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Anemia
When “Tired Blood” is Slowing You Down

by Joy Pape, RN, BSN, CDE, WOCN, CFCN

Most people have heard of anemia and know that it has something to do with the blood. Most people also associate anemia with feeling tired. But probably not too many people could explain exactly what anemia is.

Stated simply, anemia is a condition in which there is a lower than normal number of healthy red blood cells in the body and/or a lower than normal amount of hemoglobin in the red blood cells.

Red blood cells carry oxygen from your lungs to the rest of your body. The specific part of the red blood cell that carries oxygen is called hemoglobin. Red blood cells also carry waste products from the cells to the urinary and respiratory systems to be excreted. When either the number of red blood cells or the amount of hemoglobin is low, the body’s cells receive less oxygen than normal. A low oxygen level can cause fatigue and other symptoms such as weakness, difficulty exercising, and light-headedness.

Anemia can develop for many reasons. In fact, there are more than 400 types of anemia. But they can all be categorized into these three general groups:

  • Anemia caused by the loss of blood
  • Anemia caused by a decrease in red blood cell production in the bone marrow or impaired production of red blood cells
  • Anemia caused by red blood cell destruction

Anemia is a fairly common condition, but it often goes unrecognized and therefore not treated. Its symptoms are vague and easily mistaken for symptoms of other serious or chronic diseases. But even mild anemia can significantly lower one’s quality of life, and untreated anemia can have serious long-term health effects.

Diabetes and anemia
Diabetes does not directly cause anemia, but certain complications and conditions associated with diabetes can contribute to it. For example, both diabetes-related kidney disease (nephropathy) and nerve damage (neuropathy) can contribute to the development of anemia. In addition, taking certain oral diabetes drugs can raise the risk of developing anemia. People with diabetes can also have anemia as a result of not eating well or of having a condition that interferes with the absorption of nutrients.

Kidney disease. Normally, the kidneys secrete a hormone called erythropoietin, which stimulates the bone marrow to produce red blood cells. In diabetic nephropathy, the tiny blood vessels that filter waste products from the body become damaged and start “leaking” substances (such as protein) into the urine. At the same time, the amount of erythropoietin produced by the kidneys is reduced, leading to anemia. Some studies have shown that reduced erythropoietin production and anemia happen earlier in people with diabetes and kidney disease than in those with kidney disease and no diabetes.

Both chronically high blood glucose levels and high blood pressure can cause kidney damage.

Neuropathy. In people who have a type of neuropathy called autonomic neuropathy, the body may not be able to properly signal the kidneys to produce more erythropoietin in response to anemia.

Heart failure. People who have diabetes are at increased risk for heart failure, or the inability of the heart to pump adequate blood to meet the body’s needs. Decreased heart function can cause kidney dysfunction, and many people with heart failure also have nutritional deficiencies; both of these can contribute to anemia. About 20% of people with heart failure are anemic.

Nutrient deficiencies. Many people who have diabetes have nutrient deficiencies that can cause anemia. Nutrient deficiencies can be caused by either not eating enough nutrients (because a person restricts his food choices, for example) or by the body’s inability to absorb the nutrients that are eaten. Deficiencies in iron, vitamin B12, vitamin B6, and folate can all cause anemia.

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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.

 

 

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