Management of low blood levels Published July 9, 2019

Rotimi Adesanya
Child and Public Health Physician
A woman in her late 40’s once presented in the hospital with features of extreme weakness, tiredness, headache and abdominal pain for about two years.
She said she had not enjoyed her life for a single day in the past two years due to lethargy. She had been treating malaria and typhoid fever via self medications and given intravenous fluids (Drips) but all symptoms persisted.
She had also taken several iron injections and blood transfusions. A comprehensive test done suggested she had a Uterine Fibroid which made her see her menstrual period earlier than expected every month. This has been the cause of her low blood level. She was encouraged to have the fibroid removed surgically since it affected her daily activities.
Her blood level then became stable after the surgery, and no longer visited the hospitals neither did she have to take blood capsules, iron injections and blood transfusion.
The import of this woman’s story is that patients who develop low blood levels need to have comprehensive tests done to find out why the blood level is low ingesting blood supplements.
Anaemia is a medical condition in which a person’s red blood cell count is below normal, which can cause a range of health concerns and risks. Human blood is made up of both red and white cells. While white blood cells fight infection, red blood cells are responsible for transporting oxygen throughout the body. When red blood cell levels drop too low, the body feels tired due to lack of oxygen, which is why people with anaemia are sometimes said to have “tired blood.”
There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe.
Risk factors
The risk of anaemia include vegetarians, teenage girls and women with heavy menstrual cycles, children, especially during rapid growth, premature babies, pregnant women, cancer patients, immunosupression, elderly, and persons with sickle cell disease.

Causes of anaemia
There are many causes of anaemia, including: blood loss, for example through stomach or colon bleeding or heavy periods, poor dietary intake or illness, worm infestations, severe malaria, infections like HIV, side effects of medication, cancer and pregnancy.

Signs and symptoms
Paleness, tiredness, dizziness, pain in the chest, cold hands and feet, confusion, fatigue, headaches, increased heartbeat, the desire to eat or chew ice.
Most of these symptoms are relatively harmless at first, but can lead to serious complications if left untreated.

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If left untreated, anemia can cause many health problems, such as: Severe fatigue: When anemia is severe enough, one may be so tired that one can’t complete daily tasks.
Pregnancy complications: Pregnant women with iron and folate deficiency anemia may likely experience complications like intrauterine growth restrictions (IUGR) and premature birth.
Heart problems: Anemia can lead to a rapid or irregular heartbeat (arrhythmia). When anaemic the heart must pump more blood to compensate for the lack of oxygen in the blood. This can lead to an enlarged heart or heart failure.
Death: Some inherited anemias, such as sickle cell anemia, can be serious and lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal.

Types of anaemia
The most common types of anaemia include: iron deficiency (low iron levels), low folic acid and vitamin B12 levels, chronic lead poisoning, haemolytic – the body destroys the red blood cells at an earlier time than it should e.g Sickle Cell Anaemia.

To diagnose anaemia, the doctor should conduct a physical examination, check the lungs and heart, then order tests like full blood count to determine the size and shape of the red blood cells.

Treatment of anaemia
Treatments for anaemia range from taking supplements to undergoing medical procedures. One may be able to prevent some types of anemia by eating a healthy, varied diet. Simply, the treatment will depend on the underlying cause of the anaemia.
If it is due to an iron deficiency, the doctor may recommend a supplement and a healthy iron-rich diet which includes: lean red meat, poultry, iron enriched cereals, fish green vegetables, wholegrain breads, cereals and nuts. Treatment for anaemia might also include: antibiotics – to treat infections, iron injections or infusions, blood transfusion, hormones – for women and teenage girls who experience heavy menstrual cycles. Anaemia may also result from an enlarged or diseased spleen. In severe cases, the spleen may be surgically removed.

You may be able to prevent some forms of anaemia, particularly if it is related to dietary or vitamin deficiency. Dietary supplementation in children and pregnancy. Sickle cell anaemia is preventable through premarital and genetic counselling. Severe Malaria, worm infestations and other infections are all preventable.

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