Anemias Health Article

Self-care

Anyone who has anemia caused by poor nutrition should modify his or her diet to include more vitamins, minerals, and iron. Vitamin C can stimulate iron absorption. The following foods are also good sources of iron:

• almonds
• broccoli
• dried beans
• dried fruits
• enriched breads and cereals
• lean red meat
• liver
• potatoes

• poultry
• rice
• shellfish
• tomatoes

Because light and heat destroy folic acid, fruits and vegetables should be eaten raw, or cooked as little as possible.

Health care team roles

Anemia is often overlooked as a priority associated with quality patient care. Identifying the underlying causes of anemia in patients is critical to positive care outcomes and requires early assessment and intervention. The entire health care team plays a critical role in the well-being and quality of life of patients with anemia by understanding the disease and appropriate treatments, and by providing patients with any materials and education needed to understand the disease and its treatment.

Folic acid and iron deficiency anemias

It usually takes three to six weeks to correct folic acid or iron deficiency anemia. Patients should continue taking supplements for another six months to replenish iron reserves and should have periodic blood tests to make sure the bleeding has stopped and the anemia has not recurred.

Pernicious anemia

Although pernicious anemia is considered incurable, regular B₁₂ shots will alleviate symptoms and reverse complications. Some symptoms will disappear almost as soon as treatment begins.

Aplastic anemia

Aplastic anemia can sometimes be cured by bone marrow transplantation. If the condition is due to immunosuppressive drugs, symptoms may disappear after the drugs are discontinued.

Sickle cell anemia

Although sickle cell anemia cannot be cured, effective treatments enable patients with this disease to enjoy longer, more productive lives.

Thalassemia

People with mild thalassemia (alpha thalassemia trait or beta thalassemia minor) lead normal lives and do not require treatment. Those with severe thalassemia may require bone marrow transplantation. Genetic therapy is being investigated and may soon be available.

Hemolytic anemia

Acquired hemolytic anemia can generally be cured when the cause is removed.

Prevention

Inherited anemias cannot be prevented. Genetic counseling can help parents cope with questions and concerns about transmitting disease-causing genes to their children.

Avoiding excessive use of alcohol, eating a balanced diet that contains plenty of iron-rich foods, and taking a daily multivitamin can help prevent anemia.

Methods of preventing specific types of anemia include:

• Avoiding lengthy exposure to industrial chemicals and drugs known to cause aplastic anemia.
• Not taking medication that has triggered hemolytic anemia and not eating foods that have caused hemolysis (breakdown of red blood cells).
• Receiving regular B₁₂ shots to prevent pernicious anemia resulting from gastritis or stomach surgery.

KEY TERMS

Aplastic—Exhibiting incomplete or faulty development.

Diabetes mellitus—A disorder of carbohydrate metabolism brought on by a combination of hereditary and environmental factors.

Erythropoiesis—Erythropoiesis is the development of mature red blood cells (erythrocytes).

Hemoglobin—An iron-containing pigment of red blood cells composed of four amino acid chains (alpha, beta, gamma, delta) that delivers oxygen from the lungs to the tissues of the body.

Megaloblast—A large erythroblast (a red marrow cell that synthesizes hemoglobin).

Red blood cells—Yellowish, circular, biconcave disks found in the blood, which contain hemoglobin and carries oxygen. Also known as erythrocytes.

BOOKS

Ramakrishnan, Usha, ed. Nutritional anemias. London: CRC Press, 2001.

Tierney, Lawrence M., Jr., et al., eds. Current Medical Diagnosis & Treatment. Stamford, CT: Appleton & Lange, 1998.

PERIODICALS

Mahoney, Martin C. "Screening for iron deficiency anemia among children and adolescents." American Family Physician 62:3 (August 1, 2000): 671+.

Sheth, Sujit & Brittenham, Gary M. "Genetic disorders affecting proteins of iron metabolism: Clinical implications. Annual Review of Medicine 51 (2000): 443+.

Worrall, L.M., Tompkins, C.A., & Rust, D.M. "Recognizing and managing anemia." Clinical Journal of Oncology Nursing 3:4 (October 1999): 153+.

ORGANIZATIONS

Aplastic Anemia & MDS International Foundation. P.O. Box 613, Annapolis, MD 21404-0613. (800) 747-2820 or(410) 867-0242. <http://www.aplastic.org>.

Leukemia & Lymphoma Society. 1311 Mamaroneck Ave., White Plains, NY 10605. (914) 949-5213. <http://www.leukemia-lymphoma.org>.

National Heart, Lung, Blood Institute Information Center. P.O. Box 30105, Bethesda, MD 20824-0105. (301) 592-8573. <http://www.nhlbi.nih.gov>.

National Organization for Rare Disorders. P.O. Box 8923, New Fairfield, CT 06812-8923, (203) 746-6518 or (800) 999-6673. <http://www.rarediseases.org>.

OTHER

Iron Disorders Institute. <http://www.irondisorders.org>.

National Center for Biotechnology Information.

<http://www.ncbi.nlm.nih.gov>.

Jennifer F. Wilson