Anaemia - Not Just an Iron Deficiency

Unlike what is popularly known, iron-deficiency is only one form of anaemia. The definition of anaemia is actually “a deficiency of normal haemoglobin (the iron-containing, oxygen-transport component of red blood cells) in the blood”. This can come from just a decrease in the amount of red blood cells, a decreased amount of haemoglobin (Hb) in each cell, or both. Anaemia can also come from the production of abnormal haemoglobin.

Because one of the jobs of Hb is to carry oxygen, its decrease will thus give people a lack of oxygen, leaving them tired, and lacking energy. Anaemia sufferers can look pale and can be unable to sustain exercise.

Normal red blood cells

Because anaemia is simply a reduction in normal Hb concentrations, there are many types of anaemia. Here are some examples:

Iron-deficiency Anaemia

This can come from the sufferer not ingesting enough iron from the diet or the body not being able to absorb it properly. Since iron is a major component of Hb, low amounts of it lead to less Hb being produced, and hence less red blood cell production. The red blood cells that are produced are smaller than normal.

Folate-deficiency Anaemia


Not enough folic acid (or folate, Vitamin B9) can cause anaemia. Because folate helps create DNA (and is hence extremely important for pregnant women) a folate deficiency means that fewer cells divide and fewer red blood cells are produced. A deficiency in folate during pregnancy can lead to birth disorders of the child, such as spina bifida.

Aplastic Anaemia

Aplastic anaemia is simply the insufficient production of red blood cells. In this type of anaemia, the red bone marrow, whose job it is to produce red blood cells, is unable to do so. This problem usually comes from damage to the red marrow by chemicals such as benzene, drugs such as antibiotics and sedatives, or radiation.

Thalassemia

Thalassemia comes from decreased production of the globin chains of haemoglobin. It is a hereditary disease found in people of the Mediterranean, Asian and African areas. If the case is severe, and haemoglobin concentrations reach a critical level, then death can occur before 20 years of age.

This hereditary disease is found in people of African descent. A sickle-cell is one of an odd shape.
Sickle cells with normal red blood cells.

Instead of biconcave disks, sickle-cell red blood cells are shaped like a blade (like a ‘sickle’ tool for cutting grass). These cells can puncture holes in normal red blood cells, can plug up blood vessels and are more fragile than usual. In many cases the production of normal haemoglobin compensates for abnormal Hb, and the sufferer may not show any symptoms at all.

There are many other types of anaemia, such as pernicious anaemia, hemorrhagic anaemia, and sideroblastic anaemia. Signs of anaemia can be obvious or non-apparent, but are are all to do with a reduction of normal haemoglobin production, and only sometimes with iron-deficiency.