Anemia means a low red blood cell count. Red blood cells, also known as erythrocytes, are normally made in the bone marrow in adults and largely function to carry oxygen from the lungs to the tissues. Low red blood cell counts can cause such symptoms as fatigue and pale skin. Anemia is not a diagnosis. Instead, it is a manifestation of some underlying disease. At times, the underlying disease is a vitamin deficiency, and the treatment is vitamin supplementation. It is important to consult a healthcare professional for the diagnosis and management of disease and regular health maintenance.
Types of Anemia
According to "Robbins and Cotran Pathologic Basis of Disease" by Vinay Kumar M.D., anemia can be classified by general causes or morphology, meaning the way it looks. There are three general causes of anemia. First, there may be blood loss, which can be acute, meaning quick and over a short period of time, or chronic, meaning over a long period of time. Second, a disease process may destroy or sequester red blood cells. Third, there may be a problem in the formation of red blood cells. Morphologically, there are also three types of anemia, which also help decipher the cause. Microcytic anemia means that the red blood cells are small in size and few in number. Normocytic anemia means that the red blood cells are normal in size and few in number. Finally, macrocytic anemia means that the red blood cells are large sized and few in number.
Iron
As noted by "Harrison's Principles of Internal Medicine" by Anthony S. Fauci, the majority of the iron in the body is found in red blood cells, bound to the protein hemoglobin. Hemoglobin is the protein that binds oxygen and takes it to the tissues. The iron atoms attached to hemoglobin bind to the oxygen molecules. Without sufficient iron, the bone marrow is unable to synthesize the hemoglobin for red blood cells. The cells will be small and fewer in number. In other words, iron deficiency causes a microcytic anemia. Insufficient iron can be from chronic blood loss, for example. In addition, vitamin C helps the body to absorb iron, so a vitamin C deficiency can also cause anemia.
Folate
Folate -- also called folic acid and vitamin B9 -- is a vitamin needed for DNA metabolism. Other functions include helping cell division and processing the amino acid homocysteine. Folate deficiency causes a macrocytic anemia. Deficiency is generally caused by inadequate dietary intake at times of increased need, such as pregnancy or alcoholism. Certain medications, such as antiseizure medication, can also decrease folate.
Cobalamin
Cobalamin, or vitamin B12, works with folate to help the body transfer chemicals called methyl groups. B12 is important in DNA metabolism. A vitamin B12 deficiency will also cause a macrocytic anemia like folate. It can also cause nerve damage. In fact, treating a B12 deficiency with folate can be dangerous because it will treat the anemia, but not the nerve damage, which will continue. B12 deficiency can be from inadequate intake or pernicious anemia. Pernicious anemia occurs when the immune system attacks certain cells in the stomach. This damages the body's ability to secrete acid and release a protein called intrinsic factor. Intrinsic factor is needed by the body to bind to and absorb vitamin B12.
References
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar et al; 8th Ed 2009
- "Harrison's Principles of Internal Medicine"; Anthony S Fauci et al; 17th Ed 2008
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