Getting the Right Anemia Treatment
Anemia treatment is not a one-size-fits-all remedy. There are many types of anemia, and your doctor will create a treatment plan based on the cause of your anemia.
By Regina Boyle Wheeler
Medically Reviewed by Pat F. Bass III, MD, MPH
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If you're diagnosed as anemic, your anemia treatment will depend on the cause of your problem and its severity. An iron or vitamin deficiency, a chronic illness, or hereditary conditions are the most likely culprits.
Anemia simply means you have lower than normal amounts of red blood cells, or hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen throughout your body. There are three main causes of anemia:
- Blood loss, either from a sudden event or slow internal bleeding
- A low number of red blood cells being made by the body
- A high rate of red blood cells being destroyed
Anemia Treatment for Iron Deficiency
Iron-deficiency anemia is the most common type of anemia. If your blood is low in iron, it can't make hemoglobin. Typical causes of iron-deficiency anemia are a diet low in iron, your body’s inability to absorb iron, or blood loss. Children and women of childbearing age are especially susceptible.
“In young children, this type of anemia is usually related to diet,” said Zora R. Rogers, MD, pediatric hematologist-oncologist at the University of Texas Southwestern Medical Center in Dallas. She said children who drink too much milk may not get enough iron from other foods.
This type of anemia is generally treated with iron supplements, usually in the form of pills, and dietary changes. Eating more iron-rich foods can prevent the anemia from worsening, but can’t treat the deficiency, said Dr. Rogers.
Blood loss from heavy periods, especially in teens and young women, is another common cause of iron deficiency anemia. Rogers said oral contraceptives and Depo-Provera injections can create lighter flows and lessen the chance that a woman will become anemic.
In older people, iron deficiency anemia may be caused by blood loss due to gastrointestinal bleeding from colon cancer, alcohol use causing a gastric ulcer, or a non-cancerous intestinal problem. Your doctor will have to diagnose what’s causing the bleeding and treat it accordingly.
Once your doctor determines why and where you are losing blood, supplements can replenish depleted levels of iron. Sometimes people can’t tolerate iron pills because of constipation or other side effects; other times supplements simply don’t work. These people can be treated with intravenous (IV) iron, which bypasses the digestive tract. “Newer versions of IV iron are safer and better tolerated than older versions,” said Rogers.
Anemia Treatment for Vitamin Deficiency
Low levels of vitamin B-12 and folate, another B vitamin, are common causes of vitamin-deficiency anemia. Those at highest risk for developing this condition are:
- The elderly.Older people’s bodies may not be able to absorb nutrients effectively. In other cases, a diet low in these vitamins may be the problem.
- Substance abusers.Addicts might not be eating a balanced diet; alcoholics may get most of their calories from drinking.
- Some surgical patients.People who have had part of their small bowel removed might not be able to absorb nutrients properly.
Treatments include improving your overall diet, taking folic acid supplements for folate deficiency, and getting injections for vitamin B-12 deficiency.
Anemia Treatment for Chronic Diseases
A long-term or chronic illness can also cause anemia. People with inflammatory or autoimmune diseases, kidney disease, some cancers, disorders of the liver or thyroid, and certain chronic infections are at highest risk.
Rogers said these diseases cause inflammation that can keep the body from using the iron it has to make healthy red blood cells. It also suppresses the kidneys from making a hormone that signals bone marrow to create more red blood cells. The anemia will get better when the disease that is causing it is successfully treated.
People with kidney disease and cancer patients undergoing chemotherapy sometimes receive medication to stimulate red blood cell production. Recently, the safety of such drugs has been questioned. “That type of therapy usually requires a hematologist and lots of discussion,” said Rogers.
Cancer therapies, especially chemotherapy, can cause temporary anemia; treatment depends on severity.
Anemia Treatment for Inherited Diseases
Parents with certain genes can pass on anemia diseases to their children. Many hereditary anemia types exist, but generally they fall into two categories:
- Hemolytic anemia.This is a condition in which red blood cells are destroyed too quickly. Sickle cell disease and thalassemia fall into this group. Treatment is personalized to each patient with their specific anemia, symptoms, and severity in mind. During treatment, doctors monitor blood counts and growth (in children) and watch for the development of gallstones. Treatments include steroids and blood transfusions, as needed.
- Inherited bone marrow failure syndromes (IBMFS).These are rare disorders in which the marrow doesn’t produce enough blood cells, including red cells. Specific conditions include aplastic anemia and Fanconi anemia. Some patients with IBMFS may eventually develop leukemia or another cancer.
Each type of hereditary anemia condition is managed differently, but in all cases, your doctor will monitor blood counts and watch for problems with regular bone marrow and chromosome tests. Treatments include steroids, hormones, and drugs to stimulate blood cell production, or blood transfusions. Antibiotics to prevent or treat infections are used when necessary.
Some patients with hereditary anemia receive bone or stem cell transplants, which can provide a cure, but also carry risks.
If you suspect you have symptoms of anemia, it's time to speak to your physician about getting a diagnosis and, if necessary, the treatment approach that works best for you.
Video: Iron Deficiency Anemia: Causes, Symptoms, & Treatment
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