. But the most common is iron deficiency, according to statistics, it accounts for about 80% of cases.

Degrees of anemia and their symptoms

There are three degrees of anemia (I-vaya, II-paradise, III-tyaya). The higher the number, the more difficult the situation.
At stage I, the hemoglobin level drops slightly (up to 90 g/l in women and 100 g/l in men) and is not particularly felt due to the state of health. At the same time, rapid fatigue, general weakness, and drowsiness may be felt. Medical intervention is not required, it is enough just to normalize your diet and add more iron-containing foods to your diet (legumes, liver, buckwheat, eggs, oatmeal, chocolate, porcini mushrooms, etc.).
II-paradise degree is already characterized by a large decrease in hemoglobin - up to 70 g / l in women and 80 g / l in men. At the same time, a person suffering from anemia feels regular headaches, due to a slight oxygen starvation of the brain, fatigue and problems of the cardiovascular system (rapid pulse, heart pain). In this case, walks in the fresh air, the use of iron-containing foods and already drugs to increase iron in the blood are recommended.
People suffering from III degree of anemia have a hemoglobin level in the blood below 70 g / l. They feel serious disturbances in the work of the heart, cold and numbness of the extremities, they observe changes in the condition of nails, hair (brittleness, loss), the condition of the skin worsens (becomes pale and flaky). This is already a rather severe form of anemia and requires immediate medical intervention - blood plasma transfusion and maintenance of normal hemoglobin levels with the help of medications.

With anemia, in most cases, it is not a diagnostic method. And visually it is impossible to determine its presence. Although it becomes paler, it can only be seen by a specialist under a microscope.

Ways to treat anemia

Establishing the causes that caused anemia and their elimination
Restriction of iron or folate diet, depending on the cause (due to lack of iron or folic acid)
Drug treatment to raise the level of iron or folic acid in the blood. With iron deficiency anemia, the doctor prescribes internal medications at a dose that the body can absorb per day (100-300 mg); with folic acid deficiency - vitamin B12 is intramuscularly injected into the body.
In order to avoid such a difficult condition, you need to monitor your diet, be outdoors more often, lead an active lifestyle, take preventive measures to infect with worms and avoid contact with chemical toxic substances.

Good day, dear readers!

In this article, we will look at anemia with you, and everything connected with them. So…

What is anemia?

Anemia (anemia)- a special condition characterized by a decrease in the number of red blood cells and hemoglobin in the blood.

Anemia is predominantly not a disease, but a group of clinical and hematological syndromes associated with various pathological conditions and various independent ones. The exception is iron deficiency anemia, which is primarily due to iron deficiency in the body.

The most common causes of anemia are bleeding, deficiency of vitamins B9, B12, increased hemolysis, bone marrow aplasia. Based on this, it can be noted that anemia is mainly observed in women with heavy menstruation, in people who adhere to strict diets, as well as people with chronic diseases such as cancer, hemorrhoids, stomach and duodenal ulcers.

The main symptoms of anemia- increased fatigue, dizziness, during physical exertion, tachycardia, pallor of the skin and visible mucous membranes.

The essence of the treatment of anemia and its prevention is mainly in the additional intake of missing substances in the body involved in the synthesis of red blood cells and hemoglobin.

Development of anemia

Before looking at the underlying mechanisms of anemia, let's briefly review some of the terminology associated with this condition.

Erythrocytes (red blood cells)- circulating in the blood, small elastic cells, round, but at the same time biconcave shape, the diameter of which is 7-10 microns. The formation of red blood cells occurs in the bone marrow of the spine, skull and ribs, in the amount of about 2.4 million every second. The main function of red blood cells is gas exchange, which consists in the delivery of oxygen from the lungs to all other tissues of the body, as well as the reverse transport of carbon dioxide (carbon dioxide - CO2).

Hemoglobin- a complex iron-containing protein found in erythrocytes. Hemoglobin, when combined with oxygen, is delivered by red blood cells through the blood from the lungs to all other tissues, organs, systems, and after the transfer of oxygen, hemoglobin binds to carbon dioxide (CO2), and transports it back to the lungs. Due to the peculiarities of the structure of hemoglobin, a lack of iron in the body directly disrupts the function of the normal supply of oxygen to the body, without which a number of pathological conditions develop.

As you probably already guessed, dear readers, gas exchange is possible only due to the simultaneous involvement of erythrocytes and hemoglobin in this process.

Below are the indicators of the norm of erythrocytes and hemoglobin in the blood:

Doctors note the following mechanisms for the development of anemia:

Violation of the formation of red blood cells and hemoglobin- develops with a lack of iron, folic acid, vitamin B12 in the body, diseases of the bone marrow, the absence of a part of the stomach, an excess of vitamin C, because. ascorbic acid in large doses blocks the action of vitamin B12.

Loss of red blood cells and hemoglobin- occurs due to acute bleeding during injuries and operations, heavy menstruation in women, chronic bleeding in some internal diseases of the digestive system (ulcers and others).

Accelerated destruction of red blood cells, whose normal life expectancy is from 100 to 120 days - occurs when red blood cells are exposed to hemolytic poisons, lead, vinegar, certain drugs (sulfonamides), as well as in certain diseases (hemoglobinopathy, lymphocytic leukemia, cancer, liver cirrhosis).

Spread of anemia

According to the World Health Organization (WHO), anemia is present in a significant part of the world's population - about 1.8 billion people, most of whom are women, which is associated with the characteristics of the female body during the childbearing period.

Of particular difficulty with the timely diagnosis and differentiation of anemia are a large number of provoking factors and several mechanisms for the development of anemia.

Anemia - ICD

ICD-10: D50 - D89.

Symptoms of anemia largely depend on the type of anemia, but the main signs are:

Rapid fatigue, increased drowsiness;
Decreased mental activity, difficulty concentrating;
, the appearance of "flies" before the eyes;
Noise in ears;
Shortness of breath with little physical activity;
Seizures, as well as pain in the heart, similar to;
The presence of functional systolic murmur;
, visible mucous membranes, nail beds;
Loss of appetite, decreased sex drive;
Geophagy - the desire to eat chalk;
Haloz;
Irritability.

Next, consider the specific symptoms of anemia, depending on its type:

Forecast

The prognosis for recovery of anemia in most cases is favorable.

The prognosis is serious in aplastic anemia.

Supplementation with iron, B12 and folic acid is also an excellent preventive method against acute respiratory diseases in children.

Important! Before using folk remedies for the treatment of anemia, consult your doctor!

Garlic. Pour 300 g of purified 1 liter of alcohol squeezed through a garlic press. Put the product in a dark place for infusion, for 3 weeks. Take this folk remedy for anemia, you need 1 teaspoon, 3 times a day.

Vegetable juice. Mix 100 ml each of carrot, beetroot and black radish juice, pour the mixture into an earthenware vessel and place it in a slightly preheated oven for 1 hour. You need to drink cooked stewed juice in 2 tbsp. spoons 3 times a day, 20 minutes before meals, for 2-3 months.

Juice. Mix together 200 ml of pomegranate juice, 100 ml each of carrot, apple and 70 g honey. Juices must be freshly squeezed. You need to take the remedy for 2 tbsp. spoons, 3 times a day, in a slightly warmed form. Store the mixture in a sealed container in the refrigerator.

Diet. The use of foods rich in iron, vitamins B9 and B12 is also an excellent tool in the treatment of anemia, of which pistachios, walnuts, seaweed, pomegranate, pears, apples, beets, carrots, tomatoes, greens, buckwheat and cereal cereals can be distinguished .

Prevention of anemia includes the following recommendations:

Anemia - video

A clear sign of anemia is pale skin. A common cause of anemia is a lack of iron in the human body, which can be caused by frequent blood loss. In more detail what it is, what are the symptoms, types and methods of treating anemia, later in the article.

What is anemia

Anemia is a clinical and hematological syndrome, which is characterized by a decrease in the concentration of hemoglobin in the blood, with a decrease in the number of red blood cells.

Anemia weakens the body's ability to exchange gases; by reducing the number of red blood cells, the transport of oxygen and carbon dioxide is disrupted. As a result, a person may experience such signs of anemia as a feeling of constant fatigue, loss of strength, drowsiness, and increased irritability.

Severe forms of anemia due to tissue hypoxia can lead to serious complications, such as shock conditions (eg, hemorrhagic shock), hypotension, coronary or pulmonary insufficiency.

Hemoglobin indicators within the permissible norm:

The reasons

Anemia is based on:

Decrease in the amount of hemoglobin;
Decrease in the number of red blood cells (occurs in most cases);
Signs of impaired blood supply to tissues and their hypoxia (oxygen starvation).

Anemia is also dangerous because it often develops in combination with diseases that can lead to serious consequences. Such diseases, for example, include various inflammatory and infectious diseases, malignant tumors.

Anemia can also be caused by severe blood loss. A large number of red blood cells can be lost in the blood during prolonged or unnoticed bleeding. Such bleeding often occurs as a result of diseases of the gastrointestinal system, such as ulcers, hemorrhoids, gastritis (inflammation of the stomach) and cancer.

With a lack of oxygen, which is carried by the bloodstream, oxygen starvation can develop. This leads to dystrophy of tissues and organs.

The cause of anemia can be an insufficient amount of iron, vitamin B12 and folic acid in the body, and in rare cases, mainly in children, vitamin C and pyridoxine deficiency. These substances are necessary for the formation of red blood cells in the body.

Symptoms of anemia

Anemia is a dangerous condition. It is insidious, since signs of iron deficiency do not appear immediately. In the initial stages, the body first uses internal reserves and tries to cope with the disease.

The symptoms of anemia are so versatile that they affect almost every functional system of the body. Their severity depends on the degree of decrease in hemoglobin levels.

Therefore, the correct interpretation and comparison of the data available to the patient will make it possible to make the correct diagnosis even during the initial examination. The situation is quite different with the definition of a specific type of anemia and its causes.

According to generally accepted criteria, anemia in men is indicated by:

decrease in hemoglobin from 130 g / l;
the level of erythrocytes is less than 4*1012/l;
hematocrit below 39%.

For women, these indicators are as follows:

hemoglobin below 120 g/l;
erythrocytes less than 3.8*1012 g/l;
hematocrit - 36% and below.

Common symptoms of anemia include:

weakness, a significant decrease in performance;
increased fatigue, irritability, drowsiness for no apparent reason;
headaches, tinnitus, flashing "flies" before the eyes, dizziness;
dysuric disorders;
geophagy (irresistible desire to eat chalk or lime);
trophic disorders of hair, skin, nails;
pain in the region of the heart of the type of angina pectoris;
fainting, tinnitus;
muscle weakness, body aches.

Explain what anemia is, and what its signs in a person can be on the backbone of the condition of the hair. When the concentration of hemoglobin in erythrocytes decreases, hair loss is observed, nails become brittle.

In elderly patients with coronary heart disease, with anemia, there is an increase in angina attacks, even after a little physical exertion.

Symptoms of anemia can develop both gradually and at lightning speed. It all depends on the cause of its occurrence.

Types of anemia

Anemia can be caused by completely different reasons, so it is customary to divide all anemias according to various criteria, including the reasons that cause them.

All types of anemia in humans are divided into:

arising from blood loss - posthemorrhagic (acute and chronic);
developed as a result of a violation of the creation of red blood cells or the construction of hemoglobin: iron deficiency, megaloblastic, sideroblastic, anemia of chronic diseases, aplastic;
caused by increased destruction of red blood cells or hemoglobin - hemolytic.

It is manifested by dizziness, tinnitus, flies before the eyes, shortness of breath, palpitations. Dry skin, pallor are noted, ulcerations, cracks appear in the corners of the mouth. Typical manifestations are fragility and layering of nails, their transverse striation.

Symptoms are dizziness, weakness, fever, sometimes feverish conditions and chills. There is an increase in the spleen (splenomegaly), in some cases the liver.

tingling in the hands and feet,
loss of sensation in limbs
gait disorder,
muscle spasms.

Megaloblastic anemia symptoms, which are associated with oxygen starvation of the body, are accompanied by the following symptoms:

general weakness in the body
dizziness and lethargy
characteristic headaches
shortness of breath and tissue swelling
discomfort throughout the body

The main symptoms of chronic anemia are:

severe weakness;
pain in the region of the heart;
dizziness;
palpitations;
bruises under the eyes;
increased fatigue.

Common symptoms of anemia of all types are:

weakness;
dizziness, "flies" before the eyes;
palpitations, shortness of breath with habitual physical exertion;
one of the main symptoms of anemia is pallor of the skin and mucous membranes;
in the elderly - the occurrence or increase in angina attacks;
a clinical symptom of anemia in women of reproductive age is menstrual irregularities.

Degrees

There are three degrees of severity of anemia - mild, moderate and severe, depending on the content of hemoglobin and red blood cells in the blood. The lower the indicators, the more severe the form of this painful condition will be.

In addition to the severity of the disease, it is customary to distinguish:

relative anemia - more often characteristic during pregnancy or as part of significant blood loss, characterized by an increase in plasma in the blood;
absolute anemia - a noticeable decrease in the number of red blood cells and, as a result, a decrease in hemoglobin.

Complications

The consequences of anemia can be quite serious, in some cases it can even be fatal. Most often, anemia causes such problems:

decreased immunity and, as a result, an increase in ARVI diseases;
the appearance of neurological disorders and even deformations of the nervous system;
swelling of the legs;
enlargement of the liver and spleen;
pathology of the heart and blood vessels, etc.

Diagnostics

Diagnosis of anemia includes several important steps:

Determining the type of anemia, that is, it is necessary to identify the mechanism that causes a decrease in the level of red blood cells and hemoglobin.
Establishing the cause of the disease underlying the anemic syndrome.
Conducting laboratory tests, interpreting the results obtained during the examination.

A comprehensive examination for pathology includes a number of laboratory tests:

General blood analysis. Blood is taken from a finger, the level of hemoglobin is determined.
Complete blood count. This test allows you to determine the average amount of hemoglobin in a blood cell and the number of reticulocytes. This makes it possible to judge the state of the bone marrow.
Blood chemistry. In this case, blood is taken from a vein. This study allows you to determine the content of iron in the blood and the level of bilirubin.
Additional studies, the purpose of which is to study the state of the gastrointestinal tract.

To detect anemia, you need to take a general blood test. The main signs of anemia are deviations in such indicators:

hemoglobin in the blood does not reach 100 g / l;
erythrocytes less than 4*1012/l;
iron content in blood cells is less than 14.3 µmol/l.

If there are such deviations, a more detailed blood test is needed to identify a specific type of anemia.

Treatment of blood anemia

Anemia due to a decrease in red blood cell production that occurs with chronic diseases such as cancer, infections, arthritis, kidney disease, and hypothyroidism is often mild and does not require special treatment. Treatment of the underlying disease should also have a beneficial effect on anemia. In some cases, it may be necessary to cancel drugs that suppress hematopoiesis - antibiotics or other chemotherapeutic agents.

Drugs for anemia should be taken only as directed by a doctor. So, an overdose of iron can lead to constipation, hemorrhoids, stomach ulcers. In a situation where the results of laboratory tests confirm the deficient form of anemia, the patient is prescribed one of the following drugs:

The process of hematopoiesis is most influenced by: minerals:

Treatment should take place exclusively on the recommendation of a doctor, self-medication should not be done, especially during pregnancy, when you can expose the maturing child to additional risks. Only after the examination, the doctor will be able to determine what caused the anemia.

Folk remedies for anemia

Treatment with folk remedies is allowed. However, most folk recipes come down to the simple use of iron-containing vegetables and fruits. Changes in your diet should also be discussed with your doctor. These foods include red meat, legumes, egg yolks, whole grains, and more.

With a strong breakdown, it is useful to take a tablespoon of garlic boiled with honey before meals.
Pour a teaspoon of red clover inflorescences (red clover) into 1 glass of hot water, boil for 5 minutes, strain. Take 1 tablespoon 4-5 times a day.
6 g of dandelion roots and herbs pour a glass of water, boil for 10 minutes, leave for 30 minutes, take a tablespoon 3 times a day before meals.
This recipe is a great combination of taste and health. Every day before meals, eat a small amount of grated carrots with sour cream.
Rosehip, fruits. 5 tablespoons of crushed fruit per 1 liter of water. Boil 10 minutes. Wrap up for the night. Drink like tea at any time of the day with anything. Perfectly cleanses the circulatory system, improves metabolism. The infusion is rich in vitamin "C" and is used for anemia, scurvy, diseases of the kidneys and bladder, diseased liver, as a tonic.
Infusion of rowan fruits is used as a multivitamin remedy for exhaustion and anemia. Pour 2 teaspoons of fruits with 2 cups of boiling water, leave for 1 hour, add sugar to taste and drink 3-4 times a day.
Muesli is an additional source of iron. Morning breakfast with muesli contains biologically active substances that regularly accompany the iron molecules encountered on their way into the body. To improve the taste and value of such a quick breakfast, you can add fruits and nuts to the muesli.

Diet

Judging by the name of the disease, the patient needs correction of iron in the blood. It is necessary to take into account the interaction of iron-containing products with other components.

Useful foods for anemia:

meat, cream, butter - contain amino acids, proteins;
beets, carrots, beans, peas, lentils, corn, tomatoes, fish, liver, oatmeal, apricots, brewer's and baker's yeast - contain trace elements necessary for the process of hematopoiesis;
green vegetables, salads and herbs, breakfast cereals - contains a sufficient amount of folic acid;
water from mineral springs with low-mineralized iron-sulfate-hydrocarbonate-magnesium composition of waters, which contributes to the absorption of iron in ionized form by the body (for example: mineral springs in Uzhgorod);
additionally fortified foods with iron (confectionery, bread, baby food, etc.);
honey - promotes the absorption of iron;
plum juice - contains up to 3 mg of iron in one glass.

The menu is divided into 5 meals.

soft-boiled egg;
black sweet tea;
2 sandwiches with liver pate.

2nd breakfast: apple or pear.

fresh vegetable salad dressed with vegetable oil;
borscht with boiled meat;
a piece of chicken with buckwheat garnish;
rosehip decoction.

Afternoon snack: diluted pomegranate juice.

boiled fish with potatoes;
sweet tea with cookies.

Prevention

Prevention of some types of anemia is quite real. These are, first of all, iron-deficient types. Often such anemia occurs due to a disturbed diet and an unhealthy lifestyle. Therefore, it can be prevented by following the principles:

Healthy lifestyle;
Periodic medical examinations;
Early treatment of chronic pathology;
In order to prevent the development of anemia, iron-rich foods (whole grain bread, beans, green vegetables, lettuce, herbs, red lean meat) should be included in the diet.

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ANEMIA OF THE BRAIN

Treatment. Blood transfusion, the introduction of blood-substituting fluids, caffeine, ephedrine, intravenous 20-30% glucose solution are used. Rubbing the skin with volatile liniment is recommended. In case of fainting, ammonia vapors are inhaled, drugs that stimulate hematopoiesis are prescribed - liver extract, vitamin B 12, iron preparations.

arteries of the brain - see the list of anat. terms.

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Anemia: symptoms and treatment

Blood diseases are not uncommon among the population, but the undisputed leader, of course, is anemia, which can easily be attributed to a polyetiological disease that occurs as a result of the pathogenic effects of external and internal factors on the composition and condition of the blood. What is anemia and why is it dangerous, what are the symptoms of the disease, types and stages, how to treat anemia and prevent its development? In this article, we will try to figure it out!

What is anemia?

Anemia is a clinical and hematological syndrome in which there is a decrease in the concentration of hemoglobin in the blood and the number of red blood cells. In the people, anemia is often called "anemia", because in the presence of this disease, there is a violation of the blood supply to the internal organs, which do not receive enough oxygen for proper and full functioning. Anemia - symptoms and treatment depend on the stage and qualification of the disease. Women and children are much more likely to experience this disease than men. In the lungs, hemoglobin and red blood cells are enriched with oxygen, then, together with the blood flow, they are carried to all organs and tissues of the body.

With the development of anemia, metabolic processes are disturbed, the work of internal organs and systems is disturbed, which do not receive enough nutrients and oxygen.

Causes and types of anemia

There are many reasons that can lead to the development of anemia. As an independent disease, anemia rarely develops. Most often, the trigger for the appearance of this syndrome is various diseases of the internal organs or adverse factors that have affected the composition of the blood. Anemia - the causes can become acquired or genetic diseases: rheumatoid arthritis, systemic lupus erythematosus, kidney failure, chronic infections. Iron deficiency in the body can occur with an improper lifestyle, poor nutrition, large blood loss, excessive physical and psychological stress. Quite often, anemia has a mixed pathogenesis, which greatly complicates differential diagnosis.

Vitamin B12 deficiency is the cause of anemia

In medicine, there are several types of anemia, each of which has its own causes:

Iron deficiency anemia is the most common type of anemia, as it is diagnosed in 90% of patients. This type of anemia can frolic under adverse living conditions, after surgery or injuries in which there was a large loss of blood.

Pernicious anemia - develops against the background of vitamin B12 deficiency. The cause is often a congenital inability of the intestine to absorb vit. B12. In adults, the disease develops with atrophy of the stomach.

Hemolytic anemia - manifests itself as a result of the inability of the brain to produce enough cells. Among the causes of anemia can be identified: heredity, infectious diseases, constant stress, depression. Tumor-like processes in the body, burns, high blood pressure can provoke this type of disease.

Sickle cell anemia is characterized by the death of red blood cells. This condition is caused by genetic defects.

Thalassemia is the most severe form of anemia, which refers to hereditary anemia that occurs against the background of genetic disorders.

Despite a sufficient number of causes of anemia, its types, in any of the cases, the disease should not be left without due attention. In addition, each type of anemia leads to oxygen starvation of internal organs, which significantly impairs their functionality and can lead to irreversible consequences.

Why is anemia dangerous?

Anemia, like any other disease, can cause serious harm to our health. With untimely or poor-quality treatment of any type of anemia, there is a risk of developing oxygen starvation of internal organs and systems that not only do not receive oxygen, but also nutrients. The most formidable complication of anemia is hypoxic coma, in 80% of cases it leads to the death of a person. In addition, people suffering from anemia are at risk for the development of cardiovascular pathologies, as well as respiratory failure. In women with anemia, the menstrual cycle is disrupted, and children become inattentive, irritable, and often get sick.

Disorders in the work of the cardiovascular system in anemia

Stages of development of anemia

Anemia has its own stages of development:

Mild or grade 1 anemia is characterized by a decrease in hemoglobin dog / l. At this stage, there are no symptoms. To increase hemoglobin, it is enough to eat right, consume as many iron-containing foods as possible.

Corrections in nutrition with 1 degree of anemia

The middle or stage 2 anemia is accompanied by a decrease in hemoglobin dog / l. During this period, the symptoms of anemia are quite pronounced. A person feels general weakness, frequent headaches, dizziness. Medications and proper nutrition will help increase hemoglobin.

Chronic fatigue - as a sign of anemia

Severe, or stage 3 - life-threatening. The amount of hemoglobin in the blood is below 70 g / l. At this stage, the patient feels disturbances in the work of the heart, the general condition of the person worsens significantly.

Symptoms of anemia

Clinical signs of anemia are noticeable in the second and third stages of the disease. Common symptoms of anemia are the following conditions:

increased fatigue;
chronic fatigue;
trembling of the limbs;
dizziness;
fainting states;
dryness and pallor of the skin;
persistent shortness of breath, even in the absence of physical exertion;
heartbeat;
distracted attention;
memory loss;
noise in ears;
poor appetite;
circles under the eyes;
"flies" before the eyes.

Paleness and dryness of the skin with anemia

The symptoms of anemia are quite pronounced, but they can also be present in other diseases or disorders. Therefore, if you have signs of anemia, you do not need to diagnose yourself. The only right decision will be to visit a doctor who, after the results of laboratory tests, will be able to confirm or refute your assumptions.

How to define anemia?

A complete blood count will help identify anemia, which will show the number of red blood cells, their size and shape, the presence or absence of immature blood cells. If necessary, the doctor may prescribe additional studies: a biochemical blood test, puncture of the sternum and other studies.

Blood test for anemia

Anemia treatment

It is necessary to treat anemia comprehensively, only then you can achieve the desired result. Mild anemia often does not require medical treatment. The doctor recommends eating more foods that contain iron, proteins and other vitamins and minerals. Drug therapy is prescribed by a doctor only when the type of anemia, cause and severity are clear. Quite often, anemia does not require medical correction, especially when the cause, against which the anemia appeared, is eliminated.

If, nevertheless, the disease requires medical treatment, then the doctor prescribes drugs that will allow the bone marrow to quickly make up for the deficiency of red blood cells and hemoglobin in the blood. These medicines include:

Iron preparations: Fenyuls, Totetema, Sorbifer, Aktiferrin;
Vitamins: vit. B12, folic acid, vitamin B complexes.

Medical treatment of anemia

In more severe cases, when iron supplements do not work, your doctor may prescribe glucocorticoid hormones, erythropoietins, anabolic steroids, chemotherapy drugs, and other drugs that are treated in a hospital. Any type of drug therapy should be combined with proper nutrition and lifestyle. The patient should stop smoking and drinking alcohol.

Folk remedies will help to increase hemoglobin, which in their arsenal have many recipes for increasing the level of hemoglobin in the blood. Consider a few recipes:

Recipe 1. For cooking, you will need 150 ml of fresh aloe juice + 250 g of honey and 350 ml of Cahors wine. Mix everything well and take 1 spoon 3 times a day for 1 month.

Recipe 2. A good effect can be obtained from the following infusion. You will need: rose hips, wild strawberries in equal parts of 10 gr. Pour fruit with boiling water, put in a water bath for 15 minutes, then cool, squeeze and take 1/2 cup 2 times a day.

Recipe 3. Strawberry leaves (2 tablespoons) should be poured with boiling water, drained and taken 3 times a day, 2 tablespoons.

Folk remedies for the treatment of anemia

Treatment of anemia with folk remedies can only serve as an adjunct therapy to the main treatment.

Nutrition for anemia

Important in the treatment of anemia and increasing hemoglobin is food. People diagnosed with anemia need to consume high-calorie foods in sufficient quantities: meat, liver, fish, butter, milk. Cereals should be present in the diet: wheat, rice, buckwheat. Vegetables and fruits must be present in the diet. All food must be fresh, steamed, boiled or baked in the oven. With anemia, it is strictly forbidden to starve or not eat in the morning. A balanced diet, healthy food, will help provide the body with all the necessary substances to increase hemoglobin in the blood.

Nutrition for anemia

Prevention of anemia

Prevention of anemia lies in proper and healthy nutrition. In order to prevent the development of this disease, you need to pay attention to your health in time, treat internal diseases, and lead a healthy lifestyle.

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Anemia of the brain (anemia cerebri)

Anemia of the brain (anemia cerebri) - insufficient blood supply to the brain, accompanied by dysfunction of the central nervous system.

Etiology. The causes may be acute heavy bleeding, atherosclerosis and arteriosclerosis of the cerebral vessels, compression of the cerebral vessels or the main arteries of the head and neck by a tumor of blood diseases, heart defects, myocarditis and other diseases accompanied by acute cardiovascular insufficiency. Thrombosis and embolism of cerebral vessels, cerebral stroke can lead to anemia of the brain.

Symptoms. The acute course of the disease is characterized by the sudden onset of signs of insufficient blood supply to the brain. They observe a shaky gait, a sudden fall to the ground, fainting. The pulse is small, thready, breathing is rapid or slow, intermittent. The mucous membranes are pale, the scalp is cold and moist. Vomiting, excessive sweating, muscle tremors are noted, convulsions are possible. Chronic anemia of the brain is characterized by weakness, fatigue, anemic mucous membranes, decreased visual acuity and hearing, and frequent yawning. Increased muscle tension is accompanied by shortness of breath, palpitations, muscle tremors. Conditioned reflexes fade in dogs and other animals. Dogs become unsuitable for official purposes. Body temperature is within normal limits.

Diagnosis and differential diagnosis. The diagnosis is made on the basis of clinical signs, the results of observation of animals, and the collected anamnesis. It is necessary to exclude acute posthemorrhagic anemia, myoglobinuria, hypomagnesemia, coma of various origins.

Treatment. The success of treatment depends on the possibility of eliminating the etiological factor, restoring impaired blood circulation in the brain. When fainting, the animal is allowed to sniff ammonia, rub it near the ears, in the temporal region, and do a general massage of the body. Inside give diluted ethyl alcohol, wine. To improve cardiac activity and eliminate acute vascular insufficiency of the brain, corglycone, cordiamine, camphor, and caffeine are prescribed. Korglikon is administered intravenously in the form of a 0.06% solution in doses: 4-5 ml for horses; cows 3-8, dogs 0.5-1 ml together with a 40% glucose solution in appropriate doses.

Cordiamin is administered subcutaneously in doses to horses and cattle; pigs 1-4, dogs 0.5-2 ml.

In chronic course, to improve the functioning of the heart and metabolism in the brain, cardiac glycosides, B vitamins, cerebrolysin, aminalon, piracetam are prescribed for a long course. In cases where the cause of the disease is a tumor, a surgical operation is indicated.

Prevention. Prevention of anemia of the brain provides for early diagnosis and treatment of diseases leading to vascular insufficiency (posthemorrhagic anemia, diabetes mellitus, heart defects, cardiomyopathy, etc.). Harnesses for working horses, collars for dogs must be properly adjusted, and excessive exploitation of animals must be prevented.

Anemia. Causes, types, symptoms and treatment

What is anemia?

Anemia classification

According to the mechanism of development

According to the pathogenesis, anemia can develop due to blood loss, impaired formation of red blood cells, or due to their pronounced destruction.

According to the mechanism of development, there are:

anemia due to acute or chronic blood loss;
anemia due to impaired blood formation ( for example, iron deficiency, aplastic, renal anemia, as well as B12 and folate deficiency anemia);
anemia due to increased destruction of red blood cells ( for example, hereditary or autoimmune anemia).

Depending on the level of decrease in hemoglobin, there are three degrees of severity of anemia. Normally, the hemoglobin level in men is 130 - 160 g / l, and in women 120 - 140 g / l.

There are following degrees of severity of anemia:

mild degree, in which there is a decrease in hemoglobin levels relative to the norm to 90 g / l;
the average degree at which the hemoglobin level is 90 - 70 g / l;
severe degree, in which the hemoglobin level is below 70 g / l.

By color index

The color indicator is the degree of saturation of red blood cells with hemoglobin. It is calculated based on the results of a blood test as follows. The number three must be multiplied by the hemoglobin index and divided by the red blood cell index ( the comma is removed).

Classification of anemia by color index:

hypochromic anemia ( weakened color of red blood cells) color index less than 0.8;
normochromic anemia color index is 0.80 - 1.05;
hyperchromic anemia ( erythrocytes are overly stained) color index greater than 1.05.

According to morphological features

With anemia, red blood cells of various sizes can be observed during a blood test. Normally, the diameter of erythrocytes should be from 7.2 to 8.0 microns ( micrometer). Smaller RBCs ( microcytosis) can be observed in iron deficiency anemia. Normal size may be present in posthemorrhagic anemia. Larger size ( macrocytosis), in turn, may indicate anemia associated with a deficiency of vitamin B12 or folic acid.

Classification of anemia by morphological features:

microcytic anemia, in which the diameter of red blood cells is less than 7.0 microns;
normocytic anemia, in which the diameter of red blood cells varies from 7.2 to 8.0 microns;
macrocytic anemia, in which the diameter of red blood cells is more than 8.0 microns;
megalocytic anemia, in which the size of red blood cells is more than 11 microns.

According to the ability of the bone marrow to regenerate

Since the formation of red blood cells occurs in the red bone marrow, the main sign of bone marrow regeneration is an increase in the level of reticulocytes ( erythrocyte precursors) in blood. Also, their level indicates how actively the formation of red blood cells proceeds ( erythropoiesis). Normally, in human blood, the number of reticulocytes should not exceed 1.2% of all red blood cells.

According to the ability of the bone marrow to regenerate, the following forms are distinguished:

regenerative form is characterized by normal bone marrow regeneration ( the number of reticulocytes is 0.5 - 2%);
the hyporegenerative form is characterized by a reduced ability of the bone marrow to regenerate ( the reticulocyte count is below 0.5%);
hyperregenerative form is characterized by a pronounced ability to regenerate ( the number of reticulocytes is more than two percent);
aplastic form is characterized by a sharp suppression of regeneration processes ( the number of reticulocytes is less than 0.2%, or their absence is observed).

Causes of anemia

blood loss (acute or chronic bleeding);
increased destruction of red blood cells (hemolysis);
reduced production of red blood cells.

It should also be noted that depending on the type of anemia, the causes of its occurrence may differ.

Factors affecting the development of anemia

hemoglobinopathies ( a change in the structure of hemoglobin is observed in thalassemia, sickle cell anemia);
Fanconi's anemia develops due to an existing defect in the cluster of proteins that are responsible for DNA repair);
enzymatic defects in erythrocytes;
cytoskeletal defects ( cell scaffold located in the cytoplasm of a cell) erythrocyte;
congenital dyserythropoietic anemia ( characterized by impaired formation of red blood cells);
abetalipoproteinemia or Bassen-Kornzweig syndrome ( characterized by a lack of beta-lipoprotein in the intestinal cells, which leads to impaired absorption of nutrients);
hereditary spherocytosis or Minkowski-Choffard disease ( due to a violation of the cell membrane, erythrocytes take on a spherical shape).

iron deficiency;
vitamin B12 deficiency;
folic acid deficiency;
deficiency of ascorbic acid ( vitamin C);
starvation and malnutrition.

Chronic diseases and neoplasms

kidney disease ( e.g. liver tuberculosis, glomerulonephritis);
liver disease ( e.g. hepatitis, cirrhosis);
diseases of the gastrointestinal tract ( for example, gastric and duodenal ulcers, atrophic gastritis, ulcerative colitis, Crohn's disease);
collagen vascular diseases ( eg, systemic lupus erythematosus, rheumatoid arthritis);
benign and malignant tumors e.g. uterine fibroids, colon polyps, kidney, lung, bowel cancer).

viral diseases ( hepatitis, infectious mononucleosis, cytomegalovirus);

bacterial diseases ( tuberculosis of the lungs or kidneys, leptospirosis, obstructive bronchitis);
protozoal diseases ( malaria, leishmaniasis, toxoplasmosis).

Pesticides and medicines

inorganic arsenic, benzene;
radiation;
cytostatics ( chemotherapy drugs used to treat cancer);
antibiotics;
non-steroidal anti-inflammatory drugs;
antithyroid drugs ( reduce the synthesis of thyroid hormones);
antiepileptic drugs.

Iron-deficiency anemia

Causes of iron deficiency anemia

Violation of the intake of iron in the body

vegetarianism due to the lack of animal proteins ( meat, fish, eggs, dairy products);
socio-economic component ( for example, there is not enough money for good nutrition).

Impaired absorption of iron

Iron absorption occurs at the level of the gastric mucosa, so stomach diseases such as gastritis, peptic ulcer or gastric resection lead to impaired iron absorption.

Increased body's need for iron

pregnancy, including multiple pregnancy;
lactation period;
adolescence ( due to rapid growth);
chronic diseases accompanied by hypoxia ( e.g. chronic bronchitis, heart defects);
chronic suppurative diseases ( eg, chronic abscesses, bronchiectasis, sepsis).

Loss of iron from the body

pulmonary bleeding ( e.g. lung cancer, tuberculosis);
gastrointestinal bleeding ( for example, gastric and duodenal ulcers, gastric cancer, intestinal cancer, varicose veins of the esophagus and rectum, ulcerative colitis, helminthic infestations);
uterine bleeding ( for example, placental abruption, uterine rupture, uterine or cervical cancer, aborted ectopic pregnancy, uterine fibroids);
kidney bleeding ( e.g. kidney cancer, kidney tuberculosis).

Symptoms of iron deficiency anemia

anemic syndrome;
sideropenic syndrome.

Anemia syndrome is characterized by the following symptoms:

severe general weakness;
increased fatigue;
attention deficit;
malaise;
drowsiness;
black stool (with gastrointestinal bleeding);
heartbeat;
dyspnea.

Sideropenic syndrome is characterized by the following symptoms:

taste perversion (for example, patients eat chalk, raw meat);
perversion of smell (for example, patients sniff acetone, gasoline, paints);
brittle, dull, split ends;
white spots appear on the nails;
the skin is pale, the skin is flaky;
cheilitis (bites) may appear in the corners of the mouth.

Also, the patient may complain of the development of cramps in the legs, for example, when climbing stairs.

Diagnosis of iron deficiency anemia

cracks in the corners of the mouth;
"glossy" language;
in severe cases, an increase in the size of the spleen.

In the general blood test, the following changes are observed:

microcytosis (small erythrocytes);
hypochromia of erythrocytes (weak color of erythrocytes);
poikilocytosis (erythrocytes of various forms).

In the biochemical analysis of blood, the following changes are observed:

decrease in the level of ferritin;
serum iron is reduced;
serum iron-binding capacity is increased.

Instrumental research methods

To identify the cause that led to the development of anemia, the following instrumental studies can be prescribed to the patient:

fibrogastroduodenoscopy (for examination of the esophagus, stomach and duodenum);
Ultrasound (for examining the kidneys, liver, female genital organs);
colonoscopy (to examine the large intestine);
computed tomography (for example, to examine the lungs, kidneys);
X-rays of light.

Treatment of iron deficiency anemia

In nutrition, iron is divided into:

heme, which enters the body with products of animal origin;
non-heme, which enters the body with plant products.

It should be noted that heme iron is absorbed in the body much better than non-heme iron.

The amount of iron per hundred milligrams

liver;
beef tongue;
rabbit meat;
turkey;
goose meat;
beef;
fish.

9 mg;
5 mg;
4.4 mg;
4 mg;
3 mg;
2.8 mg;
2.3 mg.

Foods of plant origin

dried mushrooms;
fresh peas;
buckwheat;
Hercules;
fresh mushrooms;
apricots;
pear;
apples;
plums;
sweet cherry;
beet.

35 mg;
11.5 mg;
7.8 mg;
7.8 mg;
5.2 mg;
4.1 mg;
2.3 mg;
2.2 mg;
2.1 mg;
1.8 mg;
1.4 mg.

While dieting, you should also increase your intake of foods containing vitamin C, as well as meat protein (they increase the absorption of iron in the body) and reduce the intake of eggs, salt, caffeine and calcium (they reduce the absorption of iron).

In the treatment of iron deficiency anemia, the patient is prescribed iron supplements in parallel with the diet. These drugs are designed to compensate for iron deficiency in the body. They are available in the form of capsules, dragees, injections, syrups and tablets.

patient's age;
the severity of the disease;
causes of iron deficiency anemia;
based on the results of the analyses.

Iron supplements are taken one hour before a meal or two hours after a meal. These drugs should not be taken with tea or coffee, as iron absorption is reduced, so it is recommended to drink them with water or juice.

Take one gram orally three to four times a day.

Take one tablet daily, in the morning thirty minutes before meals.

Take one tablet one to two times a day.

with severe anemia;
if anemia progresses despite taking doses of iron in the form of tablets, capsules or syrup;
if the patient has diseases of the gastrointestinal tract (for example, gastric and duodenal ulcers, ulcerative colitis, Crohn's disease), since the iron supplement taken may aggravate the existing disease;
before surgical interventions in order to accelerate the saturation of the body with iron;
if the patient has intolerance to iron preparations when they are taken orally.

Surgery

Surgery is performed if the patient has acute or chronic bleeding. So, for example, with gastrointestinal bleeding, fibrogastroduodenoscopy or colonoscopy can be used to identify the area of bleeding and then stop it (for example, a bleeding polyp is removed, a stomach and duodenal ulcer is coagulated). With uterine bleeding, as well as with bleeding in organs located in the abdominal cavity, laparoscopy can be used.

B12 - deficiency anemia

in the red bone marrow to participate in the synthesis of red blood cells;
in the liver, where it is deposited;
to the central nervous system for the synthesis of the myelin sheath (covers the axons of neurons).

Causes of B12 deficiency anemia

insufficient intake of vitamin B12 with food;
violation of the synthesis of internal factor Castle due to, for example, atrophic gastritis, gastric resection, gastric cancer;
intestinal damage, for example, dysbiosis, helminthiasis, intestinal infections;
increased body needs for vitamin B12 (rapid growth, active sports, multiple pregnancy);
violation of vitamin deposition due to cirrhosis of the liver.

Symptoms of B12 deficiency anemia

anemic syndrome;
gastrointestinal syndrome;
neuralgic syndrome.

weakness;
increased fatigue;
headache and dizziness;
skin integuments are pale with an icteric shade ( due to liver damage);
noise in ears;
dyspnea;
heartbeat;
with this anemia, an increase in blood pressure is observed;
tachycardia.

the tongue is shiny, bright red, the patient feels a burning sensation of the tongue;
the presence of ulcers in the oral cavity ( aphthous stomatitis);
loss of appetite or its decrease;
feeling of heaviness in the stomach after eating;
weight loss;
there may be pain in the rectum;
stool disorder constipation);
enlargement of the liver ( hepatomegaly).

These symptoms develop due to atrophic changes in the mucous layer of the oral cavity, stomach and intestines.

feeling of weakness in the legs when walking for a long time or when climbing up);
feeling of numbness and tingling in the limbs;
violation of peripheral sensitivity;
atrophic changes in the muscles of the lower extremities;
convulsions.

Diagnosis of B12 deficiency anemia

decrease in the level of red blood cells and hemoglobin;
hyperchromia (pronounced color of erythrocytes);
macrocytosis (increased size of red blood cells);
poikilocytosis (a different form of red blood cells);
microscopy of erythrocytes reveals Kebot rings and Jolly bodies;
reticulocytes are reduced or normal;
a decrease in the level of white blood cells (leukopenia);
increased levels of lymphocytes (lymphocytosis);
decreased platelet count (thrombocytopenia).

In the biochemical blood test, hyperbilirubinemia is observed, as well as a decrease in the level of vitamin B12.

study of the stomach (fibrogastroduodenoscopy, biopsy);
examination of the intestine (colonoscopy, irrigoscopy);
ultrasound examination of the liver.

These studies help to identify atrophic changes in the mucous membrane of the stomach and intestines, as well as to detect diseases that led to the development of B12-deficiency anemia (for example, malignant tumors, cirrhosis of the liver).

Treatment of B12 deficiency anemia

Diet therapy is prescribed, in which the consumption of foods rich in vitamin B12 is increased.

The amount of vitamin B12 per hundred milligrams

Drug treatment is prescribed to the patient according to the following scheme:

For two weeks, the patient receives 1000 mcg of Cyanocobalamin intramuscularly daily. Within two weeks, the patient's neurological symptoms disappear.
Over the next four to eight weeks, the patient receives 500 mcg daily intramuscularly to saturate the depot of vitamin B12 in the body.
Subsequently, the patient for life receives intramuscular injections once a week, 500 mcg.

During treatment, simultaneously with Cyanocobalamin, the patient may be prescribed folic acid.

folate deficiency anemia

participates in the development of the body in the prenatal period (contributes to the formation of nerve conduction of tissues, the circulatory system of the fetus, prevents the development of some malformations);
participates in the growth of the child (for example, in the first year of life, during puberty);
affects the processes of hematopoiesis;
together with vitamin B12 is involved in DNA synthesis;
prevents the formation of blood clots in the body;
improves the processes of regeneration of organs and tissues;
participates in the renewal of tissues (for example, skin).

Absorption (absorption) of folate in the body is carried out in the duodenum and in the upper part of the small intestine.

Causes of folate deficiency anemia

insufficient intake of folic acid from food;
increased loss of folic acid from the body (for example, with cirrhosis of the liver);
violation of the absorption of folic acid in the small intestine (for example, with celiac disease, when taking certain medications, with chronic alcohol intoxication);
increased body needs for folic acid (for example, during pregnancy, malignant tumors).

Symptoms of folate deficiency anemia

Diagnosis of folate deficiency anemia

hyperchromia;
decrease in the level of red blood cells and hemoglobin;
macrocytosis;
leukopenia;
thrombocytopenia.

In the results of a biochemical blood test, there is a decrease in the level of folic acid (less than 3 mg / ml), as well as an increase in indirect bilirubin.

Treatment of folate deficiency anemia

beef and chicken liver;
pork liver;
heart and kidneys;
fatty cottage cheese and cheese;
cod;
butter;
sour cream;
beef meat;
rabbit meat;
chicken eggs;
chicken;
mutton.

240 mg;
225 mg;
56 mg;
35 mg;
11 mg;
10 mg;
8.5 mg;
7.7 mg;
7 mg;
4.3 mg;
4.1 mg;

asparagus;
peanut;
lentils;
beans;
parsley;
spinach;
walnuts;
Wheat groats;
white fresh mushrooms;
buckwheat and barley groats;
wheat, grain bread;
eggplant;
green onions;
red pepper (sweet);
peas;
tomatoes;
White cabbage;
carrot;
oranges.

262 mg;
240 mg;
180 mg;
160 mg;
117 mg;
80 mg;
77 mg;
40 mg;
40 mg;
32 mg;
30 mg;
18.5 mg;
18 mg;
17 mg;
16 mg;
11 mg;
10 mg;
9 mg;
5 mg.

aplastic anemia

Causes of aplastic anemia

stem cell defect
suppression of hematopoiesis (blood formation);
immune reactions;
lack of factors stimulating hematopoiesis;
not using the hematopoietic tissue of elements important for the body, such as iron and vitamin B12.

There are the following reasons for the development of aplastic anemia:

hereditary factor (for example, Fanconi anemia, Diamond-Blackfan anemia);
drugs (eg, non-steroidal anti-inflammatory drugs, antibiotics, cytostatics);
chemicals (eg inorganic arsenic, benzene);
viral infections (eg, parvovirus infection, human immunodeficiency virus (HIV));
autoimmune diseases (eg, systemic lupus erythematosus);
severe nutritional deficiencies (eg, vitamin B12, folic acid).

It should be noted that in half of the cases the cause of the disease cannot be identified.

Symptoms of aplastic anemia

pallor of the skin and mucous membranes;
headache;
cardiopalmus;
dyspnea;
increased fatigue;
swelling in the legs;
gingival bleeding (due to a decrease in the level of platelets in the blood);
petechial rash (red spots on the skin of small sizes), bruises on the skin;
acute or chronic infections (due to a decrease in the level of leukocytes in the blood);
ulceration of the oropharyngeal zone (the oral mucosa, tongue, cheeks, gums and pharynx are affected);
yellowness of the skin (a symptom of liver damage).

Diagnosis of aplastic anemia

decrease in the number of red blood cells;
decrease in hemoglobin level;
decrease in the number of leukocytes and platelets;
decrease in reticulocytes.

The color index, as well as the concentration of hemoglobin in the erythrocyte, remain normal.

increase in serum iron;
saturation of transferrin (an iron-carrying protein) with iron by 100%;
increased bilirubin;
increased lactate dehydrogenase.

Puncture of the red brain and subsequent histological examination revealed:

underdevelopment of all germs (erythrocyte, granulocytic, lymphocytic, monocytic and macrophage);
replacement of bone marrow with fat (yellow marrow).

Among the instrumental methods of research, the patient can be assigned:

ultrasound examination of parenchymal organs;
electrocardiography (ECG) and echocardiography;
fibrogastroduodenoscopy;
colonoscopy;
CT scan.

Treatment of aplastic anemia

immunosuppressive drugs (eg, cyclosporine, methotrexate);
glucocorticosteroids (for example, methylprednisolone);
antilymphocytic and antiplatelet immunoglobulins;
antimetabolites (eg, fludarabine);
erythropoietin (stimulates the formation of red blood cells and stem cells).

Non-drug treatment includes:

bone marrow transplantation (from a compatible donor);
transfusion of blood components (erythrocytes, platelets);
plasmapheresis (mechanical blood purification);
compliance with the rules of asepsis and antisepsis in order to prevent the development of infection.

Also, in severe cases of aplastic anemia, the patient may need surgical treatment, in which the spleen is removed (splenectomy).

complete remission (attenuation or complete disappearance of symptoms);
partial remission;
clinical improvement;
no effect of treatment.

hemoglobin index more than one hundred grams per liter;
the granulocyte index is more than 1.5 x 10 to the ninth power per liter;
platelet count more than 100 x 10 to the ninth power per liter;

hemoglobin index more than eighty grams per liter;
granulocyte index more than 0.5 x 10 to the ninth power per liter;
platelet count more than 20 x 10 to the ninth power per liter;
no need for blood transfusion.

improvement in blood counts;
reducing the need for blood transfusion for replacement purposes for two months or more.

No therapeutic effect

no improvement in blood counts;
there is a need for a blood transfusion.

Hemolytic anemia

intracellular (for example, autoimmune hemolytic anemia);
intravascular (eg, transfusion of incompatible blood, disseminated intravascular coagulation).

In patients with mild hemolysis, the hemoglobin level may be normal if the production of red blood cells matches the rate of their destruction.

Causes of hemolytic anemia

internal membrane defects of erythrocytes;
defects in the structure and synthesis of hemoglobin protein;
enzymatic defects in the erythrocyte;
hypersplenomegaly (enlargement of the liver and spleen).

Hereditary diseases can cause hemolysis as a result of red blood cell membrane abnormalities, enzymatic defects, and hemoglobin abnormalities.

enzymopathies (anemia, in which there is a lack of an enzyme, a deficiency of glucose-6-phosphate dehydrogenase);
hereditary spherocytosis or Minkowski-Choffard disease (erythrocytes of an irregular spherical shape);
thalassemia (violation of the synthesis of polypeptide chains that are part of the structure of normal hemoglobin);
sickle cell anemia (a change in the structure of hemoglobin leads to the fact that red blood cells take on a sickle shape).

Acquired causes of hemolytic anemia include immune and non-immune disorders.

pesticides (for example, pesticides, benzene);
medicines (eg, antivirals, antibiotics);
physical damage;
infections (eg malaria).

Hemolytic microangiopathic anemia results in the production of fragmented red blood cells and can be caused by:

defective artificial heart valve;
disseminated intravascular coagulation;
hemolytic uremic syndrome;
thrombocytopenic purpura.

Symptoms of hemolytic anemia

pallor of the skin and mucous membranes;
fragility of nails;
tachycardia;
increased respiratory movements;
lowering blood pressure;
yellowness of the skin (due to an increase in the level of bilirubin);
ulcers may appear on the legs;
skin hyperpigmentation;
gastrointestinal manifestations (eg, abdominal pain, stool disturbance, nausea).

It should be noted that with intravascular hemolysis, the patient has an iron deficiency due to chronic hemoglobinuria (the presence of hemoglobin in the urine). Due to oxygen starvation, cardiac function is impaired, which leads to the development of patient symptoms such as weakness, tachycardia, shortness of breath and angina pectoris (with severe anemia). Due to hemoglobinuria, the patient also has dark urine.

Diagnosis of hemolytic anemia

decrease in hemoglobin level;
decrease in the level of red blood cells;
an increase in reticulocytes.

Microscopy of erythrocytes reveals their crescent shape, as well as Cabot rings and Jolly bodies.

Treatment of hemolytic anemia

Folic acid. A prophylactic dose of folic acid is given because active hemolysis can consume folate and subsequently lead to the development of megaloblastosis.
Glucocorticosteroids (for example, Prednisolone) and immunosuppressants (for example, Cyclophosphamide). These groups of drugs are prescribed for autoimmune hemolytic anemia.
RBC transfusion. Washed erythrocytes are individually selected for the patient, as there is a high risk of destruction of the transfused blood.

Splenectomy

Splenectomy may be an initial option in the treatment of some types of hemolytic anemia, such as, for example, hereditary spherocytosis. In other cases, such as autoimmune hemolytic anemia, splenectomy is recommended when other treatments have failed.

In hemolytic anemia, the use of iron preparations is contraindicated in most cases. This is due to the fact that the level of iron in this anemia is not reduced. However, if the patient has persistent hemoglobinuria, then there is a significant loss of iron from the body. Therefore, if an iron deficiency is detected, the patient can be prescribed appropriate treatment.

Posthemorrhagic anemia

Acute blood loss is characterized by the simultaneous loss of a large amount of blood (for example, uterine bleeding, rupture of the tube during an ectopic pregnancy, injury, trauma).
Chronic blood loss is characterized by a long-term gradual loss of blood (for example, bleeding gastric and duodenal ulcers, malignant tumors of the stomach, liver, intestines or lungs, uterine fibroids).

Symptoms of posthemorrhagic anemia

how much blood was lost;
the rate at which blood loss occurs.

Symptoms of posthemorrhagic anemia are:

weakness;
dizziness;
pallor of the skin;
heartbeat;
dyspnea;
nausea, vomiting;
section of hair and fragility of nails;
noise in ears;
flashing flies before the eyes;
thirst.

With acute blood loss, the patient may develop hemorrhagic shock.

Loss of circulating blood volume

hypovolemia ( decrease in circulating blood volume) No;
the patient may feel weak and dizzy;
moderate pallor of the skin;
blood pressure is normal;
pulse 80 - 90 beats per minute;
hemoglobin index is above 90 g/l.

moderate severity of hypovolemia;
pallor of the skin;
weakness;
dizziness;
flashing flies before the eyes;
nausea;
inhibition of reactions e.g. slow speech, movement);
thirst;
blood pressure 100 - 90 millimeters of mercury;
pulse 110 - 120 beats per minute;
hemoglobin index 80 g/l and below.

severe degree of hypovolemia;
impaired consciousness ( decreased attention, incoherent speech, disorientation);
pallor and blue cyanosis) skin;
frequent breathing;
decrease in the amount of diuresis (daily urine);
blood pressure below 60 - 70 millimeters of mercury;
pulse 130 - 140 beats per minute;
hemoglobin index is below 60 g/l.

collapse ( drop in blood pressure below 60 millimeters of mercury, impaired blood supply to vital organs);
fatal outcome.

Diagnosis of posthemorrhagic anemia

complete blood count (erythrocyte and hemoglobin levels are normal or reduced, a decrease in leukocytes, an increase in platelets and reticulocytes);
biochemical analysis of blood (iron-binding capacity of serum is increased, a decrease in iron levels);
feces for occult blood (Gregersen or Weber methods) allows you to reveal the presence of chronic gastrointestinal bleeding (for example, with stomach and duodenal ulcers, with bleeding polyps or intestinal cancer);
feces on the eggs of the worm (the presence of helminths can lead to chronic post-hemorrhagic anemia).

Treatment of posthemorrhagic anemia

erythrocyte mass;
solutions of polyglucin, gelatinol;
five percent solution of albumin;
ten or five percent glucose solution.

With posthemorrhagic anemia, iron preparations are also prescribed, since they have a stimulating effect on hematopoiesis, and also compensate for iron deficiency.

Method of application and dosage

Ferrous sulfate, ascorbic acid.

Take two tablets orally three times a day.

Ferrous sulfate, calcium fructose diphosphate.

Take two tablets three times a day.

Ferrous sulfate, sodium dioctylsulfosuccinate.

Take one to two capsules three times daily.

Also, the patient is advised to monitor nutrition by increasing the intake of protein foods (for example, meat, fish, dairy products) and foods with a high iron content (for example, liver, mushrooms, buckwheat, apricots). Consumption of foods high in fat, in turn, must be reduced.

Anemia during pregnancy

problems with the absorption of iron in the intestine;
severe vomiting due to toxicosis;
multiple pregnancy;
frequent pregnancies.

The risk of developing anemia also increases if a woman has chronic diseases, such as pyelonephritis, hepatitis.

feeling tired;
sleep disorder;
dizziness;
nausea;
dyspnea;
weakness;
fragility of nails and hair, as well as hair loss;
pallor and dryness of the skin;
perversion of taste (for example, the desire to eat chalk, raw meat) and smell (the desire to sniff liquids with pungent odors).

In rare cases, a pregnant woman may experience fainting.

in the first trimester of pregnancy - 15 - 18 mg;
in the second trimester of pregnancy - 20 - 30 mg;
in the third trimester of pregnancy - 33 - 35 mg.

However, it is impossible to eliminate anemia only with the help of a diet, so a woman will additionally need to take iron-containing preparations prescribed by a doctor.

Ferrous sulfate and ascorbic acid.

As a preventive measure for the development of anemia, it is necessary to take one tablet per day. For therapeutic purposes, two tablets should be taken daily in the morning and evening.

In the treatment of iron deficiency anemia, two to three tablets should be taken ( 200 - 300 mg) per day. For prophylactic purposes, the drug is taken one tablet at a time ( 100 mg) in a day.

Ferrous fumarate and folic acid.

It is necessary to take one tablet per day, if indicated, the dose can be increased to two to three tablets per day.

For prophylactic purposes, take the drug, starting from the fourth month of pregnancy, one tablet daily or every other day. For therapeutic purposes, take two tablets a day, morning and evening.

In addition to iron, these preparations may additionally contain ascorbic or folic acid, as well as cysteine, as they contribute to better absorption of iron in the body.

Anemia is considered one of the most common pathological conditions among the world's population. Among the varieties of anemia, there are several main conditions, classifying them according to the causes of anemia:

Iron-deficiency anemia;
hemolytic anemia;
aplastic anemia;
sideroblastic type of anemia;
B12-deficient, resulting from vitamin B12 deficiency;
posthemorrhagic anemia;
sickle cell anemia and other forms.

Approximately every fourth person on the planet, in accordance with the research of specialists, suffers from an iron deficiency form of anemia due to a decrease in the concentration of iron. The danger of this condition is in the erased clinical picture of iron deficiency anemia. Symptoms become pronounced when the level of iron and, accordingly, hemoglobin drops to a critical level.

The risk groups for developing anemia in adults include the following categories of the population:

followers of vegetarian principles of nutrition;
people suffering from blood loss due to physiological causes (heavy menstruation in women), diseases (internal bleeding, severe stages of hemorrhoids, etc.), as well as donors who donate blood and plasma on a regular basis;
pregnant and lactating women;
professional athletes;
patients with chronic or acute forms of certain diseases;
categories of the population experiencing malnutrition or a limited diet.

The most common form of iron deficiency anemia is due to a lack of iron, which in turn can be triggered by one of the following factors:

insufficiency of iron intake with food;
increased need for iron due to situational or individual characteristics (developmental pathologies, dysfunctions, diseases, physiological conditions of pregnancy, lactation, professional activity, etc.);
increased loss of iron.

Mild forms of anemia, as a rule, can be cured by correcting the diet, prescribing vitamin-mineral complexes, and iron-containing preparations. The moderate and severe form of anemia requires the intervention of a specialist and a course of appropriate therapy.

Causes of anemia in men

Anemia in women

Anemia in women is diagnosed when hemoglobin levels are below 120 g / l (or 110 g / l during childbearing). Physiologically, women are more prone to anemia.
With monthly menstrual bleeding, the female body loses red blood cells. The average volume of monthly blood loss is 40-50 ml of blood, however, with heavy menstruation, the amount of discharge can reach up to 100 ml or more over a period of 5-7 days. Several months of such regular blood loss can lead to the development of anemia.
Another form of occult anemia, common among the female population with a high frequency (20% of women), is provoked by a decrease in the concentration of ferritin, a protein that stores iron in the blood and releases it when the hemoglobin level decreases.

Anemia in pregnancy

Anemia in pregnant women occurs under the influence of various factors. The growing fetus removes from the maternal bloodstream substances necessary for development, including iron, vitamin B12, folic acid, necessary for the synthesis of hemoglobin. With insufficient intake of vitamins and minerals with food, violations of its processing, chronic diseases (hepatitis, pyelonephritis), severe toxicosis of the first trimester, as well as with multiple pregnancy, anemia develops in the expectant mother.
Physiological anemia of pregnant women includes hydremia, “thinning” of the blood: in the second half of the gestational period, the volume of the liquid part of the blood increases, which leads to a natural decrease in the concentration of red blood cells and the iron transported by them. This condition is normal and is not a sign of pathological anemia if the hemoglobin level does not fall below 110 g / l or recovers on its own in a short time, and there are no signs of vitamin and microelement deficiency.
Severe anemia in pregnant women threatens with miscarriage, premature birth, toxicosis of the third trimester (preeclampsia, preeclampsia), complications of the delivery process, as well as anemia in the newborn.
The symptoms of anemia in pregnant women include the general clinical picture of anemia (fatigue, drowsiness, irritability, nausea, dizziness, dry skin, brittle hair), as well as perversions of smell and taste (the desire to eat chalk, plaster, clay, raw meat, sniff substances with a sharp smell among household chemicals, building materials, etc.).
Slight anemia of pregnant and lactating women recovers after childbirth and the end of the lactation period. However, with a short interval between repeated births, the process of restoring the body does not have time to complete, which leads to increased signs of anemia, especially pronounced when the interval between births is less than 2 years. The optimal recovery period for the female body is 3-4 years.

Anemia during lactation

According to the research of specialists, lactation anemia is most often diagnosed at a fairly pronounced stage of the disease. The development of anemia is associated with blood loss during delivery and lactation against the background of a hypoallergenic diet of nursing. By itself, the production of breast milk does not contribute to the development of anemia, however, when some important food groups are excluded from the diet, for example, legumes (due to the risk of increased gas formation in the child), dairy and meat products (due to allergic reactions in the infant) the likelihood of developing anemia increases significantly.
The reason for the late diagnosis of postpartum anemia is considered to be a shift in the focus of attention from the state of the mother to the child, especially in the youngest mother. The health features of the baby excite her more than her well-being, and the symptom complex of anemia - dizziness, fatigue, drowsiness, decreased concentration, pallor of the skin - are most often perceived as a result of overwork associated with caring for a newborn.
Another reason for the prevalence of iron deficiency anemia in nursing is associated with the wrong opinion about the effect of iron preparations that penetrate into breast milk on the functioning of the infant's gastrointestinal tract. This opinion is not confirmed by specialists, and, when diagnosing iron deficiency anemia, medicines and vitamin-mineral complexes prescribed by a specialist are mandatory.

Anemia of the menopause

Anemia during the female menopause is quite common. Hormonal restructuring, the consequences of the period of menstruation, gestation, childbirth, various dysfunctional conditions and surgical interventions cause chronic anemia, which is aggravated against the background of menopausal changes in the body.
A provocative role is also played by dietary restrictions, unbalanced diets, which are resorted to by women seeking to reduce the rate of weight gain due to fluctuations in hormonal balance in the premenopausal period and directly during menopause.
By the age of menopause, there is also a decrease in ferritin reserves in the body, which is an additional factor in the development of anemia.
Fluctuations in well-being, fatigue, irritability, dizziness are often perceived as symptoms of menopause, which leads to late diagnosis of anemia.

Anemia of childhood

According to research by the World Health Organization (WHO), 82% of children suffer from anemia of varying severity. Low hemoglobin levels and iron deficiency states of various etiologies lead to impaired mental and physical development of the child. The main causes of anemia in childhood include:

The need for iron differs in children depending on age, and after reaching puberty, it correlates with gender. Therapy of deficient anemia in children with a balanced diet is not always effective, so experts prefer regulation with medications that guarantee the intake of the required dose of trace elements in the child's body.

Anemia in infancy

A newborn baby is born with a certain supply of iron obtained from the mother's body during fetal development. The combination of imperfection of one's own hematopoiesis and rapid physical growth lead to a physiological decrease in the level of hemoglobin in the blood in healthy children born on time by 4-5 months of life, in premature babies - by the age of 3 months.
Artificial and mixed feeding are considered risk factors that increase the likelihood of developing anemia. Hemoglobin deficiency develops especially rapidly when replacing breast milk and / or artificial mixtures with cow's, goat's milk, cereals and other products in the period up to 9-12 months.
Symptoms of anemia in children under one year old include:

pallor of the skin, since the skin is still very thin, there is an increased "transparency", "cyanosis" of the skin;
anxiety, causeless crying;
sleep disorders;
loss of appetite;
hair loss outside the physiological framework of the change of hairline;
frequent regurgitation;
low weight gain;
lagging behind first in physical, then in psycho-emotional development, a decrease in interest, the lack of expression of the revitalization complex, etc.

A feature of children of this age is the ability for high (up to 70%) absorption of iron from food, therefore, not in all cases of anemia, pediatricians see the need for prescribing drugs, limiting themselves to correcting the child’s diet, transferring to full breastfeeding, and selecting a substitute mixture that meets the needs. With a pronounced degree of anemia, iron preparations are prescribed in an age dosage, for example, Ferrum Lek or Maltofer in the form of syrup drops.
When diagnosing a pronounced degree of anemia, the causes may not be in the diet, but in diseases, pathologies and dysfunctions of the child's body. Anemia can also be caused by hereditary diseases, some hereditary developmental disorders and diseases are characterized by a decrease in iron concentration, erythrocytopenia, insufficiency of the hematopoietic system, etc. With persistently low hemoglobin levels, a mandatory examination of children and correction of the primary disease are necessary.

Anemia in preschool children

A large-scale study conducted in 2010 revealed a high incidence of iron deficiency anemia in preschool children: every second child suffers from a lack of hemoglobin due to low iron levels. There may be various factors in the etiology of this phenomenon, but the most common is the consequences of uncorrected anemia in the first year of life.
The second factor that provokes anemia in preschoolers is often combined with the first. An insufficiently balanced diet, a lack of protein (meat products) and vitamins (vegetables) is often explained by the child's reluctance to eat meat and vegetables, preferring semi-finished products and sweets. It is purely a matter of educating and focusing parents on a healthy diet without providing alternative foods from an early age, which also requires the transfer of family members to a rationally formulated diet.
In the case when the nutrition corresponds to age norms, and the child shows signs of anemia (pallor, dry skin, fatigue, decreased appetite, increased fragility of the nail plates, etc.), an examination by a specialist is necessary. Despite the fact that in 9 out of 10 preschool children diagnosed with anemia it is due to iron deficiency, in 10% of anemia the cause is in diseases and pathologies (celiac disease, leukemia, etc.).

Anemia in children of primary school age

The norms of hemoglobin content in the blood in children 7-11 years old are 130 g / l. Manifestations of anemia in this age period increase gradually. The signs of developing anemia include, in addition to symptoms of anemia in preschoolers, decreased concentration, frequent acute respiratory viral and bacterial diseases, increased fatigue, which can affect the results of educational activities.
An important factor in the development of anemia in children attending educational institutions is the lack of control over the diet. In this age period, a sufficient level of iron absorption from food entering the body is still maintained (up to 10%, decreasing by the age of an adult to 3%), therefore, the prevention and correction of the iron deficiency type of anemia is a properly organized meal with dishes rich in vitamins and microelements based on it. .
Hypodynamia, limited stay in the fresh air, preference for games in the house, especially with tablets, smartphones, etc., dictating a long stay in a static position, also provoke anemia.

Anemia of puberty

Adolescence is dangerous for the development of anemia, especially in girls with the onset of menstruation, characterized by a periodic decrease in hemoglobin with blood loss. The second factor that provokes the onset of anemia in adolescent girls is associated with a concentration on one's own appearance, the desire to follow various diets and reduce the daily diet, and the exclusion of products necessary for health.
Rapid growth rates, intensive sports, malnutrition and anemia of the previous period also affect adolescents of both sexes. Symptoms of anemia of adolescence include a blue tint of the sclera of the eyes, a change in the shape of the nails (cup-shaped form of the nail plate), dysfunction of the digestive system, disturbances in taste, smell.
Severe forms of the disease in adolescence require drug therapy. A change in the blood formula is noted, as a rule, not earlier than 10-12 days after the start of the course of treatment, signs of clinical recovery, subject to the specialist's prescriptions, are observed after 6-8 weeks.

Causes of anemia

Anemia is characterized by a decrease in the concentration of hemoglobin and red blood cells in a unit of blood. The main purpose of erythrocytes is participation in gas exchange, transport of oxygen and carbon dioxide, as well as nutrients and metabolic products to cells and tissues for further processing.
The red blood cell is filled with hemoglobin, a protein that gives red blood cells and blood their red color. The composition of hemoglobin includes iron, and therefore its lack in the body causes a high incidence of iron deficiency anemia among all varieties of this condition.
There are three main factors in the development of anemia:

acute or chronic blood loss;
hemolysis, destruction of red blood cells;
decreased production of red blood cells by the bone marrow.

According to the variety of factors and causes, the following types of anemia are distinguished:

The classification of an anemic state is based on various features that describe the etiology, mechanisms of the development of the disease, the stage of anemia, and diagnostic parameters.

Classification according to the severity of the condition

The severity of anemia is based on blood tests and depends on age, gender and physiological period.
Normally, in a healthy adult male, hemoglobin levels are 130-160 g / l of blood, in a woman - from 120 to 140 g / l, during the gestation period from 110 to 130 g / l.
A mild degree is diagnosed when the level of hemoglobin concentration drops to 90 g / l in both sexes, with an average indicator corresponding to the range from 70 to 90 g / l, a severe degree of anemia is characterized by a decrease in hemoglobin levels below the limit of 70 g / l.

Classification of varieties according to the mechanism of state development

In the pathogenesis of anemia, three factors are observed that can act individually or together:

blood loss of an acute or chronic nature;
disorders of the hematopoietic system, production of red blood cells by the bone marrow (iron deficiency, renal, aplastic anemia, deficiency anemia with a lack of vitamin B12 and / or folic acid);
increased destruction of erythrocytes before the end of the functioning period (120 days) due to genetic factors, autoimmune diseases.

Classification by color index

The color indicator serves as an indicator of the saturation of red blood cells with hemoglobin and is calculated using a special formula in the blood test process.
A hypochromic form with a weakened color of erythrocytes is diagnosed with a color index below 0.80.
The normochromic form, with a color index within the normal range, is determined by the range of 0.80-1.05.
The hyperchromic form, with excessive hemoglobin saturation, corresponds to a color index above 1.05.

Classification by morphological feature

The size of red blood cells is an important indicator in diagnosing the cause of anemia. Different sizes of red blood cells may indicate the etiology and pathogenesis of the condition. Normally, red blood cells are produced with a diameter of 7 to 8.2 micrometers. The following varieties are distinguished on the basis of determining the size of the prevailing number of red blood cells in the blood:

microcytic, erythrocyte diameter less than 7 microns, indicates a high probability of iron deficiency;
normocytic variety, the size of red blood cells is from 7 to 8.2 microns. Normocytosis is a sign of the posthemarogic form;
macrocytic, with a red blood cell size of more than 8.2 and less than 11 microns, as a rule, indicates a deficiency of vitamin B12 (pernicious form) or folic acid;
megalocytosis, megalocytic (megaloblastic) form, in which the diameter of erythrocytes is more than 11 microns, corresponds to the severe stages of some forms, disorders in the formation of red blood cells, etc.

Classification based on the assessment of the ability of the bone marrow to regenerate

The degree of erythropoiesis, the ability of the red bone marrow to form erythrocytes, is assessed by the quantitative index of reticulocytes, progenitor cells or "immature" erythrocytes, which is considered the main criterion in assessing the ability of bone marrow tissues to regenerate and is an important factor for predicting the patient's condition and choosing methods of therapy . The normal concentration of reticulocytes is an indicator of 0.5-1.2% of the total number of red blood cells per unit of blood.
Depending on the level of reticulocytes, the following forms are distinguished:

regenerative, indicating the normal ability of the bone marrow to recover. The level of reticulocytes is 0.5-1.2%;
hyporegenerative, with a concentration of immature erythrocytes below 0.5%, which indicates a reduced ability of the bone marrow to self-repair;
hyperregenerative, reticulocyte count more than 2%;
aplastic anemia is diagnosed when the concentration of immature erythrocytes is less than 0.2% among the mass of all red blood cells and is a sign of a sharp suppression of the ability to regenerate.

Iron deficiency anemia (IDA)

The iron deficiency form accounts for up to 90% of all types of anemic conditions. According to research by the World Health Organization, this form affects one in 6 men and every third woman in the world.
Hemoglobin is a complex protein compound containing iron, capable of reversible bonding with oxygen molecules, which is the basis for the process of transporting oxygen from the lungs to body tissues.
The iron deficiency form is hypochromic anemia, with signs of microcytosis, the presence of erythrocytes with a diameter less than normal in the blood formula, which is associated with iron deficiency, the basic element for the formation of hemoglobin, which fills the erythrocyte cavity and gives it a red color.
Iron is a vital trace element involved in many metabolic processes, nutrient metabolism, and gas exchange in the body. During the day, an adult consumes 20-25 mg of iron, while the total supply of this element in the body is about 4 g.

Reasons for the development of IDA

The reasons for the development of this form of the condition include factors of various etiologies.
Iron intake disorders:

unbalanced diet, strict vegetarianism without compensation for iron-containing products, starvation, diets, taking medications, narcotic and other substances that suppress hunger, appetite disorders due to diseases of physical or psycho-emotional etiology;
socio-economic causes of malnutrition, lack of food.

Violations of the process of absorption, assimilation of iron:

diseases of the gastrointestinal tract (gastritis, colitis, gastric ulcer, resection of this organ).

Imbalance of consumption and intake of iron due to increased needs of the body:

pregnancy, lactation;
age of pubertal jumps in physical growth;
chronic diseases that provoke hypoxia (bronchitis, obstructive pulmonary disease, heart defects and other diseases of the cardiovascular system and respiratory organs);
diseases accompanied by purulent-necrotic processes: sepsis, tissue abscesses, bronchiectasis, etc.

Loss of iron by the body, acute or chronic post-hemorrhagic:

with pulmonary bleeding (tuberculosis, tumor formations in the lungs);
with gastrointestinal bleeding accompanying gastric ulcer, duodenal ulcer, cancer of the stomach and intestines, severe erosion of the gastrointestinal mucosa, varicose veins of the esophagus, rectum, hemorrhoids, helminthic invasion of the intestine, ulcerative colitis and others;
with uterine bleeding (heavy menstruation, cancer of the uterus, cervix, fibroids, placental abruption in the gestational period or in childbirth, ectopic pregnancy during exile, birth trauma of the uterus and cervix);
bleeding with localization in the kidneys (tumor formations in the kidneys, tuberculous changes in the kidneys);
bleeding, including internal and hidden, due to injuries, blood loss from burns, frostbite, during planned and emergency surgical interventions, etc.

IDA symptoms

The clinical picture of the iron deficiency form is anemic and sideropenic syndrome, caused primarily by insufficient gas exchange in the tissues of the body.
Symptoms of anemic syndrome include:

general malaise, chronic fatigue;
weakness, inability to endure prolonged physical and mental stress;
attention deficit disorder, difficulty concentrating, rigidity;
irritability;
headache;
dizziness, sometimes fainting;
drowsiness and sleep disturbances;
shortness of breath, rapid heart rate both during physical and / or psycho-emotional stress, and at rest;
black color of the stool (with bleeding of the gastrointestinal tract).

Sideropenic syndrome is characterized by the following manifestations:

perversion of taste preferences, craving for eating chalk, clay, raw meat, etc.;
distortion of smell, desire to sniff paint, household chemicals, substances with a pungent odor (acetone, gasoline, washing powder, etc.);
fragility, dry hair, lack of shine;
white spots on the nail plates of the hands;
dry skin, peeling;
pallor of the skin, sometimes blueness of the sclera;
the presence of cheilitis (cracks, "zayed") in the corners of the lips.

In severe stages of IDA, neurological symptoms are noted: sensations of "goosebumps", numbness of the extremities, difficulty in swallowing, weakening of bladder control, etc.

Diagnosis of IDA

The diagnosis of "iron deficiency anemia" is based on external examination data, evaluation of the results of laboratory blood tests and instrumental examination of the patient.
During an external medical examination and anamnesis, attention is paid to the condition of the skin, mucous surfaces of the mouth, corners of the lips, and the size of the spleen is assessed on palpation.
A general blood test in the classical clinical picture of IDA shows a decrease in the concentration of erythrocytes and hemoglobin relative to age and gender norms, the presence of erythrocytes of different sizes (poikilocytosis), reveals microcytosis, the presence, in severe forms, the predominance of red blood cells with a diameter of less than 7.2 microns, hypochromic , weakly expressed color of erythrocytes, low color index.
The results of a biochemical blood test for IDA have the following indicators:

the concentration of ferritin, a protein that performs the function of an iron depot in the body, is reduced relative to the limits of the norm;
low serum iron;
increased iron-binding capacity of blood serum.

Diagnosis of IDA is not limited to the detection of iron deficiency. For effective correction of the condition after collecting anamnesis, the specialist, if necessary, prescribes instrumental studies in order to clarify the pathogenesis of the disease. Instrumental studies in this case include:

fibrogastroduodenoscopy, examination of the condition of the mucosa of the esophagus, walls of the stomach, duodenum;
ultrasound examination of the liver, kidneys, female reproductive organs;
colonoscopy, examination of the walls of the large intestine;
methods of computed tomography;
x-ray examination of the lungs.

Treatment of anemia of iron deficiency etiology

Depending on the stage and pathogenesis of IDA, therapy is chosen with the help of diet correction, a drug course of treatment, surgical intervention to eliminate the causes of blood loss, or a combination of methods.

Therapeutic diet for iron deficiency

Iron that enters the body with food is divided into heme, animal origin, and non-heme iron of plant origin. The heme variety is much better absorbed and its lack in nutrition, for example, in vegetarians, leads to the development of IDA.
Products recommended for correcting iron deficiency include the following:

heme group in descending order of the amount of iron: beef liver, beef tongue, rabbit meat, turkey meat, goose meat, beef, some varieties of fish;
non-heme group: dried mushrooms, fresh peas, buckwheat, oats and oats, fresh mushrooms, apricots, pears, apples, plums, cherries, beets, etc.

Despite the seemingly high content of iron in vegetables, fruits, products of plant origin when studying the composition, the absorption of iron from them is insignificant, 1-3% of the total volume, especially when compared with products of animal origin. So, when eating beef, the body is able to absorb up to 12% of the necessary element contained in the meat.
When correcting IDA with diet, increase the intake of foods rich in vitamin C and protein (meat) and reduce the intake of eggs, salt, caffeinated drinks and foods rich in calcium due to the effect on the absorption of dietary iron.

Medical therapy

In moderate and severe form, a therapeutic diet is combined with the appointment of drugs that supply iron in an easily digestible form. Medicines differ in the type of compound, dosage, form of release: tablets, dragees, syrups, drops, capsules, injection solutions.
Preparations for oral administration are taken one hour before meals or two hours after due to the peculiarities of iron absorption, while it is not recommended to use caffeinated drinks (tea, coffee) as a liquid that facilitates swallowing, as this impairs the absorption of the element. The interval between doses of drugs should be at least 4 hours. Self-administration of medications can cause side effects from an incorrectly selected form or dosage, as well as iron poisoning.
The dosage of drugs and the form of release is determined by the specialist, focusing on the age, stage of the disease, the causes of the condition, the general clinical picture and the individual characteristics of the patient. Doses may be adjusted during the course of treatment based on the results of intermediate or control blood tests and / or the patient's well-being.
Iron preparations in the course of treatment are taken from 3-4 weeks to several months with periodic monitoring of hemoglobin levels.
Among the preparations-suppliers of iron taken orally, there are medicines with two- and three-valent form of iron. For now, according to research, ferrous iron is considered to be the preferred oral form due to its higher absorption capacity and gentler effect on the stomach.
For children, iron-containing products are produced in the form of drops and syrups, which is caused both by age-related characteristics of taking drugs and a shorter course of therapy than in adults, due to the increased absorption of iron from food. If it is possible to take capsules, dragees and tablets, as well as for long courses, preference should be given to solid forms of medicines containing iron, since liquid ones with prolonged use can have a negative effect on tooth enamel and cause it to darken.
The most popular tablet forms include the following medicines: Ferroplex, Sorbifer, Aktiferrin, Totem (ferrous form of iron) and Maltofer, Ferrostat, Ferrum Lek with ferric iron.
Oral forms are combined with vitamin C (ascorbic acid) at the dosage prescribed by the doctor for better absorption.
Intramuscular and intravenous injections of iron preparations are prescribed in limited situations, such as:

severe stage of anemia;
ineffectiveness of the course of taking oral forms of drugs;
the presence of specific diseases of the gastrointestinal tract, in which oral forms may worsen the patient's condition (with acute gastritis, gastric ulcer, duodenal ulcer, ulcerative colitis, Crohn's disease, etc.);
with individual intolerance to oral forms of iron-containing drugs;
in situations where there is a need for urgent saturation of the body with iron, for example, with significant blood loss due to trauma or before surgery.

The introduction of iron preparations intravenously and intramuscularly can lead to an intolerance reaction, which is why such a course of therapy is carried out exclusively under the supervision of a specialist in a hospital or clinical setting. Side negative consequences of intramuscular administration of iron-containing fluids include the deposition of hemosiderin subcutaneously at the injection site. Dark spots on the skin at the injection sites can persist from one and a half to 5 years.
Iron deficiency anemia responds well to drug therapy, provided that the prescribed dose and duration of treatment are observed. However, if primary serious diseases and disorders lie in the etiology of the condition, therapy will be symptomatic and have a short-term effect.
To eliminate causes such as internal bleeding, with a hemorrhagic form, iron deficiency anemia is treated with surgical methods. Surgical intervention allows you to eliminate the main factor of acute or chronic bleeding, stop blood loss. With internal bleeding of the gastrointestinal tract, fibrogastroduodenoscopy methods or colonoscopy are used to identify the area of bleeding and measures to stop it, for example, cutting off a polyp, coagulating an ulcer.
With internal bleeding of the peritoneal organs and reproductive organs in women, a laparoscopic method of intervention is used.
The methods of emergency treatment include the transfusion of donor erythrocyte mass to quickly restore the level of concentration of erythrocytes and hemoglobin per unit of blood.
Prevention of the iron deficiency form is considered to be a balanced diet and timely diagnostic and therapeutic measures to maintain health.

Anemia due to deficiency of cobalamin or vitamin B12

Deficiency forms are not limited to iron deficiency anemia. Pernicious anemia is a condition that occurs against the background of malabsorption, its insufficient intake, increased consumption, abnormalities in the synthesis of a protective protein, or liver pathologies that prevent the accumulation and storage of cobalamin. In the ptogenesis of this form, a frequent combination with folic acid deficiency is also noted.
Among the reasons for this deficient form are the following:

The clinical picture of vitamin B12 and folic acid deficiency includes anemic, gastrointestinal and neuralgic syndromes.
In particular, the anemic symptom complex with this type of deficiency includes such specific symptoms as icterus of the skin and sclera and increased blood pressure. Other manifestations are typical for IDA: weakness, fatigue, dizziness, shortness of breath, rapid heartbeat (situational), tachycardia, etc.
The manifestations associated with the functioning of the gastrointestinal tract include the following symptoms of atrophy of the mucous membranes of the gastrointestinal tract and oral cavity:

red, "glossy" tongue, often with complaints of a burning sensation on its surface;
phenomena of aphthous stomatitis, ulceration of the mucous surface of the oral cavity;
appetite disorders: decrease up to complete absence;
feeling of heaviness in the stomach after eating;
weight loss of the patient in the immediate history;
violations, difficulties in the process of defecation, constipation, pain in the rectum;
hepatomegaly, enlarged liver.

Neuralgic syndrome with vitamin B12 deficiency consists of the following manifestations:

feeling of weakness in the lower extremities with severe physical exertion;
numbness, tingling, "goosebumps" on the surface of the arms and legs;
decreased peripheral sensitivity;
atrophy of the muscle tissue of the legs;
convulsive manifestations, muscle spasms, etc.

Diagnosis of cobalamin deficiency

Diagnostic measures include a general medical examination of the patient, history taking, laboratory blood tests and, if necessary, instrumental examination methods.
With a general blood test, the following changes are noted:

the level of erythrocytes and hemoglobin levels decreased relative to the limits of the age norm;
hyperchromia, an increase in the color index of the color of erythrocytes;
macrocytosis of erythrocytes, exceeding their size in diameter of more than 8.0 microns;
poikilocytosis, the presence of red blood cells of different sizes;
leukopenia, insufficient concentration of leukocytes;
lymphocytosis, exceeding the limits of the norms of the level of lymphocytes in the blood;
thrombocytopenia, insufficient number of platelets per unit of blood.

Biochemical studies of blood samples reveal hyperbilirubinemia and vitamin B12 deficiency.
To diagnose the presence and severity of atrophy of the mucous membranes of the stomach and intestines, as well as to identify possible primary diseases, instrumental methods of examining patients are used:

fibrogastroduodenoscopy study;
analysis of biopsy material;
colonoscopy;
irrigoscopy;
Ultrasound of the liver.

Treatment Methods

In most cases, B12-deficiency anemia requires hospitalization or treatment in a hospital setting. For therapy, first of all, a diet with foods saturated with cobalamin and folic acid (liver, beef, mackerel, sardines, cod, cheese, etc.) is prescribed, and secondly, drug support is used.
In the presence of neurological symptoms, injections of Cyanocobalamin intramuscularly at an increased dose are prescribed: 1000 mcg daily until the neurological signs of deficiency disappear. In the future, the dosage is reduced, however, with a diagnosis of secondary etiology, the drug is most often prescribed on a lifelong basis.
After discharge from the hospital, the patient is required to undergo regular preventive examinations by a general practitioner, hematologist and gastrologist.

Aplastic anemia: symptoms, causes, diagnosis, treatment

Aplastic anemia can be both congenital and acquired disease, developing under the influence of internal and external factors. The condition itself occurs due to bone marrow hypoplasia, a decrease in the ability to produce blood cells (erythrocytes, leukocytes, platelets, lymphocytes).

Reasons for the development of the aplastic form

In aplastic, hypoplastic forms of anemia, the causes of this condition may be as follows:

stem cell defect
suppression of the process of hematopoiesis (hematopoiesis);
insufficiency of hematopoiesis stimulation factors;
immune, autoimmune reactions;
deficiency of iron, vitamin B12 or their exclusion from the process of hematopoiesis due to dysfunctions of hematopoietic tissues and organs.

The development of disorders that provoke an aplastic or hypoplastic form include the following factors:

hereditary diseases and genetic pathologies;
taking certain medications from the groups of antibiotics, cytostatics, non-steroidal anti-inflammatory drugs;
chemical poisoning (benzenes, arsenic, etc.);
infectious diseases of viral etiology (parvovirus, human immunodeficiency virus);
autoimmune disorders (systemic lupus erythematosus, rheumatoid arthritis);
pronounced deficiencies of cobalamin and folic acid in the diet.

Despite the extensive list of causes of the disease, in 50% of cases the pathogenesis of the aplastic form remains unidentified.

Clinical picture

The severity of pancytopenia, a decrease in the number of basic types of blood cells, determines the severity of symptoms. The clinical picture of the aplastic form includes the following signs:

tachycardia, palpitations;
pallor of the skin, mucous membranes;
headache;
increased fatigue, drowsiness;
shortness of breath
swelling of the lower extremities;
bleeding gums;
petechial rash in the form of small red spots on the skin, a tendency to easy bruising;
frequent acute infections, chronic diseases as a result of a decrease in general immunity and leukocyte insufficiency;
erosion, ulcers on the inner surface of the oral cavity;
yellowness of the skin, sclera of the eyes as a sign of liver damage that has begun.

Diagnostic procedures

To establish the diagnosis, laboratory methods for studying various biological fluids and tissues and instrumental examination are used.
With a general blood test, a reduced number of erythrocytes, hemoglobin, reticulocytes, leukocytes, and platelets is noted, while the color index and hemoglobin content in erythrocytes correspond to the norm. The results of a biochemical study showed an increase in serum iron, bilirubin, lactate dehydrogenase, saturation of transferrin with iron by 100% of the possible.
To clarify the diagnosis, a histological examination of the material removed from the bone marrow during puncture is carried out. As a rule, according to the results of the study, underdevelopment of all sprouts and replacement of the bone marrow with fat are noted.

Treatment of the aplastic form

This type of anemia cannot be treated with dietary modification. First of all, a patient with aplastic anemia is prescribed a selective or combined intake of drugs from the following groups:

immunosuppressants;
glucocorticosteroids;
immunoglobulins of antilymphocytic and antiplatelet action;
antimetabolic drugs;
stimulators of production of erythrocytes by stem cells.

With the ineffectiveness of drug therapy, non-drug methods of treatment are prescribed:

bone marrow transplant;
transfusion of erythrocyte, platelet mass;
plasmapheresis.

Aplastic anemia is accompanied by a decrease in general immunity due to a lack of leukocytes, therefore, in addition to general therapy, an aseptic environment, antiseptic surface treatment, and no contact with carriers of infectious diseases are recommended.
If the above methods of treatment are insufficient, the patient is prescribed a splenectomy operation, removal of the spleen. Since it is in this organ that the breakdown of red blood cells occurs, its removal improves the general condition of the patient and slows down the development of the disease.

Anemia: ways to prevent

The most common form of the disease - iron deficiency anemia - is subject to prevention with a balanced diet with an increase in the amount of iron-containing foods in critical periods. An important factor is also the presence in food of vitamin C, cobalamin (vitamin B12), folic acid.
If you are at risk of developing this form of anemia (vegetarianism, age-related periods of growth, pregnancy, lactation, prematurity in infants, heavy menstrual bleeding, chronic and acute diseases), regular medical examinations, a blood test for quantitative and qualitative indicators of hemoglobin, erythrocytes and additional taking drugs in accordance with the appointment of specialists.