You may not…….many people are unaware that they have anemia. You may experience certain symptoms – abnormal feelings or sensations – which may prompt you to consult a doctor. The severity of your symptoms depends not only on how anemic you are, but also on how quickly the anemia developed.
For instance, if the anemia is due to a very sudden loss of blood from a bleeding ulcer or a wound, you may faint or even die. If the anemia develops very slowly, over months or even years, you may not be aware that there is anything wrong at all.
Here are the common symptoms of anemia:
- FEELING TIRED
The most common symptom caused by anemia is tiredness. This is a very general and common complaint, but if you feel that you are much more tired than you should be, this could be due to anemia. You may have difficulty concentrating or get upset more easily than usual.
Everything may seem like a major effort. If you’re anemic, you may have a reduced sex drive (or libido) as part of your general fatigue.
If you’re anemic, you’ll feel breathless as your lungs have to work harder to compensate for the reduced number of blood cells that are supplying your body with oxygen.
- LEG AND HEART PAIN
You may have sorse pain in the leg muscles when you walk. Heart pain (angina) can occur in anemia.
You may look perfectly normal. However, particularly if the anemia is severe, you may look pale. Your doctor will check the conjunctiva (the tissue just inside the lower eyelid) and the creases in the palm of your hand. Both should be rosy pink, rather than a washed-out shade.
- OTHER CHANGES
Some types of anemia have more specific physical signs. For instance, very severe chronic iron deficiency anemica can be associated with a change in the shape of the nail, which becomes spoon-shaped.
The medical term for this is koilonychia. Your tongue can become smooth, red and very sore (this is called glossitis). Little cracks may appear in the corners of your mouth.
People who have pernicious anemia (which is due to a failure to absorb vitamin B12) tend to have a pale, almost lemon tint to their skin, grey hair and pale blue eyes. If the vitamin B12 levels are very low, there can be damage to the nerves in the spinal cord, which can lead to weakness and loss of sensation in the legs.
Sometimes anemia results from the blood cells being destroyed too quickly in an enlarged spleen. If your spleen is enlarged, your doctor should be able to feel the spleen on the left hand side of your abdomen, just beneath the ribs, and your skin may be slightly yellow, or jaundiced. The lymph nodes may be enlarged for a number of reasons in an anemic patient.
- What to do
Your first port of call, if you’re feeling unwell, will be your doctor. If you have mild anemia with an obvious cause, you probably won’t need specialist attention.
However, if the exact diagnoses isn’t obvious or it is a rare form of anemia, your doctor will probably refer you to a hematologist, someone who specialises in the diseases of the blood. So if you do consult a hematologist, you can rest assured that you’re seeing someone who is very well qualified to treat your anemia.
FULL BLOOD COUNT
The most important test they may order is a full blood count. This requires taking approximately 10ml. of blood from a vein, usually in your arm, using a needle and syringe.
The blood is put through a special machine that counts the number of blood cells in a tiny volume of blood, to see if there are too few or, rarely, too many.
If the count is abnormal, the blood will be examined under a microscope by a hematologist. The hematologist examines the size, shape and shade of the cells, and can often predict the cause of the anemia from appearance of the blood under the microscope. Further tests will be required to discover the cause. Occasionally, a bone marrow biopsy will be required.
BONE MARROW BIOPSY
A bone marrow sample is usually taken from either the breast bone (sternum) or the top of the hipbone. You will need to go to the hospital or the pathology laboratory for a couple of hours. Some hematologists give a short acting sedative before performing the test, others rely on a local anesthetic is injected into the skin, using a fine needle.
After the area is numb, a large hollow needle is pushed through the bone into the space that contains the marrow. A little marrow is sucked out into a syringe attached to the needle, which is then removed. The marrow is now smeared on to glass slides, stained with special dyes that highlight the cells, and prepared for viewing under the microscope.
You may have an ache at the site of the bio9psy. This shouldn’t last long but you may like to take paracetamol to make you more comfortable.
The results of a bone marrow test are available in a couple of days.