Monday, June 13, 2016

Anemia - can it be prevented?

What is anemia?

Over 1.6 billion people worldwide are anemic. Anemia is a condition by which red blood cells do not carry and deliver enough oxygen to the rest of the body. This is either because there are not enough red blood cells or because the red blood cells available do not function properly. The four major types of anemias include iron-deficiency anemia, megaoloblastic anemia, pernicious anemia and sickle cell anemia. Of these, the most common is iron-deficiency anemia.

Iron-deficiency anemia is a condition that occurs when there is a lack of iron in the body. Iron is essential to make hemoglobin, an iron-rich protein, which binds to oxygen to carry and deliver it throughout the body.
Without sufficient iron, the body cannot produce enough hemoglobin for red blood cells, thus leaving the body with insufficient oxygen supply.

Megaloblsatic and pernicious anemia occur when there is a deficiency in vitamin B12 or B9 (commonly known as folate). These two micronutrients are required for red blood cell replication and synthesis. Vitamin B12 is required for the body to make a usable form of folate. Therefore, the root cause of these types of anemia are either due to B12 deficiency (which leads to folate deficiency) or folate deficiency.

Sickle cell anemia is an inherited genetic condition that cannot be prevented. In this condition, the red blood cells are crescent-shaped and can stick together and get stuck in blood vessels. This sickling can lead to chest pain and eventual organ damage as a result of insufficient oxygen.

What causes anemia?

Anemia commonly occurs as a result of poor diet, pregnancy, intestinal disorders, chronic diseases, and infections. Only sickle cell anemia is caused by a genetic mutation.

Iron-deficiency anemia is most commonly due to inadequate dietary intake of iron, particularly in infants and children. This is also seen during pregnancy and breastfeeding, which can deplete a woman’s iron stores. Women already have low iron stores and when pregnant, existing iron is taken to supply the fetus.

Megaloblsatic and pernicious anemia are also commonly seen during pregnancy, in vegetarians or vegans, or conditions where there is reduced absorption of B12 from the gastrointestinal tract due to certain diseases. B12 or folate deficiency during pregnancy can lead to serious complications for the fetus so they are often supplemented during this time.

Can anemia be prevented?

The three major types of non-genetic anemia are caused by inadequate intake, excessive losses, or impaired absorption of iron.

Anemia caused by inadequate intake can be prevented to some extent by eating an iron-rich balanced diet. Foods that are high in iron include beef, dark leafy greens, dried fruits and nuts. Vitamin B12 and folate can also be supplemented if enough is not obtained through diet.

Anemia caused by excessive blood loss occurs from menstruation, intestinal parasites or blood loss due to clotting disorders (vitamin K deficiency). These cannot necessarily be prevented but can be monitored.

Anemia caused by impaired absorption tends to be due to chronic conditions that may inhibit the uptake of iron, even if there is enough in the body. These chronic diseases increase your risk for developing anemia – rheumatoid arthritis, kidney disease, cancer, liver disease, thyroid disease and inflammatory bowel disease (IBD). For instance, disorders of the gastrointestinal tract such as IBD can significantly reduce B12 absorption even when it is present in the body.


American Society of Hematology. (2016). Anemia.

Kazal LA. (2002). Prevention of iron deficiency in infants and toddlers. American Family Physician.

de Benoist B et al. (2008). Global anaemia prevalence and number of individuals affected. World Health Organization.

What is sickle cell disease? (2015). National Institute of Health: National Heart, Lung and Blood Institute.

How Can Iron-Deficient Anemia Be Prevented? (2014). National Institute of Health: National Heart, Lung and Blood Institute.