Brain anemia symptoms. Anemia. Causes, types, symptoms and treatment. Causes and complications of anemic syndrome

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

The work of the body is unthinkable without its main transport route - the circulatory system. Through the blood, all the basic substances necessary for life, and, first of all, oxygen, are delivered to organs and tissues. Therefore, any pathology of the blood, including anemia, often leads to life-threatening consequences.

What is anemia in simple words?

Anemia is a lack of blood in the body (from the Greek prefix "an", meaning denial, and "eima" - "blood". Medicine sometimes calls this condition anemia. In a narrower sense, anemia often means an insufficient amount of oxygen in the blood, which practice is expressed in a decrease in the concentration of erythrocytes or hemoglobin in it.

Pseudoanemia (hydremia) should be distinguished from anemia. With hydremia, which can occur, for example, during pregnancy, the total number of red blood cells remains unchanged, only the volume of the liquid component of the blood, the plasma, increases.

Causes of anemia: what causes the disease

It should be noted right away that anemia is not an independent disease. This is a symptom that indicates some other diseases - infectious, inflammatory, oncological, helminthic invasions, pathological childbirth and menstruation, etc.

Anemia is also often the result of an external cause. This may be the wrong diet or irregular meals, massive blood loss due to injury, injury, surgery. No less dangerous and prolonged bleeding of low intensity, which for a long time go unnoticed. This happens with diseases of the gastrointestinal tract and oncological diseases.

Most often, anemia is caused by diseases and conditions such as:

• menses,
• injury,
• stomach ulcer and

Anemia is also possible due to a lack of certain substances in the body, for example, vitamin B12 and folic acid, in children - vitamin C and pyridoxine (vitamin B6). All these substances are necessary for the formation of hemoglobin and red blood cells. Vitamin B12 and folic acid can either be found in insufficient amounts in food or poorly absorbed from food. The latter can occur with alcoholism and drug addiction, chronic diseases of the liver and stomach, taking anticonvulsant drugs.

Anemia can occur in conditions where the body requires an increased amount of iron, and iron is not supplied from the outside:

• lactation,
• adolescence (the body needs a lot of iron for growth),
• chronic diseases (pulmonary diseases, heart defects, abscesses, sepsis).

The following infectious diseases most often lead to anemia:

• tuberculosis,
• chronic,
• bacterial endocarditis,
• bronchiectasis,
• brucellosis,
• lung abscess,
• various mycoses,
• pyelonephritis,
• osteomyelitis.

Anemia also develops with collagenoses of various types:

• systemic lupus erythematosus,
• nodular polyarteritis,
• rheumatoid arthritis.

Often, anemia can develop during pregnancy. After all, the mother's body requires an increased amount of iron for the formation of the fetus, which with a high degree of probability leads to a deficiency of the element. If a woman’s body usually consumes 0.6 mg of iron per day, then during pregnancy this figure rises to 3.5 mg.

The reason for the development of anemia can also be the use of drugs that suppress hematopoiesis, for example, certain antibiotics or cytostatics.

Blood anemia

To understand what anemia is and to understand the essence of the condition, it is necessary to understand the mechanism of oxygen transfer by blood to tissues. To do this, the blood contains special cells - erythrocytes. Their other name is red blood cells, as they are what give the blood its red color. Which should not be surprising, because about 40% of the blood consists of red blood cells.

Each red blood cell contains hemoglobin, a protein that can capture free oxygen. This happens when the red blood cell enters the lungs along with the blood. Having given oxygen to the tissues, the erythrocyte in return receives carbon dioxide and delivers this gas back to the lungs, where it is exhaled out. Red blood cells are synthesized in the bone marrow and live for about three months before being destroyed in the spleen.

Physiological mechanisms responsible for the appearance of symptoms of anemia:

• decrease in the amount of hemoglobin,
• decrease in the number of red blood cells,
• violation of the supply of tissues with blood,
• oxygen starvation of tissues.

Oxygen starvation does not pass without a trace for the body - it leads to the development of dystrophy of tissues and organs. Almost every functional system is affected by this process. At the initial stages, the body tries to fight the pathology by using internal reserves. However, sooner or later they run out.

Varieties

Anemia is very often associated with a lack of hemoglobin or red blood cells. On this basis, there are three types of anemia:

• caused by a reduced ability of the body to synthesize red blood cells or hemoglobin,
• caused by a lack of red blood cells
• caused by accelerated destruction of red blood cells (hemolytic).

Anemia caused by a reduced ability of the hematopoietic system to form hemoglobin or red blood cells is divided into several types:

• iron deficiency,
• megaloblastic,
• sideroblastic,
• aplastic,
• anemia of chronic disease.

Anemia associated with a violation of the synthesis of red blood cells and hemoglobin also includes those caused by a deficiency of vitamin B12 and folic acid. Sometimes this condition is associated with hypervitaminosis of vitamin C, which to a certain extent is an antagonist of vitamin B12.

Pathologies caused by a lack of red blood cells and iron include all posthemorrhagic anemia.

Hemolytic anemias are the result of accelerated destruction of red blood cells. Hemolytic anemia is manifested by the following symptoms:

• hemolytic jaundice;
• elevated levels of bilirubin;
• dizziness;
• weakness;
• fever;
• elevated temperature;
• chills;
• enlargement of the spleen, less often - the liver.

Often, hemolytic anemia develops in newborns due to the Rh conflict between the mother and the newborn.

Also, anemia can be divided into different categories according to the color index (CPI) of the blood. The CPU indicates how saturated the red blood cells are with hemoglobin. The norm of the color index is 0.86-1.1. This rate is the same for both sexes. Based on the value of the CPU, the following types of pathology are distinguished:

• hypochromic appearance (CP<0,86),
• normochromic appearance (CP within normal limits),
• hyperchromic appearance (CP > 1.1).

Hypochromic include iron deficiency anemia and thalassemia. The cause of hypochromic anemia can be lead poisoning (for example, when working in hazardous industries), a lack of vitamin B6, inflammatory diseases that disrupt iron metabolism.

Normochromic include the following types of pathology:

• hemolytic,
• posthemorrhagic,
• neoplastic,
• aplastic,
• caused by cancer,
• caused by a decrease in the production of erythropoietin.

Hyperchromic anemias are caused by deficiency of vitamin B12 and folic acid, as well as myelodysplastic syndrome.

Different types of anemia can often occur simultaneously, such as iron deficiency anemia and folate deficiency.

Aplastic anemia occurs as a result of disorders in the formation of red blood cells in the bone marrow.

Also, anemia is divided into different categories according to such a criterion as the ability of the bone marrow to produce new red blood cells. This ability can be assessed by how saturated the peripheral blood is with young erythrocytes (reticulocytes). The normal indicator of this parameter is 0.5-2%. Depending on the concentration of reticulocytes, anemia is divided into several types:

• regenerative (absence of reticulocytes),
• hyporegenerative (reticulocytes less than 0.5%),
• normoregenerative (reticulocytes within the normal range),
• hyperregenerative (more than 2% reticulocytes).

Aplastic anemia belongs to regenerators. To hyporegenerative - anemia caused by a deficiency of iron and vitamin B12. To normoregenerative - posthemorrhagic anemia. To hyperregenerative - hemolytic anemia.

According to the pathogenetic signs of anemia are divided into:

• iron deficiency,
• dyshemopoietic,
• posthemorrhagic,
• hemolytic,
• megaloblastic,
• folic acid deficiency.

The mechanism of occurrence of various types of pathology

iron deficiency anemia

Iron deficiency anemia accounts for approximately 90% of all cases of this pathology. These conditions often develop after surgery or injury.

Iron is the most important component of red blood cells and is the most difficult for the body to restore this chemical element. In total, the body contains 4.4-5 g of iron. The main consumer of iron in the body is blood and red blood cells. 1 mg is excreted from this volume every day, and the body must somehow make up for the losses.

The most common symptoms of iron deficiency anemia are:

• dizziness,
• noise in ears,
• flashing flies before the eyes,
• dyspnea,
• heartbeat,
• dry skin,
• pallor,
• brittle nails.

sickle cell anemia

There are also rare forms of anemia, such as sickle cell anemia. This is the name of a genetically determined type of anemia, in which red blood cells take on a crescent shape instead of the usual round one. This type of disease is usually manifested by unpleasant symptoms only in conditions of intense physical exertion. Sometimes it may present with jaundice.

Anemia due to vitamin B12 deficiency

This type is not common and is usually due to a decrease in vitamin intake from food. This is often observed with various diets, for example, vegan. Among the symptoms, it should be noted the appearance of abnormally large red blood cells, tingling in the hands and feet, loss of sensation in the limbs, muscle spasms, and gait disturbances.

How does anemia manifest?

Symptoms of anemia largely depend on the type and extent of the disease. In most cases, anemia causes hypoxia. And usually manifestations of anemia are the result of a lack of oxygen in the body.

As a rule, the patient has:

• tachycardia;
• drowsiness without objective reasons or insomnia;
• decrease in working capacity;
• irritability;
• prostration;
• thinning and hair loss;
• dry skin;
• fragility of nails;
• temperature rise to subfebrile values;
• fast fatiguability;
• low pressure;
• headache;
• heart rhythm disturbances;
• pale skin;
• frequent fainting;
• noise in ears;
• dizziness;
• flashing flies before the eyes;
• urination disorders;
• craving for consumption of chalk and lime;
• shortness of breath at rest or with little physical exertion;
• pain in the heart, resembling angina pectoris;
• muscle weakness;
• body aches;
• nausea and vomiting;
• pain in the tongue and when swallowing;
• in women - menstrual irregularities.

With anemia caused by vitamin B12, there may be a decrease in sensitivity, with hemolytic anemia - jaundice.

Analyzes show a decrease in hemoglobin. When listening to the heart, characteristic systolic murmurs can be observed.

Symptoms of anemia can develop gradually or quickly. It all depends on the cause and type of condition.

Complications of anemia:

• decrease in immunity
• cardiovascular diseases,
• enlargement of the spleen or liver.

Severe anemia can lead to:

• hemorrhagic shock,
• hypotension,
• lung and coronary insufficiency.

Hand anemia symptoms

Sometimes there is not enough blood circulating in the forelimbs or the blood stagnates in them. This type of pathology is often caused by a lack of blood throughout the body or is the result of some other disease (thrombosis, atherosclerosis, osteochondrosis). The syndrome manifests itself in the loss of sensitivity of certain areas of the skin, the loss of motor functions of the muscles of the hands. Hands become more sensitive to cold.

Degrees

With a mild degree of anemia, the symptoms are usually subtle. In order for the blood to be better saturated with iron, it is enough to improve nutrition, the use of iron-containing preparations. With an average degree, the symptoms become more pronounced. There is weakness, frequent headaches, dizziness. The severe stage is a threat to life. There are signs of tissue hypoxia, violations of cardiac activity.

Dependence of the degree of anemia on the content of hemoglobin

It is also customary to separate relative and absolute anemia. When relative, the relative content of plasma increases, but the number of erythrocytes remains unchanged. With absolute, a decrease in the number of erythrocytes is observed.

Hemoglobin levels vary with age and gender. For children under 12 years of age, the hemoglobin rate is the same for both sexes. Then, men have a slightly higher concentration of hemoglobin than women.

Hemoglobin norms for children

Hemoglobin norms for women

Hemoglobin norms for men

Diagnostics

External symptoms of anemia are easy to identify even during the initial examination. However, the type and causes of anemia, the diseases behind it, can be difficult to identify. The data of anamnesis and analyzes mean a lot in making a diagnosis.

First of all, the patient's blood is subjected to the study. To determine the type and causes of anemia, general and biochemical blood tests are done. In this case, the following parameters are examined, first of all:

• hemoglobin level,
• the average amount of hemoglobin in erythrocytes,
• the number of reticulocytes
• iron level,
• bilirubin level.

It may be necessary to analyze feces for occult blood, ultrasound, CT and MRI of internal organs, endoscopy of the gastrointestinal tract.

Methods and objectives of research in anemia

How to treat and what to eat

Treat, first of all, not the anemia itself, but the disease that caused it. If the patient gets rid of the disease, then the amount of blood in the body is restored on its own. Or they eliminate the cause that led to anemia, for example, the wrong diet. However, symptomatic treatment is also very important.

With anemia, the body usually lacks iron. To replenish iron stores, the patient is prescribed iron-containing drugs. Also prescribed drugs with vitamin B12, folic acid.

It must be remembered that drugs should be taken only as prescribed by a doctor. With self-treatment and taking medications, the patient can only harm himself. In particular, an overdose of iron preparations can lead to constipation, hemorrhoids, and stomach ulcers.

Pharmacies sell many types of preparations containing iron:

• Sorbifer,
• Ferrum Lek,
• totem,
• Maltofer,
• Tardiferon.

Also, during treatment, preparations containing vitamins A, D, E, B vitamins, copper, zinc can be prescribed.

With a large blood loss, a transfusion of donor blood is necessary for treatment. With a deficiency of vitamin B12, it is administered intramuscularly.

Anemia has long been treated with diet. It is selected in such a way that the products contain a sufficient amount of iron. These products primarily include:

• meat,
• fish,
• eggs (yolks).

There is also a lot of iron in plant products, especially in legumes and nuts. However, iron from vegetables and fruits is poorly absorbed (10 times worse than from meat products), which must be borne in mind. Calcium-containing foods also prevent the absorption of iron. Tea, more precisely, the tannin it contains, also interferes with the absorption of iron. Therefore, it is best to drink tea a few hours after eating. But honey and sugar, on the contrary, improve the absorption of iron from food.

With a lack of folic acid, greens and vegetables are useful.

• iron,
• sulfates,
• magnesium bicarbonates.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

What is anemia?

Erythrocytes are formed in the red bone marrow from protein fractions and non-protein components under the influence of erythropoietin (synthesized by the kidneys). For three days, erythrocytes provide transport mainly of oxygen and carbon dioxide, as well as nutrients and metabolic products from cells and tissues. The life span of an erythrocyte is one hundred and twenty days, after which it is destroyed. Old erythrocytes accumulate in the spleen, where non-protein fractions are utilized, and protein enters the red bone marrow, participating in the synthesis of new erythrocytes.

The entire cavity of the erythrocyte is filled with protein, hemoglobin, which includes iron. Hemoglobin gives red blood cells their red color and also helps them carry oxygen and carbon dioxide. Its work begins in the lungs, where red blood cells enter with the bloodstream. Hemoglobin molecules capture oxygen, after which oxygen-enriched erythrocytes are sent first through large vessels, and then through small capillaries to each organ, giving cells and tissues the oxygen necessary for life and normal activity.

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, as well as increased irritability.

Anemia is a manifestation of the underlying disease and is not an independent diagnosis. Many diseases, including infectious diseases, benign or malignant tumors can be associated with anemia. That is why anemia is an important symptom that requires the necessary research to identify the underlying cause that led to its development.

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

Anemia classification

• according to the mechanism of development;
• by severity;
• by color indicator;
• on a morphological basis;
• on the ability of the bone marrow to regenerate.

Causes of anemia

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

Iron-deficiency anemia

Iron deficiency anemia is characterized by a decrease in red blood cells, hemoglobin and a color index.

Iron is a vital element involved in many metabolic processes in the body. In a person weighing seventy kilograms, the iron reserve in the body is approximately four grams. This amount is maintained by maintaining a balance between the regular loss of iron from the body and its intake. To maintain balance, the daily need for iron is 20-25 mg. Most of the incoming iron in the body is spent on its needs, the rest is deposited in the form of ferritin or hemosiderin and, if necessary, is consumed.

Causes of iron deficiency anemia

Symptoms of iron deficiency anemia

• anemic syndrome;
• sideropenic syndrome.

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

• 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.

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.

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

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

• 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

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

Medical treatment
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.

The dose and duration of treatment is selected individually depending on the following indicators:

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

Iron preparations in the form of injections (intramuscular or intravenous) are used in the following cases:

• 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.

If necessary, the patient may be assigned a transfusion of red blood cells to replenish the volume of circulating blood.

B12 - deficiency anemia

Normally, vitamin B12 enters the body with food. At the level of the stomach, B12 binds to a protein produced in it, gastromucoprotein (Castle's intrinsic factor). This protein protects the vitamin that has entered the body from the negative effects of the intestinal microflora, and also promotes its absorption.

The complex of gastromucoprotein and vitamin B12 reaches the distal (lower) small intestine, where this complex breaks down, absorption of vitamin B12 into the intestinal mucosa and its further entry into the blood.

From the bloodstream, this vitamin comes:

• 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.

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).

A puncture of the red bone marrow revealed an increase in megaloblasts.

The patient may be assigned the following instrumental studies:

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

Treatment of B12 deficiency anemia

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

The daily requirement for vitamin B12 is three micrograms.

Medical treatment
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.

A patient with B12-deficiency anemia should be observed for life by a hematologist, gastrologist and family doctor.

folate deficiency anemia

Folic acid (vitamin B9) is a water-soluble vitamin, which is partly produced by intestinal cells, but mainly must come from outside to replenish the body's needs. The daily intake of folic acid is 200-400 micrograms.

In foods, as well as in the cells of the body, folic acid is in the form of folates (polyglutamates).

Folic acid plays an important role in the human body:

• participates in the development of the organism 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).

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);
• impaired 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

Also, the patient may experience an increase in the size of the spleen.

Diagnosis of folate deficiency anemia

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

When conducting a myelogram, an increased content of megaloblasts and hypersegmented neutrophils is detected.

Treatment of folate deficiency anemia

It should be noted that with any culinary processing of products, folates are destroyed by approximately fifty percent or more. Therefore, to provide the body with the necessary daily norm, it is recommended to consume fresh products (vegetables and fruits).

Drug treatment of folic acid deficiency anemia involves taking folic acid in an amount of five to fifteen milligrams per day. The required dosage is set by the attending physician, depending on the age of the patient, the severity of the course of anemia and the results of the studies.

The prophylactic dose includes taking one to five milligrams of the vitamin per day.

aplastic anemia

Aplastic anemia can be congenital or acquired.

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.

• 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).

Symptoms of aplastic anemia

With aplastic anemia, the patient has the following symptoms:

• pallor of the skin and mucous membranes;
• headache;
• dyspnea;
• increased fatigue;
• 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.

In a biochemical blood test, the following is observed:

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

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

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

Treatment of aplastic anemia

In the treatment of aplastic anemia, the patient is prescribed:

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

• 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.

Depending on the effectiveness of the treatment, a patient with aplastic anemia may experience:

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

Hemolytic anemia

Hemolytic anemia can develop due to hereditary or acquired diseases.

By localization, hemolysis can be:

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

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).

There are the following hereditary hemolytic anemias:

• enzymopathies (anemia, in which there is a lack of enzyme, 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).

Immune disorders are characterized by autoimmune hemolytic anemia.

Non-immune disorders can be caused by:

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

• defective artificial heart valve;
• disseminated intravascular coagulation;
• hemolytic uremic syndrome;

Symptoms of hemolytic anemia

It should be noted that hemolytic anemia may be asymptomatic, and hemolysis may be detected incidentally during routine laboratory testing.

Symptoms of hemolytic anemia include:

• 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).

Prolonged hemolysis can lead to the development of gallstones due to impaired bilirubin metabolism. At the same time, patients may complain of abdominal pain and bronze skin color.

Diagnosis of hemolytic anemia

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

In a biochemical blood test, there is an increase in the level of bilirubin, as well as hemoglobinemia (an increase in free hemoglobin in the blood plasma).

In children whose mothers suffered from anemia during pregnancy, iron deficiency is also often found by the first year of life.

Symptoms of anemia often include:

• 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).

It should be noted that a mild form of anemia may not manifest itself in any way, so it is very important to regularly take blood tests to determine the level of red blood cells, hemoglobin and ferritin in the blood.

During pregnancy, the norm of hemoglobin is considered to be 110 g / l and above. A drop below normal is considered a sign of anemia.

Diet plays an important role in the treatment of anemia. From vegetables and fruits, iron is absorbed much worse than from meat products. Therefore, the diet of a pregnant woman should be rich in meat (for example, beef, liver, rabbit meat) and fish.

The daily iron requirement is:

• 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.

Anemia of the brain and its membranes (Anemia cerebri et meningum) is a disease characterized by a decrease in blood flow to the brain, as a result of which the body develops a disorder of the functions of the brain and oxygen starvation of the brain tissue.

Animals of all kinds are affected, but horses are the most common.

Etiology. Anemia of the brain and its membranes most often occurs in animals as a secondary disease, with large blood loss, pronounced cardio - vascular insufficiency (with complete atrioventricular blockade of the heart, acute expansion of the heart, arterial hypotension), squeezing the carotid arteries with a harness or with a sudden outflow of a large the amount of blood to the internal organs, for example, after the rapid release of transudate with dropsy or fermenting gases by the trocar with and swelling of the caecum in horses, with a drop in intra-abdominal pressure during an early delivery. Anemia of the brain in animals can occur with a decrease in vascular tone and a decrease in blood pressure during traumatic shock, with arteriosclerosis of cerebral vessels, acute infectious diseases and intoxications.

Chronic anemia of the brain and membranes in animals is observed with difficulty in blood flow in the cranial cavity due to increased intracranial pressure (symptomatic anemia in hydrocephalus, brain tumors), with myocardial dystrophy, cardiofibrosis, decompensated heart defects, with hypoplastic anemia, infectious anemia, leukemia, disorders metabolism, avitaminosis.

Pathogenesis. As a result of a decrease in blood flow to the brain, a malnutrition of the nervous tissue occurs. Brain cells need a continuous supply of glucose and oxygen. With insufficient intake of glucose and oxygen, as a result of a decrease in the reserves of macroergic compounds, there is an accumulation in the nerve cells of under-oxidized metabolic products: lactic acid, carbon dioxide, inorganic phosphate, glycogen, etc., a weakening of the processes of excitation and inhibition in the brain, which leads to a distortion - reflex activity, weakening of muscle tone in animals, disorders of secretion and motility of the stomach and intestines, disorders of pulmonary and tissue gas exchange.

Clinical picture. In acute anemia of the brain in animals, rapidly progressing symptoms of impaired function of the cortex and subcortical centers are observed. Animals develop depression, disorder of consciousness, general weakness and disorder of coordination of movements. In severe cases of the course of the disease, a sick animal may develop a fainting or coma, in such cases the animal falls to the ground and loses "consciousness". Against the background of a coma, the animal may die.

Chronic anemia of the brain is characterized by a slow increase in dysfunction of the cortex and subcortical centers: reduced reaction to the environment, lethargy, apathy, soporous or stuporous state, decreased muscle tone, impaired coordination of movements, fibrillar muscle contractions. In cattle, there is atony of the proventriculus and a weakening of intestinal motility.

In acute and chronic anemia of the brain, symptoms of cardiovascular insufficiency are almost always noted: pallor with a bluish tinge of visible mucous membranes, a small filling pulse, arrhythmias, deafness of heart sounds, a decrease in maximum blood pressure and an increase in minimum, an increase in venous pressure.

The duration of the course of the disease depends on the causes that caused it. In mild cases, the sick animal recovers quickly, but the oppression and lethargy that has arisen, atony of the proventriculus and reduced productivity may remain for a long time.

Forecast careful. The outcome of the disease in an animal depends on the timeliness of the provision of medical care and the nature of etiological factors. Progressive weakness, the disappearance of the animal's pupillary reaction to light, the appearance of convulsions, abnormal weak breathing and deterioration in the quality of the pulse for a veterinarian should serve as a signal of an unfavorable prognosis.

Pathological changes. The vessels of the meninges are poorly filled with blood, the choroid plexuses are poorly distinguishable, the membranes themselves are pale. The brain is pale, the border between the gray and white matter of the cerebral cortex is smoothed.

Differential Diagnosis. We differentiate from acute, hypomagnesemia, coma in various diseases.

The prognosis in acute cases of the disease, subject to the timely provision of medical care, is favorable. In chronic anemia, the prognosis is questionable to unfavorable.

Treatment start by giving the animal rest, the head is given as low a position as possible. Further treatment is carried out depending on the causes that caused anemia of the brain. In case of bleeding, measures are taken to immediately stop it, a 10% solution of calcium chloride is administered intravenously, and physiological saline is administered intravenously to replenish blood volume or a homogeneous blood transfusion is performed. In case of anemia caused by redistribution of blood, vigorous rubbing of the skin with tourniquets is carried out, turpentine or mustard alcohol is rubbed into the skin of the lateral surfaces of the chest or abdomen, ammonia is inhaled, ammonia is rubbed near the ears, heart and breathing are monitored. When the work of the heart is weakened, the animal is injected with caffeine, camphor, cordiamine, corglicon, and oxygen inhalation is prescribed. Korglikon is given to animals intravenously in the form of a 0.06% solution in the following doses: horses 4-5 ml; cows 3-8 ml; dogs 0.5 -1 ml; corglicon is administered in a 40% glucose solution. Cordiamin is administered subcutaneously - to horses and kr.r.sk. 10-20ml; pigs 1-4 ml; dogs 0.5-2 ml. In more severe cases, eufillin and other vasoconstrictor drugs are used to eliminate cerebral apoplexy. In the chronic course of the disease, in order to improve the functioning of the heart and metabolic processes in the brain, a course of cardiac glucosides, B vitamins, cerebrolysin, aminolone, piracetome is prescribed. In the case when the cause of anemia of the brain is a tumor, a surgical operation is performed in high-value animals. Sick animals must be kept in well-ventilated rooms (to partially compensate for insufficient blood circulation with oxygen) and provide a diet that is complete in terms of protein and vitamin composition. Recovered animals are drawn into work gradually.

Prevention. Prevention of brain anemia consists in early diagnosis and treatment of diseases that lead to vascular insufficiency (posthemorrhagic anemia, heart defects, diabetes mellitus, cardiomyopathy). Pet owners must follow the rules for fitting harnesses for working animals (collars, yokes, etc.), collars for dogs, and prevent excessive exploitation of animals. Provide timely treatment for blood loss. Follow the rules when puncturing the scar (tympania), slowly release gases and fluids during punctures of the peritoneal cavity.

And only when these resources are largely exhausted, the characteristic symptoms of hemodeficiency appear: chronic weakness and fatigue, dark circles under the eyes, the appearance of spots and black dots when the eyes are closed, insomnia and lethargy, headache attacks and sometimes dizziness.

Behavior becomes inadequate: increased resentment, nervousness, irritability for any reason, frequent mood swings are characteristic. There may be arrhythmia or pain in the region of the heart, a change in the rhythm of breathing, the usual physical activity becomes impossible due to weakness.

The reduced iron content in the body negatively affects the condition of the hair and skin, as the level of hemoglobin decreases and, as a result, the supply of all organs and tissues with oxygen. The skin becomes pale, the hair becomes dry and split, the nails brittle and deformed, white spots or longitudinal stripes appear on the nails. There may be swelling of the face, cracks in the corners of the lips.

The causes of anemia are polluted air with insufficient oxygen, an unbalanced diet, consisting of a limited set of products that do not contain all the vitamins and minerals necessary for the body. As well as long-term diets, mostly vegetable or fruit, without meat products, which include amino acids and iron.

Even in healthy girls and women every month, after menstruation, within 3-5 days, a decrease in iron levels is observed: 50 mg is lost with every 100 ml of blood. Therefore, with any deviations in the usual state of the body, with a deterioration in well-being, with the appearance of heavy bleeding, it is necessary to consult a doctor and take a general blood test that determines the level of hemoglobin.

Especially carefully it is necessary to monitor the change in the level of this indicator during pregnancy. Anemia can lead to the birth of a weakened baby, in which the state of the cardiovascular, nervous, immune or hematopoietic systems may be impaired.

It is no coincidence that strange changes in taste are observed during pregnancy: very often you want to eat chalk, something salty or sour. Do not ignore these desires - you need to change your diet to include foods with a high content of vitamin C, folic acid and iron. After all, expectant mothers need to be provided with healthy blood, with a normal hemoglobin content in erythrocytes, two at once.

Prevention and treatment of anemia with medicinal herbs.

As a prophylactic, we can recommend an infusion of wild rose and oregano or lemon balm, brewed overnight in a thermos. Drink in the morning and throughout the day with honey.

Berries are useful: cranberries, currants, mountain ash, lingonberries, fresh, in fruit drinks and jams. If the level of iron is significantly reduced, then a vitamin mixture of cranberry or lingonberry juice, chopped walnuts and honey will help to restore it intensively. Store in the refrigerator and take tbsp. before meals 2-3 times a day.

Juice therapy will help to increase the level of hemoglobin: juices of carrots, apples and beets are mixed in a ratio of 3:2:1. Beetroot juice must first settle for half an hour so as not to injure the walls of the stomach. Drink a glass every morning.

Fresh dandelion juice is useful for restoring blood composition, as a prophylactic and for treatment: every spring for a week, prepare juice from all parts of the plant. Grind the leaves, roots and flowers and take the juice in tbsp. for 1-3 weeks once a day. From the dried roots and leaves, you can prepare an infusion every month for 5-7 days: grind and pour tbsp overnight. collection with a glass of cold water. Bring to a boil in the morning and immediately remove from heat. Insist until cool, strain and drink throughout the day, taking a quarter cup before meals.

An infusion of parsley roots and leaves can also be prepared throughout the year and taken as needed, for example, after menstruation. Cut the root into circles, pour a liter of boiling water over the night in a thermos along with the leaves. Drink during the day.

You can cook for 10 days any of the collections for blood purification, or prepare a collection of medicinal herbs from nettle leaves, raspberries or blackberries, strawberries, St. John's wort inflorescences, rose hips. All components are taken equally. Steam 2 tbsp. collection with 2 cups boiling water, insist until cool. Take half a glass, regardless of the meal.

You can reduce the risk of anemia by prophylactic intake of juices of immunostimulating plants for a week: aloe or kalanchoe. The leaves are pre-aged in the refrigerator for 3-5 days on the bottom shelf to activate the action of enzymes. Then grind 3-4 leaves of aloe or 7-10 leaves of Kalanchoe, squeeze the juice and mix it with the juice of a small lemon and half a glass of honey. Take tsp. before eating.

Useful products for hemodeficiency.

It is important not only the presence of iron in certain foods, but also in what form it is contained and how it is absorbed by the body. Therefore, it is preferable to cook dishes from red meat: beef and veal, from chicken and turkey meat, from the liver. It is necessary to include eggs, salads from leafy vegetables of dark green color, dishes from soy, peas and beans, oatmeal and buckwheat in the menu. Buckwheat can be calcined in a pan, chopped and taken in the morning by tsp.

To create your weekly menu, dishes from the diet to improve the condition of blood vessels and memory can help you: this diet is well balanced and includes foods with essential vitamins and minerals.

These measures for the prevention and treatment of anemia are useful if its signs have just begun to appear. With a deeper development of the disease, when the organs experienced oxygen starvation for a long time, the help of a doctor and individually prescribed treatment with the use of iron-containing preparations are necessary. It is not recommended to take them uncontrollably: an excess of iron is just as harmful to the body as its deficiency.

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Why is iron deficiency anemia dangerous?

Doctors consider iron deficiency anemia to be a fairly common female disease, since any woman, regardless of age and lifestyle, is at risk of getting this disease.

After all, despite the emancipation and desire of women to be in no way inferior to men, the physiological characteristics of the body are inherent in them by nature, which turn them into the weaker sex.

The role of iron in the body

Scientists have long proven that iron plays a vital role in the body, especially when you consider that its internal reserves are small and amount to about 4 g.

Why is iron so important for the body? First of all, the fact that iron ions are an integral part of hemoglobin and combine in the lungs with oxygen from the air, which facilitates the transport of this very oxygen to the internal organs and ensures their proper operation.

But this is not all the benefits of iron for the body. Iron is also involved in the synthesis of myoglobin. Myoglobin is a protein that delivers oxygen to the muscles. In addition, iron is involved in the synthesis of about seventy different enzymes, due to which the full growth of the body occurs, defenses are maintained, foreign substances are neutralized and hormones are synthesized.

What is the source of iron?

The natural source of iron is food. Iron enters the blood from the intestines. However, a small amount of iron is necessarily deposited in reserve and enters the spleen, liver and bone marrow.

If the body ceases to receive the required amount of iron with food, then first of all it will seek to store it in hemoglobin, using the reserves deposited in the above organs. At this stage, it is not yet possible to determine anemia, however, iron deficiency in the body already exists. If the lack of iron is not replenished in the near future, then the body will begin to consume it from the skin, muscles, hair, mucous membranes and other organs. When these reserves are exhausted, there will be a process of violation of hemoglobin synthesis and its level in the blood will drop markedly. A decrease in hemoglobin in the blood to a level of less than 120 g / l is a direct sign of iron deficiency anemia.

As iron stores in the body are depleted, a person begins to experience signs of anemic syndrome, which include:

• A sharp decline in working capacity (the very first sign of iron deficiency anemia);
• Poor health, severe weakness and fatigue, drowsiness, dizziness. Often, all these symptoms are accompanied by a rapid heartbeat;
• External signs: peeling and dryness of the skin, brittleness and pallor of nails, hair loss, cracks in the corners of the mouth;
• Often anemia is accompanied by a sharp decrease in the body's immune defenses and a high probability of catching an infection;
• Changes in smell and taste sensations. It happens that you may want to eat something unusual, such as coal, chalk or raw minced meat. A person begins to like the smells of leather, paint and varnishes;
• The psycho-emotional state of a person worsens. He becomes too irritable and prone to sudden mood swings, his memory deteriorates sharply.

If you observe similar symptoms in yourself, or in your relatives and friends, you should consult a doctor.

What is the danger of iron deficiency anemia?

If anemia is not diagnosed and treated in time, the immune system of the body suffers first of all, the risk of catching intestinal and viral infections increases. In addition, the cardiovascular system and the central nervous system suffer greatly, the myocardium becomes decrepit.

Iron deficiency during pregnancy significantly complicates its very course, negatively affects the development of the fetus and childbirth.

Who is more likely to get iron deficiency anemia?

Women are more susceptible to this disease. This is due to the physiological processes in their body. The most striking example is menstruation, when a woman loses a lot of blood, against which iron deficiency anemia develops.

First of all, the risk group includes adolescent girls whose menstrual cycle has not yet been established, as well as women during menopause with uterine bleeding.

The period of childbirth is also critical for women. Even from the earliest stages of pregnancy, the body's need for iron increases dramatically (more than twice). And if you consider that the birth itself, as well as the period of breastfeeding that follows them, reduces iron stores in the body by an average of 20 percent, then we can calculate that it takes about four or five years to restore this mineral in the body naturally. That is why almost every third woman after childbirth suffers from iron deficiency anemia.

How to protect yourself from iron deficiency anemia?

To protect yourself from iron deficiency anemia, you first need to eat right. The diet should contain a sufficient amount of foods containing iron. These are meat (rabbit, poultry and beef). Also, iron-containing foods include buckwheat and oatmeal, apples, raisins, legumes and nuts.

You should be aware that the nutritional value of iron-containing foods is different. For example, animal products are digested much better than plant products.

In order for iron to be better absorbed in the intestines, it is necessary to consume vitamin C. Therefore, it is advisable to combine meat, for example, with bell peppers or cabbage. Also, after a hearty meat dish, it will be good to drink a glass of freshly squeezed orange juice. But it is better to exclude such drinks as coffee and tea for a while, as they reduce the absorption of iron due to the tannins present in them.

Daily human need for iron

Experts have calculated that a woman should receive at least 18 mg of iron per day. For a pregnant woman, this figure increases to 20 mg per day, but during the feeding period, the daily dose of iron is 25 mg at all.

For men, the daily requirement for iron is slightly lower and they need to consume as little as 10 mg daily.

Women need to be extremely careful when following low-calorie diets. If you can’t do without them, it is recommended to take a vitamin-mineral complex during this period, which will necessarily contain iron.

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Anemia Symptoms: How to Recognize the Signs of the Condition

Symptoms of anemia are formed against the background of a decrease in hemoglobin. The norm of this substance is debatable. Signs of anemia can be traced in some people with a hemoglobin index of 110 g / l.

In other patients, clinical manifestations of the disease are not observed at concentrations below 90 g / l. By classical standards, a severe anemic state is observed when the hemoglobin level is below 70 g/l.

Some therapists have observed ideal health in older patients with lower figures for this indicator. Of course, the pathological symptoms of the disease appear against this background, but they are compatible with life.

Discussions on the topic of laboratory norms for anemia continue, but this does not cancel the clinical manifestations of the disease, requiring immediate treatment.

Symptoms of anemia in the early stages

Symptoms of anemia differ in the early and late stages. The prelatent form of the disease is characterized by the following manifestations:

• Decreased performance;
• General fatigue;
• Increased performance;
• Noise in ears;
• Dizziness;
• Acceleration of the heart rate;
• Dyspnea.

There are few complaints in people at the early (latent) stage of the disease. Most often, 2-3 of the above anemic markers predominate.

Classic signs of severe anemia

Signs of anemia depend on the biochemical changes in the body. With pathology, not only erythrocytes suffer. Destruction of the iron depot - ferritin is observed, the level of the transport protein - transferrin increases, and the destruction of myoglobin occurs. These processes affect the manifestations of the disease.

What are the signs of iron deficiency anemia in severe course:

• Tachycardia - increased heart rate;
• pale skin;
• dizziness and headache;
• Dryness of the tongue and swelling;
• Perversion of taste (use of chalk and lime).

Symptoms of anemia vary depending on the type of disease. There are several options for it:

Consider how to recognize the manifestations of anemia in adults and children by pathological forms.

Signs of aplastic anemia when observed

Signs of aplastic anemia occur against the background of a violation of the formation of red blood cells by the bone marrow. Specific manifestations of the disease:

1. Constant fatigue;
2. Dizziness and general weakness;
3. Rapid weight loss and loss of appetite;
4. Bleeding from the nose and intestines;
5. Heat;
6. The formation of ulcerative defects of the oral cavity.

Aplastic anemia is rare, so its clinical symptoms are detected late. Only on the basis of laboratory tests, specific changes in the blood are detected. Impaired bone marrow erythrogenesis is studied after growth studies by taking bone biopsies.

Signs of hemolytic anemia, how to recognize

Signs of hemolytic anemia can be recognized by a specific increase in the size of the liver and spleen (hepatosplenomegaly). They are clearly visible when performing an ultrasound examination.

At the latent stage of the disease, hemolysis (destruction of red blood cells) is difficult to determine. A slight breakdown of red cells is compensated by an increase in erythrogenesis in the bone marrow.

There are 2 types of hemolysis:

• intravascular;
• Intracellular.

Intracellular destruction of erythrocytes is carried out by the spleen, bone marrow and liver. The process is necessary to obtain iron from dead red cells for the reverse utilization of iron.

The intravascular type of the disease is carried out directly in the vascular bed. For this type of disease, the following signs of anemia are characteristic:

1. Tachycardia;
2. dark urine;
3. Enlargement of the spleen and liver;
4. Dyspnea;
5. Weakness and dizziness.

Of all types of the disease, hepatosplenomegaly is the specific symptom of an anemic state of the hemolytic type.

Signs of anemia in vitamin B12 deficiency in women

Signs of anemia in vitamin B12 deficiency in women are more pronounced than in men. Violation of the metabolism of this substance has an acquired and congenital character. Pathology develops slowly, so the representatives of the strong half proceed without symptoms. In women, on the background of menstruation, the symptoms of the disease intensify.

Genetic predisposition leads to the following symptoms of B12 deficiency anemia in childhood:

• Pain in the lower abdomen with damage to the gastrointestinal tract;
• Headaches, memory impairment and other neurological diseases;
• Violation of bone marrow erythrogenesis.

Signs of anemia in women are "veiled" by the menstrual cycle. Representatives of the beautiful half of some manifestations of the disease are "written off" for malaise before the next menstruation. Only when the manifestations of the disease become pronounced, they understand that the symptoms are not related to the hormonal system.

What are the manifestations of an anemic condition in children

Manifestations of anemia in children are most pronounced between 3 and 6 months. If the baby is premature, he has an iron deficiency already in the first months of life.

The main signs of an anemic condition in infants:

1. Dryness of the skin;
2. Pallor;
3. The formation of cracks in the corners of the mouth, stomatitis in the mouth;
4. Brilliant tongue;
5. Immobility and fatigue;
6. Tearfulness.

To determine the signs of an anemic condition in children, it is necessary to conduct laboratory tests and identify a decrease in the number of red blood cells, a low level of hemoglobin.

Hypochromic anemia is the main symptom of blood pathology in adults.

Blood hypochromia in mild adults does not lead to external clinical manifestations. Against the background of pathology, the skin may turn pale. After physical exertion, the heart rate slightly increases and the respiratory rhythm accelerates.

With an average degree of pathology, the symptoms of an anemic state of the blood in adults appear more clearly. Only with a severe degree of the disease are signs of the disease observed:

• Fast fatiguability;
• Difficulty swallowing;
• Indigestion;
• Hair loss;
• Brittle nails;
• General weakness;
• Dizziness;
• Noise in ears;
• Dyspnea.

It should be understood that signs of iron deficiency anemia in adults exist against the background of another pathology. Because of this, they are difficult to diagnose.

Symptoms of pathology in men and women differ depending on the cause of the disease. The representatives of the strong half have higher endurance than the lady. Beauties are prone to blood loss, therefore, against the background of heavy menstruation, the pathological manifestations of the anemic syndrome intensify in them.

If in children the signs of anemia exist constantly and for a long time, then in women they become aggravated before the start of the menstrual cycle (we are talking about iron-deficient normochromic variants of the pathology).

In adults, you need to pay attention not to external signs of the disease:

• Flabbiness of the skin;
• Hair loss;
• Brittle nails;
• Change in taste sensations.

Against the background of iron deficiency, a person has an increased need for the use of acidic, spicy and salty foods.

Causes and complications of anemic syndrome

Causes of anemic syndrome: bleeding (uterine, nasal, intestinal), diseases of the liver and spleen. There are dosage forms of the disease, toxic forms. Under the influence of unfavorable factors, an aplastic variant of the disease appears, hemolysis of erythrocytes. With a lack of vitamin B12, a pernicious form of pathology appears.

Atrophy of the gastric mucosa appears against the background of intestinal diseases. The lack of blood supply to the epithelium enhances the manifestations of the disease. Such changes are often observed during pregnancy. They are dangerous fetal hypoxia.

During pregnancy, anemic syndrome with a long and uncontrolled state of a person leads to a violation of blood clotting.

Severe degrees of the disease are dangerous for death. When the disease is detected in the initial stages, the lethal outcome can be stopped. Even in this case, the treatment of anemia is long. It lasts at least 4 months.

Throughout the course, the condition of the blood should be monitored using laboratory tests. They allow, if necessary, to control the dose of the drug.

Anemia (anemia): types, symptoms, nutrition for anemia

A hundred years ago, the pallor of the face "testified" to the refinement of nature, the aristocracy of the girl and her high chances of success with the opposite sex. Unhealthy whiteness was in fashion, the young ladies massively fainted at the slightest excitement, languidly rolled their eyes with unhealthy bruises under them to show their belonging to the "blue blood".

Now, fortunately, views on female beauty have changed. In fashion - health and energy, even blush and strong nerves. Now everyone knows that excessive pallor is evidence of ill health, some kind of malfunction in the body, and very often speaks of anemia.

Anemia (colloquially - anemia) is a blood condition characterized by a decrease in the level of erythrocytes (red blood cells) and hemoglobin levels. By itself, this condition is not considered a disease by doctors, but it indicates the presence of certain pathological conditions in the organs.

Types of anemia

Doctors distinguish between several types of anemia, depending on the cause of the appearance.

The most common is iron deficiency anemia, in which oxygen synthesis is disturbed in the blood due to a lack of iron. The most susceptible to iron deficiency anemia are children in the period of intensive growth (second year of life and transitional age), pregnant women in the second or third trimester of pregnancy, women at the beginning of menopause.

Anemia resulting from significant or permanent blood loss is called posthemorrhagic. Acute anemia develops rapidly due to serious injuries, bleeding from internal organs, blood loss due to complicated childbirth. The closer the damaged vessel is located to the heart, the stronger its damage, the more rapid and life-threatening the condition.

Fortunately, such conditions do not occur often. Much more common are blood loss associated with the already mentioned prolonged menstruation, uterine bleeding and helminthic invasions.

With insufficient intake of vitamin B12 in the body, B12-deficiency anemia develops. The cause may also be functional disorders of the body, due to which vitamin B12 is not sufficiently absorbed. Usually, this form affects the elderly, with severe diseases of the gastrointestinal tract, after abdominal operations on the stomach.

Due to a deficiency in the body of folic acid, folic acid deficiency anemia develops. Folic acid plays an important role in the hematopoietic system. Its deficiency leads to a number of pathological conditions: enlargement of the spleen, the appearance of slight jaundice, damage to the digestive tract. Such anemia can be caused by both insufficient intake of folic acid and a violation of its absorption. Often, folic acid deficiency anemia occurs in people who have undergone surgery on the small intestine, since folic acid is absorbed in the small intestine.

Doctors distinguish hemolytic anemia, which appears due to the increased breakdown of red blood cells. But this condition is actually a blood disease that requires serious medical intervention.

How to diagnose anemia

Anemia is diagnosed by a doctor on a general blood test, in which the main indicator is the level of hemoglobin. For women, the lower limit of the norm is 100 g / l, for men - 110 g / l. These indicators cannot be called absolutely reference in determining anemia. The level of hemoglobin is affected by a number of factors that are not related to health itself.

For example, for residents of the highlands, due to chronic hypoxia, a low level of hemoglobin will be considered normal, while their state of health will not cause any concern. And heavy smokers, on the contrary, have an increased level of hemoglobin, although health and smoking are incompatible concepts.

Symptoms of anemia

According to some indirect signs, anemia can be determined independently. First of all, we are talking about the pallor and dryness of the skin - just about the "beauty" that Turgenev's girls so aspired to. Weakness, fatigue, drowsiness are also indirect signs of anemia. Any, even minor, physical activity can cause palpitations and shortness of breath. This condition can be experienced with anemia, including trained people.

Elderly people with anemia complain of exacerbation of chronic diseases. Angina attacks are especially painful for those suffering from coronary heart disease.

Often, with a low level of hemoglobin in the blood, a person experiences bouts of dizziness: flickering of "flies" before the eyes, dizziness. Should alert tinnitus and head, frequent headaches. In chronic forms of anemia, hair becomes dull and brittle, teeth may begin to crumble, and nails may peel off. In general, beauty and does not smell.

Anemia treatment

Treatment of anemia should be carried out under the supervision of a doctor, because it is possible to diagnose it, determine the course of treatment, only according to the results of a blood test, which can only be done in a medical institution. Depending on the forms of anemia, the doctor will identify the cause of its occurrence and prescribe treatment aimed at eliminating the cause, as well as getting rid of the actual anemia.

After establishing the cause, doctors prescribe complex therapy aimed at improving blood counts. With the most common anemia - glandular - iron preparations are prescribed, with anemia associated with a deficiency of other components, appropriate drugs are prescribed.

Nutrition for anemia

Diet plays a huge role in the treatment of anemia. So, with iron deficiency anemia, an increase in the amount of protein consumed is shown. The amount of protein should increase to 200 grams, and at the expense of animal protein. The main suppliers of protein are lean meats and fish, shrimp, egg white. Vegetable protein, such as found in legumes, is not as effective.

Since very often iron deficiency anemia is accompanied by a decrease in the level of vitamins and microelements in the body, in addition to taking multivitamin preparations, doctors recommend filling the menu with dishes such as beef and cod liver, garlic, and salad. You need to know the products that have a positive effect on the processes of hematopoiesis in the body: grapes, onions, rutabaga, pumpkin, buckwheat, gooseberries.

An excellent supplier of iron to the body are cocoa beans. It is important to eat not milk chocolate, richly flavored with sugar and milk powder, but bitter, with a maximum cocoa content. Children diagnosed with iron deficiency anemia need to prepare cocoa, make a drink from natural cocoa powder, and not use instant drinks.

It is useful to use special phyto-collections, which, on the one hand, should compensate for the deficiency of certain microelements, and on the other hand, improve the absorption of substances entering the body. The composition of herbal teas for the treatment of anemia includes: St. Pharmacies offer a huge selection of herbal tea for the treatment of anemia.

Prevention of anemia

Prevention of anemia is to prevent conditions associated with blood loss. Pregnant women need regular blood tests. Chronically ill - make sure that you are constantly in remission. Eating a balanced diet is important: Aggressive weight loss diets can lower blood counts.

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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 gastric 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 organism 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, a bleeding ulcer of the stomach and duodenum, a malignant tumor 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.