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Feeling tired and short of breath?

According to Matthew Kaufman, M.D., hematology and oncology specialist at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School, these are the two most common complaints from patients suffering from anemia. Often these symptoms are accompanied by a host of others, including dizziness, irritability, headaches, pale skin, and difficulty concentrating.

Anemia is a blood condition in which there are either too few red blood cells or the red blood cells are deficient in hemoglobin, a protein that carries oxygen from the lungs to the body’s tissues.

Although there are several types of anemia, Dr. Kaufman groups them into two categories: nutritional and non-nutritional. People with nutritional anemia are deficient in folic acid, vitamin B12 or iron. Of the three, iron deficiency is the most common.

Non-nutritional anemia often stems from either blood loss or problems of the bone marrow and stem cells. For women, blood loss anemia is often due to heavy menstrual cycles; for men, blood loss frequently stems from gastrointestinal (GI) tract disorders.

The good news, says Dr. Kaufman, is that “anemia is a very treatable condition.” In diagnosing anemia, your doctor will perform a physical exam and ask questions about your medical history and symptoms. This is followed by certain blood tests, including a complete blood count (CBC) and measurements of folic acid, vitamin B12 and iron levels. In rare cases, a doctor will need to examine a sample of bone marrow as well.

Treatment plans for anemia are tailored to their specific cause. In general, people with nutritional-based anemia are prescribed supplements and diets to alleviate the underlying deficiency. For example, people with folic acid deficiency anemia are usually prescribed a daily multivitamin containing folic acid as well as a diet rich in this nutrient. Examples of these foods include citrus fruits, leafy green vegetables, fortified cereals, grains, legumes, poultry, pork and shellfish.

For those suffering from vitamin B12 deficiency anemia, doctors typically prescribe shots containing a high-dose of vitamin B12, usually every day or every other day for about two weeks. After that, the patient may receive shots once every one to three months or pills to keep the deficiency from returning. Many people, however, will find high-dose pills to be just as effective as the shots, plus more convenient and affordable. In general, people can prevent vitamin B12 deficiency by adhering to a diet rich in milk, cheese and eggs.

People with an iron deficient anemia are usually treated with iron supplements. Although an improvement may be noticeable within days, patients are encouraged to keep taking the pills for several months to build up their iron reserves. Dr. Kaufman cautions patients against treating themselves because iron supplements can sometimes mask a more serious problem, such as a bleeding ulcer or colon cancer.

For patients suffering from non-nutritional anemia, treatments can vary widely depending on the specific condition and its severity. Some patients may require minimal treatment, while others may require repeated transfusions and other measures. In the case of blood loss, the source of the blood loss must be determined first and stopped. Patients dealing with blood loss may be treated with fluids, blood transfusion, oxygen and possibly iron to help the body build new red blood cells.

Individuals whose anemia originates in the bone marrow and stem cells have new medications to help alleviate their problems. For example, Procrit is an injectable drug that stimulates cells in the bone marrow to produce new red blood cells. Aranesp® is a treatment for anemia that is related to kidney disease or induced by chemotherapy. It helps patients regain their energy with fewer injections.

“Research is continually being done to give patients more options for alleviating anemia,” says Dr. Kaufman.

For a free Mount Auburn Hospital cancer education packet, please call us at 617-499-5094.