Hardly a novice runner, Allison was working hard to improve her distance and run a half marathon…without success. After only a few miles, she felt extremely tired and had to stop and walk for a few minutes. As her frustration mounted, a running friend suggested that she see a doctor. “Sounds like anemia to me,” the friend said. And it was. With some iron supplements, her training is back on track.
Anemia has been called tired blood, and fatigue is the most common symptom. The cells of the body need oxygen, and this is delivered to them by the iron-rich hemoglobin which attaches itself to oxygen in the lungs and travels through the body in red blood cells. When there is a shortage of red blood cells, there is a shortage of oxygen in working cells, and the result is anemia. There are about 400 types of anemia, but there are three main causes: 1) loss of blood, 2) lack of red blood cell production and 3) destruction of large numbers of red blood cells.
BLOOD LOSS: The loss of red blood cells through bleeding is common, and women of child-bearing age are vulnerable, particularly if they have heavy periods.
Heavy use of aspirin, ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs)–common among endurance athletes–can cause gastrointestinal bleeding, including ulcers.
Rapid blood loss can occur following surgery, childbirth or a ruptured blood vessel. Gradual, chronic loss because of ulcers or heavy menstrual bleeding is more common and can be equally dangerous because the symptoms are more subtle and may go unnoticed.
When blood loss exceeds production of red blood cells, the result is often iron-deficient anemia–by far the most common type.
LACK OF RED BLOOD CELL PRODUCTION: Iron deficiency anemia can also occur because of diet. Without enough foods rich in iron, folate and vitamin B12, the body is hampered in its effort to create sufficient healthy red blood cells.
A substantial portion of the iron in most of our diets comes from meat; as a result, vegetarians and vegans are at risk. There are, however, plenty of non-meat sources of iron: dark green, leafy vegetables; beans; lentils; dried fruits; nuts; and iron-fortified cereals.
Folate is found in these foods plus citrus fruits and juices and fortified breads and cereals. Vitamin B12 is found naturally in dairy products and is often added to cereals and soy products.
Iron-deficiency anemia can occur because of the extra demands placed on the body by pregnancy, breast feeding or high-level endurance training. Chronic diseases that affect the body’s ability to produce red blood cells include cancer, HIV/AIDS, rheumatoid arthritis and kidney disease.
DESTRUCTION OF RED BLOOD CELLS: Hemolytic anemia occurs when red blood cells are prematurely destroyed and removed from the system. Cells die at a pace faster than the bone marrow can replace them.
Hemolytic anemia is often associated with an autoimmune disorder in which the spleen mistakenly traps and destroys healthy blood cells.
One of the most severe forms of hemolytic anemia occurs when a person receives a transfusion of blood of the wrong blood type. Existing red blood cells produce antibodies to fight the transfused blood, causing extremely rapid destruction. A newborn can develop this type of hemolytic anemia when the mother and child have incompatible blood types.
Sickle cell anemia is an inherited disorder in which red blood cells form an abnormal crescent shape that causes them to get stuck in tiny blood vessels and break down prematurely. This disorder affects mainly African American and Hispanic Americans.
WHAT TO DO: Whether because of diet, destruction or blood loss, the bottom line is blood that does not contain enough red blood cells and hemoglobin to nourish the tissues of the body. In addition to fatigue, symptoms can include weakness, pale skin, cold hands and feet, shortness of breath, dizziness and a fast or irregular heartbeat.
All of these are symptoms of other common ailments, so a visit to your doctor and a complete blood count is needed to confirm a diagnosis. In some cases, the patient may have symptoms too mild to be noticed, especially at first.
In many cases, treatment is simple: a change of diet plus iron and other supplements. If a medical condition or illness is responsible for the deficiency, then the underlying cause must be identified and treated. Visit your doctor to get more information. Don’t have a doctor? Visit http://www.affinityhealth.org/Affinity/Find-a-Doctor.htm to find one closest to you.