Let's learn about Anemia of Chronic Disease (ACD)?

Do you have diabetes, arthritis, kidney disease, or another chronic illness that makes you feel tired and lethargic? You may think that it's because of your illness. There's some truth to that story, but there could be another reason. That's what we're talking about today. We call this condition 'Anemia of Chronic Disease' or 'Anemia of Inflammation'. Simply put, it's a lack of blood that results from a long-term illness.

What exactly is 'Anemia of Chronic Disease'?

Okay, let's put this simply. Anemia, or low blood pressure, is a condition where we have a low number of red blood cells. These red blood cells carry oxygen throughout our bodies. So when they are low, we feel tired and lifeless.

In a condition called 'Anemia of Chronic Disease', chronic inflammation within the body caused by an illness that has been present for more than three months prevents our body from using the iron needed to make red blood cells.

Think about it this way. We have all the cement, bricks, and iron bars to build a house. But the workers have some problem and cannot use those materials to work. That's what happens here too. Even though we have iron in our bodies, due to the inflammation caused by the long-term illness, the body cannot use that iron to make new red blood cells. Most of the time, this is a mild anemia that is not that severe.

Who is most likely to develop this condition?

As the name suggests, this anemia can occur in anyone with any long-term (chronic) medical condition. However, it is especially common among people over the age of 65. There are several main medical conditions that can cause this anemia. Let's see what they are.

Why does this disease cause anemia? What is really happening inside the body?

This is a very interesting story. The average lifespan of a red blood cell in our body is about 120 days. After these old red blood cells die, our body is very clever at recycling the iron in them to make new red blood cells. Our bone marrow is the main source of this work.

But when you have a long-term illness like the one mentioned above, some things in our body change due to the inflammation that occurs.

1. The iron is stuck:Special cells in our immune system called macrophages store iron from old red blood cells for reuse. It's like someone who has left some items they need in a cupboard and lost the key. Even though the body has iron, the bone marrow can't use it to make new red blood cells.

2. Red blood cell production decreases: Due to the inflammatory condition, the rate at which new red blood cells are produced by the bone marrow may also decrease slightly.

3. The lifespan of red blood cells is shortened: Sometimes, the lifespan of newly formed red blood cells can be less than 120 days.

When all these reasons come together, the number of healthy red blood cells in our body gradually decreases, leading to anemia.

What are the symptoms? Do you suspect you have this condition?

The symptoms of 'Anemia of Chronic Disease' are very similar to those of normal iron deficiency anemia. Some people may not have any symptoms at all. Others may only experience these symptoms during times of stress, such as exercise. A person with symptoms may experience:

• Constant feeling of extreme fatigue and a feeling of weakness. You may feel so tired that you cannot even do the normal tasks of the day.
• Feeling short of breath at times, such as when walking a little or climbing stairs.
• Your skin, especially your face, palms, and lips, looks pale.
• Sweating for no particular reason.
• Feeling dizzy, fainting.
• Frequent headaches.

If you have symptoms like these with a long-term illness, it is very important to talk to your doctor about this.

How do you find this, Doctor?

When you go to see your doctor, he will ask you about your symptoms and any other illnesses you may have, and will examine you. He will then order several blood tests to determine exactly what type of anemia you have. These blood tests are usually the ones that diagnose this condition.

In some special cases, if the doctor needs further information, he or she may also recommend a bone marrow biopsy, which involves taking a small sample of bone marrow and testing it.

What are the treatments for this?

The most important and satisfying thing here is that in most cases, this anemia can be cured.

However, sometimes if the anemia is severe, or if it is accompanied by conditions such as cancer or kidney disease, the doctor may recommend some additional treatments.

• Blood Transfusion: Blood transfusions can be a short-term solution for people whose anemia is so severe that they can't bear the strain. However, this is not something that can be done continuously.
• Synthetic EPO Therapy: Our kidneys produce a hormone called `(Erythropoietin - EPO)`. This is what signals the bone marrow to "make new red blood cells". In some diseases, the production of this hormone decreases. In that case, this hormone is given externally as an injection.
• Iron Supplements: Sometimes, especially with EPO treatment, your doctor may decide to give you iron supplements or injections.

But remember this! Never start taking iron tablets from a pharmacy without consulting a doctor because you think you have anemia. This is because in the case of 'Anemia of Chronic Disease', the body may have iron, but the problem is that it cannot be used. At such a time, adding more iron to the body can cause other problems. Therefore, always take the treatment as prescribed by your doctor.

What can we do to reduce the risk?

If you have a chronic illness, you may not be able to completely prevent anemia from occurring. However, maintaining good overall health can help reduce your risk and lessen the impact of anemia if it does occur. Eating a nutritious diet is important for this.

• Eat lean proteins like chicken, fish, beans, and lentils.
• Always include dark green vegetables and herbs like spinach and kale in your diet.
• Choose iron-fortified bread and cereal.
• Eat foods rich in nutrients like vitamin B12 and folate.

Important: Do not take vitamin or iron supplements on your own unless recommended by your doctor.

If you already live with a chronic illness, it can feel like an additional burden to deal with anemia. That's normal. But the best part is that this condition is often mild and gets better when the underlying condition is treated. After treatment, talk to your doctor about lifestyle changes, such as diet and exercise, that can help reduce the risk of this condition recurring.