Introduction

What is Anaemia?

It is a condition when there is not enough healthy red blood cells in the blood circulation to carry oxygen to the tissues. This function is carried out by a protein called haemoglobin. Anaemia usually means not having enough haemoglobin. The normal haemoglobin level is between 11.5 to 16.5g/dL for a female person and 12.5 to 18.5g/dL for a male person.

Causes of anaemia

1. Blood loss (which can be acute or chronic).
   1. Acute blood loss may be seen in a motor vehicle accident or following surgery. Blood loss of more than 500ml usually warrants replacement.
   2. Chronic blood loss occurs during excessive menstruation in female, chronic worm infestation and other conditions.
2. Inadequate production of normal red cells by bone marrow. This may be due to :
   1. Deficiency of essential factors like iron, vitamin B12, folate and erythropoietin.
      1. Marked growth spurt in adolescence, causing an increased iron requirement which outstrips the rate of iron absorption.
      2. Menstruation in females with an average loss of 30 mg of iron each month may lead to an iron deficiency situation.
   2. Toxic factors: inflammatory disease, liver or kidney failure, medications.
   3. Hormone deficiency: low thyroid hormone levels.
   4. Invasion of bone marrow: blood cancers, bone marrow disease.
   5. Disorder of developing red cells: conditions such as Thalassemia.
3. Excessive destruction of red blood cells. May occur with certain infections or the use of certain medications. The commonest type of Anaemia is:
   1. Iron deficiency anaemia.
   2. Thalassemia.

Signs and symptoms

Many adult suffer from anaemia and do not even know it. Symptoms include:

• Feeling tired all the time.
• Dizziness.
• Shortness of breath when engaging in physical activities.
• Pale skin.
• Rapid heart beat.
• Poor memory.
• Weight loss.

Complications

If anaemia is very severe it may lead to:

• Heart failure where the heart function becomes very weak and inadequate.
• Poor pregnancy outcomes including prematurity and intrauterine growth retardation.

Treatment

A local clinic can check your haemoglobin level to determine whether you have anaemia. The treatment of anaemia depends on what is the cause is :

• If it is due to a medical condition e.g. thalassemia and leukaemia, specific treatment is required.
• If it is due to iron deficiency, then one needs to eat a balanced diet rich in iron and take iron supplements. See Table 1 and Table 2 for Iron content in foods.

Other hints when treating iron deficiency:

• It is advisable to take iron supplement with Vitamin C to enhance iron absorption.
• Specific causes like worm infestation and inflammatory bowel disease will also need to be treated.

Table 1: Iron contents in the foods

Reference: Malaysian Dietary Guidelines 2005

Table 2: Source of iron

Reference: Recommended Nutrient Intakes for Malaysia, Kementerian Kesihatan Malaysia, 2005.

Pencegahan

1. Eat a balanced diet every day. See Food Pyramid
2. Eat iron-rich foods.