Anemia Overview

Anemia is one of the widest spread public problems through in  the world. In this condition more developing from that countries where people suffer from malnutrition and helminthic  infection. In this condition characterized  by  a deficiency in the number of red blood cells ( RBC ) in the blood and also hemoglobin in the blood  hemoglobin is iron – protein in red blood cells that carries oxygen to the whole bodies when the bodies have not proper red blood cells or hemoglobin that oxygen carries capacity of the blood is low or reduced,in the tissues or organs and then show sign and symptoms and show their complication. It happens in all stages of human life especially in women and children then pregnant women effected in the world wide. anemia is about 1.62 billion people and then children which means pre- school children the highest prevalence is 74.4%  and then men is lowest prevalence is 12.7% only. Today anemia is the second leading diseases cause in the world and the one of the most significant public health issues in the world according to( WHO 2018 ). Anemia can be cause by variety of factors including poor diet, chronic disease, genetic disorders and blood loss. the symptoms including like fatigue, shortness of breath, dizziness and pale skin. In severe cases, anemia can lead to serious complication such as heart problem,  organ damage and increased risk of infections. According to who report 2 billion people are suffering from anemia in world of which major portion is from south Asia. Anemia which means hemoglobin (HB) Concentration level is lower than 11g/dl for pregnant women and children ( 6 month to 5 Years ) 12g/dl for children 6-14 age and 13g/dl for men.

1. Types of Anemia

Source :- https://www.nature.com/articles/s41598-024-84120-w

• Iron deficiency anemia

This is the most common type of anemia in the world. Iron deficiency anemia develops when you don’t have enough iron in your which reduce production of hemoglobin and cause iron deficiency anemia.

• Vitamin deficiency anemia

Vitamin deficiency anemia is a condition where body doesn’t have enough amount of healthy RBC due to the lack of certain types of vitamins and amino acid or folic acid,  vitamin B12  which are essential for RBC cell production.

• Sickle cell anemia

Sickle cell anemia is a severe form of the inherited blood disorder sickle cell diseases. It is caused by the genetic changes ( Mutation ) that lead to abnormal RBC cells are became like a sickle cell.

• Thalassemia anemia

It is  blood related and genetic disorder. It passes for, parents to children through gens,  gene carry information. Thalassemia causes the body to have less of the protein hemoglobin than usual.  Hemoglobin is present in RBC cells to carry oxygen not having enough hemoglobin or RBC cells can lead to a condition called anemia.

2. Search method ( Sources, data collection )

This article review uses various  database such as Google Scholar, Pubmed,Science Direct,  scopus and Research Gate. The keywords used in the article review such as  Anemia, pathophysiology, prevention  of anemia, diagnosis and treatment were used. Article  published  between 2016 to 2025 were considered. and some additional  information was obtained from the text book and official organization website.

3. Etiology

• Iron deficiency anemia

 Iron deficiency anemia occurs when the body have insufficient iron to produce hemoglobin. the causes of iron deficiency anemia can be classified into several broad categories According to who estimated that about 50% of anemia is related to iron deficiency Adequate iron  intake.

A diet which has lack of iron rich foods or consumes a low iron rich protein such as red meat, and fortified cereals  plant - based diet may lack of sufficient heme iron and may be at higher risk due to lower iron bioavailability from plant bases sources.

• Blood loss ( Menstrual, ulcer, GI )

Heavy menstrual periods can cause iron deficiency in women due to monthly blood loss. Gastrointestinal disorders such as celiac disease,  crohn’s disease or atrophic  gastritis can impair iron absorption in intestine. Chronic diarrhea led to loss iron before it can be absorbed. Parasite infections hookworm and other intestinal parasite cause blood loss.

• Sickle cell anemia

Sickle cell anemia is a genetic disorder that affects the production of hemoglobin, causing red blood cells to be misshaped and break down prematurely. Sickle cell anemia is caused by a mutation in the HBB of beta-globin chain of hemoglobin

• Bone marrow failure

Bone marrow failure refers to the condition where bone marrow is unable to produce enough RBC and also white blood cell platelets.  This  can  be caused by various factors including immune system attacks on steam cells. exposure   to toxins or drugs, inherited condition and certain type of infections.

4. Pathophysiology

Anemia is defined as a reduction of red cell mass below the normal range for age and sex of the individual   and reduction in the oxygen carrying capacity of blood, primarily due to the decrease in the number of red blood cells ( RBC )  or hemoglobin concentration. In adult, hematocrit  below 35% ( HB below 13g/dl ) male and below 35% ( Hb Below 12g/dl ) in female is level for diagnosis of anemia

The pathophysiology of anemia involves in multiple mechanism depending on the type and cause of anemia

• Blood loss

Chronic or acute blood loss reduce the number of RBC cell. common cause like any trauma and heavy menstrual bleeding.

• Impaired hemoglobin

In any case RBC count adequate, If hemoglobin synthesis is defective anemia can occur.

• Decrease RBC cell production

In the condition where  bone marrow not produce proper amount of RBC cells anemia can occurs.

Types of Anaemia: Anemia arises as a result of a variety of defects in RBC such as impaired production as seen in aplastic anemia, impaired maturation deficit in megaloblastic anemia, errors in hemoglobin synthesis characterized by iron deficiency anemia, genetic defects of hemoglobin maturation manifested in thalassemia, synthesis of abnormal hemoglobin detected in hemoglobinopathies, sickle cell anemia and thalassemia and weight loss of RBC's are in haemolytic anaemias.

Iron-Deficiency Anaemia: IDA is one of the most common anaemia in world as well as in India. It is a condition in which there is deficiency of iron in the bloodstream. Haemoglobin, a protein is present in RBC which carries oxygen throughout the body. The body needs iron to make haemoglobin. Without enough iron, less haemoglobin and fewer RBCs are made, leading to anaemia. Iron is essential for the various functions of the human body, especially in the synthesis of hemoglobin. Adolescents and women are more likely to develop anemia (Prema R 1992).

Causes

• Diets low in iron
• Inability to absorb iron
• Abnormalities of GIT (Gastrointestinal tract)
• Internal bleeding
• Pregnancy, menopause, blood loss due to periods
• Excessive blood donation

 Symptoms

• Tiredness,
• Irritability
• Feeling faint
• breathlessness
• Headache
• Palpitation
• Sore or swollen tongue, altered taste
• Pregnancy anemia increases the risk of complications.

For both mother and baby, including low birth weight, premature birth, and postpartum depression. Anemia in the newborn can be caused by the lack of iron reserves in the baby. In addition, vitamin C helps to absorb iron in the body. Iron diet treatment and iron supplements often make anemia better. If you are taking iron pills, your doctor may recommend taking them along with a source of vitamin C, such as a glass of orange juice or an orange fruit.

Pernicious Anaemia: (Pernicious means destructive or injurious) Once thought to be a deadly disease, this type of anemia was given the name "dangerous." Vitamin B-12 injections or B-12 oral supplements can now be used for treatment.

Causes

• Inadequate diet
• Vitamin B12 deficiency
• Intrinsic Factor deficiency in the body
• Gastrointestinal tract infection

Symptoms

• Fatigue
• Breathlessness
• Pale skin
• Chest pain
• Poor coordination, balance difficulties
• Slow reflexes
• Depression

Which red blood cells (RBCs) are separated from the blood until they reach the end of their natural life. People of all ages, races, and genders are affected by this type of anemia. Sickle cell anemia, Thalassemias, and hereditary spherocytosis are all examples of this inherited form of anemia. RBCs can also be damaged by certain diseases and chemicals, which has led to the end of.

Haemolytic anemia. The most serious form of haemolytic anemia is caused by receiving a transfusion of red blood cells of the wrong blood type.

Symptoms Some symptoms of haemolytic anaemia are the same as those for other forms of anaemia.

• Jaundice
• Fatigue
• Shortness of breath, dizziness, and headaches are all symptoms of a low RBC count, as are cold hands and feet, pale skin, and chest pain.
• Abdominal pain

Blood transfusions, drugs, blood and bone marrow transplants, lifestyle changes, and surgery are all treatments for haemolytic anemia. The spleen may need to be removed in the worst cases. In fact, RBCs are missing. The canopy can be removed to reduce the destruction of RBCs.

Aplastic Anaemia: Aplastic anemia is a blood disorder in which the bone marrow fails to produce enough new blood cells, leading to a variety of health conditions such as arrhythmias, enlarged heart, heart failure, infection and bleeding.

Causes

• Although radiation and chemotherapy are effective against cancer cells, they can also damage healthy cells, such as bone marrow stem cells.
• It is possible to fix this by avoiding contact with these chemicals.
• Immune Deficiency Syndrome - Stem cells in your bone marrow can be involved in the immune system when your immune system destroys healthy cells.

Symptoms

• Pale skin
• Fatigue
• Shortness of breath
• Dizziness
• Headache
• Chest pains

Treatment includes transfusion of blood, bone marrow stem cell transplants, and medications. These treatments are useful for preventing or limiting complications, relieving symptoms, and improving quality of life.

Causes of Anaemia: A healthy diet is always what gives you enough nutrients to meet your body's needs. Therefore, a balanced diet is sufficient to prevent anemia. The main cause of anemia is anemia, folic acid, and iron-rich foods. Anemia is common in children due to low iron content at birth, low iron content in breast milk, and low iron intake in the diet during childhood and adolescence. Nutritional Treatment of Anaemia: Anemia can be treated by simply looking at how much food we help produce hemoglobin. Generally, to combat anemia, people should be aware of the importance of iron, copper, zinc, folic acid, vitamin B-12, and protein. Treatment of anemia requires a combination of iron and vitamin B.

5. Recant advance treatment

Recant advance anemia treatment has improved with new methods like gene therapy and many types of special medicines that help the body produce more amount of RBC cells using hormone called erythropoietin. Recant advance technique for anemia treatment especially with the introduction and a deeper understanding of the root causes of anemia some treatment like that oral iron supplement and blood transfusion are still in use, newer method is included intravenous iron therapies.

6. Prevention and Public health

To protect from anemia require combination of nutrient,  medicinal, and public health measures.These strategies can be divided into three main areas : improving dietary intake in the daily basis  education awareness program and promoting behavior medication. A well proper balance diet rich in iron folic acid and other essential nutrient play a major role in  preventing anemia.

• Supplementation program

In this supplementation program preventing from anemia  in many countries especially where anemia is common Ex-  Yemen, Pakistan, India  crucially during pregnancy in second trimester and weekly iron rich food and folic acid tablet syrup are provided to adolescent both in and out of school. The program are often supports by health department government and crucial in reducing in anemia related complication.

• Regular screening and early detection

High risl of anemia chance in like pregnant women infants and older person there are no any symptoms in early stage of the anemia making regular screening indentified   before   its  progresses. Early treatment of the anemia can prevent the development of   serious  complication  symptoms   like – fatigue, weakness.

Nutritional program in india like ( Anemia mukt  bharat )

The program was launched by : Ministry of health and family welfare, Government of India Year : 2018. Purposed of this program: To reduce the prevalence of anemia across different age groups in India, especially children, adolescent, women and pregnant women.

Anemia is a major health issue in India. According to national health survey of India more than 50% of women and children in India suffer from anemia. Anemia Mukt Bharat strategy is implemented to reduce the anemia among   six beneficiaries  age group children ( 6-59 months ), children ( 5- 9 years ), Adolescents ( 10 – 19 years ), Pregnant and lactating women and women of reproductive age group ( 15 -49 ).

7. Diagnosis

Diagnosis  involving   assessing symptoms, conducting a physical test and utilizing blood test:-

Physical symptoms

• Pale skin
• Fatigue or weakness
• Chest pain
• Shortness of breath
• Dizziness    

Some blood test for diagnosis of anemia

(1) CBC ( Complete blood count )

The CBC  test is basic test for detection of anemia.In CBC test hemoglobin ( HB ) count It indicate anemia.

2.  Peripheral blood smear

This test identified visualization of RBC under a microscope. It helps to identify the:-

• Abnormal shapes
• Size variations
• Immature  cell

3. Bone marrow biopsy

A bone marrow biopsy is advance technique for diagnostic anemia. The bone marrow is the primary site of RBC production, white blood cells and Platelets. when anemia not clearly by routine test then move to the bone marrow biopsy test help assess whether the functioning normally or affected by diseases.

Ranges of anemia