Nutritional anemia

Nutritional anemia refers to types of anemia that can be directly attributed to nutritional disorders. Examples include Iron deficiency anemia and pernicious anemia.[1] It is often discussed in a pediatric context.[2][3][4][5]

Nutritional anemia
SpecialtyHematology
Symptomsfatigue, lack of energy, shortness of breath, rapid pulse, paleness, swelling of ankles, hair loss, lightheadedness, compulsive and atypical cravings, constipation, depression, muscle twitching, numbness, or burning and chest pain.
CausesNutritional disorder
Diagnostic methodFBC- Red blood cell count, Hemoglobin and hematocrit levels.

Grouping and crosshatching. Serum for vitamin B12 diagnosis. Bone marrow aspiration.

History and physical examination.

According to the World Health Organization, a hemoglobin concentration below 110 g/L for children under 5 years of age and pregnant women and below 130 g/L for men, respectively, is considered to be anemic. Thus, anemia can be diagnosed with blood tests. Hemoglobin is used to transport and deliver oxygen in the body. Without oxygen, the human body cannot undergo respiration and create Adenosine triphosphate, thereby depriving cells of energy.[6]

Nutritional anemia is caused by a lack of iron, protein, vitamin B12, and other vitamins and minerals that needed for the formation of hemoglobin. Folic acid deficiency is a common association of nutritional anemia and iron deficiency anemia is the most common nutritional disorder.[6]

Signs of anemia include cyanosis, jaundice, and easy bruising.[6] In addition, anemic patients may experience difficulties with memory and concentration, fatigue, lightheadedness, sensitivity to temperature, low energy levels, shortness of breath, and pale skin. Symptoms of severe or rapid-onset anemia are very dangerous as the body is unable to adjust to the lack of hemoglobin. This may result in shock and death. Mild and moderate anemia have symptoms that develop slowly over time.[5] If patients believe that they are at risk for or experience symptoms of anemia, they should contact their doctor.[7]

Symptoms

Symptoms of nutritional anemia can include fatigue and lack of energy. However if symptoms progress, one may experience shortness of breath, rapid pulse, paleness --especially in the hands, eyelids and fingernails---, swelling of ankles, hair loss, lightheadedness, compulsive and atypical cravings, constipation, depression, muscle twitching, numbness, or burning and chest pain.

Those who have nutritional anemia often show little to no symptoms. Often, symptoms can go undetected as mild forms of the anemia have only minor symptoms.[8][9]

Cause

Internationally, anemia caused by iron deficiencies is the most common nutritional disorder. It is the only significantly prevalent nutritional deficiency disorder in industrialized countries. In poorer areas, anemia is worsened by infectious diseases such as HIV/AIDS, tuberculosis, hookworm infestation, and Malaria. In developing countries, about 40% of preschool children and 50% of pregnant women are estimated to be anemic. 20% of maternal deaths can be contributed to anemia. Health consequences of anemia include low pregnancy outcome, impaired cognitive and physical development, increased rate of morbidity, and reduced rate of work in adults.[10]

Nutritional Anemia has many different causes, each either nutritional or non-nutritional. Nutritional causes are vitamin and mineral deficiencies and non-nutritional causes can be infections. The number one cause of this type of anemia however is iron deficiency.[11]

An insufficient intake of iron, Vitamin B12, and folic acid impairs the bone marrow function. The lack of iron within a person’s body can also stem from ulcer bacteria. These microbes live in the digestive track and after many years cause ulcer’s in the lining of your stomach or small intestine. Therefore, a high percentage of patients with nutritional anemia may have potential gastrointestinal disorder that causes chronic blood loss.[12] This is common in immunocompromised, elderly, and diabetic people. High blood loss can also come from increases loss of blood during menstruation, childbirth, cancers of the intestines, and a disorder that hinders blood’s ability to coagulate. Medications can have adverse effects and cause nutritional anemia as well. Medications that stop the absorption of iron in the gut and cause bleeding from the gut (NSAIDs and Aspirin) can be culprits in the development of this condition. Hydrocortisones and valproic acid are also two drugs that cause moderate bleeding from the gut. Amoxicillin and phenytoin are the ability to cause a vitamin B12 deficiency.

Other common causes are thyroid disorders, lead toxcities, infectious diseases (e.g Malaria), Alcoholism, and Vitamin E deficiency.

Treatment

Treatments for nutritional anemia includes replacement therapy is used to elevate the low levels of nutrients.[1] Diet improvement is a way to combat nutritional anemia and this can be done by taking dietary supplements such as iron, folate, and Vitamin B12.[2] These supplements are available over-the-counter however, a doctor may prescribe prescription medicine as needed, depending on the patient’s health needs.[7][13]

References
  1. "Nutritional Anemias And Anemia of Chronic Disease". http://MedicalAssistantOnlinePrograms.org/. Retrieved 6 November 2013. External link in |website= (help)
  2. STURGEON P (May 1952). "Treatment of nutritional anemia in infants". Calif Med. 76 (5): 346–9. PMC 1521268. PMID 14935884.
  3. Sinha N, Deshmukh PR, Garg BS (February 2008). "Epidemiological correlates of nutritional anemia among children (6-35 months) in rural Wardha, Central India". Indian J Med Sci. 62 (2): 45–54. doi:10.4103/0019-5359.39366. PMID 18319531.
  4. Vieira AC, Diniz AS, Cabral PC, et al. (2007). "Nutritional assessment of iron status and anemia in children under 5 years old at public daycare centers". J Pediatr (Rio J). 83 (4): 370–6. doi:10.2223/JPED.1680. PMID 17676239.
  5. West CE (November 1996). "Strategies to control nutritional anemia". Am. J. Clin. Nutr. 64 (5): 789–90. doi:10.1093/ajcn/64.5.789. PMID 8901803.
  6. "Nutritional Anemia." The Free Dictionary. Accessed March 31, 2017. http://medical-dictionary.thefreedictionary.com/nutritionalanemia.
  7. “What are the symptoms of anemia?” Health Grades, INC. Accessed March 31, 2017. https://www.healthgrades.com/conditions/anemia--symptoms.
  8. "Health Library: Symptoms of Nutritional Anemia". Winchester Hospital. Winchester Hospital. Retrieved 27 April 2017.
  9. Kraft B.A., Sy. "What is nutritional deficiency anemia? What causes nutritional deficiency anemia?". Medical News Today. Healthline Media. Retrieved 27 April 2017.
  10. “Micronutrient deficiencies” World Health Organization. Accessed March 31, 2017. http://www.who.int/nutrition/topics/ida/en/.
  11. Kraft, Sy. "What is nutritional deficiency anemia? What causes nutritional deficiency anemia?". Medical News Today.
  12. "What Is H. pylori?". WebMD.
  13. “Treatments for Nutritional anemia.” Right Diagnosis. Assessed March 31, 2017. http://www.rightdiagnosis.com/n/nutritional_anemia/treatments.htm
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