COMBATING NUTRIENT DEFICIENCY ANAEMIA

Anaemia is a very common blood disorder that results from a reduction in either the number of red blood cells or the amount of haemoglobin in the blood. The oxygen-carrying capacity of blood is decreased, and less oxygen is available to cells of the body to perform their functions

Anaemia is not a disease but rather a symptom of various diseases. Anything that causes a deficiency in the formation of red blood cells or that leads to the accelerated destruction of red blood cells can result in anaemia. Anaemia can bean early indicator of arthritis, infection, or certain major illnesses like cancer.

Drug use, hormonal disorders, chronic inflammation in the body, surgery, infections, peptic ulcers, haemorrhoids, diverticular disease, heavy menstrual bleeding, repeated pregnancies, liver damage, thyroid diseases, rheumatoid arthritis, bone marrow disease, hereditary disorders, and dietary deficiencies (especially deficiencies of iron, folate, and vitamins B6 and B12) can all lead to anaemia.

Severe anaemia is associated with fatigue, weakness,dizziness, and drowsiness. The risk for anaemia increases because of poor diet, intestinal disorders, chronic diseases,infections, and other conditions. Women who are menstruating or pregnant, people with chronic medical conditions, and children have a higher risk profile of developing anaemia. The risk of anaemia also increasesin the elderly. Nutritional interventions can have a positive impact on micronutrient deficiencies and undernutrition, as well as on acute infections like diarrhoea, malaria, HIV/AIDS, and tuberculosis.

Normal level of red blood cells (LEFT) & Anaemia level of red blood cells (RIGHT).

IRON DEFICIENCY AND ITS ROLE IN ANAEMIA

Iron deficiency and iron-deficiency anaemia are global health problems and common medical conditions seen in everyday clinical practice. The classic textbook symptoms of iron-deficiency such as koilonychia (spoon nails), glossitis, ordysphagia are not commonly seen in developed countries.

Iron plays a crucial role in biologic functions, including energy production, respiration, cell proliferation, and DNA synthesis. Due to the absence of an excretion mechanism and the potential for iron levels to become toxic, daily absorption is limited as the body has developed mechanisms to recycle the iron which is released after the breakdown of red blood cells.

CAUSES OF IRON-DEFICIENCY ANAEMIA

Iron deficiency refers to the reduction in iron stores that either precedes overt iron-deficiency anaemia or persists without progression. Low iron levels in iron-deficiency anaemia result in anaemia with the presence of microcytic hypochromic red cells. The reported prevalence of iron deficiency in the absence of dietary fortification is estimated to be 40% in preschool children, 30% in menstruating girls and women, and 38% in pregnant women. These high rates reflect the increased physiological demands during particular life-stages and according to gender. A further critical period is the growth spurt of adolescence.

DIETARY IRON SUPPLEMENTATION

Once iron deficiency has been diagnosed and the physician has identified and, where possible, addressed the underlying cause, it is important to restore iron levels through supplementation. A dietary assessment should be conducted, and appropriate advice provided. Although dietary changes and counselling are important, dietary changes alone are not usually adequate and medicinal iron supplementation should be considered.