Have you been suffering from diabetes, arthritis, kidney disease, or another chronic illness for months, maybe even years, and are you feeling tired and sluggish all the time? Your doctor may have told you that you have low blood count. This could be due to a specific blood deficiency that is caused by your chronic illness. That's what we're talking about today. This is medically called 'Anemia of Chronic Disease'.
What is anemia caused by long-term diseases?
Simply put, this is also anemia. It means that the number of red blood cells that carry oxygen throughout the body decreases. But this is a little different from the anemia that we usually hear about due to iron deficiency. This condition is caused by inflammation caused by a medical condition that has been in your body for more than three months. Sometimes doctors also call this ``Anemia of Inflammation``.
Imagine that you have a chronic illness that causes your body to constantly have a small "burn" (inflammation). This prevents our body from properly utilizing the iron it needs to make red blood cells. It's like having all the ingredients for cooking at home, but not being able to cook without gas. But the good news is that most people with this condition have mild anemia, which is not that severe.
Who is most likely to develop this condition?
As the name suggests, anemia can develop in anyone with any type of chronic illness. However, it is more common in people over the age of 65. There are several main categories of diseases that can cause anemia:
- Cancer
- Chronic kidney disease
- Heart failure
- Autoimmune diseases: These are diseases in which the immune system, which is supposed to protect our body, attacks the body itself.
Let's look at how this anemia can be caused by several immune system diseases and other conditions.
| Medical condition | A simple explanation |
|---|---|
| Rheumatoid arthritis | Long-term swelling and pain in the joints. |
| Lupus | Damage caused by the immune system attacking various tissues in the body. |
| Vasculitis | Inflammation or swelling of blood vessels. |
| Inflammatory bowel disease | Intestinal conditions such as Crohn's disease and ulcerative colitis. |
| Any type of long-term infection | Any infection that persists in the body for a long time can cause this. |
| Obesity | Obesity can also cause chronic inflammation in the body. |
Why is the iron in the body not used in this disease?
This is a little difficult to understand, but it's a very important point. Think about it this way...
A red blood cell in our body normally lives for about 120 days. After they die, the body cleverly recycles the iron in those cells to make new red blood cells.
But, when you have inflammation due to a long-term illness, a type of cell in our body called macrophages holds on to the iron that comes from these old red blood cells. That is, they don't release that iron. It's like they're locking up the iron.
Therefore, even though iron is stored in the body (as a protein called `Ferritin`), the iron is not released into the blood, so new red blood cells cannot be made. This is the main thing that happens in this disease.
What are the symptoms of this?
These symptoms are very similar to those of anemia caused by iron deficiency. Some people may not have any symptoms at all. Others may only experience these symptoms when they exercise. People who have symptoms may experience:
| Symptom | Description |
|---|---|
| Extreme fatigue and weakness | Feeling so weak that you can't even do your daily tasks. |
| Difficulty breathing | Feeling dizzy even when walking a little or climbing stairs. |
| Pale appearance of the skin | Skin, lips, and palms appear paler than normal. |
| Sweating for no reason | Feeling cold and sweating for no particular reason. |
| Dizziness and fainting | Feeling like your eyes are turning blue when you stand or get up suddenly. |
| Headache | Frequent headaches. |
How do you find this, Doctor?
Your doctor will ask you about your symptoms and any other medical conditions you may have, and if they suspect this is the case, they will order some blood tests. These blood tests are the only way to diagnose this condition.
What blood test reports show
| Test | Simply put, what do you see in this? |
|---|---|
| Hemoglobin level | The protein that gives red blood cells their red color and carries oxygen. Its value is decreasing. |
| Serum iron level | The amount of free iron in the blood. This is a low value. |
| Reticulocyte count | This refers to "baby" red blood cells. If this number is low, it means that the bone marrow is not making new cells at a slow rate. |
| Serum ferritin level | This is the most important thing . Ferritin is a protein that stores iron in the body. While it is low in general iron deficiency, its value is normal or high in Anemia of Chronic Disease . |
Very rarely, the doctor may also recommend a bone marrow biopsy if necessary.
What are the treatments for this?
The best and most important treatment for this anemia is to properly treat the underlying disease that caused the anemia.
Imagine that you have this anemia due to rheumatoid arthritis. When you take the medication your doctor prescribes to control your arthritis, the inflammation in your body decreases. Then the trapped iron is released, and the anemia almost automatically improves.
Very important: Never take iron supplements on your own without consulting your doctor. This is because iron is stored in the body during this illness, and adding more iron can be harmful to the body.
People with severe anemia may sometimes need other treatments:
- Blood transfusion: This is a quick fix, but it's not a long-term solution.
- Synthetic EPO therapy: EPO is a hormone produced by the kidneys. It signals the bone marrow to "make red blood cells." When this injection is given, red blood cell production increases.
- Iron tablets: Sometimes, your doctor may decide to give you iron tablets along with the EPO injection, but this should only be done under medical supervision.
You may be feeling very tired and stressed due to these anemia symptoms, along with your long-term medical condition. But remember, this condition is often mild and gets better when the underlying condition is treated. It is important to talk to your doctor about dietary and lifestyle changes that are right for you.
Take-Home Message
- Anemia of Chronic Disease is not a lack of iron in your diet. It is caused by inflammation in the body due to a long-term illness.
- The best treatment for this is to treat the underlying condition you have (e.g., arthritis, kidney disease).
- If you have symptoms such as extreme fatigue, shortness of breath, and paleness, tell your doctor.
- Do not use iron tablets without medical advice for any reason. In this case, it can harm the body.
- Talk openly with your doctor about all your health problems and treatments.
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