Most of my patients know that anaemia makes you tired and can be caused by heavy periods. But while blood loss from periods is the most common cause of anaemia in younger women, there's lots more to it than that.
What are red blood cells and why do we need them?
The red colour of blood comes from red blood cells - doughnut shaped cells which float in clear plasma around your body. They're perfectly designed to pick up oxygen from your lungs and carry it round your body to supply your vital organs. Blood in your arteries is full of oxygen, making it look bright red. Once it's lost its oxygen and is on the way back to your heart and lungs via your veins, it takes on a bluish tinge.
Red blood cells only live for about three months before they're naturally broken down and removed from your system, so your body needs a constant new supply. This supply is made in your bone marrow, and three of the vital constituents of red blood cells are iron, vitamin B12 and folic acid. Iron is needed to make haemoglobin - the chemical in red blood cells that locks on to oxygen. You'll be diagnosed as being anaemic on the basis of a low haemoglobin level.
What causes anaemia?
You can develop anaemia for several reasons:
- You're short of the vitamins and minerals you need to make enough red blood cells - the most common are deficiencies in iron , vitamin B12 and folic acid
- You have enough vitamins but there's a fault with the blood-making process in your bone marrow. This happens in diseases such as leukaemia - but remember that the vast majority of people with anaemia don't have cancer
- You have other chronic diseases such as chronic kidney disease that stop your body making red cells efficiently
- Your body is breaking down blood cells too fast. This most commonly happens in childhood because of inherited blood disorders such as thalassaemia or sickle cell anaemia . Occasionally it can be due to infection or problems with your liver or spleen
- You're making enough blood cells but you're losing too much blood to make up the loss fast enough.
In women having periods, by far the most common cause of anaemia is iron-deficiency anaemia - usually because you're losing more iron in blood during your periods than you are getting in your diet. If you're losing blood, you're more likely to be short of iron than vitamin B12 or folic acid. Vegans can struggle to get enough vitamin B12 to make red blood cells. Marmite® is a great vegan-friendly source, whether you love it or hate it!
After the menopause, iron deficiency is less likely, although it can be due to a limited diet or not absorbing food well. It's important not just to assume this is causing your symptoms and buy iron tablets. It is possible to have too much iron in your system if you're taking supplements.
What are the symptoms of anaemia?
Anaemia means it's harder for your body to get the oxygen it needs. This means you're likely to look pale and may feel tired, lightheaded, faint or breathless. You can also suffer from palpitations (as your body pumps blood faster to get more blood cells to where they're needed), headaches, tinnitus (ringing in the ears) and swollen ankles.
If you get these symptoms, do see your GP. A blood will tell if you're anaemic, and can also hint at possible causes. After the menopause, one of the most common reasons for iron-deficiency anaemia is bleeding from your gut. You may not get any symptoms, but it can cause black, tarry poos; tummy pain; and losing weight without meaning to.
With age, your kidneys naturally work less efficiently. This is known as ' chronic kidney disease', or CKD - although for older people it's more a natural part of ageing than a disease as such. In more severe cases, as well as in other conditions like rheumatoid arthritis, you can become anaemic. In many cases it's mild and gradual, and doesn't need treatment.
Not surprisingly, everyone worries about cancer. Cancer, and sometimes treatments for cancer, can cause anaemia. Cancers affecting the blood or bone marrow, such as leukaemia or myeloma, may first be spotted on the basis of anaemia. However, other causes are much more likely.
With thanks to 'My Weekly' magazine where this article was originally published.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.