Anemia – Classification of the forms of Anemia

ANEMIA: Segment Two

Are you suffering from Anemia?  

Anemia is a lack of red blood pigment and/or red blood cells Simply put; the proportion of blood cells in the body is too low.

Anemia is a complex subject and requires an understanding on various levels. Therefore this article will be presented in 3 segments so you can get a complete understanding of subject.

In the Segment One we discussed the symptoms and causes of Anemia and briefly explained the Classification of the forms of anemia:

  • Disturbed blood formation
  • Increased breakdown or loss of red blood cells

In Segment Two we will review in depth the classifications of the forms of Anemia in order to fully understand the depth of this topic and offer an understanding of why it is important to diagnose the correct form of Anemia when developing treatment protocols.

With Disturbed blood formation possible reasons are changes in the stem cells in the bone marrow, from which all other blood cells are formed, or a displacement of healthy blood formation due to diseases of the bone marrow. Other causes can be a deficiency in iron, vitamin B12 or folic acid as well as (chronic) kidney diseases, through which too little of the hormone erythropoietin is produced. Erythropoietin normally signals the bone marrow to produce blood cells, and 90% of it is made in the kidneys after birth.

The red blood cells only live for around four months. This is why the body is constantly producing new erythrocytes in the bone marrow, which begin their work in the blood after around seven days of development in the bone marrow. The red blood cells and all other cell types are formed from an original cell. It has the ability to mature into different cell types as required (pluripotent stem cell).

If there is a disease in these stem cells or if they are displaced by diseases that require space in the bone marrow, insufficiently functional red blood cells can be formed. In addition, certain nutrients are necessary so that the erythrocytes in the bone marrow can be formed and mature. The most important ones include iron, folic acid and vitamin B12.

  • Stem cell disease and bone marrow involvement: Stem cell diseases are very rare causes of anemia. These include, for example, aplastic anemia (AA), myelodysplastic syndrome (MDS), paroxysmal nocturnal hemoglobinuria (PNH) and congenital dysplastic anemia. The displacement of blood formation by tumors growing in the bone marrow or in leukemia or lymphoma is very rare in comparison to the other causes of anemia, but shows that it is important to find out the cause of anemia.
  • Folic acid and vitamin B12 (cobalamin) deficiency: Folic acid is found in yeast, liver, green leafy vegetables, broccoli, asparagus, carrots, beetroot, nuts, whole grains and egg yolks, for example. The recommended daily requirement is 300 micrograms. For women who want to have children, pregnant women and breastfeeding women, the recommended daily intake is 500 micrograms. In addition, the need for folic acid is increased in the case of chronic inflammatory or malignant diseases or an increased blood formation rate. Folic acid is absorbed in the human body through the small intestine and stored in the liver. The amount of folic acid stored in the liver (approx. 5 mg) is sufficient for almost three months if there is no intake.
  • Vitamin B12 is mainly found in animal foods (meat, fish, milk and eggs) and, in small amounts, in plant-based products (for example sauerkraut). Microorganisms that produce vitamin B12 are located in the human intestines. However, the vitamin B12 formed by the microorganisms in the human intestine cannot be absorbed. Therefore, humans depend on an adequate intake through food.
  • Vitamin B12 can only be absorbed in the functional form via the small intestine if the so-called intrinsic factor (IF) is formed in the stomach. If it is insufficiently produced, the vitamin B12 is digested and loses its function. The daily requirement for vitamin B12 is 5 micrograms. The amount of vitamin B12 stored in the liver is sufficient for about one to two years.

In summary, folic acid and vitamin B12 are necessary for the formation of the building blocks that encode the genome of living things (DNA). If one of the two substances is missing, fewer red blood cells are produced because DNA production is impaired. The red blood cells formed are larger than usual because of this disorder.

Iron deficiency: In addition to animal foods (meat, offal such as liver or kidneys, hen’s egg yolk), iron is also found in legumes, brewer’s yeast, parsley and cereals. Iron is essential for blood formation in the human organism and an essential component of hemoglobin, the molecule in red blood cells that binds oxygen. If there is not enough iron, there will be a sufficient number of red blood cells. However, these then contain so little hemoglobin that they can only carry a limited amount of oxygen and are smaller than usual. The daily iron loss in men is 1 mg, in women of childbearing age 2 mg and in pregnant women 3 mg.

Iron deficiency is by far the leading cause of anemia. Around 25 percent of people worldwide suffer from an iron deficiency, and around 80 percent of all anemias can be traced back to iron deficiency. Often times, those affected simply do not get enough food. In particular, in phases with increased iron requirements (sport, pregnancy, breastfeeding and growing children), it is important to ensure sufficient intake. Vegetarians, patients with nutritional disorders or intestinal diseases are at risk.

The recommended daily iron intake with food is 12 mg for men, 15 mg for women of childbearing age and 30 mg for pregnant women. Bleeding, especially excessive and prolonged periods, can also be a reason for the iron deficiency. Because while iron is lost with the blood, a lot of it is needed to form new erythrocytes. Significantly less often, an iron deficiency is caused by a reduced absorption of the trace element in the intestine – in various intestinal diseases such as celiac disease / celiac disease, chronic inflammatory bowel diseases or after part of the stomach has been removed.

Another cause of iron deficiency anemia that should not be neglected is an infestation with parasites, particularly with the hookworm, which sucks blood from the intestinal wall of its host.  However, infection is possible when traveling, therefore your naturopath or  family doctor should be informed about long-distance travel when clarifying an anemia.

  • Kidney-related (renal) anemia: A diseased kidney is also a possible cause of anemia: On the one hand, blood can be lost in the urine. On the other hand, healthy kidneys measure the oxygen content of the blood. If it is too low, the hormone erythropoietin is released in excess. It enters the bone marrow via the bloodstream, where it stimulates the formation of red blood cells. Severe kidney damage, especially in the context of chronic kidney disease, can mean that the filter organs can no longer produce sufficient erythropoietin. The result is reduced blood formation in the bone marrow and thus anemia. Renal anemia is considered a risk factor for increased mortality in kidney patients and is associated with a reduced quality of life.
  • Other causes of blood formation disorders: The formation and maturation of red blood cells in the bone marrow can also be hindered or reduced for other reasons. For example, certain hereditary diseases or genetic changes can lead to the formation of blood cells being disturbed.

With increased breakdown or loss of red blood cells possible causes are acute or chronic bleeding, enlargement of the spleen (the usual breakdown site for red blood cells), but also increased breakdown of erythrocytes (hemolysis), for example due to infectious diseases, metabolic disorders or drugs.

Possible causes for an increased breakdown or loss of red blood cells are acute and chronic bleeding, an enlargement of the spleen (the usual breakdown of red blood cells), but also increased breakdown of the erythrocytes (hemolysis).

  • Bleeding: When we bleed, the body loses blood, including its components such as red blood cells, hemoglobin and iron. In the case of small bleeding, such as a sting on the thorn of a rose or a graze, this is not a problem, because the amounts involved are small. The body can compensate for this by briefly absorbing more fluid into the vascular system, releasing iron from its storage reserves and stimulating the production of new erythrocytes. The situation is different with longer and / or heavy bleeding, for example as a result of operations or serious accidents. Even with less conspicuous but long-lasting bleeding – for example from a gastric ulcer or in women with unusually heavy menstrual bleeding – so large amounts of blood can be lost that the body can no longer compensate for the losses and anemia develops.
  • Enlargement of the spleen (splenomegaly): The spleen filters dead, defective or deformed erythrocytes from the blood and breaks them down. In this way, it ensures that only healthy, functional red blood cells remain in the circulation. Enlargement of the spleen or changes in the shape of the red blood cells can cause too many blood cells to be removed in this way, leading to anemia.
  • Shortening of the erythrocyte survival time with increased breakdown (hemolysis): Certain defects of the erythrocytes can result in the survival time of the red blood cells being shortened and they die earlier or burst (hemolysis). This group includes, for example, spheroid cell anemia (spherocytosis), glucose-6-phosphate dehydrogenase deficiency (= favism) or disorders in the formation of red blood pigment (e.g. thalassemia, sickle cell disease). Furthermore, a so-called autoimmune hemolytic anemia (AIHA) can lead to the breakdown of red blood cells. In the process, antibodies (heat autoantibodies, cold autoantibodies) are formed that are directed against and destroy your own red blood cells. In addition, an increased blood fall can result from erythrocyte damage. This can be done mechanically, for example through an artificial heart valve, thermally in the case of a burn, or chemically, for example through snake venom, arsenic, lead and copper. Other possible reasons are changes in the smallest vessels (hemolytic uremic syndrome (HUS), thrombotic thrombocytopenic purpura (TTP)), various infectious diseases (e.g. malaria) and drugs.

This break down of blood formation or the loss of blood should provide you with a good background for understanding Segment Three where we will discuss the composition of the Blood, Diagnosis, Laboratory Work and treatments for Anemia.

Remember cleaning out your colon with a Holistic colon Hydrotherapy session can help with Anemia and many other health challenges.

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