The Citizen (KZN)

Feeling tired? Dr Dulcy can help

IT’S ABOUT BLOOD CELLS: WHEN YOU HAVEN’T GOT ENOUGH YOU MAY FEEL WEAK

- Dr Dulcy Rakumakoe

There are different types, each with its own solution of diet and supplement­s.

Your body makes three types of blood cells — white blood cells to fight infection, platelets to help your blood clot and red blood cells to carry oxygen throughout your body.

Red blood cells contain haemoglobi­n — an iron-rich protein that gives blood its red colour. Haemoglobi­n enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide to your lungs so that it can be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow — a spongy material found within the cavities of your large bones. To produce haemoglobi­n and red blood cells, your body needs iron, Vitamin B12, folate and other nutrients from the foods you eat.

Anaemia is a condition in which a person does not have enough healthy red blood cells to carry oxygen to the body’s tissues, which may make you feel weak. There are many forms of anaemia, each with its own cause.

It can be temporary or long term, and can range from mild to severe. Treatments range from taking supplement­s to undergoing medical procedures. You may be able to prevent anaemia by eating a healthy, varied diet.

Please make sure you see your doctor if you are feeling very tired for unexplaine­d reasons. Some anaemias, such as iron deficiency anaemia or vitamin B12 deficiency, are common. Fatigue has many causes besides anaemia, so don’t assume that if you’re tired you must be anaemic. Some people learn that their haemoglobi­n is low, which indicates anaemia, when they go to donate blood.

SYMPTOMS At first anaemia can be so mild that it goes unnoticed. But symptoms worsen as anaemia worsens. Signs and symptoms vary depending on the cause of your anaemia. They may include:

Fatigue Weakness Pale or yellowish skin Irregular heartbeats Shortness of breath Dizziness or lightheade­dness Chest pain Cold hands and feet Headache

CAUSES Anything that causes your body to not have enough red blood cells will cause anaemia. It can be because:

Your body doesn’t make enough red blood cells

Bleeding causes you to lose red blood cells more quickly than they can be replaced

Your body destroys red blood cells

DIFFERENT TYPES OF ANAEMIA AND THEIR CAUSES: Iron deficiency anaemia.

This is the most common type of anaemia. It is caused by a shortage of iron in your body. Your bone marrow needs iron to make haemoglobi­n. Without adequate iron, your body can’t produce enough haemoglobi­n for red blood cells. Without iron supplement­ation, this type of anaemia occurs in many pregnant women. It is also caused by blood loss, such as from heavy menstrual bleeding, an ulcer, cancer and regular use of some over-the-counter pain relievers, especially aspirin.

Vitamin deficiency anaemia.

In addition to iron, your body needs folate and vitamin B12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Additional­ly, some people may consume enough B12 but their bodies aren’t able to process the vitamin. This can lead to vitamin deficiency anaemia, also known as pernicious anemia.

Anaemia of chronic disease.

Certain diseases, such as cancer, tuberculos­is, HIV/Aids, rheumatoid arthritis, kidney disease, Crohn’s disease and other chronic inflammato­ry diseases – can interfere with the production of red blood cells.

Aplastic anaemia.

This rare, life-threatenin­g anaemia occurs when your body doesn’t produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.

Anaemias associated with bone marrow disease.

A variety of diseases, such as leukaemia and myelofibro­sis, can cause anaemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatenin­g.

Haemolytic anaemias.

This group of anaemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destructio­n. You can inherit a haemolytic anaemia, or you can develop it later in life.

Sickle-cell anaemia.

This inherited and sometimes serious condition is an inherited haemolytic anaemia. It’s caused by a defective form of haemoglobi­n that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurel­y, resulting in a chronic shortage of red blood cells. RISK FACTORS

A diet lacking in certain vitamins

Having a diet that is consistent­ly low in iron, vitamin B12 and folate increases your risk of anaemia.

Intestinal disorders

Having an intestinal disorder that affects the absorption of nutrients in your small intestine such as Crohn’s disease puts you at risk of anaemia.

Menstruati­on

In general, women who haven’t experience­d menopause have a greater risk of iron-deficiency anaemia than do men and postmenopa­usal women. That’s because menstruati­on causes the loss of red blood cells.

Pregnancy

If you’re pregnant and aren’t taking a multivitam­in with folic acid, you’re at an increased risk of anaemia.

Chronic conditions

If you have cancer, kidney failure or another chronic condition, you may be at risk of anaemia of chronic disease. These conditions can lead to a shortage of red blood cells. Slow, chronic blood loss from an ulcer or other source within your body can deplete your body’s store of iron, leading to iron deficiency anemia.

Family history

If your family has a history of an inherited anaemia, such as sicklecell anaemia, you also may be at increased risk of the condition.

Other factors

A history of certain infections, blood diseases and autoimmune disorders, alcoholism, exposure to toxic chemicals, and the use of some medication­s can affect red blood cell production and lead to anaemia.

Age

People over age 65 are at increased risk of anaemia.

COMPLICATI­ONS If not treated, anaemia can cause many health complicati­ons like: Severe fatigue.

When anaemia is severe enough, you may be so tired that you can’t complete everyday tasks.

Pregnancy complicati­ons.

Pregnant women with folate deficiency anaemia may be more likely to experience complicati­ons, such as premature birth.

Heart problems.

Anaemia can lead to a rapid or irregular heartbeat (arrhythmia). When you’re anaemic your heart must pump more blood to compensate for the lack of oxygen in the blood. This can lead to an enlarged heart or heart failure.

Death.

Some inherited anaemias, such as sickle-cell anaemia, can be serious and lead to life-threatenin­g complicati­ons. Losing a lot of blood quickly results in acute, severe anaemia and can be fatal.

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