A Word from a Nurse

Jamie, a nurse at Compass Imaging in Gulfport, MS (228-314-SCAN) contributed her own article about anemia. You can read what she has to say below:

Anemia means that the body does not have enough healthy red blood cells. It can be divided into two broad categories: 1. iron deficient and 2. hemolytic. Some info on each:

Iron deficiency anemias: This is the more common of the two- what people are generally referring to when they talk about anemia. It’s probably safe to say that many, if not most, women experience some iron deficiency anemia at some time.

Iron is needed to make hemoglobin, the component in red blood cells that carries oxygen. About 2/3 of the body’s iron is found in hemoglobin; the rest is stored in other proteins and enzymes. Main causes of iron deficiency anemia are lack of iron in the diet and an ability of the gastro tract to absorb it. Blood loss may also be a factor.

  1. Diet: dietary iron is either heme (animal products) or non-heme (plant sources). Iron-rich foods include red meat, poultry, fish, organ meats, oatmeal, soybeans, tofu, lentils, spinach and raisins. A diet lacking in iron and/or folic acid can lead to anemia.
  2. Absorption: dairy products block absorption of iron in the gut; vitamin C increases it (so a cheeseburger will yield less iron than a hamburger with a slice of tomato). Low nutrient-density foods (junk food) also block absorption. Your body will attempt to absorb more when stores are low, less when they are adequate or high (high iron is toxic). Another factor that affects absorption is the health of the small intestines. Chronic health conditions such as Crohn’s or celiac disease, or a history of intestinal resection will make it harder for the body to absorb iron.
  3. Blood loss and women at risk: menstrual blood loss depletes iron each month, particularly for women who have heavy periods; pregnancy is a major strain on iron stores because they are needed for the baby and also the added fluid in a pregnant woman’s bloodstream means that whatever iron/hemoglobin she has is diluted. Childbirth and postpartum blood loss are also factors, coming at a time when many women are already iron depleted.
  4. At least three other types of anemia are not exactly iron deficiency related but are similar in effects on the body- aplastic anemia is when the bone marrow stops producing adequate red blood cells, usually due to autoimmune disorders, cancer treatment, cancers, or exposure to toxins; pernicious anemia happens in people who do not absorb enough B12 from their diet, and renal anemia can sometimes happen in people with kidney damage, because the kidneys produce a substance called erythropoiten, which signals the bone marrow to make blood cells.

Hemolytic anemias: Hemolytic means “destruction of blood cells”- hemo coming from the word for blood and lytic, meaning tearing apart. These anemias are fairly rare and are usually hereditary; although, they can be acquired as the result of a mechanic action, blood incompatibility or exposure to transient medical issues.

Hemolytic anemias include:

  1. Hereditary conditions like sickle cell (blood cells are sickle-shaped and don’t travel through the blood stream easily- they are rigid, fragile and sticky which causes them to get easily damaged, clump and clog small vessels, and cause pain), spherocytosis/eliptocytosis/ovalsytosis (these are disorders that cause the blood cells to have abnormal membrane shape and surface area, and so they have similar issues to sickle cell), G6PD, Pyruvate kinase deficiency, and paroxysmal nocturnal hemoglobinuria.
  2. Autoimmune hemolytic conditions happens when the body’s cell attack the immune system for an unknown reason. TTP (thrombotic thrombocytopenia purport) is another condition of unknown cause that results in many small clots in the body as well as hemolysis. There are other conditions or infections that also cause hemolysis and anemia, many of them are transient and once they are treated or resolved, the hemolytic anemia goes away.
  3. Mechanical hemolytic anemia happens when the blood is damaged by the mechanical actions of artificial heart valves or by dialysis.
  4. Blood incompatibility due to poorly matched blood transfusion or Rh disease in newborns.

Q: My patient has anemia. Are labs needed?

A: Probably not. For the iron deficiency anemias and the like, labs are not needed. For hemolytic anemias, please notify nursing- the radiologists may want labs on a patient with a hemolytic anemia depending on what type or the situation. When in doubt about anything having to do with anemia, please just feel free to ask.

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