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Anemia

Anemia is an insufficient amount of red blood cells that carry vital oxygen to the tissues. There are different types of anemia with unique pathological processes. This post will explore the pathophysiology of iron deficiency and folate deficiency anemia, including the impact of behavior on these disorders.

Iron deficiency anemia is like it sounds. The body has a deficiency of iron and cannot produce enough hemoglobin to oxygenate the tissues properly. The heme molecules that constitute hemoglobin need iron as it attracts oxygen to attach to the red blood cell (erythrocyte). When it is not available, hematopoiesis (red blood cell formation) cannot occur. The body has some reserves of iron, but it does not last because hematopoiesis happens throughout life. Red blood cells die or are lost through bleeding and need replacement. The causes of iron deficiency include inadequate dietary intake, chronic blood loss, and metabolic disorders via insufficient delivery or absorption. In all types of anemia, patients present with classic symptoms of weakness, fatigue, dyspnea, and paleness (Hammer & McPhee, 2019). Obtaining a serum ferritin level is the best way to measure iron deficiency as the iron binds to ferritin. Treatment includes increasing dietary intake of iron or giving supplemental iron after ruling out a chronic bleed (most often the gastrointestinal tract). If there is bleeding, this needs correction to resolve the anemia.

Folate deficiency anemia is an insufficient amount of folic acid. Folic acid is necessary for RNA and DNA synthesis in erythrocytes (Huether & McCance, 2017). Folate deficiency occurs more often in alcoholics or malnourished individuals. Symptoms that can present with this type of anemia include watery diarrhea, stomatitis, burning mouth syndrome, and ulcers in the mouth to name a few. Treatment requires an oral supplement of folic acid until blood levels rise to adequate levels. Although different in their pathology, both types of anemia effect hematopoiesis, and this is critical for oxygen delivery to the tissues.

Behavior

Adequate dietary intake of iron and folate can reduce these types of anemia. However, as mentioned above, with iron deficiency anemia, it is essential to determine the cause because it could be from bleeding. Odewole et al. (2013) conducted a study of folate deficiency anemia after the mandatory enrichment of folic acid into cereal grains in the United States. The researchers found only two individuals out of over 1500 surveyed, suggesting that this type of anemia is nearly nonexistent in the United States. (Odewole et al., 2013).

References

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Odewole, O. A., Williamson, R. S., Zakai, N. A., Berry, R. J., Judd, S. E., Qi, Y., … Oakley Jr., G. P. (2013). Near-elimination of folate-deficiency anemia by mandatory folic acid fortification in older US adults: Reasons for Geographic and Racial Differences in Stroke study 2003-2007. The American Journal of Clinical Nutrition, 98(4), 1042–1047. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.3945/ajcn.113.059683

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