Anemia

Anemia stands for 'without blood' in Greek; When the number of red blood cells (RBC) falls below normal, Anemia is a resultant condition. Hemoglobin is an important constituent of RBC. Hemoglobin usually occurs in the range of 12 and 18 g/dL (grams per deciliter of blood). If the hemoglobin levels show a decrease, anemic conditions set in. Consequently, the various organs and tissues of the body do not receive adequate oxygen on account of the diminished oxygen carrying capacity of the blood. This impairs their normal functioning. Usually women have smaller stores of iron than men. Besides, they also lose blood during menstruation making them primary targets for anemia.

World Health Organization (WHO) defines anemia as a hemoglobin level lower than 13 g/dL in men and lower than 12 g/dL in women. It is essential to be familiar with the typical symptoms of anemia. Often anemia is misdiagnosed and left untreated. An anemic person is likely to feel extremely tired and weak. This is accompanied with dizziness and breathlessness. A person suffering from anemia tends to appear pale and experience feelings of depression. In some cases, anemia can lead to heart ailments too.

Causes of Anemia

• Serious disease or infection such as hookworm infection, bleeding piles, esophageal var ices and peptic ulcers.
  
• Hemorrhagic - Excessive blood loss due to surgery, menstruation or injury.
  
• Genetic defects lead to sickle cell anemia, Thalassemia anemia and aplastic anemia.
  
• Hemolytic - Excessive intravascular blood destruction where red blood cells are destroyed prematurely.
  

Types of Anemia

Iron deficiency Anemia - Nearly 20% adult women tend to suffer from this form of anemia. Loss of blood due to menstruation is not compensated with an iron-rich diet. Pregnancy and breast feeding can also deplete iron stores. Iron deficiency anemia is also noticed during growth spurts or internal bleeding.

Aplastic anemia - When the bone marrow does not produce sufficient quantities of blood cells, aplastic anemia is noticed. Childhood cancers such as leukemia are often responsible for this form of anemia. Other possible causes of aplastic anemia are radiation, cancer or antiseizure medications and chronic diseases such as thyroid or kidney malfunction. Treatment for aplastic anemia involves blood transfusions and bone marrow transplant. This is done to replace malfunctioning cells with healthy ones.

Vitamin deficiency anemia - Low levels of folic acid lead to faulty absorption of iron. Anemia caused due to folic acid deficiency is called Megaloblastic anemia. Pregnancy doubles the body requirements of folic acid and it is imperative that pregnant women take folic acid supplements. Good dietary sources of folate are fresh fruits, green leafy vegetables, cruciferous vegetables, liver and kidney, dairy products and whole grain cereals. Vegetables should be eaten raw or lightly cooked.Folic acid anemia is also a common problem faced by alcoholics. Vitamin B-12 deficiency can lead to a condition of Pernicious anemia. Diseases such as thyroid malfunction or diabetes mellitus can affect the body's ability to absorb vitamin B-12. This vitamin is vital in the production of hemoglobin.

Vitamin C Deficiency Anemia is a rare form of Anemia that is the result of small red cells owing to prolonged dietary deficiency of the Vitamin C.

Sideroblastic Anemia: In this anemia, the body has sufficient iron but it fails to incorporate it into hemoglobin.

Hemolytic Anemia results from high rate of destruction of Red Blood Cells (RBC) at a rate faster than the rate bone marrow can replenish them.

Thalassemia anemia - Thalassemia or Cooleys Disease is a hereditary disorder found predominantly in people of South East Asian, Greek and Italian racial groups. This form of anemia is seen in differing degrees as Thalassemia encompasses a group of related disorders that affect the human body in similar ways. The most common occurrences of Thalassemia are alpha and beta thalassemia. Alpha thalassemia occurs when there are defects in the genes that produce alpha globin, while beta thalassemia occurs when there are defects in the genes that produce beta globin. The severity of the disorder depends on how many genes are affected and the specific mutations involved. Thalassemia anemia is characterized by symptoms like jaundice, enlarged spleen, shortness of breath and facial bone deformities.
Thalassemia is a group of inherited blood disorders that affect the production of hemoglobin, a protein in red blood cells that carries oxygen throughout the body. The disorder is caused by mutations in the genes that control the production of hemoglobin. Thalassemia anemia occurs when a person has fewer red blood cells than normal, or the red blood cells are smaller and do not contain enough hemoglobin. This can lead to a range of symptoms, including fatigue, weakness, pale skin, jaundice, and an enlarged spleen.

Treatment for thalassemia anemia may involve blood transfusions, iron chelation therapy to remove excess iron from the body, and bone marrow transplant in severe cases. With appropriate treatment and management, many people with thalassemia can lead healthy and productive lives.

Diagnosing Anemia

A complete blood count test will test for hemoglobin levels and display an anemic condition. But often anemia is a symptom whose cause lies deeper. The cause and type of anemia will determine the treatment that is needed. A stool test will help in detecting occult blood. Hemoglobin electrophoresis is a blood test that helps identify abnormal hemoglobins. Diagnosing thalassemia or sickle cell anemia becomes possible with this test.

Treating Anemia

Deficiency can be treated with supplements of iron, Vitamin B-12 and Vitamin C. Partaking an iron-rich diet can be beneficial for those suffering from nutritional deficiency anemia. Seafood, nuts, whole grains and dried fruits such as raisins, prunes and apricots are rich in iron. Ensure adequate consumption of Vitamin C as it aids and stimulates iron absorption. Try and combine citrus foods with iron-rich foods - add tomatoes to a turkey sandwich or chopped strawberries with iron-fortified breakfast cereals.

Paraplegia

Paraplegia is sensory or motor disorder in the lower extremities of the body. The impairment is due to damage caused as a result of congenital deformities or trauma and spinal injuries. The effects of paraplegia are predominantly seen in the thoracic, lumbar and sacral region. The damage caused as a result of paraplegia can lead to other issues such as monoplegia (dysfunction of one organ), paralysis and some times fecal incontinence and impotence.

Spastic paraplegia and flaccid paraplegia are two important forms of the disease which are differentiated based on the location. Flaccid paraplegia is associated with the lesion caused in the spinal cord; which in turn causes two significant forms of myelopathies compressive and non-compressive respectively. The compressive form of paraplegia occurs because of the destruction of the spinal cord due to pressure exerted on it. In most cases the pressures caused are because of underlying medical conditions such as neoplasms, degenerative spinal disease or hematoma. The compressive forms are predominantly located in extradural and subdural regions causing extra medullary and intramedullary complications such as neurofibroma and meningioma.

The lesions caused affect the spinal arteries causing ischemia eventually leading to tissue necrosis in the respective region. This leads to the development of edema in the spinal region causing compression and damage. Because of increased pressure, paraplegia can initiate complications such as pneumonia, pressure sores which are decubitus in origin. Often the pain associated with paraplegia radiates in the region of nerve damage. Vitamin B 12 deficiency also leads to the occurrence of paraplegia of non compressive origin.

Vitamin B complex

B Vitamins - the group of water soluble vitamins essential for the normal functioning are not usually produced by our bodies and require to be replenished regularly.

Vitamin B1 - Thiamine
Vitamin B2 - Riboflavin
Vitamin B3 - Niacin, Niacinamide
Vitamin B5 - Pantothenic acid
Vitamin B6 - Pyridoxine
Vitamin B7 - Biotin
Vitamin B8 - Inositol
Vitamin B9 - Folic Acid
Vitamin B12 - Cyanocobalamin

Some Vitamin B Complex formulations, in addition to the above major B Vitamins, may contain Inositol, choline bitartrate and Para Amino Benzoic Acid - PABA.

Vitamin B1

Vitamin B1 or thiamine helps the body convert carbohydrates into energy and it is necessary for the heart muscles, nervous system and brain to function properly. Very low levels of Vitamin B1 can lead to Beriberi - a cardiovascular and neurological disease. Deficiency of Vitamin B1 can cause weight loss and weakness. Fortified breads, cereals, pasta, meat, fish, dried beans, leafy vegetables, whole grains, egg yolk, soy foods and peas contain Vitamin B1. Brewer's yeast is a natural source high in thiamine.

RDA - Recommended Daily Allowance:

Adults - Men: 1.2 mg
Adults - Women: 1.1 mg
Pregnant Women: 1.4 mg
Breastfeeding Women: 1.5 mg

Vitamin B1 is generally well tolerated and rarely produces adverse side effects with high doses. Deficiency of Vitamin B1 can result in Beriberi ( literally 'I can't' in Sinhalese language) - a disease with the symptoms of loss of appetite, weakness, irritability, tingling of nerves, poor muscles coordination and muscular pain in the calves. This disease is due to poor metabolization of glucose.

Vitamin B2

This is essential for converting carbohydrates into energy and produce red blood cells. Significantly, this vitamin is important for vision. Vitamin B2 or Riboflavin is essential for fat and protein metabolization. Vitamin B2 boosts the immune system, maintains healthy hair and helps functioning of the nervous system. Deficiency of Vitamin B2 can lead to acne, muscle cramps, carpal tunnel syndrome and migraine headache. Best natural sources of Riboflavin are meat, eggs, legumes, nuts, dairy products, green leafy vegetables, broccoli, asparagus, and fortified cereals.

RDA - Recommended Daily Allowance:

Adults - Men: 1.3 mg
Adults - Women: 1.1 mg
Pregnant Women: 1.4 mg
Breastfeeding Women: 1.6 mg

Vitamin B2 is generally well tolerated and rarely produces adverse side effects like sensitivity to light with high doses. Supplements of Riboflavin can result in bright yellow urine.

Vitamin B3

Food is turned into energy in the body by Niacin. Niacin or Vitamin B3 also helps maintain healthy skin and important nerve functions. The benefits of Vitamin B3 include good blood circulation and brain functioning. Vitamin B3 is also required in order to produce various hormones including progesterone and testosterone. Vitamin B3 - Niacin and its related compounds Nicotinic Acid and Nicotinamide plays an important role in lowering cholesterol levels and aiding widening of arteries. It plays a role in fat, protein and carbohydrate metabolization. Severe deficiency of Vitamin B3 can lead to Pellagra - diarrhea, scaly skin and dementia. This vitamin is naturally found in red meat, poultry, fish, fortified cereals and peanuts.

RDA - Recommended Daily Allowance:

Adults - Men: 16 mg
Adults - Women: 14 mg
Pregnant Women: 18 mg
Breast feeding Women: 17 mg

Vitamin B3 in high doses can result in burning, tingling sensation with/without red flushed skin. Niacin can also trigger hyperglycemia in the case of type 2 diabetes. Humans can synthesize Niacin from the amino acid Tryptophan in the presence of Vitamin B2 and Vitamin B6.

Vitamin B5

Vitamin B5 also known as Pantothenic acid is often used in combination with other B Vitamins in Vitamin B formulations. Vitamin B5 is primarily used for treating dietary deficiencies, acne, alcoholism, allergies, baldness, asthma, attention deficit-hyperactivity disorder (ADHD), autism, burning feet syndrome, yeast infections, heart failure, carpal tunnel syndrome, respiratory disorders, celiac disease, colitis, conjunctivitis, convulsions and cystitis. Some times Vitamin B5 is also used for controlling dandruff, depression,tongue infections, gray hair, headache, hyperactivity, low blood sugar, insomnia, irritability, muscular dystrophy, muscular cramps in the legs associated with pregnancy or alcoholism and improving athletic performance.

RDA - Recommended Daily Allowance:
Adults - Men: 5 mg
Adults - Women: 5 mg
Pregnant Women: 6 mg
Breastfeeding Women: 7 mg
Vitamin B5 is generally well tolerated in moderate doses but may produce adverse side effects like diarrhea with high doses.

Vitamin B6

Important for brain and nerve function, vitamin B6 - Pyridoxine helps the body break down the proteins and produce red blood cells. It is essential in making antibodies, maintaining nerve function and in the production of hemoglobin. Vitamin B6 also has a role in homocysteine metabolism. Vitamin B 6 deficiency leads to confusion, irritability and depression. Potatoes, bananas, beans, nuts, legumes, whole grains and poultry, fish, eggs, spinach and fortified cereals naturally contain Vitamin B6.

RDA - Recommended Daily Allowance:
Adults - Men below 50 years: 1.3 mg
Men - above 50 years: 1.7 mg
Adults - Women Below 50 years: 1.3 mg
Women Above 50 years: 1.5 mg
Pregnant Women: 1.9 mg
Breastfeeding Women: 2 mg

Vitamin B6 is generally well tolerated but may produce neurological disorders with high doses.

Vitamin B7

Vitamin B7 / Biotin plays a key role in breaking down of fats, proteins and Carbohydrates apart from regulating signals between cells. Some studies have indicated that supplementation of this Vitamin B / Biotin has some positive effect on hair loss and brittle nails.

Biotin or Vitamin B7: RDA - Recommended Daily Allowance:
Adults: 30 microgram
Biotin deficiency manifests in the form of scaly inflammation of the skin, poor appetite, hair loss, nausea, vomiting, anemia, depression and general weakness.

Vitamin B8

Inositol is part of the Vitamin B group and included as Vitamin B8. Our body manufactures Inositol from glucose. Next to Niacin, in terms of quantities, human body contains more Inositol, specifically in the spinal cord nerves, the brain and the cerebral spinal fluid. Inositol is a fundamental ingredient of cell membranes. It is necessary for proper functioning of nerves, brain and muscles in the body.

RDA - Recommended Daily Allowance:
It has not been established in any Scientific study as of now - about the minimum / maximum for this Vitamin B8 / Inositol. In many cases administration of this Vitamin B8 has been as high as 22gm without any adverse effects - indicating that this Vitamin is well tolerated.

Vitamin B9

Folate or Vitamin B9 is folic acid or folacin, that helps to produce red blood cells and it essential for DNA creation. Dried beans, legumes, green leafy vegetables, orange juice, asparagus, fortified bread, rice, and cereals are all good natural sources of Vitamin B9.

RDA - Recommended Daily Allowance:
Adults - Men: 400 mcg
Adults - Women: 400 mcg
Pregnant Women: 600 mcg
Breast feeding Women: 500 mcg

Vitamin B9 is generally well tolerated but may mask a Vitamin B12 deficiency with high doses. Deficiency of Folate can result in Megaloblastic Anemia which is also known as large cell Anemia or Macrocytic Anemia. Deficiency during the time of pregnancy or the period preceding pregnancy may result in neural tube defects in the fetus.

Vitamin B12

Vitamin B12 or cobalamin helps to make red blood cells and is important for brain and nerve cell functions. Vitamin B12 is effective in DNA synthesis, fatty acid synthesis and cell metabolism. Vitamin B 12 is found naturally in fish, red meat, poultry, milk, cheese, and eggs and also breakfast cereals. B12 deficiency leads to pernicious anemia - which manifests in the form of weakness, sore tongue, general apathy, back pain and tingling in the extremities. Vitamin B12 helps maintain a healthy digestive system, healthy skin and hair and protect against high blood pressure and heart disease. Vitamin B 12 helps protect against breast cancer, colon cancer and prostate cancer.

RDA - Recommended Daily Allowance:
Adults - Men: 2.4 mcg
Adults - Women: 2.4 mcg
Pregnant Women: 2.6 mcg
Breast feeding Women: 2.8 mcg

Vitamin B12 is generally well tolerated.