This is not an independent disease, anemia occurs as a syndrome in a number of diseases and leads to a disruption in the supply of oxygen to all organs and tissues of the body, which, in turn, provokes the development of many other diseases and pathological conditions.

Severity

Depending on the concentration of hemoglobin, it is customary to distinguish three degrees of severity of anemia:

• anemia of the 1st degree is recorded when the hemoglobin level decreases by more than 20% of the normal value;
• anemia of the 2nd degree is characterized by a decrease in hemoglobin by about 20-40% of the normal level;
• grade 3 anemia is the most severe form of the disease, when hemoglobin is reduced by more than 40% of the normal value.

It is unequivocal to show that the patient has 1 degree or a more severe stage can only be a blood test.

Causes

What it is: anemia, that is, anemia, is nothing more than a lack of hemoglobin in the blood. Namely, hemoglobin carries oxygen to all tissues of the body. That is, anemia is caused precisely by a lack of oxygen in the cells of all organs and systems.

1. The nature of nutrition. With insufficient intake of iron-containing foods, iron deficiency anemia can develop, this is more common in populations where there is already a high level of nutritional anemia;
2. Violation of the gastrointestinal tract (with violations of the absorption process). Since iron absorption occurs in the stomach and upper small intestine, if the absorption process is disturbed, the mucous membrane of the digestive tract develops this disease.
3. Chronic blood loss (gastrointestinal bleeding, nosebleeds, hemoptysis, hematuria, uterine bleeding). Belongs to one of the most important causes of iron deficiency.

Iron-deficiency anemia

The most common form of anemia. It is based on a violation of the synthesis of hemoglobin (oxygen carrier) due to iron deficiency. It is manifested by dizziness, tinnitus, flies before the eyes, shortness of breath, palpitations. Dry skin, pallor are noted, jams and cracks appear in the corners of the mouth. Typical manifestations are fragility and layering of nails, their transverse striation.

aplastic anemia

This is more often an acquired acute, subacute or chronic disease of the blood system, which is based on a violation of the hematopoietic function of the bone marrow, namely a sharp decrease in its ability to produce blood cells.

Sometimes aplastic anemia begins acutely and develops rapidly. But more often the disease occurs gradually and does not manifest itself with bright symptoms for quite a long time. The symptoms of aplastic anemia include all the symptoms that are characteristic of a lack of red blood cells, platelets and white blood cells.

B12 deficiency anemia

It occurs when there is a lack of vitamin B12 in the body, which is necessary for the growth and maturation of red blood cells in the bone marrow, as well as for the proper functioning of the nervous system. For this reason, one of the hallmark symptoms of B12 deficiency anemia is tingling and numbness in the fingers and a staggering gait.

Hemolytic anemia

Hemolysis occurs under the influence of antibodies. These can be maternal antibodies directed against the child's erythrocytes in case of incompatibility between the child and the mother for the Rh antigen and much less often for antigens of the ABO system. Antibodies against one's own erythrocytes may be active at normal temperature or only when cooled.

They can appear for no apparent reason or in connection with the fixation on erythrocytes of incomplete haptens antigens alien to the body.

signs

We list the main signs of anemia that can disturb a person.

• pallor of the skin;
• increased heart rate and respiration;
• fast fatiguability;
• headache;
• dizziness;
• noise in ears;
• spots in the eyes;
• muscle weakness;
• difficulty concentrating;
• irritability;
• lethargy;
• slight rise in temperature.

Symptoms of anemia

Among the symptoms of anemia, manifestations directly related to hypoxia are considered leading. The degree of clinical manifestations depends on the severity of the decrease in the number of hemoglobin.

1. With a mild degree (hemoglobinag / l level), general weakness, increased fatigue, and a decrease in concentration may be observed.
2. With an average (90-70 g / l), patients complain of shortness of breath, palpitations, frequent headaches, sleep disturbance, tinnitus, loss of appetite, lack of sexual desire. Patients are characterized by pallor of the skin.
3. In the case of a severe degree (hemoglobin less than 70 g / l), symptoms of heart failure develop.

With anemia, symptoms in many cases do not manifest themselves. The disease can only be detected by laboratory blood tests.

Diagnosis of the disease

In order to understand how to treat anemia, it is important to determine its type and cause of development. The main method for diagnosing this disease is the study of the patient's blood.

• for men grams per liter of blood.
• for womeng/l.
• for pregnant women, the lower limit of the norm is 110g / l.

Anemia treatment

Naturally, the methods of treating anemia radically differ depending on the type of anemia that caused its cause and severity. But the basic principle of treating anemia of any kind is the same - it is necessary to deal with the cause that caused the decrease in hemoglobin.

1. With anemia caused by blood loss, it is necessary to stop the bleeding as soon as possible. With a large blood loss that threatens life, a transfusion of donor blood is used.
2. With iron deficiency anemia, you should eat foods rich in iron, vitamin B12 and folic acid (they improve iron absorption and blood formation processes), the doctor may also prescribe medications containing these substances. Often folk remedies are effective.
3. In case of anemia provoked by infectious diseases and intoxication, it is necessary to treat the underlying disease, to carry out urgent measures to detoxify the body.

In the case of anemia, an important condition for treatment is a healthy lifestyle - proper balanced nutrition, alternation of stress and rest. It is also necessary to avoid contact with chemical or poisonous substances and oil products.

Nutrition

An important component of the treatment is a diet with foods rich in substances and trace elements that are necessary for the process of hematopoiesis. What foods should be eaten with anemia in a child and an adult? Here is the list:

• meat, sausages;
• offal - especially the liver;
• a fish;
• egg yolks;
• whole grain flour products;
• seeds - pumpkin, sunflower, sesame;
• nuts - especially pistachios;
• spinach, cabbage, Brussels sprouts, fennel, parsley leaves;
• beet;
• black currant;
• sprouts, wheat germ;
• apricots, prunes, figs, dates;

Drinks containing caffeine (eg, tea, coffee, cola) should be avoided, especially with meals, as caffeine interferes with iron absorption.

Iron supplements for anemia

Iron preparations for anemia are much more effective. The absorption of this microelement in the digestive tract from iron preparations is much higher than from food.

This allows you to effectively use iron supplements for anemia: raise hemoglobin faster, restore iron stores, eliminate general weakness, fatigue and other symptoms.

1. Ferretab composite (0154g ferrous fumarate and 0.0005g folic acid). Additionally, it is desirable to take ascorbic acid in a daily dose of 0.2-0.3 g).
2. Sorbifer durules (0.32 g of ferrous sulfate and 0.06 g of vitamin C) is available in dragee daily dosage depending on the degree of anemia 2-3 times a day.
3. Totem - is available in bottles of 10 milliliters, the content of the elements is the same as in the sorbifer. It is used orally, it can be diluted with water, it is possible to prescribe it for intolerance to tablet forms of iron. Daily dose 1-2 doses.
4. Fenyuls (0.15g, ferrous sulfate, 0.05g vitamin C, vitamins B2, B6, 0.005g calcium pantothenate.
5. Vitamin B12 in 1 ml ampoules 0.02% and 0.05%.
6. Folic acid tablets 1mg.
7. Ampoule iron preparations for intramuscular and intravenous administration are sold only by prescription and require injections only in stationary conditions due to the high frequency of allergic reactions to these drugs.

You can not take iron supplements in conjunction with drugs that reduce their absorption: Levomycitin, Calcium preparations, Tetracyclines, Antacids. As a rule, iron preparations are prescribed before meals, if there is no vitamin C in the drug, then an additional intake of ascorbic acid in a daily dose of 0.2-0.3 g is required.

For each patient, the daily need for iron is specially calculated, as well as the duration of the course of treatment, the absorption of the specific prescribed drug and the iron content in it are taken into account. Long-term courses of treatment are usually prescribed, therapeutic doses are taken within 1.5-2 months, and prophylactic doses are taken in the next 2-3 months.

Consequences

Iron deficiency anemia, if not treated early, can have serious consequences. A severe degree turns into heart failure, associated with tachycardia, edema, and low blood pressure. Sometimes people end up in the hospital with a sharp loss of consciousness, the cause of which is undertreated or not detected in time anemia.

Therefore, if you suspect that you have this disease or are prone to low hemoglobin, then it is worth taking a control blood test every three months.

Anemia

In the vast majority of cases, a reduced concentration of hemoglobin in human blood is associated with iron deficiency in the body. This condition is called anemia, and according to official medical statistics, it is diagnosed in almost 20 percent of the population.

The normal content of hemoglobin in the body of an adult healthy person is determined within the following limits: g / l for women and / l for men.

Along with a decrease in hemoglobin in anemia, there is also a decrease in the number of erythrocytes in the blood (red blood cells).

Causes of anemia

Among the main causes of iron deficiency and subsequent anemia are significant blood loss that occurs during extensive operating, gastric, uterine, nasal bleeding; as well as with constant donation.

In addition to prolonged bleeding, accompanied by profuse blood loss, anemia can be caused by acute and chronic diseases of the gastrointestinal tract, in which the function of iron absorption is impaired in the human body.

Periods of increased body need for iron preparations are also accompanied by a decrease in hemoglobin in the blood. Often this condition develops in women during pregnancy, childbirth and breastfeeding.

The causes of anemia can be clearly attributed - long-term vegetarianism, malnutrition, strict adherence to starvation diets. All of these nutritional deficiencies and errors significantly increase the risk of anemia, even in a perfectly healthy person.

The causes of anemia in children lie in the still physiologically immature hematopoietic system of the child. Anemia progresses in children against the background of the same adverse factors listed above as in the adult population.

Degrees of anemia

Experts distinguish three main degrees of anemia, which are divided into mild, moderate and severe. To determine by eye, without the use of laboratory tests, to what degree of anemia this or that case of the disease belongs is very difficult even for a medical worker. The fact is that the main criterion for the degree of anemia is the level of hemoglobin content and it is possible to determine its level solely on the basis of a patient's blood test.

Mild, first-degree anemia is characterized by a slight decrease in hemoglobin levels with the following indicators g / l in men and / l in women.

As a rule, patients do not experience any changes in their condition. As a treatment for anemia of this type, dieting and the consumption of foods with a high iron content are recommended.

In the second, moderate degree of anemia, hemoglobin has a more significant degree of reduction - dog / l. This condition is characterized by the appearance of the following symptoms of anemia and complaints: headaches, slight dizziness, etc. In this case, one nutritional adjustment is not enough, and iron medications are prescribed.

Severe, third-degree anemia is already considered life-threatening. Hemoglobin drops to the level of 70 g/l and below. There are disturbances in the functioning of the cardiovascular system, blood thinning occurs, and the general condition of the body worsens significantly.

Symptoms of anemia

Common symptoms of anemia are as follows. Patients usually complain of increased fatigue, weakness, trembling of the limbs (tremor) and constant dizziness. With further progression of the disease with anemia, the development of fainting conditions is also possible.

The appearance of people suffering from anemia is easily determined by external examination. The skin of such patients is dry and very pale, sometimes bluish, the mucous membranes are also unnaturally pale.

Even minor physical activity causes severe shortness of breath and palpitations in an anemic person. Without timely treatment of anemia, patients may develop symptoms of coronary heart disease.

Anemia treatment

Regular consumption of iron-containing foods can be recommended as the main means for self-treatment of anemia and prevention of its occurrence. Such means include a whole list of affordable and inexpensive plant products growing in our domestic garden beds.

Carrots, beets, sorrel, celery, pumpkin, rutabaga, turnips - all these vegetables, eaten daily as salads or freshly squeezed juices, will become a reliable obstacle to the occurrence of such a serious disease as anemia.

In addition to garden vegetables, it can be advised to take infusions and decoctions of some wild plants for the treatment of anemia. Clover flowers, dandelion roots, nettle and many other natural preparations will effectively help you in increasing the level of hemoglobin in the blood.

Anemia 1 degree

Anemia of the 1st degree is the easiest manifestation of a whole complex of diseases that are characterized by a decrease in the concentration of hemoglobin or the number of red blood cells. As a result of anemia, many changes begin in the body, which are caused by insufficient oxygen supply to organs and tissues. Manifestations and pathological changes in the body directly depend on the severity of the course of the disease.

Anemia 1 degree

Classification

The classification of anemia is quite simple. They are distinguished depending on the causes of occurrence into the following types:

• Posthemorrhagic anemia, which develops as a result of a decrease in the number of blood cells, erythrocytes, as a result of acute or chronic blood loss. Their causes may be trauma, heavy and frequent childbirth, heavy menstruation, stomach ulcers. In infants, posthemorrhagic anemia most often develops as a result of birth trauma, internal hemorrhages, placental bleeding, and hemorrhagic diathesis.
• Hemolytic anemia results from the abnormal breakdown of red blood cells. This form of the disease is quite rare and occurs under the influence of various autoimmune and hereditary factors.
• Deficiency anemia due to impaired erythropoiesis. This group of anemias is the most common. It includes iron deficiency anemia, which occurs in the vast majority of cases, megaloblastic anemia, due to a lack of vitamin or folic acid. Sometimes so-called multifactorial anemia develops, caused by a simultaneous deficiency of iron and B12.
• Hypoplastic and aplastic anemia resulting from impaired bone marrow function. This variety is extremely rare. It is either hereditary or develop after severe chronic diseases, the action of drugs, chemicals.

In addition, to prescribe the correct treatment regimen, it is required to determine the degree of anemia by hemoglobin. This is calculated based on the deviation of the hemoglobin value from the norm. Hemoglobin is the main iron-containing coloring element of red blood cells, which is "responsible" for the transport of oxygen with blood throughout the body.

For an adult male, the hemoglobin concentration is 135 - 160 g / l. For women, this value is somewhat lower and ranges from 120 to 140 g/l. For children, the norm of hemoglobin content depends on age. These values ​​are shown in the table:

Age

For teenagers over 16 years old, adult rules apply.

Causes

Most of the iron contained in the body is part of the erythrocytes, there are also reserves of this substance in the muscles, liver and bone marrow. The daily requirement of an adult for iron is about 10-15 mg. Of this amount, no more than 1.5 mg is absorbed into the blood, approximately the same amount is normal daily physiological losses with sweat, urine and feces. For children, the daily iron requirement for an infant is 0.5 to 1.2 mg, which increases with age, and a two-year-old child needs about 10 mg of iron per day.

Here you will find detailed information about the treatment methods.

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How to treat anemia? What Helped Me With Iron Deficiency?

The causes of iron deficiency anemia are most often not too abundant, but chronic blood loss during hemorrhoidal bleeding, acute peptic ulcer, strong menstruation and other similar conditions. In the development of iron deficiency anemia, insufficient intake of iron with food or a violation of its absorption after undergoing surgery on the stomach also plays a certain role.

Often, iron deficiency anemia develops in premature babies, since many of the substances necessary for normal hematopoiesis are formed precisely in the last two months of pregnancy. The cause of this disease in infants may also be iron deficiency anemia of varying severity in a woman during the period of bearing a child.

B12 - deficiency anemia develops due to insufficient intake of this vitamin with food, since it is not synthesized in the body. B12 is absorbed in the gastrointestinal tract with the help of a special enzyme called gastromucoprotein (also called the Castle factor). After resection of the stomach, with gastritis, chronic alcohol consumption, the secretion of the Castle factor sharply decreases and, as a result, B12 deficiency develops.

There are certain reserves of folic acid in our body. It also comes from food and is absorbed in the duodenum and ileum. This process can be disturbed under the influence of alcohol, long-term use of hormonal contraceptives, anticonvulsants, certain antibacterial drugs, in particular trimethoprim or sulfamethoxazole.

Clinical manifestations

Symptoms largely depend on the severity of the disease. Moreover, with each subsequent stage, existing symptoms are aggravated and new ones may appear.

• Anemia of the first degree is almost asymptomatic. Sometimes a person complains of mild weakness, malaise, fatigue. There is a noticeable pallor of the skin, sweating, loss of appetite. Mild anemia in infants is characterized by increased excitability of the child, tearfulness, profuse regurgitation after feeding (or vomiting in older children).
• Anemia of moderate severity is manifested by headaches, dizziness associated with insufficient oxygen supply. Children with this form of anemia get tired very quickly, they can hardly endure even the lightest physical exertion. A child under one year old may even experience a regression in the development of motor skills. Roughness or dryness of the skin is noted, very painful cracks in the corners of the mouth, digestive disorders may occur, which manifest themselves in the form of diarrhea or constipation, flatulence. From the side of the cardiovascular system, tachycardia, heart murmurs may be noted.
• Anemia of the 3rd degree is characterized by changes in the structure of nails and hair (they become dull and become very brittle), hair loss, a feeling of cold and numbness of the extremities, a perverted perception of smells and tastes. Stomatitis and caries (up to tooth decay) may appear. Children may lag behind in physical and psychological development. On ultrasound of the abdominal organs, an increase in the liver and spleen is noticeable. If left untreated, severe anemia is dangerous and can cause extremely serious consequences.

The severity of symptoms may vary depending on the general condition of the child or adult suffering from anemia. Also, the likelihood of a particular clinical sign depends on the cause of the disease.

Diagnostics

It is possible to assume the development of this disease in oneself or in a child by a simple clinical blood test, which can be taken without a doctor's referral in any laboratory. When the concentration of hemoglobin drops below normal, it is imperative to contact a general practitioner or pediatrician.

Then a biochemical blood test is prescribed. There is a decrease in the amount of serum iron, the level of ferritin (a protein that maintains the supply of iron), and the saturation of transferrin with iron.

Naturally, the doctor pays attention to the general symptoms of anemia and conducts a comprehensive examination to determine what changes this disease has caused in the body.

Treatment of anemia of the first degree

Anemia of the 1st degree in children and adults is usually very mild and in most cases does not require medical correction. It is enough to make certain changes in the diet and daily routine. Long walks in the fresh air, moderate physical activity are recommended.

If anemia of the 1st degree is detected, then the diet for children and adults should be based on the following principles:

• Increase your protein intake. To do this, you need to eat eggs, dairy products, liver, kidneys, fish and meat.
• Limit milk and strong tea, as these drinks slow down the absorption of iron from the gastrointestinal tract. Preservatives, oxalates, phosphates and some drugs, such as antacids and antibiotics of the tetracycline group, have the same effect.
• Instead of animal fats, vegetable fats should be preferred. It is necessary to use butter, dress salads with a variety of vegetable oils (sunflower, olive, grape and the like).
• If the problem with being overweight is not acute, then the amount of carbohydrates in the diet can not be limited.
• Vitamins C and group B contribute to better absorption of iron. Therefore, it is advisable to introduce products that contain them into the menu. These are citrus fruits, herbs, legumes, many berries, etc.
• The use of iron-containing foods (beef liver, rabbit and turkey meat, buckwheat and oatmeal, millet, caviar).

It is worth noting that it is imperative to monitor the dynamics of the blood and control the level of hemoglobin. In most cases, with proper dieting, its value rises to normal numbers, and further prescription of drugs is not required.

Treatment of anemia 2 and 3 degrees

Therapy of anemia of moderate and more severe forms consists in the appointment of special medications, depending on the cause of the development of the disease. Thus, iron deficiency anemia requires long-term treatment with iron preparations at a dosage of 100-120 mg per day. It is worth noting that medication should be continued even after the patient's condition is normalized and hemoglobin levels are restored. This is due to the fact that in addition to eliminating the state of deficiency, it is necessary to replenish iron stores in the body. In most cases, for the convenience of the patient, medications are prescribed in tablets. Parenteral administration is indicated for violation of the absorption of this element in the digestive tract.

Treatment of B12 deficiency anemia is carried out with the help of injections of cyanocobalamin or hydroxocobalamin at a dosage of 400-500 mcg per day during the first week. Then they switch to maintenance therapy, during which the same injection is done once every 7 days. The total duration of therapy is about two months. In the event that the cause of such anemia cannot be eliminated, then it is necessary to give prophylactic injections of cyanocobalamin several times a year to maintain a normal level of B12.

Treatment of 2 and 3 degrees of folate deficiency anemia is the same. Assigned to 5 mg of folic acid three times a day.

Therapy for rarer forms of anemia is much more difficult. With hemolytic anemia, a long course of prednisolone is indicated. Aplastic anemia was previously considered incurable and often ended in death. At the moment, the treatment of this disease is carried out with the help of bone marrow transplantation.

Features of the treatment of anemia in children

Therapy of anemia should be carried out under the strict supervision of a physician. If babies are bottle-fed, then special mixtures with a high iron content are recommended. A child with iron deficiency anemia is advised to introduce complementary foods a few weeks earlier and start with applesauce and oatmeal and buckwheat porridge.

Anemia of the 2nd degree in children is not treated with a simple correction of nutrition. Requires the use of drugs that contain ferric iron. These are maltofer, ferrum lek, ferlatum, etc. With this form of the disease, they are given in the form of drops or syrup. Parenteral administration of drugs is indicated for anemia of the third degree. In parallel with these medications, multivitamin complexes are also prescribed, because this disease is accompanied by beriberi.

With the development of severe anemia in infants, recombinant human erythropoietin is also prescribed. These are drugs such as recormon, eprex, epokrin. The same drugs are also prescribed for premature babies born 4 to 5 weeks ahead of schedule. Usually the dosage of such drugs is 250 IU per kg of body weight three times a week, but the younger the child, the greater the dose required for effective treatment.

In addition to drug therapy, long walks, a strict daily regimen, and the elimination of psychological stress are recommended. The effect of the treatment of anemia in children is noticeable already on the seventh day. If there is no effect after two weeks of therapy, then a second examination is carried out or the dose of medication is adjusted.

In general, the most common types of deficiency anemia are easily treatable, even at the most severe stage of the course. However, taking medications can be avoided with a proper diet and an active lifestyle.

Treatment of anemia of 1 and 2 degrees with folk remedies and medications

Treatment of anemia with folk remedies and medications requires determining the degree of anemia. There are 3 stages of the disease, in which the methods of therapy differ.

With grade 1 anemic syndrome, the level of hemoglobin (Hb) is slightly higher than 90 grams per liter. The second stage of the disease is exhibited in the presence in the general blood test of the amount of red pigment of erythrocytes from 70 to 90 g / l. Third degree - hemoglobin below 70 grams per liter.

In medicine, it is believed that stage 3 anemia is incompatible with life, but in practice, doctors often encounter chronic forms of the disease, in which the Hb concentration is below the indicated values, but cardiac activity and brain function do not stop.

Anemia is a pathological condition with a decrease in the number of red blood cells and hemoglobin below the physiological norm (g / l).

Anemia 1 degree: causes and symptoms

Anemia of the 1st degree is characterized by difficulty in diagnosis. The disease is not accompanied by severe clinical symptoms. The main signs of pathology are constant fatigue, depression and discomfort. Against the background of pathology, the overall working capacity decreases, so a person cannot perform daily physical activity. He often rests after doing his normal daily activities.

The cardiovascular system responds to this type of disease with only a slight increase in heart rate. Against this background, breathing accelerates. Only patients with coronary heart disease acutely feel anemia.

Anemia of the first degree is detected on the basis of laboratory tests:

1. A complete blood count shows a decrease in the number of erythrocytes and Hb;
2. Red cells lose their shape and size.

It should be noted that there are several types of anemia, depending on the pathogenetic basis of the disease: iron deficiency, aplastic, hemolytic, B12 deficient.

With an iron deficiency form of the disease, it is enough to eat meat food and iron supplements for 4 months to restore the level of red cells. True, in the presence of chronic bleeding, it is difficult to cope with the disease.

The hemolytic variant occurs against the background of blood intoxication when toxins, drugs enter it, with an enlarged spleen. It is accompanied by active destruction of red cells inside blood vessels or tissues of internal organs.

Aplastic anemia of the 1st degree occurs when there is a violation of erythrogenesis in the red bone marrow. The cause of the pathology is congenital or acquired factors. With hereditary defects, not only the process of producing erythroid tissues is disturbed: the leukocyte and platelet blood supply sprouts are affected.

Very often, anemic syndrome of the 1st degree is observed during pregnancy. Against the background of the growing needs of the fetus, the body's need for red cells increases. To make up for the lack of oxygen, iron is actively supplied from mother to child.

Other causes of anemia of the first stage during pregnancy:

1. Early detachment of the placenta;
2. Decreased blood pressure;
3. Toxicosis;
4. Weakness of childbirth;
5. Delayed fetal development;
6. risk of bleeding;
7. Child hypoxia.

During pregnancy, a mild degree of anemic syndrome is eliminated by iron preparations. Until she has passed into stage 2, it is necessary to carry out treatment.

How to treat anemia 1 degree

Treatment of anemia of the 1st degree is carried out according to the following principles:

• Dieting;
• Reception per day of iron;
• Compensation for the lack of cyanocobalamin (vitamin B12) by eating liver, milk, eggs, hard cheeses, fish, oysters and shellfish;
• Chronic aplastic anemia is not treated. It becomes chronic. To get rid of it, you will need a bone marrow transplant;
• Anemia of the first degree against the background of a deficiency of folic acid and vitamin B12 requires replenishment of the lack of these chemicals. For these purposes, the use of broccoli, whole grains, cabbage, greens and fruits is recommended. Cook food raw or steamed.

The aplastic appearance is not treated with drugs, but a diet is prescribed for it to prevent the progression of the pathology and the occurrence of complications. With this type of disease, the use of dairy products, apricots, liver, offal is recommended. It is especially important to follow a diet for anemia during pregnancy.

Anemia of the 2nd degree: symptoms and treatment with folk remedies

Anemia of the 2nd degree occurs at a concentration of hemoglobinograms per liter. This condition causes the following symptoms:

• Dizziness;
• Headache;
• General fatigue;
• Malaise;
• Increased heart rate;
• Increasing the speed of breathing.

With an iron deficiency form of the disease, the use of iron preparations and meat products is required. They are necessary to normalize the level of red blood cells.

Anemia of the 2nd degree leads to fainting. The harbingers of fainting are blanching of the skin, cyanosis of the mucous membranes, palpitations and shortness of breath. Against this background, ischemic heart disease often occurs.

Anemia of the second stage is a dangerous condition. If the iron deficiency form can be treated effectively, albeit for a long time, then the aplastic and hemolytic form of the disease often requires surgical treatment.

Hemolytic anemia of the 2nd degree occurs against the background of diseases of the internal organs. If it is possible to eliminate the disease of the liver and spleen, complications can be prevented. The aplastic form of the disease can be treated only by surgery.

Principles of anemia treatment with folk remedies

Treatment of anemia with folk remedies helps to normalize the level of red blood cells and hemoglobin. It must be understood that even an excess of iron is detrimental to the body, so the treatment of the disease should be carried out as directed by a doctor.

Popular folk remedies for the treatment of anemia:

• With iron deficiency anemic syndrome of 1 and 2 degrees, the use of foods rich in iron (meat, green vegetables, millet, pumpkin, fish) is recommended. A high rate of divalent Fe in fish, meat and offal. It is well absorbed, so it must be included in the diet of a person with anemic syndrome. Vegetables contain a minimal amount of this mineral, but they are a rich source of vitamins and minerals. In order for iron to be well absorbed, it must be prescribed along with vitamin C;
• Women who are engaged in dietary nutrition and consume muesli rarely develop iron deficiency anemia of the 2nd degree. Clinical studies have shown that this product contains a lot of the mineral;
• Willow tea for anemia is a useful and common remedy. It should be drunk 3 times a day in a glass;
• During pregnancy, to replenish the concentration of iron, dried fruits are recommended - prunes, raisins and rose hips. They need to be filled with boiled water so that the berries hide under water. If you skip dried fruits through a meat grinder, you get a puree mass, which you need to take 4 times a day for a tablespoon.

Treatment of anemia with folk remedies can be carried out according to other recipes. The main thing is that they are used as directed by a doctor!

Anemia of moderate severity, what threatens?

Anemia of the 2nd degree is a condition of blood in the human body with a low level of hemoglobin, a substance that is part of red blood cells. It performs the respiratory function of the human body at the cellular level. Oxygen entering through the lungs is absorbed into the blood, tends to form compounds with hemoglobin and be carried with it to each cell. In return, hemoglobin takes carbon dioxide from the cell and returns it to the lungs, thereby performing gas exchange in the body.

Causes and dangers of lowering hemoglobin

This is explained as follows:

1. With a mild degree of anemia, a person's condition often does not give noticeable signs of this condition, and only in the blood can one see a decrease in hemoglobin levels, this is 110 - 90 g / l.
2. The second is followed by an average degree, with which a person has symptoms of anemia, a blood test will have hemoglobin levels of 90 - 70 g / l.
3. If this period is missed and anemia is not treated, then a severe third degree sets in, in which irreversible consequences develop. With this degree in the blood, the hemoglobin level will be less than 70 g / l.

There are many reasons that affect the composition of the blood and contribute to the occurrence of anemia. They can be individual for each type and form of the disease.

But there are common ones that unite all varieties:

• loss of blood of an acute or chronic course;
• shortening the life cycle of erythrocytes;
• failure of the bone marrow to perform its functions.

With normal blood composition, anemia can occur due to blood loss. This is due to a violation of the skin and mucous membranes by various factors. Trauma and surgery can lead to significant, acute blood loss.

Donors have blood loss from donating it in small amounts, incapable of harming them. In this case, the normal state of a person is quickly restored. With chronic bleeding, there is a constant, at first glance imperceptible, loss of blood.

This can happen for various reasons:

1. With heavy periods in women or with bleeding hemorrhoids.
2. Every cell in the human body has its own life cycle. RBCs have a normal lifespan of 120 days. This period can be shortened with a lack of proteins, vitamins B12, B6 and folic acid, as well as vitamin C involved in hematopoiesis or trace elements, copper and iron.
3. Also, hereditary disorders can affect the duration of the life cycle of red blood cells. Red blood cells born with a defect have an irregular shape and do not participate in the transport of gases. Such cells are rapidly destroyed in large numbers, this is called hemolysis.
4. The bone marrow ceases to perform the function of reproducing blood cells due to a deficiency of substances that contribute to this process or its replacement with fibrous or fatty compounds. Kidney disease and the development of endocrine disorders also affect hematopoiesis.

Symptoms of moderate anemia

For an average degree of anemia, vivid symptoms are characteristic, it is manifested by various external signs:

• severe fatigue, even after sleep;
• general malaise;
• constant weakness;
• tachycardia;
• shortness of breath even with light exertion;

• noise in the ears and flies before the eyes;
• decreased mood;
• change in taste preferences;
• pale skin and blue circles under the eyes;
• jaundice;
• enlargement of internal organs.

A healthy person gets tired after work or playing sports. With severe anemia, fatigue becomes chronic and occurs without visible stress. Even waking up in the morning, a person already feels this feeling of fatigue.

The general condition of a person can be described as follows:

• Constant general malaise and weakness, even with slight physical exertion, deprive a person of his usual activities. Also joins shortness of breath and tachycardia due to oxygen deficiency in the body. The heart, working with a vengeance, beats twice as fast as its normal rhythm in order to quickly deliver the missing oxygen to the cells.

• The pressure in the vessels is low and insufficient blood enters the brain, thereby causing cerebrovascular accident, which is the cause of depressed, depressive mood, tinnitus and poor sleep. The reason for poor sleep and memory, distracted attention also lies in the disruption of oxygen supply to the brain.
• Indigestion develops against the background of anemia due to changes in fermentation and thinning of the mucous membrane. This entails a change in taste preferences. Food previously consumed no longer attracts, and various inedible substances seem tasty and people eat it: earth, clay, chalk.
• The appearance of a person also changes, the skin becomes first pale, and then yellow. This is reflected on the lips, they crack, these wounds do not heal even with their treatment.
• The lower and upper limbs become numb, and sometimes there is a tingling sensation. Due to problems with the heart and kidneys, the legs swell, and a staggering gait occurs.

Diagnostic methods

A general blood test is sometimes enough to make a diagnosis.

But for a complete examination you need:

• urine tests;
• blood chemistry;
• radiographic examination;
• bone marrow biopsy;
• endoscopy.

1. A blood test shows a low hemoglobin concentration and a decreasing red blood cell count.
2. The color of the urine is dark due to the excreted bilirubin in large quantities.
3. A biochemical blood test determines the amount of free, unbound hemoglobin in it, bilirubin, which in this state enters the liver for further utilization in it.
4. Ultrasound determines the state of internal organs and changes in them. The liver and spleen are enlarged, renal, gastric and intestinal pathologies are observed.
5. In women, the uterus is examined to identify the causes of uterine bleeding.

To determine hidden bleeding, endoscopy of the internal organs and intestines is performed. In case of violation of hematopoiesis, an x-ray of the bones is taken to diagnose pathologies in the bone marrow due to the growth of connective or adipose tissue, as well as in injuries, the presence of fractures and internal injuries is determined. A bone marrow biopsy determines the cause of the formation of defective red blood cells, as well as its cellular composition.

Treatment

The treatment regimen is selected for each patient individually and looks something like this:

• identification and elimination of causes of blood loss;
• the use of iron preparations according to indications;
• the appointment of vitamins to improve blood formation;
• blood transfusion;
• medical nutrition;
• symptomatic treatment;
• hormone therapy;
• splenectomy;
• bone marrow transplant.

The resulting anemia due to bleeding cannot be fully treated without eliminating the causes that caused the loss of blood.

For this you need:

• Stop the loss of blood from the internal organs in a surgical way.
• Next, blood transfusion is performed to restore the normal volume of circulating blood in the body. Transfusion of blood and erythrocyte mass is also done with extensive hemolysis and leukemia, malignant anemia.

• In almost all cases of an anemic condition, it is due to a lack of iron, except for hemolytic anemia. Therefore, treatment with iron preparations is prescribed immediately after the diagnosis is made and continues until the restoration of a normal blood picture.

Iron deficiency leads to impaired absorption of B vitamins by the digestive organs. Injections of vitamin B12, and for children also vitamin B 6, folic and ascorbic acids are also used to treat anemia. There is also a correction in the patient's diet.

Food products must contain:

For concomitant diseases from the internal organs and systems, symptomatic treatment is used. With inflammation and infections, antibiotic therapy and corticosteroid drugs may be used.

Pernicious anemia is treated by transplantation of red bone marrow and stem cells to restore blood formation. This requires a compatible donor. If it is not available, then cells for transplantation are taken from the patient himself, this treatment can improve the composition of the blood. Recovery occurs when a stable remission is achieved, when the concentration of erythrocytes in the blood test will be 120 g / l.

To prevent the disease, it is necessary to treat all diseases in the body in a timely manner. Periodically donate blood for analysis to control the concentration of hemoglobin in it. Human nutrition should be varied and contain foods with a high content of all the necessary vital substances.

Food must contain:

Moderate exercise and walking in the fresh air improves blood circulation and respiratory function of the body.

what is grade 2 anemia? Thank you

Acute posthemorrhagic anemia

Anemia that occurs after bleeding can be acute or chronic, depending on the size of the affected vessel and the amount of bleeding. Acute post-hemorrhagic anemia usually occurs after injuries and massive bleeding from internal organs, for example, with a complicated course of peptic ulcer, typhoid fever, pulmonary tuberculosis, aortic aneurysm, and also with rupture of the fallopian tube in case of ectopic pregnancy. The most life-threatening bleeding from large vessels located close to the heart, since in this case there is a sharp drop in blood pressure and a deficiency in filling the heart cavities. If more than half of the total blood is lost, the bleeding becomes life-threatening. In other cases, after stopping the bleeding, the volume and composition of the blood are gradually restored due to increased hematopoiesis in the tissues of the bone marrow, spleen, lymph nodes, and in the tissues of the goiter (thymus) gland.

Chronic posthemorrhagic anemia

Chronic posthemorrhagic anemia occurs when there is a slow but constant loss of blood that depletes the body's iron stores. This usually occurs with small bleeding from the hemorrhoidal veins of the intestine, from the uterine cavity, with hemophilia, frequent nosebleeds, bleeding stomach ulcers, hemorrhagic diathesis, etc. Increased bleeding may occur as a result of taking certain drugs that reduce blood clotting (anticoagulants). as well as some antipyretic, pain medications, such as aspirin. To increased bleeding sometimes leads to a lack of vitamins in the body - ascorbic acid, routine. Regenerative processes in the bone marrow and other organs are often unable to compensate for the ongoing loss of blood. As a result, the patient's body begins to suffer from chronic oxygen deficiency. With prolonged anemia, dystrophic changes in the structures of the brain, fatty degeneration of the liver, myocardium, kidneys, etc.

If the body lacks any substance, so-called deficiency anemia occurs. This group, in particular, includes anemia that occurs when the functions of the bone marrow are suppressed by worm toxins. Iron deficiency anemia (“pale sickness”, chlorosis), which is quite common in girls at the age of age, can be the result of both a lack of iron in food and a violation of its digestibility. In this case, the number of red blood cells in the blood remains normal, but the content of hemoglobin in them decreases.

With hereditary deficiency of the enzymes necessary for the synthesis of heme hemoglobin, hypochromic anemias develop, for example, congenital porphyrin disease and sideroblastic anemia. Porphyria can also occur as a result of lead poisoning.

Lack of certain vitamins can also lead to the development of anemia. So, vitamin B12 and folic acid are necessary for the maturation of red blood cells. Both substances enter the body through the gastrointestinal tract, where vitamin B12 combines with the so-called internal factor of Castle - the secret of the fundic glands of the stomach. The most common form of anemia associated with a lack of vitamin B12 and folic acid is Addison-Birmer anemia (pernicious anemia, pernicious anemia). In the bone marrow of such patients, hematopoiesis even increases, but the resulting erythrocytes are defective and undergo phagocytosis by macrophages. Thus, the processes of hemorrhage are transformed

With a decrease in the concentration of red blood cells, the load on the heart increases - it has to “pump” more blood in order to ensure normal access of oxygen to the tissues. Learn more about the most common types of anemia - iron deficiency, sickle cell and aplastic anemia.

and the rest. there.. .

lack of iron in the body; 3rd degree - already a deficit that cannot be replenished only with food;

in general, the origin of the disease cannot be accurately explained; the second degree may develop due to malnutrition, for example.

so if you have the 2nd degree, pay attention to your diet.

Anemia is a disease that has three main degrees. The severity of symptoms depends on the stage of the disease. In this case, the disease can cause severe complications, in some cases it can lead to death. Adequate treatment can benefit a person, as well as completely relieve oxygen starvation.

Hemoglobin is responsible for the supply of oxygen to the tissues, the lower the hemoglobin level in the blood, the more severe the degree of anemia. Normal indicators for women are 120, and for men 140, for children the indicators are slightly lower, but if the child is already 16 years old, then his indicators should correspond to the level of hemoglobin in the blood for an adult.

The degrees of anemia are different, and the disease occurs for various reasons, in most cases, the deficiency of hemoglobin in the blood is affected by:

1. Lack of iron, which a person receives from food.
2. Loss of blood during menstrual bleeding in women.
3. Surgical interventions of various kinds.
4. Diseases of the digestive system.
5. Autoimmune diseases and metabolic disorders.
6. Oncological diseases of various organs.
7. Hemorrhages and bleeding.

If we talk about women, then they have a lack of hemoglobin in the blood occurs not only because of menstrual bleeding, which is frequent or heavy. The cause of anemia can also be: uterine bleeding, childbirth, pregnancy and lactation.

Severe anemia can occur as a result of an oncological disease, in which case it is pointless to treat it. It is necessary to deal with the treatment of the underlying disease, against which the hemoglobin deficiency developed.

If the disease arose only after surgery, then the condition will be corrected in the postoperative period so that the human body can cope with the condition that has arisen and fully recover.

Severe anemia can also develop against the background of diseases of the liver, kidneys and gastrointestinal tract. If a person loses blood for a long period of time, the disease quickly begins to progress. Such blood loss is the most dangerous, since it proceeds for a long time without pronounced symptoms.

And also the disease can develop against the background of a long-term refusal of a person from products of animal origin. If the body does not receive proteins, carbohydrates from food, then it has every chance of encountering problems of a similar nature.

Autoimmune diseases can also cause iron deficiency in the body. In this case, treatment comes down to strengthening the human immune system, treating the root cause of anemia.

Bleeding and hemorrhage can also lead to the development of anemia. If the level of hemoglobin in the blood is low, then it is necessary to undergo a comprehensive examination and identify the cause of the condition.

Anemia of the 3rd degree is considered a serious disease, it can occur as a result of injury or injury, damage to internal organs, prolonged blood loss. Her treatment consists in the introduction of drugs of a different nature. Medicines can correct the patient's condition, but even after correction, treatment should continue.

Anemia of varying degrees can also be observed in newborns who were born prematurely. It is worth treating such a disease under the supervision of a pediatrician, the doctor will help correct the child's condition and avoid consequences.

Important: Anemia of any severity requires medical treatment and identification of the cause of the disease. Otherwise, the disease can lead to serious consequences.

Diagnostics

The severity of anemia varies, but the doctor must classify the disease. To do this, you need to donate blood for analysis. In addition to general chemical analysis, a number of additional examinations will be required:

• do an ultrasound of the abdominal cavity;
• Ultrasound of the liver and kidneys;
• MRI of the brain;
• donate blood for tumor markers.

Attention! In some cases, iron deficiency occurs due to cirrhosis of the liver, as well as during hemodialysis.

A person, one way or another, loses a certain amount of this trace element with sweat, urine and feces, but such losses are not capable of causing serious harm to the body.

Depending on the stage of anemia, the doctor may recommend that the patient undergo certain examinations, they will help to make an accurate diagnosis.

Anemia is often caused by stomach ulcers, brain tumors, or damage to the liver or kidneys. In this case, an ultrasound of the internal organs will help determine the cause of anemia.

Important: Anemia is the same anemia that you can get rid of with the help of conservative medicine. In the old days, the disease was treated with milk.

Anemia of the first stage is not considered a pathological condition, for this reason, its treatment consists in correcting nutrition and following the regimen.

Anemia has different types, but the doctor does not have any particular difficulties in making a diagnosis. Iron deficiency can be suspected in a person by the pallor of the skin and general weakness.

Classification and degrees

The classification of anemia has several varieties:

• post-traumatic;
• chronic;
• acute;
• hemolytic.

Anemia of the first degree of severity can occur against the background of injury or damage. This type of disease is not associated with pathological processes in the human body, the disease can go away on its own or after a short therapy.

The classification of anemia also distinguishes the chronic type of the disease, that is, when iron deficiency is permanent. In this case, the disease requires constant correction.

Anemia is severe, can be acute, that is, the disease progresses rapidly and leads to complications. This type of disease can lead to death.

Attention! Anemia, which is called hemolytic, has no classifications, because it is a blood disease, and it requires long-term treatment.

By severity they meet:

• 1 stage.
• Stage 2.
• 3 stage.

The classification of anemia in this way helps to establish the degree of the disease and to identify the harm that the disease can cause to a person.

Classifying anemia of the first stage, it should be noted that this is the initial stage of the disease, which has minimal consequences. In this case, a person feels a slight malaise, but at the same time does not experience any special problems with the performance of physical and mental stress.

The second stage of the disease classifies itself as more severe symptoms, a person experiences severe malaise, lack of oxygen affects his mental activity, the ability to perform physical activity. The patient quickly gets tired, his appetite decreases, a depressed state occurs. During this period, tissues experience a serious lack of oxygen and nutrients.

In the third stage of the disease, iron deficiency is observed, which is acute. A person practically does not get out of bed, his mental abilities suffer. The patient has an enlarged liver and spleen, the body is not able to digest and fully absorb food.

What indicators are at various stages of anemia:

• Stage 1 disease: hemoglobin level ranging from 90 to 110 g/l.
• Stage 2 disease: hemoglobin level ranging from 70 to 90 g/l.
• Stage 3 of the disease: the indicator is below 70 g / l.

Attention! One third of the population of our country has an iron deficiency in the blood. This is the most common disease.

All types of anemia have different symptoms, the disease can affect a person's condition. Iron deficiency is especially dangerous for children, it can cause developmental delays. Patients with this disease grow and develop more slowly. In certain cases, regression is possible.

Features of the disease in childhood

It is not difficult to classify anemia in a child; for this, it is enough to send the baby for a blood test. If the readings are low, then the baby needs urgent help.

Causes of the disease in children:

1. Brain injury (cyst or hemorrhage).
2. Difficult childbirth.
3. Difficult pregnancy.
4. Diseases of the liver, kidneys and gallbladder.
5. Iron deficiency in a woman during pregnancy.

If an iron deficiency is diagnosed in a child after birth, then he needs to start taking medication. Doctors prescribe a special diet for the mother if she is breastfeeding the baby, and also supplement the diet with medication. The drug is prescribed to the baby in the form of drops or syrup.

A child with anemia can be significantly retarded in development, while the baby does not eat well, often burps after eating, and cries a lot. His skin is pale and the corners of his mouth dry. Motor skills may also be affected. But the child is able to catch up with his peers in development, provided that he is denied timely and qualified assistance.

Anemic syndrome is a disease that is chronic, if the disease is constantly progressing, then it can lead to death. It all depends on the age of the child and the complications that have arisen.

Attention! In children with anemia, complementary foods should start earlier, it is worth feeding the baby with apples and porridge. Carbohydrates and fiber, as well as the iron found in apples, will help raise hemoglobin.

Symptoms of the disease

There are several signs that will help recognize the disease:

• loss of appetite;
• general fatigue;
• intolerance to high physical exertion;
• pallor and dryness of the skin;
• a special color in the whites of the eyes.

Important: When contacting a doctor, the totality of symptoms is taken into account, that is, weakness individually may be a sign of iron deficiency, or may be associated with overwork.

If several symptoms are observed at the same time, then in this case an appeal to a doctor is necessary, since only a doctor is able to make a correct diagnosis and prescribe adequate therapy.

Teenagers are often diagnosed with anemia, the reason for this is that the child is growing and developing rapidly, and hormonal changes are taking place in his body that affect the level of hemoglobin in the blood.

Therapy Methods

If we are talking about the first stage of the disease, then it is treated with the help of adherence to the regimen and nutrition. The patient's diet should include:

1. Products of animal origin.
2. Proteins and carbohydrates.
3. Vegetables and fruits.

Proper nutrition will help to correct the patient's condition. But you should not relax, you need constant monitoring of indicators.

Often the disease begins to progress against the background of beriberi or general weakness. In this case, the treatment is to take vitamins. The complex will help eliminate the deficiency of trace elements and vitamins in the body, and normalize hemoglobin levels in the blood.

The second stage of the disease characterizes itself with more severe symptoms. In this case, the treatment of anemia should take place with the use of medicines, it is treated with vitamins and folic acid. The doctor may prescribe injections or oral medications for the patient. The dose is selected individually and, if necessary, increases it.

Important: Anemia can occur against the background of long-term use of hormones. In this case, hormones should be stopped.

The third stage is the most difficult and most difficult, it has serious consequences for the human body. If the disease is not treated, it will lead to serious complications. Therapy is reduced to intravenous or intramuscular administration of drugs of various spectrums. Such treatment is long-term. If therapy is not started on time, then the patient has every chance of facing the consequences of iron deficiency. They are most dangerous for children and the elderly.

Prevention

Proper and balanced nutrition can be distinguished among preventive methods. All foods, especially meat and poultry, should be present in the human diet.

What can you eat with iron deficiency:

• red meat;
• white meat;
• fish and seafood;
• dairy products.

But tea, coffee and juice should be avoided. These drinks help flush out iron from the body and can make anemia worse. You will also have to give up alcohol, it negatively affects the patient's body and interferes with the absorption of iron.

A person receives a greater amount of a microelement from food, so it is necessary to carefully follow the diet.

Methods of preventive procedures:

1. Walks in the open air.
2. Taking vitamins.
3. Moderate physical activity.

Regular walks in the fresh air is a kind of prevention, especially if anemia is observed in a child. But even for an adult, fresh air will not hurt anything.

Hematologist

Higher education:

Hematologist

Samara State Medical University (SamSMU, KMI)

Level of education - Specialist
1993-1999

Additional education:

"Hematology"

Russian Medical Academy of Postgraduate Education

Degrees of anemia, classification and stages of its development: at least elementary knowledge about this disease must be, first of all, for women who are going to know the joy of motherhood, as well as for young mothers. Why this particular category of our readers? We will talk about this a little lower. In the meantime, we recall that anemia is a pathological condition of the circulatory system, expressed in a decrease in the hemoglobin content in red blood cells.

The main factors that provoke the disease are:

1. deficiency in the human body of some vital trace elements and vitamins - iron, folic acid and vitamin B 12. Accordingly, iron deficiency anemia is distinguished (by the way, this form of anemia occurs most often - in about eight out of ten clinical cases), as well as B - twelve deficiency and folic acid deficiency of its variety;
2. the second factor is profuse blood loss, which can be acute or chronic. In this case, we are dealing with posthemorrhagic anemia;
3. the third factor is genetic predisposition, past viral infections, chemicals or certain drugs can cause aplastic anemia;
4. another culprit is the process of breaking down red blood cells (hemolysis). This type of disease is called hemolytic.

If we briefly describe the reaction of these factors to the human body, we get the following clinical picture: the supply of oxygen and other nutrients to the organs and tissues of the patient is delayed or disturbed, provoking one or another degree of severity of the disease. More about this.

The main indicators for the classification of anemia are the following:

• development mechanism;
• degree of severity;
• color index;
• morphological feature;
• the ability of the bone marrow to regenerate.

Three stages of the disease

The stages of anemia are intermediate transitional states through which the disease passes in its development.

The first stage, called prelatent iron deficiency, is characterized by a constant decrease in its supply in tissues, and the amount of iron obtained from food also decreases. The hemoglobin content remains within the acceptable range.

The second stage is a latent iron deficiency. In the course of it, not only the amount of stored iron decreases sharply, but also the concentration in the blood serum.

The third stage registers a total severe lack of iron in the body; while the hemoglobin level is greatly reduced. In parallel, the percentage of red blood cells in the blood is reduced. This is how a disease called iron deficiency anemia begins.

Severity of anemia

The severity is one of the most important classifications of this disease. It directly depends on the amount of hemoglobin in the blood cells and can be diagnosed only after appropriate laboratory tests.

According to the severity, the following stages of anemia are distinguished:

• Light(anemia 1). It is characterized by a decrease in the level of hemoglobin, however, by no more than 20 percent of the norm;
• Medium(anemia 2). Registered when its level drops to 40 percent of the optimal;
• heavy(anemia 3). At the same time, hemoglobin falls by more than 40 percent of the standard value.

Symptoms of mild anemia

The main symptoms of mild anemia are:

• frequent ailments;
• fatigue, weakness, observed mainly in the morning and evening hours;
• apathetic attitude to ongoing events;
• unwillingness, and often - the inability to concentrate;
• permanent decline in performance.

Risks associated with anemia 1

In anemia 1, the following are most at risk:

Attention! If the child's behavior shows such changes as lethargy, pallor, apathy, loss of appetite - it is urgent to be tested for helminthic invasions, which you may not have suspected!

Anemia can also be caused by problems with the digestive system, liver, and kidneys. It can also accompany certain infectious or oncological diseases.

Such a wide negative palette has its own explanation: negative environmental stimuli much more easily affect the child's hematopoietic organs that are not yet fully formed - both anatomically and physiologically. The risk is doubly increased when the disease affects expectant mothers, since this disease is dangerous not only for themselves, but also - to a much greater extent - for the unborn child. The fact is that often the disease proceeds haphazardly, and its symptoms are usually attributed to the general physiological state of the pregnant woman. As a result, a woman learns about her only after passing the appropriate blood tests, while the baby in the mother's womb is already experiencing oxygen hunger.

Complications of anemia 1

If you do not stop the disease in the bud and do not begin to treat the disease, in the future you may encounter the following complications:

• lowering blood pressure;
• intrauterine growth retardation;
• toxicosis;
• premature birth;
• weak labor activity;
• fetal hypoxia;
• increased risk of bleeding.

Prevention of anemia 1

To prevent these risks and prevent the disease from progressing to a more serious or chronic stage, it is necessary:

• balance nutrition by enriching it with iron, vitamin B 12 and other essential trace elements;
• follow an appropriate diet.

Features of the diet for pregnant women

The diet of a pregnant woman must necessarily consist of chicken eggs, in particular, yolks, as well as dairy products, turkey meat, beef liver, almonds, cocoa and some other products. Moreover, the iron-containing food in her diet should increase quantitatively as it approaches the time of resolution from the burden.

By the way, such a diet is also an excellent prevention for healthy women and is recommended already in the first weeks of pregnancy.

Anemia treatment 1

Effective treatment of anemia of the first degree involves, in addition to the diet, drug therapy, since the body absorbs many times more iron from drugs than when eating. Intravenous or intramuscular injections of iron may also be given. If long-term use of iron-containing preparations did not give tangible results, therefore, it is not an iron deficiency anemia and one should look for other causes of the disease described above.

If the problem is a deficiency of vitamin B 12, it is urgent to enrich the menu with milk, eggs, hard cheeses, seafood, liver, kidneys. In the case of folic acid deficiency anemia, supplements containing folic acid are prescribed, and the presence of fresh fruits, cauliflower, greens, broccoli, whole grain cereals is desirable in the diet.

Symptoms of moderate anemia

With anemia of moderate severity, an even greater drop in hemoglobin content occurs, leading to an increase in the number of concomitant sores, therefore, to additional anemic symptoms, expressed as follows:

• headache and dizziness;
• cardiopalmus;
• decrease in the ability of the myocardium of the heart to contract;
• noise and whistling in the ears;
• sleep disorders;
• loss of appetite;
• drop in sex drive.

If, in addition, a deficiency of minerals and amino acids has arisen in the body, we are dealing with multifactorial anemia of the second degree of severity, in some cases accompanied by oxygen starvation (scientifically speaking, hypoxia) of all tissues of the body. With this type of anemia, additional symptoms may appear:

• swelling appears in the form of bags around the eyes;
• acquire pallor mucous membranes and skin;
• the patient sees flashing dots;
• memory is rapidly deteriorating.

Anemia treatment 2

In addition to drug therapy for iron deficiency anemia with iron-containing compounds and the required vitamins, it is recommended:

• balanced diet;
• maximum possible access to fresh air.

Symptoms of severe anemia

Severe anemia is the most difficult to treat and poses an immediate danger to human life.

Characteristic additional symptoms of anemia of the third degree:

• nails begin to crumble and hair break and fall off;
• there is a change in the taste sensations of food, there is a desire to taste inedible materials, for example, lime or earth;
• there are violations of the function of the cardiovascular system;
• immunity decreases;
• there is a cold snap and a violation of the sensitivity of the limbs, up to complete numbness;
• frequent attacks of tachycardia;
• almost always there is severe shortness of breath;
• there is a gradual atrophic changes in the muscles;
• stomatitis may occur;
• problems begin with the healing of the mucous membranes and skin. She starts to peel and itch.
• the patient suffers from urinary incontinence;
• cyanosis of the whites of the eyes appears;
• there are permanent increases in temperature, reaching 37.5 degrees.

Pregnant anemia 3 threatens with the appearance of uterine and placental dystrophy, and for an unborn baby - with breath holding, the development of infectious diseases.

Risks for Children with Severe Anemia

For children, the most serious hazards are:

• physical and mental development is inhibited;
• there are interruptions in the heart rate;
• disruption of the digestive system;
• following a decrease in immunity, frequent diseases appear.

Treatment of severe anemia

Anemia 3 is usually treated in an inpatient setting and includes extensive medical therapy and red blood cell transfusion, after which measures must be taken to maintain an optimal hemoglobin level.

Anemia- this is a pathological condition of the body, which is characterized by a decrease in the number of red blood cells and hemoglobin in a unit of blood.

Erythrocytes are formed in the red bone marrow from protein fractions and non-protein components under the influence of erythropoietin (synthesized by the kidneys). For three days, erythrocytes provide transport mainly of oxygen and carbon dioxide, as well as nutrients and metabolic products from cells and tissues. The life span of an erythrocyte is one hundred and twenty days, after which it is destroyed. Old erythrocytes accumulate in the spleen, where non-protein fractions are utilized, and protein fractions enter the red bone marrow, participating in the synthesis of new erythrocytes.

The entire cavity of the erythrocyte is filled with protein, hemoglobin, which includes iron. Hemoglobin gives red blood cells their red color and also helps them carry oxygen and carbon dioxide. Its work begins in the lungs, where red blood cells enter with the bloodstream. Hemoglobin molecules capture oxygen, after which oxygen-enriched erythrocytes are sent first through large vessels, and then through small capillaries to each organ, giving cells and tissues the oxygen necessary for life and normal activity.

Anemia weakens the body's ability to exchange gases; by reducing the number of red blood cells, the transport of oxygen and carbon dioxide is disrupted. As a result, a person may experience such signs of anemia as a feeling of constant fatigue, loss of strength, drowsiness, as well as increased irritability.

Anemia is a manifestation of the underlying disease and is not an independent diagnosis. Many diseases, including infectious diseases, benign or malignant tumors can be associated with anemia. That is why anemia is an important symptom that requires the necessary research to identify the underlying cause that led to its development.

Severe forms of anemia due to tissue hypoxia can lead to serious complications, such as shock conditions (for example, hemorrhagic shock), hypotension, coronary or pulmonary insufficiency.

Anemia classification

Anemias are classified:

• according to the mechanism of development;
• by severity;
• by color indicator;
• on a morphological basis;
• on the ability of the bone marrow to regenerate.

Classification	Description	Kinds
According to the mechanism of development	According to the pathogenesis, anemia can develop due to blood loss, impaired formation of red blood cells, or due to their pronounced destruction.	According to the mechanism of development, there are: anemia due to acute or chronic blood loss; anemia due to impaired blood formation ( for example, iron deficiency, aplastic, renal anemia, as well as B12 and folate deficiency anemia); anemia due to increased destruction of red blood cells ( for example, hereditary or autoimmune anemia).
By severity	Depending on the level of decrease in hemoglobin, there are three degrees of severity of anemia. Normally, the hemoglobin level in men is 130 - 160 g / l, and in women 120 - 140 g / l.	There are following degrees of severity of anemia: mild degree, at which there is a decrease in the level of hemoglobin relative to the norm up to 90 g / l; average degree, at which the hemoglobin level is 90 - 70 g / l; severe degree, at which the hemoglobin level is below 70 g / l.
By color index	The color indicator is the degree of saturation of red blood cells with hemoglobin. It is calculated based on the results of a blood test as follows. The number three must be multiplied by the hemoglobin index and divided by the red blood cell index ( the comma is removed).	Classification of anemia by color index: hypochromic anemia (weakened color of red blood cells) color index less than 0.8; normochromic anemia the color index is 0.80 - 1.05; hyperchromic anemia (erythrocytes are overly stained) color index greater than 1.05.
According to morphological features	With anemia, red blood cells of various sizes can be observed during a blood test. Normally, the diameter of erythrocytes should be from 7.2 to 8.0 microns ( micrometer). Smaller RBCs ( microcytosis) can be observed in iron deficiency anemia. Normal size may be present in posthemorrhagic anemia. Larger size ( macrocytosis), in turn, may indicate anemia associated with a deficiency of vitamin B12 or folic acid.	Classification of anemia by morphological features: microcytic anemia, at which the diameter of erythrocytes is less than 7.0 microns; normocytic anemia, at which the diameter of erythrocytes varies from 7.2 to 8.0 microns; macrocytic anemia, at which the diameter of erythrocytes is more than 8.0 microns; megalocytic anemia, at which the size of erythrocytes is more than 11 microns.
According to the ability of the bone marrow to regenerate	Since the formation of red blood cells occurs in the red bone marrow, the main sign of bone marrow regeneration is an increase in the level of reticulocytes ( erythrocyte precursors) in blood. Also, their level indicates how actively the formation of red blood cells proceeds ( erythropoiesis). Normally, in human blood, the number of reticulocytes should not exceed 1.2% of all red blood cells.	According to the ability of the bone marrow to regenerate, the following forms are distinguished: regenerative form characterized by normal bone marrow regeneration ( the number of reticulocytes is 0.5 - 2%); hyporegenerative form characterized by a reduced ability of the bone marrow to regenerate ( the reticulocyte count is below 0.5%); hyperregenerative form characterized by a pronounced ability to regenerate ( the number of reticulocytes is more than two percent); aplastic form characterized by a sharp suppression of regeneration processes ( the number of reticulocytes is less than 0.2%, or their absence is observed).

Causes of anemia

There are three main causes leading to the development of anemia:

• blood loss (acute or chronic bleeding);
• increased destruction of red blood cells (hemolysis);
• reduced production of red blood cells.

It should also be noted that depending on the type of anemia, the causes of its occurrence may differ.

Factors affecting the development of anemia	Causes
genetic factor	hemoglobinopathies ( a change in the structure of hemoglobin is observed with thalassemia, sickle cell anemia); Fanconi's anemia develops due to an existing defect in the cluster of proteins that are responsible for DNA repair); enzymatic defects in erythrocytes; cytoskeletal defects ( cell scaffold located in the cytoplasm of a cell) erythrocyte; congenital dyserythropoietic anemia ( characterized by impaired formation of red blood cells); abetalipoproteinemia or Bassen-Kornzweig syndrome ( characterized by a lack of beta-lipoprotein in intestinal cells, which leads to impaired absorption of nutrients); hereditary spherocytosis or Minkowski-Choffard disease ( due to a violation of the cell membrane, erythrocytes take on a spherical shape).
Nutritional factor	iron deficiency; vitamin B12 deficiency; folic acid deficiency; deficiency of ascorbic acid ( vitamin C); starvation and malnutrition.
physical factor
Chronic diseases and neoplasms	kidney disease ( e.g. liver tuberculosis, glomerulonephritis); liver disease ( e.g. hepatitis, cirrhosis); diseases of the gastrointestinal tract ( e.g. gastric and duodenal ulcer, atrophic gastritis, ulcerative colitis, Crohn's disease); collagen vascular diseases ( e.g. systemic lupus erythematosus, rheumatoid arthritis); benign and malignant tumors for example, uterine fibroids, polyps in the intestines, cancer of the kidneys, lungs, intestines).
infectious factor	viral diseases ( hepatitis, infectious mononucleosis, cytomegalovirus); bacterial diseases ( tuberculosis of the lungs or kidneys, leptospirosis, obstructive bronchitis); protozoal diseases ( malaria, leishmaniasis, toxoplasmosis).
Pesticides and medicines	inorganic arsenic, benzene; radiation; cytostatics ( chemotherapy drugs used to treat cancer); antithyroid drugs ( reduce the synthesis of thyroid hormones); antiepileptic drugs.

Iron-deficiency anemia

Iron deficiency anemia is hypochromic anemia, which is characterized by a decrease in the level of iron in the body.

Iron deficiency anemia is characterized by a decrease in red blood cells, hemoglobin and a color index.

Iron is a vital element involved in many metabolic processes in the body. In a person weighing seventy kilograms, the iron reserve in the body is approximately four grams. This amount is maintained by maintaining a balance between the regular loss of iron from the body and its intake. To maintain balance, the daily need for iron is 20-25 mg. Most of the incoming iron in the body is spent on its needs, the rest is deposited in the form of ferritin or hemosiderin and, if necessary, is consumed.

Causes of iron deficiency anemia

Causes	Description
Violation of the intake of iron in the body	vegetarianism due to the lack of animal proteins ( meat, fish, eggs, dairy products); socio-economic component ( for example, there is not enough money for good nutrition).
Impaired absorption of iron	Iron absorption occurs at the level of the gastric mucosa, therefore, stomach diseases such as gastritis, peptic ulcer or gastric resection lead to impaired iron absorption.
Increased body's need for iron	pregnancy, including multiple pregnancy; lactation period; adolescence ( due to rapid growth); chronic diseases accompanied by hypoxia ( e.g. chronic bronchitis, heart defects); chronic suppurative diseases ( e.g. chronic abscesses, bronchiectasis, sepsis).
Loss of iron from the body	pulmonary bleeding ( e.g. lung cancer, tuberculosis); gastrointestinal bleeding ( for example, gastric and duodenal ulcers, gastric cancer, intestinal cancer, varicose veins of the esophagus and rectum, ulcerative colitis, helminthic invasions); uterine bleeding ( e.g. placental abruption, uterine rupture, uterine or cervical cancer, aborted ectopic pregnancy, uterine fibroids); kidney bleeding ( e.g. kidney cancer, kidney tuberculosis).

Symptoms of iron deficiency anemia

The clinical picture of iron deficiency anemia is based on the development of two syndromes in a patient:

• anemic syndrome;
• sideropenic syndrome.

Anemia syndrome is characterized by the following symptoms:

• severe general weakness;
• increased fatigue;
• attention deficit;
• malaise;
• drowsiness;
• black stool (with gastrointestinal bleeding);
• heartbeat;

Sideropenic syndrome is characterized by the following symptoms:

• taste perversion (for example, patients eat chalk, raw meat);
• perversion of smell (for example, patients sniff acetone, gasoline, paints);
• brittle, dull, split ends;
• white spots appear on the nails;
• the skin is pale, the skin is flaky;
• cheilitis (bites) may appear in the corners of the mouth.

Also, the patient may complain of the development of leg cramps, for example, when climbing stairs.

Diagnosis of iron deficiency anemia

On physical examination, the patient has:

• cracks in the corners of the mouth;
• "glossy" language;
• in severe cases, an increase in the size of the spleen.

• microcytosis (small erythrocytes);
• hypochromia of erythrocytes (weak color of erythrocytes);
• poikilocytosis (erythrocytes of various forms).

In the biochemical analysis of blood, the following changes are observed:

• decrease in the level of ferritin;
• serum iron is reduced;
• serum iron-binding capacity is increased.

Instrumental research methods
To identify the cause that led to the development of anemia, the following instrumental studies can be prescribed to the patient:

• fibrogastroduodenoscopy (for examination of the esophagus, stomach and duodenum);
• Ultrasound (for examining the kidneys, liver, female genital organs);
• colonoscopy (to examine the large intestine);
• computed tomography (for example, to examine the lungs, kidneys);
• X-rays of light.

Treatment of iron deficiency anemia

Nutrition for anemia
In nutrition, iron is divided into:

• heme, which enters the body with products of animal origin;
• non-heme, which enters the body with plant products.

It should be noted that heme iron is absorbed in the body much better than non-heme iron.

Food	Product Names
Food animal origin	liver; beef tongue; rabbit meat; turkey; goose meat; beef; a fish.	9 mg; 5 mg; 4.4 mg; 4 mg; 3 mg; 2.8 mg; 2.3 mg.
	dried mushrooms; fresh peas; buckwheat; Hercules; fresh mushrooms; apricots; pear; apples; plums; cherries; beet.	35 mg; 11.5 mg; 7.8 mg; 7.8 mg; 5.2 mg; 4.1 mg; 2.3 mg; 2.2 mg; 2.1 mg; 1.8 mg; 1.4 mg.

While dieting, you should also increase your intake of foods containing vitamin C, as well as meat protein (they increase the absorption of iron in the body) and reduce the intake of eggs, salt, caffeine and calcium (they reduce the absorption of iron).

Medical treatment
In the treatment of iron deficiency anemia, the patient is prescribed iron supplements in parallel with the diet. These drugs are designed to compensate for iron deficiency in the body. They are available in the form of capsules, dragees, injections, syrups and tablets.

The dose and duration of treatment is selected individually depending on the following indicators:

• patient's age;
• the severity of the disease;
• causes of iron deficiency anemia;
• based on the results of the analyses.

Iron supplements are taken one hour before a meal or two hours after a meal. These drugs should not be taken with tea or coffee, as iron absorption is reduced, so it is recommended to drink them with water or juice.

Iron preparations in the form of injections (intramuscular or intravenous) are used in the following cases:

• with severe anemia;
• if anemia progresses despite taking doses of iron in the form of tablets, capsules or syrup;
• if the patient has diseases of the gastrointestinal tract (for example, gastric and duodenal ulcers, ulcerative colitis, Crohn's disease), since the iron supplement taken may aggravate the existing disease;
• before surgical interventions in order to accelerate the saturation of the body with iron;
• if the patient has intolerance to iron preparations when they are taken orally.

Surgery
Surgery is performed if the patient has acute or chronic bleeding. So, for example, with gastrointestinal bleeding, fibrogastroduodenoscopy or colonoscopy can be used to identify the area of ​​bleeding and then stop it (for example, a bleeding polyp is removed, a stomach and duodenal ulcer is coagulated). With uterine bleeding, as well as with bleeding in organs located in the abdominal cavity, laparoscopy can be used.

If necessary, the patient may be assigned a transfusion of red blood cells to replenish the volume of circulating blood.

B12 - deficiency anemia

This anemia is due to a lack of vitamin B12 (and possibly folic acid). It is characterized by a megaloblastic type (increased number of megaloblasts, erythrocyte progenitor cells) of hematopoiesis and represents hyperchromic anemia.

Normally, vitamin B12 enters the body with food. At the level of the stomach, B12 binds to a protein produced in it, gastromucoprotein (Castle's intrinsic factor). This protein protects the vitamin that has entered the body from the negative effects of the intestinal microflora, and also promotes its absorption.

The complex of gastromucoprotein and vitamin B12 reaches the distal (lower) small intestine, where this complex breaks down, absorption of vitamin B12 into the intestinal mucosa and its further entry into the blood.

From the bloodstream, this vitamin comes:

• in the red bone marrow to participate in the synthesis of red blood cells;
• in the liver, where it is deposited;
• to the central nervous system for the synthesis of the myelin sheath (covers the axons of neurons).

Causes of B12 deficiency anemia

There are the following reasons for the development of B12-deficiency anemia:

• insufficient intake of vitamin B12 with food;
• violation of the synthesis of internal factor Castle due to, for example, atrophic gastritis, gastric resection, gastric cancer;
• intestinal damage, for example, dysbiosis, helminthiasis, intestinal infections;
• increased body needs for vitamin B12 (rapid growth, active sports, multiple pregnancy);
• violation of vitamin deposition due to cirrhosis of the liver.

Symptoms of B12 deficiency anemia

The clinical picture of B12 and folate deficiency anemia is based on the development of the following syndromes in the patient:

• anemic syndrome;
• gastrointestinal syndrome;
• neuralgic syndrome.

Name of the syndrome	Symptoms
Anemia syndrome	weakness; increased fatigue; headache and dizziness; skin integuments are pale with an icteric shade ( due to liver damage); flashing flies before the eyes; dyspnea; heartbeat; with this anemia, there is an increase in blood pressure;
Gastrointestinal syndrome	the tongue is shiny, bright red, the patient feels a burning sensation of the tongue; the presence of ulcers in the oral cavity ( aphthous stomatitis); loss of appetite or its decrease; feeling of heaviness in the stomach after eating; weight loss; there may be pain in the rectum; stool disorder constipation); enlargement of the liver ( hepatomegaly). These symptoms develop due to atrophic changes in the mucous layer of the oral cavity, stomach and intestines.
Neuralgic syndrome	feeling of weakness in the legs when walking for a long time or when climbing up); feeling of numbness and tingling in the limbs; violation of peripheral sensitivity; atrophic changes in the muscles of the lower extremities; convulsions.

Diagnosis of B12 deficiency anemia

In the general blood test, the following changes are observed:

• decrease in the level of red blood cells and hemoglobin;
• hyperchromia (pronounced color of erythrocytes);
• macrocytosis (increased size of red blood cells);
• poikilocytosis (a different form of red blood cells);
• microscopy of erythrocytes reveals Kebot rings and Jolly bodies;
• reticulocytes are reduced or normal;
• a decrease in the level of white blood cells (leukopenia);
• increased levels of lymphocytes (lymphocytosis);
• decreased platelet count (thrombocytopenia).

In the biochemical blood test, hyperbilirubinemia is observed, as well as a decrease in the level of vitamin B12.

A puncture of the red bone marrow revealed an increase in megaloblasts.

The patient may be assigned the following instrumental studies:

• study of the stomach (fibrogastroduodenoscopy, biopsy);
• examination of the intestine (colonoscopy, irrigoscopy);
• ultrasound examination of the liver.

These studies help to identify atrophic changes in the mucous membrane of the stomach and intestines, as well as to detect diseases that led to the development of B12-deficiency anemia (for example, malignant tumors, cirrhosis of the liver).

Treatment of B12 deficiency anemia

All patients are hospitalized in the hematology department, where they undergo appropriate treatment.

Nutrition for B12 deficiency anemia
Diet therapy is prescribed, in which the consumption of foods rich in vitamin B12 is increased.

The daily requirement for vitamin B12 is three micrograms.

Medical treatment
Drug treatment is prescribed to the patient according to the following scheme:

• For two weeks, the patient receives 1000 mcg of Cyanocobalamin intramuscularly daily. Within two weeks, the patient's neurological symptoms disappear.
• Over the next four to eight weeks, the patient receives 500 mcg daily intramuscularly to saturate the depot of vitamin B12 in the body.
• Subsequently, the patient for life receives intramuscular injections once a week, 500 mcg.

During treatment, simultaneously with Cyanocobalamin, the patient may be prescribed folic acid.

A patient with B12-deficiency anemia should be observed for life by a hematologist, gastrologist and family doctor.

folate deficiency anemia

Folate deficiency anemia is a hyperchromic anemia characterized by a lack of folic acid in the body.

Folic acid (vitamin B9) is a water-soluble vitamin that is partly produced by intestinal cells, but mainly must come from outside to replenish the body's needs. The daily intake of folic acid is 200-400 micrograms.

In foods, as well as in the cells of the body, folic acid is in the form of folates (polyglutamates).

Folic acid plays an important role in the human body:

• participates in the development of the body in the prenatal period (contributes to the formation of nerve conduction of tissues, the circulatory system of the fetus, prevents the development of some malformations);
• participates in the growth of the child (for example, in the first year of life, during puberty);
• affects the processes of hematopoiesis;
• together with vitamin B12 is involved in DNA synthesis;
• prevents the formation of blood clots in the body;
• improves the processes of regeneration of organs and tissues;
• participates in the renewal of tissues (for example, skin).

Absorption (absorption) of folate in the body is carried out in the duodenum and in the upper part of the small intestine.

Causes of folate deficiency anemia

There are the following reasons for the development of folate deficiency anemia:

• insufficient intake of folic acid from food;
• increased loss of folic acid from the body (for example, with cirrhosis of the liver);
• impaired absorption of folic acid in the small intestine (for example, with celiac disease, when taking certain medications, with chronic alcohol intoxication);
• increased body needs for folic acid (for example, during pregnancy, malignant tumors).

Symptoms of folate deficiency anemia

With folate deficiency anemia, the patient has an anemic syndrome (symptoms such as increased fatigue, palpitations, pallor of the skin, decreased performance). Neurological syndrome, as well as atrophic changes in the mucous membrane of the oral cavity, stomach and intestines, are absent in this type of anemia.

Also, the patient may experience an increase in the size of the spleen.

Diagnosis of folate deficiency anemia

In a general blood test, the following changes are observed:

• hyperchromia;
• decrease in the level of red blood cells and hemoglobin;
• macrocytosis;
• leukopenia;
• thrombocytopenia.

In the results of a biochemical blood test, there is a decrease in the level of folic acid (less than 3 mg / ml), as well as an increase in indirect bilirubin.

When conducting a myelogram, an increased content of megaloblasts and hypersegmented neutrophils is detected.

Treatment of folate deficiency anemia

Nutrition in folate deficiency anemia plays a big role, the patient needs to consume foods rich in folic acid daily.

It should be noted that with any culinary processing of products, folates are destroyed by approximately fifty percent or more. Therefore, to provide the body with the necessary daily norm, it is recommended to consume fresh products (vegetables and fruits).

Food	Name of products	The amount of iron per hundred milligrams
Food of animal origin	beef and chicken liver; pork liver; heart and kidneys; fatty cottage cheese and cheese; cod; butter; sour cream; beef meat; rabbit meat; chicken eggs; hen; mutton.	240 mg; 225 mg; 56 mg; 35 mg; 11 mg; 10 mg; 8.5 mg; 7.7 mg; 7 mg; 4.3 mg; 4.1 mg;
Foods of plant origin	asparagus; peanut; lentils; beans; parsley; spinach; walnuts; Wheat groats; white fresh mushrooms; buckwheat and barley groats; wheat, grain bread; eggplant; green onions; Red pepper ( sweet); peas; tomatoes; White cabbage; carrot; oranges.	262 mg; 240 mg; 180 mg; 160 mg; 117 mg; 80 mg; 77 mg; 40 mg; 40 mg; 32 mg; 30 mg; 18.5 mg; 18 mg; 17 mg; 16 mg; 11 mg; 10 mg; 9 mg; 5 mg.

Drug treatment of folic acid deficiency anemia involves taking folic acid in an amount of five to fifteen milligrams per day. The required dosage is set by the attending physician, depending on the age of the patient, the severity of the course of anemia and the results of the studies.

The prophylactic dose includes taking one to five milligrams of the vitamin per day.

aplastic anemia

Aplastic anemia is characterized by bone marrow hypoplasia and pancytopenia (decrease in the number of red blood cells, white blood cells, lymphocytes and platelets). The development of aplastic anemia occurs under the influence of external and internal factors, as well as due to qualitative and quantitative changes in stem cells and their micro-environment.

Aplastic anemia can be congenital or acquired.

Causes of aplastic anemia

Aplastic anemia can develop due to:

• stem cell defect
• suppression of hematopoiesis (blood formation);
• immune reactions;
• lack of factors stimulating hematopoiesis;
• not using the hematopoietic tissue of elements important for the body, such as iron and vitamin B12.

There are the following reasons for the development of aplastic anemia:

• hereditary factor (for example, Fanconi anemia, Diamond-Blackfan anemia);
• drugs (eg, non-steroidal anti-inflammatory drugs, antibiotics, cytostatics);
• chemicals (eg inorganic arsenic, benzene);
• viral infections (eg, parvovirus infection, human immunodeficiency virus (HIV));
• autoimmune diseases (eg, systemic lupus erythematosus);
• severe nutritional deficiencies (eg, vitamin B12, folic acid).

It should be noted that in half of the cases the cause of the disease cannot be identified.

Symptoms of aplastic anemia

The clinical manifestations of aplastic anemia depend on the severity of pancytopenia.

With aplastic anemia, the patient has the following symptoms:

• pallor of the skin and mucous membranes;
• headache;
• dyspnea;
• increased fatigue;
• gingival bleeding (due to a decrease in the level of platelets in the blood);
• petechial rash (red spots on the skin of small sizes), bruises on the skin;
• acute or chronic infections (due to a decrease in the level of leukocytes in the blood);
• ulceration of the oropharyngeal zone (the oral mucosa, tongue, cheeks, gums and pharynx are affected);
• yellowness of the skin (a symptom of liver damage).

Diagnosis of aplastic anemia

In the general blood test, the following changes are observed:

• decrease in the number of red blood cells;
• decrease in hemoglobin level;
• decrease in the number of leukocytes and platelets;
• decrease in reticulocytes.

The color index, as well as the concentration of hemoglobin in the erythrocyte, remain normal.

In a biochemical blood test, the following is observed:

• increase in serum iron;
• saturation of transferrin (an iron-carrying protein) with iron by 100%;
• increased bilirubin;
• increased lactate dehydrogenase.

Puncture of the red brain and subsequent histological examination revealed:

• underdevelopment of all germs (erythrocyte, granulocytic, lymphocytic, monocytic and macrophage);
• replacement of bone marrow with fat (yellow marrow).

Among the instrumental methods of research, the patient can be assigned:

• ultrasound examination of parenchymal organs;
• electrocardiography (ECG) and echocardiography;
• fibrogastroduodenoscopy;
• colonoscopy;
• CT scan.

Treatment of aplastic anemia

With the right supportive treatment, the condition of patients with aplastic anemia improves significantly.

In the treatment of aplastic anemia, the patient is prescribed:

• immunosuppressive drugs (for example, cyclosporine, methotrexate);
• glucocorticosteroids (for example, methylprednisolone);
• antilymphocyte and antiplatelet immunoglobulins;
• antimetabolites (eg, fludarabine);
• erythropoietin (stimulates the formation of red blood cells and stem cells).

Non-drug treatment includes:

• bone marrow transplantation (from a compatible donor);
• transfusion of blood components (erythrocytes, platelets);
• plasmapheresis (mechanical blood purification);
• compliance with the rules of asepsis and antisepsis in order to prevent the development of infection.

Also, in severe cases of aplastic anemia, the patient may need surgical treatment, in which the spleen is removed (splenectomy).

Depending on the effectiveness of the treatment, a patient with aplastic anemia may experience:

• complete remission (attenuation or complete disappearance of symptoms);
• partial remission;
• clinical improvement;
• no effect of treatment.

Treatment effectiveness	Indicators
Complete remission	hemoglobin index more than one hundred grams per liter; the granulocyte index is more than 1.5 x 10 to the ninth power per liter; platelet count more than 100 x 10 to the ninth power per liter; no need for blood transfusion.
Partial remission	hemoglobin index more than eighty grams per liter; granulocyte index more than 0.5 x 10 to the ninth power per liter; platelet count more than 20 x 10 to the ninth power per liter; no need for blood transfusion.
Clinical Improvement	improvement in blood counts; reducing the need for blood transfusion for replacement purposes for two months or more.
No therapeutic effect	no improvement in blood counts; there is a need for a blood transfusion.

Hemolytic anemia

Hemolysis is the premature destruction of red blood cells. Hemolytic anemia develops when the activity of the bone marrow is not able to compensate for the loss of red blood cells. The severity of anemia depends on whether hemolysis of red blood cells began gradually or abruptly. Gradual hemolysis may be asymptomatic, while anemia in severe hemolysis may be life-threatening for the patient and cause angina pectoris, as well as cardiopulmonary decompensation.

Hemolytic anemia can develop due to hereditary or acquired diseases.

By localization, hemolysis can be:

• intracellular (for example, autoimmune hemolytic anemia);
• intravascular (eg, transfusion of incompatible blood, disseminated intravascular coagulation).

In patients with mild hemolysis, the hemoglobin level may be normal if the production of red blood cells matches the rate of their destruction.

Causes of hemolytic anemia

Premature destruction of red blood cells may be due to the following reasons:

• internal membrane defects of erythrocytes;
• defects in the structure and synthesis of hemoglobin protein;
• enzymatic defects in the erythrocyte;
• hypersplenomegaly (enlargement of the liver and spleen).

Hereditary diseases can cause hemolysis as a result of red blood cell membrane abnormalities, enzymatic defects, and hemoglobin abnormalities.

There are the following hereditary hemolytic anemias:

• enzymopathies (anemia, in which there is a lack of enzyme, deficiency of glucose-6-phosphate dehydrogenase);
• hereditary spherocytosis or Minkowski-Choffard disease (erythrocytes of an irregular spherical shape);
• thalassemia (violation of the synthesis of polypeptide chains that are part of the structure of normal hemoglobin);
• sickle cell anemia (a change in the structure of hemoglobin leads to the fact that red blood cells take on a sickle shape).

Acquired causes of hemolytic anemia include immune and non-immune disorders.

Immune disorders are characterized by autoimmune hemolytic anemia.

Non-immune disorders can be caused by:

• pesticides (for example, pesticides, benzene);
• medicines (for example, antivirals, antibiotics);
• physical damage;
• infections (eg malaria).

Hemolytic microangiopathic anemia results in the production of fragmented red blood cells and can be caused by:

• defective artificial heart valve;
• disseminated intravascular coagulation;
• hemolytic uremic syndrome;

Symptoms of hemolytic anemia

Symptoms and manifestations of hemolytic anemia are diverse and depend on the type of anemia, the degree of compensation, and also on what treatment the patient received.

It should be noted that hemolytic anemia may be asymptomatic, and hemolysis may be detected incidentally during routine laboratory testing.

Symptoms of hemolytic anemia include:

• pallor of the skin and mucous membranes;
• fragility of nails;
• tachycardia;
• increased respiratory movements;
• lowering blood pressure;
• yellowness of the skin (due to an increase in the level of bilirubin);
• ulcers may appear on the legs;
• skin hyperpigmentation;
• gastrointestinal manifestations (eg, abdominal pain, stool disturbance, nausea).

It should be noted that with intravascular hemolysis, the patient has an iron deficiency due to chronic hemoglobinuria (the presence of hemoglobin in the urine). Due to oxygen starvation, cardiac function is impaired, which leads to the development of patient symptoms such as weakness, tachycardia, shortness of breath and angina pectoris (with severe anemia). Due to hemoglobinuria, the patient also has dark urine.

Prolonged hemolysis can lead to the development of gallstones due to impaired bilirubin metabolism. At the same time, patients may complain of abdominal pain and bronze skin color.

Diagnosis of hemolytic anemia

In the general analysis of blood is observed:

• decrease in hemoglobin level;
• decrease in the level of red blood cells;
• an increase in reticulocytes.

Microscopy of erythrocytes reveals their crescent shape, as well as Cabot rings and Jolly bodies.

In a biochemical blood test, there is an increase in the level of bilirubin, as well as hemoglobinemia (an increase in free hemoglobin in the blood plasma).

In children whose mothers suffered from anemia during pregnancy, iron deficiency is also often found by the first year of life.

Symptoms of anemia often include:

• feeling tired;
• sleep disorder;
• dizziness;
• nausea;
• dyspnea;
• weakness;
• fragility of nails and hair, as well as hair loss;
• pallor and dryness of the skin;
• perversion of taste (for example, the desire to eat chalk, raw meat) and smell (the desire to sniff liquids with pungent odors).

In rare cases, a pregnant woman may experience fainting.

It should be noted that a mild form of anemia may not manifest itself in any way, so it is very important to regularly take blood tests to determine the level of red blood cells, hemoglobin and ferritin in the blood.

During pregnancy, the norm of hemoglobin is considered to be 110 g / l and above. A drop below normal is considered a sign of anemia.

Diet plays an important role in the treatment of anemia. From vegetables and fruits, iron is absorbed much worse than from meat products. Therefore, the diet of a pregnant woman should be rich in meat (for example, beef, liver, rabbit meat) and fish.

The daily iron requirement is:

• in the first trimester of pregnancy - 15 - 18 mg;
• in the second trimester of pregnancy - 20 - 30 mg;
• in the third trimester of pregnancy - 33 - 35 mg.

However, it is impossible to eliminate anemia only with the help of a diet, so a woman will additionally need to take iron-containing preparations prescribed by a doctor.

Name of the drug	Active substance	Mode of application
Sorbifer	Ferrous sulfate and ascorbic acid.	As a preventive measure for the development of anemia, it is necessary to take one tablet per day. For therapeutic purposes, two tablets should be taken daily in the morning and evening.
Maltofer	iron hydroxide.	In the treatment of iron deficiency anemia, two to three tablets should be taken ( 200 - 300 mg) per day. For prophylactic purposes, the drug is taken one tablet at a time ( 100 mg) in a day.
Ferretab	Ferrous fumarate and folic acid.	It is necessary to take one tablet per day, if indicated, the dose can be increased to two to three tablets per day.
Tardyferon	Iron sulfate.	For prophylactic purposes, take the drug, starting from the fourth month of pregnancy, one tablet daily or every other day. For therapeutic purposes, take two tablets a day, morning and evening.

In addition to iron, these preparations may additionally contain ascorbic or folic acid, as well as cysteine, as they contribute to better absorption of iron in the body. Before use, you should consult with a specialist.

Anemia has long been popularly known as anemia, since the internal symptoms and external manifestations indicate a condition characterized by a lack of blood. In medicine, this disease has received its own term and classification according to severity. Anemia of the 2nd degree is considered the most common.

The disease itself refers to moderate pathologies of hematopoiesis, manifested by a complex of clinical and hematological syndromes. This form of deviation affects both adults and children, manifesting almost the same symptoms.

Anemia of any degree refers to diseases that progress due to a decrease in the total amount of hemoglobin in the blood. It is known that it is this molecule that performs an important function in the normalization of gas exchange, transporting oxygen to tissues and organs and removing carbon dioxide from there. Lack of oxygen as a result of a small amount of "transport agents" threatens with tissue hypoxia, oxygen starvation of organs.

Doctors attribute many factors, both internal and external, to the reasons for a noticeable decrease in hemoglobin in the blood.

1. The nature and habits of nutrition play an important role in the normalization of blood counts. It is known that among population groups that are careless about the regimen and diet, the percentage of iron deficiency anemia is several times higher.
2. Complex malfunctions in the work of the gastrointestinal tract disrupt the absorption of trace elements and nutrients, including iron. Against this background, hemoglobin deficiency and anemia of varying severity develop.
3. Chronic blood loss against the background of complex disruptions in the body has long been considered among physicians as one of the most important and significant causes in the development and progression of anemia.

Anemia of moderate severity often occurs precisely because of a lack of iron in the patient's body. The complexity of the treatment lies in the difficulty in assimilation of this element, and also in the fact that many internal causes affect its performance.

The scheme for the occurrence of iron deficiency pathology is simple: initially, iron deficiency occurs in the body, which entails a lack of hemoglobin and, as a result, poor blood supply to the whole body.

Symptoms of the violation

Anemia in a mild degree can be asymptomatic - only blood counts signal a dysfunctional failure in the body.

Anemia of 2 or moderate severity, in turn, greatly complicates the general condition of the patient. This pathology is considered severe, and it is characterized by the following symptoms and signs:

• constant fatigue, including in the morning and after a day's rest;
• symptoms of general malaise and disease state;
• asthenic syndrome, manifested by constant weakness;
• attacks of tachycardia;
• shortness of breath and insufficiency of respiratory functions, even against the background of small physical exertion;
• frequent noise or buzzing in the ears;
• decreased visual acuity, flashing "flies" before the eyes;
• depression and lethargy;
• taste change;
• pale skin with severe bruising under the eyes;
• icteric skin tone;
• an increase in the size of internal organs.

Reduced hemoglobin levels are considered pronounced and range from 70 to 90 g / l.

General condition of the patient

Against the background of obvious signs and symptoms of hematopoietic pathology, the general condition of the patient also changes for the worse.

1. It is difficult for a person with anemia of the 2nd degree to do his usual things. Constant shortness of breath and persistent weakness progress sharply even with minor physical exertion, the condition is aggravated by manifestations of tachycardia. Heart palpitations are caused by the fact that the heart, due to a lack of oxygen, begins to work with redoubled energy to make up for this deficiency.
2. Against the background of oxygen starvation of brain cells, the patient develops and begins to progress into an oppressed, depressive state. Frequent companions of a patient with anemia of the second degree are tinnitus and dizziness, which drastically reduces the quality of life: the patient does not sleep well, it is difficult for him to concentrate and hold attention, to remember even a small amount of information.
3. Due to a pronounced change in fermentation, a person changes his taste habits up to deformation: giving up his favorite dishes, he begins to prefer chalk, clay, even earth.
4. The appearance of the patient noticeably changes: the skin first acquires a pale shade, then - an icteric color. Lips crack and “jams” appear in the corners of the mouth, which bring a lot of trouble because they are difficult to cure.
5. The upper and lower limbs go numb, the process is accompanied by tingling sensations. Cardiac disorders also gradually progress, as well as kidney problems, accompanied by edema and a change in gait.

Violations of the general condition of the patient do not develop immediately, but, as a rule, gradually, aggravated, as the pathology progresses.

Diagnosis of moderate anemia

Experienced specialists can assume a violation of hematopoiesis already during the examination of the patient and the collection of anamnesis data. Anemia of the second degree has pronounced characteristic symptoms and signs that make it possible to diagnose the disease even during the initial external examination. To clarify the diagnosis and subsequent correction of the treatment regimen, the doctor prescribes the following diagnostic measures to his patients:

1. A general urine test, which shows a holistic picture of the functioning of the excretory system, as well as the amount of excreted bilirubin.
2. A complete blood count reflects the level of concentration of hemoglobin and red blood cells. A low concentration of hemoglobin against the background of a decrease in red blood cells indicates the progression of anemia of the second degree.
3. A biochemical blood test determines the volume of free, unbound hemoglobin, as well as bilirubin entering the liver for its further utilization.
4. An ultrasound examination of the internal organs is prescribed to determine their changes. In patients suffering from anemia of the 2nd degree, an enlarged liver and spleen are diagnosed, intestinal, renal and gastric pathological processes are manifested.
5. A study by a gynecologist of the reproductive system of women is carried out to identify possible uterine bleeding. For the same purpose, the patient is prescribed endoscopy of the internal organs and intestines.

A comprehensive examination may include an X-ray examination of the bones for the presence of pathologies in the bone marrow. In advanced and complicated cases, the patient is prescribed a bone marrow biopsy.

Treatment of moderate anemia

Most often, the treatment of moderate anemia is carried out in a hospital with constant supervision of doctors and timely correction of the treatment regimen. The therapy of this pathology is complex and includes the treatment and elimination of the causes that provoked the appearance of the disease.

Principles for constructing a treatment regimen

The doctor corrects the therapeutic scheme for diagnosed anemia of the second degree, taking into account the individual characteristics of the patient's body and the conditions for the course of the pathology. The general treatment regimen for moderate anemia includes:

• identification and elimination of the main causes of possible blood loss;
• taking iron-containing drugs according to the doctor's indications and taking into account the individual characteristics of the course of the disease;
• vitamin therapy to stabilize the processes of blood clotting in the body;
• blood transfusion procedures;
• symptomatic therapy;
• hormone therapy;
• removal of the spleen in especially severe cases of pathology;
• bone marrow transplant.

Iron deficiency in the body entails an acute lack of B vitamins, so doctors also prescribe specific treatment for their patients:

1. Injection of B12 in the treatment of childhood anemia is supplemented with vitamin B6.
2. Folic acid is most often prescribed for internal use, the scheme and dosage of which is adjusted by the attending physician. Often, as an accompanying treatment, ascorbic acid is prescribed.

Concomitant diseases of internal systems and organs are treated with corticosteroids and antibacterial drugs.

Diet therapy for anemia of the 2nd degree

It is equally important during the treatment period to organize a proper and balanced diet for the patient. In the daily diet of the patient must be present:

• meat and liver of animals;
• legumes;
• a sufficient amount of fresh herbs;
• fruits rich in iron;
• dried fruits;
• nuts;
• dairy products;
• fresh vegetables.

Fresh juices are considered especially useful: pomegranate, tomato, beetroot, apple, orange. It is allowed to include dark chocolate, cocoa-containing drinks in the diet.

In addition to drug treatment and diet therapy, experts recommend their patients long walks in the fresh air and the normalization of the mode of physical activity. An important role is played by a strict and orderly daily routine, the elimination of psychological stress.

Even the most severe forms of anemia can be treated if the patient follows all the recommendations of the attending physician and avoids contact with toxic substances and petroleum products.