Anemia is a common condition in older people

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The word anemia means low number of red blood cells.

Since red cells carry oxygen, people with anemia may have symptoms such as fatigue, pallor or shortness of breath. Many people have annual blood work which includes a red blood cell count, so anemia is often discovered that way, rather than by having symptoms.

If you have symptoms of anemia and you do not have anemia, you should talk to your doctor about other causes of fatigue. 

Red cells, white cells, and platelets are the three cells that make up blood. Iron is used for making hemoglobin and hemoglobin is the substance in red blood cells that carries oxygen.

Blood cells are produced in the bone marrow. Red cells last for about 120 days and then they die. There is constant production of new red blood cells in the bone marrow. Anemia is common in older persons and it may be caused by lack of iron, early death of red blood cells, lack of certain vitamins, or loss of blood due to bleeding, 

The most common cause of anemia is iron deficiency. This may occur if the diet does not include enough iron. Iron is found in meat, and you may be deficient because you don’t eat enough meat.

Except in the situation of an unusual diet, the cause of iron deficiency anemia needs to be investigated. One cause is poor absorption of iron, which can happen after surgery of the GI tract, including gastric bypass. Second cause is cancer which may cause hidden bleeding in the GI tract. Also, cancer treatment may decrease red cell production. 

If iron is low in the diet and that cannot be corrected, the patient can take iron supplements, by mouth. If it is not absorbed, intravenous iron medication may be recommended. Cancer doctors treat anemia that occurs during the time they are taking care of the patient. 

Another cause of anemia is deficiency of Vitamin B12, which is sometimes called pernicious anemia. The blood level of vitamin B12 can be obtained, and if it is low, the doctor will prescribe the vitamin, either orally or by injection.

The name “pernicious” is old-fashioned and indicates the condition is fatal. Currently, people with this problem can receive vitamin B12 and their anemia and other symptoms improve. Untreated vitamin B12 deficiency can lead to neurological problems, memory loss, or problems with the digestive tract. There also may be bone weakness. 

A third type of anemia is hemolytic anemia. In this case the red blood cells are fragile and break down early. The body can compensate for mild hemolysis by creating new red blood cells in the bone marrow. If the bone marrow cannot keep up with the early breakdown, the patient will become anemic.

Your doctor will tell you if you have hemolytic anemia. This is determined by the initial blood tests, but the cause may not be clear. Hemolytic anemia may occur in people who have sickle cell anemia or thalassemia. It may occur in patients who have infections, cancer or auto-immune diseases. Treatment will be appropriate to the cause. 

If you go to a primary care doctor and every year or two you have blood work done, you are probably checked for anemia. If you feel particularly tired, ask to be tested the next time you go to the doctor. Be sure you eat a healthy diet, with a moderate amount of meat. If you don’t eat meat, ask your doctor about taking an iron supplement.

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