Anemia, one of the most common blood disorders, occurs when the level of healthy red blood cells (RBCs) in the body becomes too low, or the RBCs don’t have enough hemoglobin. Hemoglobin carries oxygen from the lungs to the rest of the body. In anemia, the blood does not carry enough oxygen to the rest of the body. As a result, people with anemia can face variety of complications, including fatigue and stress on bodily organs. In severe or prolonged cases of anemia, the lack of oxygen in the blood can cause serious and sometimes fatal damage to the heart and other organs of the body.
Archive for January, 2007
Causes of Anemia are as follows:
Blood loss: excessive bleeding such as hemorrhages or abnormal menstrual bleeding.
Chronic illness secondary to refractory anemia: inflammatory GI/GU diseases, malignancies (cancer), arthritis, kidney or liver failure, and acute and chronic infections.
Cancer therapy: surgery, radiotherapy, chemotherapy and/or immunotherapy.
Infiltration (replacement) of bone marrow with cancer.
Hemolysis: Breakdown or destruction of red blood cells.
Decreased red cell production due to low levels of erythropoietin which promotes red blood cell production.
The symptoms of anemia will vary according to the type of anemia, the underlying cause, and the underlying health problems. Symptoms common to many types of anemia are:
- Shortness of breath
- Dizziness or fainting
- Pale skin, including decreased pinkness of the lips, gums, lining of the eyelids, nail beds and palms
- Rapid heart beat (tachycardia)
- Feeling cold
- Sadness or depression
- Decreased sexual function
- Difficulty sleeping
- Decreased appetite
Addison’s disease is an endocrine or hormonal disorder that occurs in all age groups and afflicts men and women equally. The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and nonexposed parts of the body.
Addison’s disease occurs when the adrenal glands do not produce enough of the hormone cortisol and, in some cases, the hormone aldosterone. The disease is also called adrenal insufficiency, or hypocortisolism.
The slowly progressive loss of cortisol and aldosterone secretion usually produces a chronic, steadily worsening fatigue, a loss of appetite, and some weight loss. Blood pressure is low and falls further when a person is standing, producing lightheadedness. Nausea, sometimes with vomiting, and diarrhea are common. The muscles are weak and often go into spasm. There are often emotional changes, particularly irritability and depression. Because of salt loss, a craving for salty foods is common. Finally, the increase in ACTH due to the loss of cortisol will usually produce a darkening of the skin that may look like an inappropriate tan on a person who feels very sick. Unfortunately, the slowly progressive chronic symptoms are usually missed or ignored until a sudden event like a flu virus, an accident, or the need for surgery suddenly precipitates a dramatic change for the worse because of the deficient response from the adrenals to one of these stresses. This is referred to as an Addisonian crisis and is a medical emergency.
Gradual destruction and/or shrinking of the adrenal cortex is the most common cause of Addison’s Disease. Autoimmune disorders are the cause in about 70 percent of all reported cases. Instead of identifying foreign invaders such as bacteria or viruses and killing them, the immune system makes antibodies that attack the body’s own tissues or organs and slowly destroys them. When at least 90 percent of the adrenal cortex has been destroyed, adrenal insufficiency, i.e., Addison’s Disease occurs. Tuberculosis accounts for about 20 percent of all cases in developed countries. Less common causes of Addison’s disease may be due to fungal infections; cancer cells spreading from other parts of the body to the adrenal glands; surgical removal of the adrenal glands and amyloidosis. In amyloidosis disease a starchy substance called amyloid is deposited in abnormal places throughout the body interfering with the function of whatever structure it is present within.
In its early stages, adrenal insufficiency can be difficult to diagnose. A review of a patient’s medical history based on the symptoms, especially the dark tanning of the skin, will lead a doctor to suspect Addison’s disease.
A diagnosis of Addison’s disease is made by biochemical laboratory tests. The aim of these tests is first to determine whether there are insufficient levels of cortisol and then to establish the cause. X-ray exams of the adrenal and pituitary glands also are useful in helping to establish the cause.
The goal of treatment is to restore the adrenal glands to normal function, producing normal levels of corticosteroid hormones. Specific treatment for Addison’s disease will be determined by your physician based on:
- Your overall health and medical history
- Extent of the disease
- Your tolerance for specific medications, procedures, or therapies.
- Expectations for the course of the disease
- Your opinion or preference
Since Addison’s disease can be life threatening, treatment often begins with administration of corticosteroids. Corticosteroids, such as prednisone, may be taken orally or intravenously, depending on the patient’s condition. Usually the patient has to continue taking the corticosteroid the rest of his/her life. Treatment may also include taking fludrocortisone, a drug that helps restore the body’s level of sodium and potassium.