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Anemia happens when your blood doesn't have enough hemoglobin (he-mo-GLOBE-in). Hemoglobin helps red blood cells carry oxygen from your lungs to all parts of your body.
Anemia happens when your blood doesn't have enough hemoglobin (he-mo-GLOBE-in). Hemoglobin helps red blood cells carry oxygen from your lungs to all parts of your body.
There are many types of anemia, all with different causes: Iron deficiency anemia (IDA). IDA is the most common type of anemia. IDA happens when you don't have enough iron in your body. You need iron to make hemoglobin. This can happen when you lose blood from problems like heavy periods, ulcers, colon polyps, or colon cancer. A diet that doesn't have enough iron in it can also cause IDA. Pregnancy can also cause IDA if there's not enough iron for the mother and fetus. You can get iron from foods like ground beef, clams, spinach, lentils, baked potato with skin, sunflower seeds, and cashews. Megaloblastic (or vitamin deficiency) anemia. This most often happens when your body doesn't get enough folic acid or vitamin B-12. These vitamins help your body keep healthy blood and a healthy nervous system. With this type of anemia, your body makes red blood cells that can't deliver oxygen right. Folic acid supplements (pills) can treat this type of anemia. You can also get folic acid in beans and legumes; citrus fruits and juices; wheat bran and other whole grains; dark green leafy vegetables; and poultry, pork, shellfish, and liver. Sometimes, with this disease, your health care provider may not realize you're not getting enough B-12. This usually happens to someone with pernicious anemia, a type of autoimmune disease. B-12 deficiency may also be more common in people with other autoimmune diseases, like Crohn's disease. Not getting enough B-12 can cause numbness in your legs and feet, problems walking, memory loss, and problems seeing. The treatment depends on the cause. But you may need to get B-12 shots or take special B-12 pills.
Underlying diseases. Certain diseases can hurt the body's ability to make red blood cells. For example, people with kidney disease, especially those getting dialysis (takes out wastes from your blood if your kidneys can't), are at higher risk for developing anemia. Their kidneys can't create enough hormones to make blood cells, and iron is lost in dialysis.
Inherited blood disease. If you have a blood disease in your family, there is a higher risk that you will also have this disease. One type of inherited blood disease is sickle cell anemia. Instead of having normal red blood cells that move through blood vessels easily, sickle cells are hard and have a curved edge. These cells cannot squeeze through small blood vessels and block the organs from getting blood. Your body destroys sickle red cells quickly, but it can't make new red blood cells fast enough. This causes anemia. Another inherited blood disease is thalassemia. It happens when the body is missing certain genes or when variant (different from normal) genes are passed down from parents that affect how the body makes hemoglobin.
Aplastic anemia. This rare problem happens when your body doesn't make enough red blood cells. Since this affects the white blood cells too, there is a higher risk for infections and bleeding that can't be stopped. This can be caused by many things:
The treatment depends on how serious the anemia is. It can be treated with blood transfusions, medicines, or a bone marrow transplant.
Anemia takes some time to develop. In the beginning, you may not have any signs or they may be mild. But as it gets worse, you may have these symptoms:
Anemia is diagnosed by a blood test. If you have anemia, your health care provider (HCP) may want to do other tests to find out what's causing it, like ulcers (sore on the lining of the stomach or duodenum [beginning of the small intestine]) or polyps (growths).
It depends on the cause of the anemia. For example, treatment for sickle cell anemia is different than treatment for a diet low in iron or folic acid. Talk to your HCP about the best treatment for the cause of your anemia.
Take these steps to help prevent some types of anemia:
Most people get enough iron through a regular healthy diet that has iron-rich foods. But some groups of people don't get enough iron:
These groups of people should be screened periodically for iron deficiency. If the tests show that the body isn't getting enough iron, iron supplements may be prescribed. Many health care providers prescribe iron supplements during pregnancy because many pregnant women don't get enough. They can help when diet alone can't restore the iron level back to normal. Talk with your HCP to find out if you are getting enough iron through your diet or if you or your child needs to be taking iron supplements. Please see to the chart below to see how many milligrams (mg) of iron you should take every day:
| Age | Infants & Children | Women | Pregnant | Breastfeeding |
| 7 to 12 months | 11 mg | |||
| 1 to 3 years | 7 mg | |||
| 4 to 8 years | 10 mg | |||
| 9 to13 years | 8 mg | 27 mg | 10 mg | |
| 14 to18 years | 15 mg | 27 mg | 10 mg | |
| 19 to 50 years | 18 mg | 27 mg | 9 mg | |
| 51+ years | 8 mg |
Many pregnant women have a hard time getting enough iron. During pregnancy, your body demands more iron because of the growing needs from the fetus, the higher volume of blood, and blood loss during delivery. Not getting enough iron can cause preterm labor and delivering a low-birthweight baby. If you're pregnant, follow these tips:
It might. If you are still getting your period while taking HT, you may need more iron than women who are postmenopausal and not taking HT. Talk to your health care provider.
It could. Some women who take birth control pills have less bleeding during their periods. This would lower their risk for anemia. But women who use an intrauterine device (IUD) may have more bleeding and increase their chances of getting anemia. Talk to your health care provider.
It depends on your diet. Since it's easier to get iron from meat than from plant-derived foods, some vegetarians may need to take a higher amount of iron each day than what is recommended for other people. Follow the tips above to prevent anemia, and try to take vitamin C with other iron-rich foods.
Iron overload happens when the body absorbs too much iron over many years. Excess iron builds up in organs, like the heart and liver. Many problems can cause iron overload. It can happen from years of taking too much iron or from repeated blood transfusions. But the most common form of iron overload in the United States is an inherited condition (runs in families) called hereditary hemochromatosis (he-mo-kro-ma-toe-sis).
Signs of early hemochromatosis may include:
As iron accumulation progresses, patients may have these symptoms:
Signs of advanced stages of hemochromatosis include:
Treatment depends on how severe the iron overload is. The first step is to get rid of the extra iron in the body. The process is called phlebotomy (fle-bot-o-me), which means removing blood. It is simple and safe. A pint of blood will be taken once or twice a week for several months to a year, and sometimes longer. Once iron levels go back to normal, you will give a pint of blood every 2 to 4 months for life. Although treatment cannot cure the problems caused by hemochromatosis, it will help most of them. Arthritis is the only problem that does not improve after excess iron is removed.
There is a lot you can do to make your life as healthy as possible:
A bleeding disorder exists when it is hard for a person to stop bleeding. When a person bleeds, the blood clots, stopping the bleeding. The clotting process, also called coagulation, changes blood from a liquid to a solid state. It takes both blood cells (called platelets) and proteins (called clotting factors) for blood to clot properly. When a person has a bleeding disorder, the blood platelets are not working like they should, or there are not enough platelets or clotting factors in the blood. This causes a person to bleed for longer periods of time than normal. Bleeding disorders tend to run in families and can be hard to detect in women. These disorders can be controlled, so a person can have a healthy and full life.
Yes, there are different types of bleeding disorders a person can have. The two most common types of bleeding disorders are:
Heavy bleeding, or menorrhagia, during menstruation is not necessarily caused by a bleeding disorder. But, heavy bleeding can be a symptom of the bleeding disorder von Willebrand Disease (VWD). When a woman has heavy bleeding, it can be hard to find the exact cause of the bleeding. Certain gynecological diseases, using an intrauterine device for birth control, and taking medications can also cause heavy bleeding in women.
Symptoms of bleeding disorders include:
If you have any of the following symptoms, you should discuss them with your health care provider. Your doctor may order tests to rule out a bleeding disorder, including a test for VWD. Be aware that your test results could be affected by your menstrual cycle. Because of this, tests may need to be done at different points in your menstrual cycle. Also know that just because your mother or your sister may also have had heavy periods, this may not be normal for you. If you are having heavy periods with no known reason, you need to be tested for VWD. Not all health care providers test for VWD when a woman is having heavy bleeding. In December 2001, the American College of Obstetrics and Gynecologists (ACOG) issued a report to health care providers to consider VWD as a possible cause for heavy menstrual bleeding in women. ACOG now recommends testing for VWD when:
When a bleeding disorder is not diagnosed and treated, it can cause serious problems, some of which can be life threatening. Women can have severe bleeding during and after childbirth or with a miscarriage. Severe bleeding can also happen during or after dental or other kinds of surgery, and after an injury or accident. A person can suffer internal bleeding, as well as bleeding in the brain. If you know that you have a bleeding disorder, be sure to tell your health care providers, especially before dental procedures, surgery, pregnancy and childbirth.
The treatment for bleeding disorders varies. Disorders that cause minor bleeding problems may need no treatment. Medications are available to prevent or treat more severe bleeding problems, such as heavy periods or extreme bleeding during dental or surgical procedures. Birth control pills are frequently used to treat heavy bleeding in women with VWD. Nasal sprays, like desmopressin acetate (DDAVP), are used for both heavy menstrual bleeding and nosebleeds. A form of DDAVP can also be injected into a person's vein before surgery or if they are having serious bleeding. Medicines to clot the blood, called clotting agents, help control bleeding. For women who have extreme menstrual bleeding that does not go away with medication, sometimes surgery is an option. Endometrial ablation can be done, which applies heat, laser, or radio waves to the inside of the uterus, or womb, to control bleeding. Hysterectomy, or removal of the uterus may also be done to stop bleeding. But, both of these surgeries, for women with bleeding disorders, increase the risk of bleeding from the surgery itself.
There are health care providers, called hematologists, who have special training in bleeding disorders that can help you find the best treatment options. For information about hemophilia, VWD and other bleeding disorders, contact HANDI, the National Hemophilia Foundation's information clearinghouse toll free at 800-42-HANDI. Or, log on to their Internet web site, http://www.hemophilia.org.
The heart pumps blood to supply oxygen and nutrients to all parts of the body. Arteries carry blood from the heart towards the body parts, while veins carry blood from the body parts back to the heart. As the blood is pumped back to the heart, veins act as one-way valves to prevent the blood from flowing backwards. If the one-way valve becomes weak, some of the blood can leak back into the vein, collect there, and then become congested or clogged. This congestion will cause the vein to abnormally enlarge. These enlarged veins can be either varicose veins or spider veins.
Varicose veins are very swollen and raised above the surface of the skin. They are dark purple or blue in color, and can look like cords or very twisted and bulging. They are found most often on the backs of the calves or on the inside of the leg, anywhere from the groin to the ankle. During pregnancy, varicose veins called hemorrhoids can form in the vagina or around the anus.
Spider veins are similar to varicose veins, but they are smaller, are often red or blue in color, and are closer to the surface of the skin than varicose veins. They can look like a tree branch or spider web with their short jagged lines. Spider veins can be found on both the legs and the face. They can cover either a very small or very large area of skin.
As many as 60% of all American women and men suffer from some form of vein disorder, but women are more affected_up to 50% overall. It also is estimated that 41% of all women will suffer from abnormal leg veins by the time they are in the 50s.
No one knows the exact cause of spider and varicose veins, but there are several factors that cause a person to be more likely to develop them. Heredity, or being born with weak vein valves, is the greatest factor. Hormones also play a role. The hormonal changes that occur during puberty, pregnancy, and menopause, as well as taking estrogen, progesterone, and birth control pills can cause a woman to develop varicose veins or spider veins. During pregnancy, besides the increases in hormone levels, there also is a great increase in the volume of blood in the body that can cause veins to enlarge. The enlarged uterus also puts more pressure on the veins. (Within 3 months after delivery, varicose veins usually improve. However, more abnormal veins are likely to develop and remain after additional pregnancies.)
Other factors that weaken vein valves and that may cause varicose or spider veins include aging, obesity, leg injury, and prolonged standing, such as for long hours on the job. Spider veins on the cheeks or nose of a fair-skinned person may occur from sun exposure.
The veins in the legs have the toughest job of carrying blood back to the heart. They endure the most pressure — pressure that can overcome the strength of these one-way valves. The force of gravity, the pressure from body weight, and the task of carrying the blood from the bottom of the body up to the heart make the legs the primary location for varicose and spider veins.
Medical treatment usually is not required for varicose or spider veins. However, varicose veins can become quite uncomfortable as well as look unattractive. Varicose veins usually enlarge and worsen over time. They can cause the legs and feet to swell. Although severe leg pain is not common, leg muscles may feel fatigued or heavy, or throb and cramp at night. The skin on the legs and around the ankles also can itch or burn.
In some cases, varicose veins and spider veins can cause more serious problems, and medical treatment will provide benefits. If the veins become severe, they can cause a condition called venous insufficiency, a severe clogging of the blood in the veins that prevents it from returning to the heart. This condition can cause problems like a deep-vein thrombosis (blood clot), or a severe bleeding infection. These usually are caused by injury to the varicose vein. A blood clot can be very dangerous because of the possibility of it traveling from the leg veins to the lungs, where it may block the heart and lungs from functioning. Lastly, because the skin tissue around the varicose vein may not receive enough nourishment, sores or skin ulcers may develop.
There are several easy things you can do to help prevent varicose and spider veins and to relieve discomfort from the ones you have:
Remember these important questions when deciding whether to see your doctor:
Besides a physical examination, your doctor can take x-rays or ultrasound pictures of the vein to assess the cause and severity of the problem. You may want to speak with a doctor who specializes in vein diseases (phlebology). You should discuss which treatment options are best for your condition and lifestyle. It is important to remember that not all cases of varicose veins are the same. Doctors may differ in the ways they treat you. Some available treatments or surgeries include:
Some side effects may only occur at the site of the injection, such as stinging or painful cramps; red raised patches of skin, small skin ulcers, and bruises. Spots, brown lines, or groups of fine red blood vessels could appear around the vein being treated. These usually disappear. The treated vein could become inflamed or develop lumps of coagulated or congested blood. These are not dangerous. Applying heat and taking aspirin or antibiotics can relieve inflammation. Lumps of coagulated blood can be drained. Health insurance coverage varies. If the treatment is done for cosmetic reasons only, it may not be covered.
Laser surgery works by sending very strong bursts of light onto the vein that makes the vein slowly fade and disappear. Lasers are very direct and accurate, and only damage the area being treated. All skin types and colors can be safely treated with lasers. The American Academy of Dermatology believes that the new laser technology is more effective with fewer side effects. Laser surgery is more comfortable for patients because there are no needles or incisions. When the laser hits the skin, the patient only feels a small pinch, and the skin is soothed by cooling both before and after the laser is applied. There may be some redness or swelling of the skin right after the treatment, but this disappears within a few days. The skin also may be discolored, but this will disappear within one to two weeks. Treatments last 15 to 20 minutes, and depending on the severity of the veins, two to five treatments are generally needed to remove varicose veins in the legs. Patients can return to normal activity right after treatment.
There are several types of lasers that can be used to treat varicose veins and spider veins on the legs and face. Although your doctor will decide which type is best to treat your condition, some of the lasers used to treat veins include yellow light lasers, green light lasers, and other intense pulsed light systems. Again, health insurance coverage varies. If the treatment is done for cosmetic reasons only, it may not be covered.
Surgery is used mostly to treat very large varicose veins. Available surgical options include:
Serious side effects or complications with this surgery are uncommon. However, with general anesthesia, there always is a risk of cardiac and respiratory complications. Similar to the risks of sclerotherapy, bleeding and congestion of blood can be a problem, but the collected blood usually settles on its own and does not require any further treating. Wound infection, inflammation, swelling and redness also can occur. This surgery also can leave permanent scars. A very common complication is the damage of nerve tissue around the treated vein. Small sensory nerve branches are difficult to avoid when veins are removed. This damage can cause numbness in small areas of skin, burning, or a change in sensation around the surgical scar. The most serious, but rare, complication of surgery is the creation of a deep vein blood clot that may travel to the lungs and heart. To be safe, many surgeons give injections of heparin, a drug that reduces blood coagulation, for one to two days before the surgery. However, heparin also can increase the normal amount of bleeding and bruising after the operation.
Current treatments for varicose veins and spider veins have very high success rates. Although it is uncommon, these veins can return after treatment. One reason may be hidden areas in the body where there is a lot of pressure on the veins. This pressure may cause new spider veins. Doctors can diagnose this with ultrasound. Another cause may be new re-growth of vein branches. Doctors have found that tiny vein branches can grow through scar tissue to connect to both deep and superficial veins even after surgery.
American Academy of Dermatology
847-330-0230
1-888-462-DERM (3376)
Internet Address: http://www.aad.org
American Dietetic Association
Phone: (312) 899-0040 or (800) 366-1655 (Consumer Nutrition Hotline)
Internet Address: http://www.eatright.org
American Society for Dermatologic Surgery
847-330-9830
Internet Address:
http://www.asds-net.org/
Aplastic Anemia & MDS International Foundation, Inc.
Phone: (800) 747-2820
Internet Address: http://www.aamds.org
Centers for Disease Control and Prevention, Hematologic Diseases Branch
Internet Address: http://www.cdc.gov/ncidod/dastlr/Hematology/
Division of Nutrition and Physical Activity, NCCDPHP, CDC, HHS
Phone: (770) 488-5820 or (888) 232-4674
Internet Address: http://www.cdc.gov/nccdphp/dnpa/
Iron Disorders Institute
Phone: (864) 241-0111 or (864) 244-2104
Internet Address: http://www.irondisorders.org
National Heart, Lung, and Blood Institute Information Center, NHLBI, NIH, HHS
Phone: (301) 592-8573
Internet Address: http://www.nhlbi.nih.gov/health/infoctr
National Hemophilia Foundation
Phone Number(s): (800) 424-2634
Internet Address: http://www.hemophilia.org/
Project Red Flag
Internet Address: http://www.projectredflag.org/
The American College of Phlebology
510-832-7300
Internet Address: http://www.phlebology.org/
The American College of Phlebology
510-832-7300
Internet Address: http://www.phlebology.org/
World Federation of Hemophilia
Phone Number(s): (514) 875-7944
Internet Address: http://www.wfh.org/