I am a 45 year old woman. In 2005 I was told I had anemia. The next day I was given a blood transfusion (2 pints). In 2006, I again had a transfusion, but with iron dextran 1500ml+. It's been almost a year, and this last week I've been having constant headaches and break out sweating. There is a pain on my backside (by my right shoulder blade), and then today when I awoke, all my limbs felt very heavy and sore. By 11:00 I looked at my left knee and is it all swollen above the knee cap and on the right side and it hurts to move it.(it's my left knee). I have done nothing to injure myself. Is this just symptoms of anemia or could it be something completely different..
Understanding Anemia -- the Basics
What Causes Anemia?
There are more than 400 types of anemia, which can be broadly classified into three categories:
anemia caused by blood loss.
anemia caused by decreased or faulty red blood cell production.
anemia caused by destruction of red blood cells.
Anemia caused by blood loss. Red blood cells can be lost through bleeding, which can occur slowly over a long period of time, and can often go undetected. This kind of chronic bleeding commonly results from gastrointestinal conditions such as ulcers, hemorrhoids, gastritis (inflammation of the stomach) and cancer. Chronic bleeding can also occur with use of nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin or Motrin. Menstruation and childbirth often cause significant blood loss in women, especially if menstrual bleeding is excessive and if there are multiple pregnancies.
Anemia caused by decreased or faulty red blood cell production. In sickle cell anemia, an inherited disorder that affects African-Americans, red blood cells become crescent-shaped (hence the name, "sickle cell") because of a genetic defect. They break down rapidly, so oxygen does not get to the body's organs, causing anemia. The crescent-shaped red blood cells also get stuck in tiny blood vessels, causing pain.
Anemia caused by decreased red blood cell production. Iron deficiency anemia occurs because of a lack of the mineral iron in the body. Your bone marrow (in the center of the bone) needs iron to make hemoglobin, the part of the red blood cell that transports oxygen to the body's organs. Without adequate iron, your body cannot produce enough hemoglobin for red blood cells. The result is iron deficiency anemia.
An iron-poor diet can cause iron-deficiency anemia, especially in infants, children, teens and vegetarians. The metabolic demands of pregnancy and breastfeeding can deplete a woman's iron stores, as can menstruation. Both frequent blood donation and endurance training can also run down the body's iron stores. Some people have enough iron in their diets, but cannot absorb the iron because of digestive conditions such as Crohn's disease or because part of their stomach or small intestine has been surgically removed. Certain drugs, foods and caffeinated drinks can also interfere with iron absorption.
Vitamin B-12 and folate deficiency anemia (megaloblastic anemia) is another anemia caused by vitamin deficiency. The body needs vitamin B-12 and folate to manufacture red blood cells, and will develop megaloblastic anemia if one or both of these substances is deficient.
Some people have a condition that prevents the body from absorbing vitamin B-12 from food, leading to what's called pernicious anemia. Poor vitamin B-12 absorption may also result from Crohn's disease, an intestinal parasite infection, surgical removal of part of the stomach or intestine, and infection with HIV. People who eat little or no meat -- vegetarians or vegans -- may not have enough vitamin B-12 in their diets.
A folate deficiency can develop from eating too few folate-containing foods -- such as vegetables -- or overcooking vegetables. Deficiency may also occur if your body needs extra folate (for example, during pregnancy), if you take certain medications, or if you abuse alcohol. Two intestinal diseases -- tropical sprue and gluten-sensitive enteropathy (celiac disease) -- can deplete your body of both vitamin B-12 and folate. During early pregnancy, sufficient folic acid can prevent the fetus from developing neural tube defects such as spina bifida.
Anemia caused by problems of the bone marrow and stem cells. Sometimes the body can't produce enough red blood cells because of a problem with the primitive cells (that can develop into red cells) in the bone marrow called stem cells. These critical cells may decrease in number, may carry defects, or may be replaced by other cells, such as metastatic cancer cells.
Aplastic anemia is a very serious condition that occurs when there's a marked reduction in the number of stem cells or absence of these cells. Aplastic anemia can be inherited, can occur without apparent cause, or can occur when the bone marrow is injured by medications, radiation, chemotherapy or infection.
Thalassemia is an inherited anemia that occurs when the red cells can't mature and grow properly. Thalassemia is an inherited condition that typically affects people of Mediterranean, African, Middle Eastern, and Southeast Asian descent. This condition can range in severity from mild to life-threatening; the most severe form is called Cooley's anemia.
Lead is toxic to the bone marrow, and lead exposure can lead to anemia. Lead poisoning occurs in adults from work-related exposure and in children who eat paint chips. Improperly glazed pottery can also taint food and liquids with lead.
Anemia associated with other conditions. In advanced kidney disease and hypothroidism the body does not produce adequate hormones necessary for red blood cell production. Other chronic diseases -- such as autoimmune disorders, such as lupus or rheumatoid arthritis, cancer, and infection -- can also reduce red blood cell production.
Anemia caused by premature destruction of red blood cells. When red blood cells are fragile and cannot withstand the routine stress of the circulatory system, they may rupture prematurely, causing hemolytic anemia. Hemolytic anemia can be present at birth or develop later. Several inherited conditions, such as sickle cell anemia, can cause these defective red blood cells. Some hereditary conditions that decrease cell production, such as thalassemia, also produce fragile cells.
Hemolytic anemia may occur spontaneously or can be triggered by stressors such as infections, drugs, snake or spider venom, or certain foods. Toxins from advanced liver or kidney disease can also shorten the life of red blood cells.
The immune system may inappropriately attack red blood cells that it perceives as foreign, leading to anemia. When a pregnant woman's immune system targets her baby's red blood cells, the baby develops a specific type of anemia called hemolytic disease of the newborn.
Vascular grafts, prosthetic heart valves, tumors, severe burns, chemical exposure, severe hypertension, and clotting disorders can all damage normal red blood cells and mark them for early destruction. In rare cases, an enlarged spleen can trap red blood cells and destroy them before their circulating time is up.
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