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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.

Red Blood Cells

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. Thalassemia anemia is characterized by symptoms like jaundice, enlarged spleen, shortness of breath and facial bone deformities.


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.

Restless Leg Syndrome

Restless leg syndrome or RLS involves an urge to restlessly move the legs in order to stop certain unpleasant sensations. RLS is also known as Willis-Ekbom disease. Affected part of the legs experience itching, tickle or burning sensation. Typically, the victim can suffer from RLS at all times of the day and more so in the night.


Restless leg syndrome occurs most often in middle aged and older adults. Stress can make it worse. Nervous and circulatory systems are most often involved in this syndrome. Deficiencies of folic acid and B complex vitamins are other causes for restless leg syndrome. A particular form of RLS is passed down in families. Persons suffering peripheral neuropathy, Parkinson's disease or Chronic kidney disease are more likely to suffer restless legs.


Warm baths, electric nerve stimulation, massage and gentle stretching exercises offer relief to those suffering from Restless Leg Syndrome. Oral magnesium, Vitamin E, Folic Acid and Quinine water can help tackle this condition.



Homocysteine Blood Test

Homocysteine blood test measures the amount of amino acid homocysteine in the blood. High level of homocysteine is associated with low level of vitamin B6/ B12, and folate. This blood test helps us to identify the deficiency and get treated accordingly. The results of the blood test are generally ready within 24 to 72 hours. Homocysteine is measured in micromoles per liter of blood.


Homocysteine (HCY) is considered as the main biochemical marker of several primary and secondary disorders of methionine metabolism. Methionine is one of the essential Amino acids and sweeps the blood stream of heavy metals. It plays a major role in protecting the liver. Poor Methionine Metabolism can result in Homocysteinemia, Cystathionine Synthase (CS) deficiency (Homocystinuria) and Methylenetetrahydrofolate reductase (MTHFR) deficiency.


Homocysteine is a non protein amino acid that is produced by the body and is present in small levels in the blood. Amino acids are the building blocks of all proteins in the body. In our body, vitamins B6, B12 and folate convert homocysteine into other usable substances. A deficiency in these vitamins may cause an elevated level of homocysteine. Elevated levels in infants can prove fatal as the infant may be highly prone to develop heart or blood vessel diseases at an early age.


Reference Level of Homocysteine : Less than or equivalent to : 13 µmol/L (micromoles per liter)


Elevated levels of homocysteine could be due to genetic causes (a rare disorder called Homocystinuria that is caused by a dysfunctional enzyme that is essential for metabolism in the body) or due to other causes like atherosclerosis.
In addition to be the important marker for inherited disorders of methionine metabolism, the total homocysteine (HCY) level can accurately predict conditions such as cardiovascular disease (atherosclerosis, thromboembolism). Besides it can also indicate acquired folate or cobalamin deficiency - a contributing factor in the pathogenesis of neural tube defects.


Homocysteine is measured using a simple blood test. This blood test is done to identify


  • B12 deficiency or folic acid deficiency
  • Cause for blood clots
  • Rare inherited disease that causes deficiency of enzymes needed to convert food to energy.

What causes high/low homocysteine value in blood ?

High values in blood may be caused by:


  • Vitamin B12, B6 or folic acid deficiency
  • Homocysteine value is usually high in men than in women. However post-menopause the levels tend to match. But during middle age women record low levels of homocysteine when compared to men.
  • Consuming too much alcohol, smoking
  • Other diseases like hypothyroidism, Alzheimer's disease, kidney disease, certain cancers can influence the homocysteine level.
  • Advancing age, reduced appetite leads to inadequate vitamin intake thus leading to the condition.
  • Lifestyle factors also contribute to the surge in homocysteine levels in the blood.

How is high level of homocysteine harmful ?

Higher levels of homocysteine can point to an underlying Cardiovascular disease or a Neuro vascular disease.
Elevated levels of homocysteine can:

Damage artery lining: Arteries tend to become damaged and begin to clog, thicken and become inflexible thus leading to atherosclerosis.

Create blood clots: Homocysteine can elevate the cholesterol levels thus clogging the arteries and thickening them thus leading to atherosclerosis. Blood clots form easily thus leading to heart attack.

Strokes: Elevated level of homocysteine can affect the arteries leading to and from the brain thereby causing a blood clot or a rupture in the blood vessel. This in turn can cut off/reduce the oxygen supply to the brain thereby starving the brain cells of nutrition and oxygen thus leading to a stroke.

Osteoporosis: Density of the bone mass reduces thus leading to fragile and weakened bones.

Cause infertility: Women with high level of homocysteine find it difficult to conceive and are at the risk of repeated miscarriages.

Cause dementia and Alzheimer's: Old age can contribute to high levels of homocysteine thus damaging the brain cells. Over time memory is lost thus killing more and more cells.


Homocysteine level in the blood can be lowered by:


1. Consuming more fruits and vegetables, as it can help increase the folate level in the blood. Green leafy vegetables like Brussels sprouts, broccoli, spinach, asparagus, etc contribute largely in increasing the folate level.

2. Fortified grain products, lentils, spinach, asparagus, and breakfast cereals also are a good source of folate.

3. Consuming citrus fruits like oranges and grapefruit can help.

4. Potatoes, breakfast cereals, chickpeas (garbanzo beans), bananas, and chicken are a good source of Vitamin B6 which help improve the homocysteine level in the blood.

5. Beef, organ meats, dairy products and fish are a great source of Vitamin B12 which in turn can increase the homocysteine.

6. Apart from folate in the diet, Vitamin B6 and B12 supplements help in raising the homocysteine level.

Who should get this test done?

People who have a history of heart diseases and are at a high risk for heart disease should get their homocysteine level checked. People who are at risk for stroke also need to get this check done.


Tags: #Anemia #Restless Leg Syndrome #Homocysteine Blood Test
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Collection of Pages - Last revised Date: June 24, 2021