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Johns Hopkins Health Alert

Don't Underestimate Anemia

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Because the symptoms of anemia can seriously undermine your quality of life and may point to an underlying illness, it is important to know the facts about anemia.

Hemoglobin (Hb) is the protein in red blood cells that picks up and transports oxygen throughout the body. A deficiency in the oxygen-carrying capacity of blood is called anemia. The risk of anemia generally increases with age, but it often goes unnoticed. Symptoms of anemia include weakness, fatigue, trouble concentrating, sexual dysfunction, shortness of breath, and dizziness.

Getting a proper diagnosis for anemia is important. Studies show that anemia may exacerbate the symptoms of underlying heart disease and may be a risk factor for frailty. Through simple tests your doctor can determine the cause of your anemia and, in turn, recommend treatment to boost your Hb levels and restore vitality.

A serum ferritin blood test for iron levels is the first step in diagnosing anemia. Hb needs iron to function and bind to oxygen. The chemical interaction between oxygen and iron-rich Hb makes blood red (think of how oxygen interacts with metals to create rust). Iron-deficiency anemia can result from a decreased ability to absorb nutrients from food -- not uncommon for people over 50. It can also result from malnutrition or a strict vegetarian diet, as meat is an important source of iron.

If your iron levels are low, your doctor will prescribe supplements. Never take over-the-counter iron supplements just because you feel tired. Too much iron can cause hemochromatosis, a rare but dangerous condition in which toxic levels of iron collect in the pancreas and liver. And self-treating with supplements may improve symptoms while their cause -- for example, colon cancer -- goes undiscovered.

Iron-deficiency anemia is often caused by a loss of red blood cells during chronic, low-level gastrointestinal bleeding. Internal bleeding can result from prolonged aspirin or nonsteroidal anti-inflammatory drug use, colon polyps, stomach ulcers, and gastrointestinal cancer. Thus, doctors will typically perform a fecal occult blood test on people diagnosed with iron-deficiency anemia. If blood is found in the stool, an endoscopy is done to check for colon cancer.

You can have normal iron levels and still suffer from anemia. Anemia caused by chronic disease, the most common form of anemia in people over 50. This kind of anemia is not caused by an iron deficiency, but by chronic inflammation from an underlying illness, which signals the immune system to release a steady supply of anti-inflammatory proteins that interfere with the production of red blood cells.

Chronic infections, rheumatoid arthritis, kidney disease, and certain cancers may all lead to this type of anemia. Iron supplements will not help, since the heart of the problem is the source of inflammation. Your doctor may give you injections of erythropoietin, a hormone produced in the kidneys that boosts Hb production, but in most cases anemia of chronic disease is reversed by treating the source of infection or inflammation.

Posted in Healthy Living on July 11, 2007
Reviewed September 2011


Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer


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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or Remedy Health Media, LLC, which has no responsibility for any comments posted on this site.


MY B/F HAS NOTICED BLOOD ON TISSUE AFTER WIPING HIMSELF. HE HAS NO IDEA WHERE IT IS COMING FROM AND I'M NOT VOLUNTEERING TO BE THE EXAMINER. I AM CONCERNED AS HE SUFFERED A BOWEL BLOW-OUT AND HAD SURGERY TO CORRECT MEDICAL SITUATION AND HAS MESH IN HIS STOMACH. I FEEL THAT HAVING A COLONOSCOPY EVERY 10 YRS. IS TOO LONG TO WAIT REGARDING HIS PAST HISTORY WITH HIS BOWELS. WHAT SHOULD HE DO? I KNOW WHAT I'D DO. ANYTHING OR ONE HAVE ANY SUGGESTIONS? THANK YOU :) ................................................................

Posted by: DUCKY529 | September 22, 2012 10:54 PM

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