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Anaemia

Anaemia occurs when you have low levels of red blood cells in your body.

Last modified: April 20, 2020

What is anaemia?What is anaemia?

Anaemia is a blood disorder which is caused by a number of different reasons, including blood loss, red blood cell destruction (also referred to as haemolysis) and the body not producing enough red blood cells (e.g. due to a deficiency of nutrients required by the bone marrow).

Types of anaemiaTypes of anaemia

There are many different types of anaemia, including:

Iron-deficient anaemia

This type of anaemia occurs when there is not enough iron in your body. Iron is vital for the body to produce the protein haemoglobin, which transports oxygen around your body in your red blood cells.

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Aplastic anaemia

This type of anaemia occurs if the bone marrow is significantly underactive. The bone marrow is responsible for making all the blood cells in your body, including red blood cells, white blood cells and platelets.

Pernicious anaemia

This type of anaemia is a disorder characterised by the body being unable to absorb enough vitamin B12 from your diet to produce red blood cells.Both vitamin B12 as well as folate (also a B vitamin) are required for healthy red blood cell formation.

Hemolytic anaemia

This type of anaemia occurs when red blood cells are destroyed faster than they can be made.Typically red blood cells have a lifespan of three months, however in some inherited conditions (such as sickle cell disease and thalassemia) the body destroys red blood cells before the end of their lifespan.

Risk factors for anaemiaRisk factors

Anaemia is relatively common in people with cancer, being seen in 40-50% in people with cancer. Anaemia in patients with cancer can be due to many different factors including:

Certain cancer treatments such as radiation therapy, as well as chemotherapy drugs – These can damage bone marrow tissue where blood cells are made. Certain drugs can also damage the kidneys, where a hormone (erythropoietin) is made, which helps make the red blood cells in the bone marrow
Certain types of cancers – Such as blood cancers and cancers that spread to the bone marrow eg. ovarian and lung tumours
Side effects of cancer and cancer treatments – These can often cause vomiting and nausea and poor appetite, which can result in low levels of iron, folate and B12
Blood loss – This can be as a result of surgery or internal bleeding arising from the cancer itself

Signs and symptoms of anaemiaSigns and symptoms

Typical symptoms of anaemia include:

Fatigue and tiredness
Dizziness
Irregular or rapid heart rate
Headaches
Pains in your chest
Cold hands or feet
Difficulty catching your breath

If you experience any of these symptoms, it is important you see your doctor straight away.

Treatment for anaemiaTreatment

The treatment of anaemia will be dependent on your symptoms as well as the cause of your anaemia. Treatment options can include:

Supplementation – Iron, B12 or folate (folic acid) can be prescribed, usually as tablets, although iron can be given as an infusion and vitamin B12 given as an injection
Increasing your intake of iron-rich foods
Blood transfusion – If your haemoglobin is very low, or if your levels need to be increased quickly
Medication – If your anaemia is a result of chemotherapy, you may be prescribed medication that increases the production of erythropoietin, known as erythropoietin stimulating agents (ESAs), which help your bone marrow make more red blood cells

Frequently asked questionsFAQs

How is anaemia diagnosed?

Anaemia is diagnosed through a blood test (called a Complete Blood Count (CBC) or Full Blood Count (FBC)) which can be ordered by your doctor. In Australia, haemoglobin levels range between approximately 120g/L – 160g/L for women, and 130g/L – 180g/L for men.Anaemia is diagnosed when haemoglobin levels is below these ranges.

How can I manage my symptoms of anaemia?

There are many things you can do to help manage your symptoms of anaemia including:

Take short naps and rest where you can
Ask for help and accept offers of help when given
Keep up your fluid intake or speak to a registered dietitian for advice on dietary changes you could make

What foods are rich sources of iron?

In the diet there are two main sources of iron, known as heme-iron (these are animal-based foods) and non-heme iron (these are plant-based foods). Animal-based sources of iron are more easily absorbed by your body, compared with plant-based sources.

Animal-based sources of iron in the diet – Red meat such as lean beef and lamb, chicken and fish as well as eggs
Plant-based sources of iron in the diet – Green leafy vegetables, dried lentils, nuts and seeds as well as foods that have been iron-fortified (had iron added to them) such as cereals and spreads

ReferencesReferences

For a full list of references, click here.

American Society for Clinical Oncology (ASCO).(2019). Anaemia. Retrieved on 12^th June 2019 from https://www.cancer.net/coping-with-cancer/physical-emotional-and-social-effects-cancer/managing-physical-side-effects/anemia
NIH: National Heart, Lung and Blood Institute. (2011). In brief: your guide to anaemia. Retrieved on 12^th June 2019 from https://www.nhlbi.nih.gov/files/docs/public/blood/anemia-inbrief_yg.pdf
American Cancer Society. (2017). Anaemia in people with cancer. Retrieved on 12^th June 2019 from https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/low-blood-counts/anemia.html
Ludwig, H., Van Bell, S., Barrett-Lee, P, et al. (2004). The European Cancer Anaemia Survey (ECAS): A large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients. European Journal of Cancer. 40 (15). Retrieved on 12^th June 2019 from https://www.sciencedirect.com/science/article/pii/S0959804904005118
Seshadri, T., et al. (2005). The Australian Cancer Anaemia Survey: a snapshot of anaemia in adult patients with cancer. The Medical Journal of Australia. 182 (9). Retrieved on 12^th June 2019 from https://www.mja.com.au/journal/2005/182/9/australian-cancer-anaemia-survey-snapshot-anaemia-adult-patients-cancer
Australian Red Cross Blood Service. (n.d). Retrieved on 12^th June 2019 from https://mytransfusion.com.au/reasons-transfusion/anaemia
National Cancer Institute. (n.d). Anaemia and Cancer Treatment. Retrieved on 12^th June 2019 from https://www.cancer.gov/about-cancer/treatment/side-effects/anemia?redirect=true
Dietitians Association of Australia. (n.d). Anaemia: my doctor says I need more iron. Retrieved on 12^th June 2019 from https://daa.asn.au/smart-eating-for-you/smart-eating-fast-facts/nourishing-nutrients/anaemia-my-doctor-says-i-need-more-iron/
American Society of Haematology. (n.d). Anaemia. Retrieved on 12^th June 2019 from https://www.hematology.org/Patients/Anemia/

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