Medicine / Internal Medicine
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What is all this anemia talk?

September 5, 2007

Matthew Vasey, MD

The prevalence of anemia in the United States has been reported to be about 29 to 30 cases per 1,000 females of all ages. (1) This makes anemia is the most common disorder of the blood. Given the complex fluid nature of blood, these disorders of the blood can be quite difficult to understand. Blood provides life, so you can imagine it is packed with some important stuff. Imagine if you will, Mr. Wizard dropping a bunch of ingredients into his flask. Not the kind you sneak into parties, but a chemistry flask. Blood comes to life. It is is made of red blood cells (also called RBCs or erythrocytes), white blood cells (also called leukocytes) and platelets (also called thrombocytes) suspended in a complex fluid medium known as blood plasma which contains water, proteins and minerals. Blood allows just about everything in the body to take place. Yeah, that's way cooler than Gatorade, and even the most expensive Vitamin Water. Parts of those drinks do however, ultimately make their way into the blood.

Anemia is defined as a reduction below normal in the total red blood cell volume (hematocrit) or in the concentration of blood hemoglobin. (2) Hemoglobin is a protein that looks a little like Willy Wonka's "Everlasting Gobstopper" (Click here to view an Everlasting Gobstopper) that is made of iron and carries the oxygen you breath to the cells in your body. Hematocrit is just a measurement of the proportion of blood that is red blood cells. The two work hand-in-hand, and doctors are always referring to "H and H" levels, taken from a standard needle stick at the doctor's office.

The symptoms of anemia are a result of not having enough oxygen, or a term called "hypoxia" which can range from heart failure and death to just feeling plain old, tired. The main causes of anemia are losing blood from bleeding (yes, a woman's period counts), inappropriate destruction of red blood cells within the body or ineffective production of red blood cells. Blame Mr. Wizard for the later from our analogy for most likely not using enough Iron, altough there are many other complex causes of ineffective production besides Iron deficiency. Iron deficiency is the most common cause of anemia worldwide. (2) Other common diet related deficiencies include Vitamin B12 and Folate.

Anemia is very common and often goes without diagnosis. Be sure keep anemia in the back of your mind if you just haven't been feeling yourself lately and be sure begin a discussion of anemia with your doctor if you are concerned. There are many medical causes for anemia and I only mentioned a couple common causes. Once the cause is established there are many safe and effective treatments. In emergency cases of anemia, a blood transfusion might be required. (Click here to save a life)


1. Current estimates from the National Health Interview Survey, 1994. Hyattsville, Md.: Dept of Health and Human Services, Public Health Service, Centers for Disease Control, National Center for Health Statistics, 1995; DHHS publication no. 95-1521.
2. Brown RG. Anemia. In: Taylor RB, ed. Family medicine: principles and practice. 4th ed. New York: Springer-Verlag, 1994:997-1005. on Social Media