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What are the causes of anaemia?

Anaemia is a pathological condition that manifests when haemoglobin levels in the blood are below normal. There are many types of anaemia which differ mainly according to their causes. In this article, we will look specifically at the causes of sideropenic anaemia or iron deficiency anaemia.

Anaemia: causes and disorders

Normal haemoglobin (Hb) values in adults are as follows:

  • 13.4 – 17.5 g/dL in men;
  • 12 – 15.5 g/dL in women.

When lower values are measured, we’re dealing with low haemoglobin. Anaemias are diseases characterised by haemoglobin values below normal. This results in a reduced ability to transport oxygen from the red blood cells.

Three main types of anaemia can be distinguished according to their causes:

  1. Anaemias caused by blood loss;
  2. Anaemia with reduced red blood cell production that may be related to iron deficiency, vitamin B12 deficiency or bone marrow cancer;
  3. Anaemia with increased red blood cell destruction caused by genetic causes (e.g., sickle-cell anaemia), related to autoimmune diseases, infections or malaria.

Anaemia affects around a quarter of the world’s population. Some types of anaemia, such as Mediterranean anaemia, sickle-cell anaemia or Fanconi anaemia are hereditary in origin and have a lower incidence than iron deficiency anaemia, which affects around 700 million people worldwide. Iron deficiency anaemia is most commonly found in women, children and the elderly. It is estimated that, in Italy, 7.1% of women and 2.8% of men suffer from iron deficiency due to food-related reasons.

Anaemia-related symptoms may vary depending on the rate at which anaemia sets in. Slowly developing anaemia may be characterised by a feeling of general tiredness, muscle weakness, difficulty breathing (even at rest), headaches and irritability. When anaemia occurs quickly (e.g., as a result of trauma or significant blood loss) a feeling of fainting, confusion and increased thirst occurs. Pale skin and mucous membranes occur especially when haemoglobin values are significantly lower than normal. Depending on the causes of the anaemia, there may be some variability in the type and intensity of the disorders.

Iron deficiency anaemia: causes

When there is a lack of iron in the body some of the symptoms listed above may occur. In these cases, the doctor will check blood haemoglobin levels, circulating iron levels in the blood (serum iron), transferrin and ferritin levels by prescribing blood tests. Haematocrit, a blood test that indicates (as a percentage) the volume of blood occupied by red blood cells, can also be a useful diagnostic investigation tool. In any case, the doctor will make the diagnosis by taking an accurate history of the patient.

How do you overcome iron deficiency anaemia by acting on the causes?

When iron deficiency anaemia is diagnosed by the doctor, he/she may prescribe:

Iron deficiency may be sometimes also associated with a deficiency of vitamin B12 and folic acid: in these cases, the doctor will provide a diet rich in foods that also contain vitamin B12, such as meat, eggs, fish, soy and grins and folic acid (green leafy vegetables are particularly rich in this nutrient).

Specific physiological conditions (pregnancy, breastfeeding, menstruation) or pathological conditions (diseases that decrease iron absorption in the intestine) can aggravate a condition of iron deficiency already present in the body. In these cases, the doctor will assess the best diet to balance the iron deficiency and will consider whether to recommend a dietary supplement to compensate for the deficiency or increased demand for iron by the body.

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