Anemia is a condition where there is a lack of red blood cells, or a lack of hemoglobin that carry oxygen inside the red blood cells, in the circulatory system. The most common anemia pathophysiology, or the process by which anemia most frequently occurs, is a shortage of iron. Iron is needed to make heme, the part of the hemoglobin molecule that attaches to oxygen. Causes of iron deficiency anemia include diets that are low in iron, difficulties absorbing iron, pregnancy, certain medications and excessive blood loss. Worldwide, hookworm infections are thought to be the most frequent cause of blood loss and subsequent lack of iron leading to anemia.
In people with anemia there is not enough oxygen being carried in the blood to fully supply the body's needs. This lack of oxygen, or hypoxia, gives rise to symptoms such as feeling tired and faint, becoming out of breath easily, and generally lacking in energy. There may also be abnormal heartbeats, or palpitations, together with a rapid heart rate, and the skin might appear pale. Some less common symptoms include headaches, ringing in the ears, a sore mouth and altered sense of taste, and brittle, spoon-shaped nails. Apart from the anemia pathophysiology, there may be deficiencies of some other proteins which need iron for their manufacture, and this may prevent muscles from working efficiently, cause poor concentration or lead to repeated infections.
A lack of iron due to blood loss represents a common anemia pathophysiology, and this often occurs in women who suffer from heavy menstrual periods. If the amount of iron lost through menstruation is not adequately replaced by iron in the diet, anemia is likely to occur. In certain diseases, there may be bleeding from the gut, kidneys or bladder, and over time this can also lead to anemia. Blood may be lost due to ulcers, cancers, inflammatory bowel diseases or even hemorrhoids. Sometimes the amount of blood lost is too small to be visible so a disease goes undetected and the first sign might be iron deficiency anemia.
Diet has a great effect on the amount of iron in the body, with diets which are lacking in meat sometimes causing anemia, although iron is also present in other foods, such as green leafy vegetables. Where a diet is only just providing enough iron, children can be vulnerable to anemia during a growth phase where the body experiences an increased demand for iron. Pregnancy can also cause anemia due to the baby's iron requirements having to be met.
Iron deficiency as an anemia pathophysiology is also seen in conditions where food absorption in the gut is abnormal, such as celiac disease. It is also common if hookworms infest the gut, as these parasites feed on blood from the gut wall. Where anemia pathophysiology stems from lack of iron, any underlying disease is treated if possible to prevent further loss, and iron tablets are given to build up the amount in the body. If the cause is a dietary one, then iron tablets might not be necessary, as a change to a diet containing more iron-rich foods may be all that is required to treat the anemia.
