About primary anemia

What is primary anemia?

Pernicious anemia is a rare blood disorder characterized by the inability of the body to properly utilize vitamin B12, which is essential for the development of red blood cells. Most cases result from the lack of the gastric protein known as intrinsic factor, without which vitamin B12 cannot be absorbed.

The symptoms of pernicious anemia may include weakness, fatigue, an upset stomach, an abnormally rapid heartbeat (tachycardia), and/or chest pains. Recurring episodes of anemia (megaloblastic) and an abnormal yellow coloration of the skin (jaundice) are also common. Pernicious anemia is thought to be an autoimmune disorder, and certain people may have a genetic predisposition to this disorder.

There is a rare congenital form of pernicious anemia in which babies are born lacking the ability to produce effective intrinsic factor. There is also a juvenile form of the disease, but pernicious anemia typically does not appear before the age of 30. The onset of the disease is slow and may span decades. When the disease goes undiagnosed and untreated for a long period of time, it may lead to neurological complications. Nerve cells and blood cells need vitamin B12 to function properly.

What are the symptoms for primary anemia?

Signs and symptoms, if they do occur, might include:

  • Fatigue
  • Weakness
  • Pale or yellowish skin
  • Irregular heartbeats
  • Shortness of breath
  • Dizziness or lightheadedness
  • Chest pain
  • Cold hands and feet
  • Headaches

At first, anemia can be so mild that you don't notice it. But symptoms worsen as anemia worsens.

What are the causes for primary anemia?

Anemia can be due to a condition present at birth (congenital) or to a condition you develop (acquired). Anemia occurs when your blood doesn't have enough red blood cells.

This can happen if:

  • Your body doesn't make enough red blood cells
  • Bleeding causes you to lose red blood cells more quickly than they can be replaced
  • Your body destroys red blood cells

What red blood cells do

Your body makes three types of blood cells — white blood cells to fight infection, platelets to help your blood clot, and red blood cells to carry oxygen from your lungs to the rest of your body and carbon dioxide from the body back to the lungs.

Red blood cells contain hemoglobin — an iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs to be exhaled.

Most blood cells, including red blood cells, are produced regularly in your bone marrow — a spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, vitamin B-12, folate and other nutrients from the foods you eat.

Causes of anemia

Different types of anemia have different causes. They include:

  • Iron deficiency anemia. This most common type of anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can't produce enough hemoglobin for red blood cells.

    Without iron supplementation, this type of anemia occurs in many pregnant women. It's also caused by blood loss, such as from heavy menstrual bleeding; an ulcer in the stomach or small bowel; cancer of the large bowel; and regular use of some pain relievers that are available without a prescription, especially aspirin, which can cause inflammation of the stomach lining resulting in blood loss. It's important to determine the source of iron deficiency to prevent recurrence of the anemia.

  • Vitamin deficiency anemia. Besides iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production. Some people who consume enough B-12 aren't able to absorb the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.
  • Anemia of inflammation. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn's disease and other acute or chronic inflammatory diseases — can interfere with the production of red blood cells.
  • Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn't produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
  • Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
  • Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.
  • Sickle cell anemia. This inherited and sometimes serious condition is a hemolytic anemia. It's caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.

What are the treatments for primary anemia?

Anemia treatment depends on the cause.

  • Iron deficiency anemia. Treatment for this form of anemia usually involves taking iron supplements and changing your diet. For some people, this might involve receiving iron through a vein.

    If the cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and the bleeding stopped. This might involve surgery.

  • Vitamin deficiency anemias. Treatment for folic acid and vitamin C deficiency involves dietary supplements and increasing these nutrients in your diet.

    If your digestive system has trouble absorbing vitamin B-12 from the food you eat, you might need vitamin B-12 shots. At first, you might have the shots every other day. Eventually, you'll need shots just once a month, possibly for life, depending on your situation.

  • Anemia of chronic disease. There's no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. If symptoms become severe, a blood transfusion or injections of a synthetic hormone normally produced by your kidneys (erythropoietin) might help stimulate red blood cell production and ease fatigue.
  • Aplastic anemia. Treatment for this anemia can include blood transfusions to boost levels of red blood cells. You might need a bone marrow transplant if your bone marrow can't make healthy blood cells.
  • Anemias associated with bone marrow disease. Treatment of these various diseases can include medication, chemotherapy or bone marrow transplantation.
  • Hemolytic anemias. Managing hemolytic anemias includes avoiding suspect medications, treating infections and taking drugs that suppress your immune system, which could be attacking your red blood cells. Severe hemolytic anemia generally needs ongoing treatment.
  • Sickle cell anemia. Treatment might include oxygen, pain relievers, and oral and intravenous fluids to reduce pain and prevent complications. Doctors might also recommend blood transfusions, folic acid supplements and antibiotics. A cancer drug called hydroxyurea (Droxia, Hydrea, Siklos) also is used to treat sickle cell anemia.
  • Thalassemia. Most forms of thalassemia are mild and require no treatment. More-severe forms of thalassemia generally require blood transfusions, folic acid supplements, medication, removal of the spleen, or a blood and bone marrow stem cell transplant.

What are the risk factors for primary anemia?

These factors place you at increased risk of anemia:

  • A diet lacking in certain vitamins and minerals. A diet consistently low in iron, vitamin B-12, folate and copper increases your risk of anemia.
  • Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in your small intestine — such as Crohn's disease and celiac disease — puts you at risk of anemia.
  • Menstruation. In general, women who haven't had menopause have a greater risk of iron deficiency anemia than do men and postmenopausal women. Menstruation causes the loss of red blood cells.
  • Pregnancy. Being pregnant and not taking a multivitamin with folic acid and iron, increases your risk of anemia.
  • Chronic conditions. If you have cancer, kidney failure or another chronic condition, you could be at risk of anemia of chronic disease. These conditions can lead to a shortage of red blood cells.

    Slow, chronic blood loss from an ulcer or other source within your body can deplete your body's store of iron, leading to iron deficiency anemia.

  • Family history. If your family has a history of an inherited anemia, such as sickle cell anemia, you also might be at increased risk of the condition.
  • Other factors. A history of certain infections, blood diseases and autoimmune disorders increases your risk of anemia. Alcoholism, exposure to toxic chemicals and the use of some medications can affect red blood cell production and lead to anemia.
  • Age. People over age 65 are at increased risk of anemia.

Is there a cure/medications for primary anemia?

Primary Anemia treatment depends on the cause and type of anemia.

  • Iron deficiency anemia: Treatment for this form of anemia usually involves taking iron supplements and changing your diet. For some people, this might involve receiving iron through a vein.
  • If the cause of iron deficiency is loss of blood — other than from menstruation — the source of the bleeding must be located and the bleeding stopped. This might involve surgery.
  • Vitamin deficiency anemias: Treatment for folic acid and vitamin C deficiency involves dietary supplements and increasing these nutrients in your diet.
  • If your digestive system has trouble absorbing vitamin B-12 from the food you eat, you might need vitamin B-12 shots.
  • Anemia of chronic disease: There's no specific treatment for this type of anemia. Doctors focus on treating the underlying disease. If symptoms become severe, a blood transfusion or injections of a synthetic hormone normally produced by your kidneys might help stimulate red blood cell production and ease fatigue.
  • Aplastic anemia: Treatment for this anemia can include blood transfusions to boost levels of red blood cells. You might need a bone marrow transplant
  • Anemias associated with bone marrow disease: Treatment of these various diseases can include medication, chemotherapy or bone marrow transplantation.
  • Hemolytic anemias: Managing hemolytic anemias includes avoiding suspect medications, treating infections and taking drugs that suppress your immune system, which could be attacking your red blood cells. Severe hemolytic anemia generally needs ongoing treatment.
  • Sickle cell anemia: Treatment might include oxygen, pain relievers, and oral and intravenous fluids to reduce pain and prevent complications. D.
  • Thalassemia: Most forms of thalassemia are mild and require no treatment. More-severe forms of thalassemia generally require blood transfusions, folic acid supplements, medication, removal of the spleen.


Symptoms
Fatigue,Weakness,Pale or yellowish skin,Irregular heartbeats,Shortness of breath,Dizziness or lightheadedness,Chest pain,Cold hands and feet,Headaches
Conditions
A condition where the body lacks enough healthy red blood cells to carry adequate oxygen to your body's tissues
Drugs
Nutritional therapy,Blood transfusion,Bone marrow transplant

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