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Anaemia

Anaemia occurs when you have low levels of red blood cells in your body.

What is anaemia?What is anaemia?

Anaemia can be due to various causes including blood loss, red blood cell destruction (also referred to as haemolysis) or the body not producing enough red blood cells (e.g. due to a deficiency of nutrients required by the bone marrow).¹

Types of anaemiaTypes of anaemia

There are many different types of anaemia, including:

Iron-deficient anaemia

This occurs when there is not enough iron in your body. Iron is vital for the body to produce the protein haemoglobin, which transports oxygen around your body in your red blood cells.²

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Aplastic anaemia

This occurs if the bone marrow is significantly underactive. The bone marrow is responsible for making all the blood cells in your body, including red blood cells, white blood cells and platelets.²

Pernicious anaemia

This is a disorder characterised by the body being unable to absorb enough vitamin B12 from your diet to produce red blood cells.²Both vitamin B12 as well as folate (also a B vitamin) are required for healthy red blood cell formation.²

Hemolytic anaemia

This occurs when red blood cells are destroyed faster than they can be made.²Typically red blood cells have a lifespan of 3 months, however in some inherited conditions (such as sickle cell disease and thalassemia) the body destroys red blood cells before the end of their lifespan.³

Risk factors for anaemiaRisk factors for anaemia

Anaemia is relatively common in people with cancer, being seen in 40-50% in people with cancer.^{4, 5}

Anaemia in patients with cancer can be due to many different factors including:

Certain cancer treatments such as radiation therapy, as well as chemotherapy drugs – These can damage bone marrow tissue where blood cells are made. Certain drugs can also damage the kidneys, where a hormone (erythropoietin) is made, which helps make the red blood cells in the bone marrow¹
Certain types of cancers – Such as blood cancers and cancers that spread to the bone marrow e.g. ovarian and lung tumours^{1, 3}
Side effects of cancer and cancer treatments – These can often cause diarrhoea, vomiting and nausea and poor appetite, which can result in low levels of iron, folate and B12¹
Blood loss – This can be as a result of surgery or internal bleeding arising from the cancer itself¹

Signs and symptoms of anaemiaSigns and symptoms

Typical symptoms of anaemia include: ¹

Fatigue and tiredness
Dizziness
Irregular or rapid heart rate
Headaches
Pains in your chest
Cold hands or feet
Difficulty catching your breath

If you experience any of these symptoms, it is important you see your doctor straight away. You may not have any symptoms if your anaemia is mild.

Treatment for anaemiaTreatment for anaemia

The treatment of anaemia will be dependent on your symptoms as well as the cause of your anaemia. Treatment options can include:

Supplementation – Iron, B12 or folate (folic acid) can be prescribed, usually as tablets, although iron can be given as an infusion and vitamin B12 given as an injection¹
Increase your intake of iron-rich foods
Blood transfusion – If your haemoglobin is very low, or if your levels need to be increased quickly³
Medication – If your anaemia is a result of chemotherapy, you may be prescribed medication that increases the production of erythropoietin, known as erythropoietin stimulating agents (ESAs), which help your bone marrow make more red blood cells¹

Frequently asked questionsFrequently asked questions

How is anaemia diagnosed?

Anaemia is diagnosed through a blood test (called a Complete Blood Count (CBC) or Full Blood Count (FBC)) which can be ordered by your doctor. Additional tests may be required to determine the cause of the anaemia.

How can I manage my symptoms of anaemia?

There are many things you can do to help manage your symptoms of anaemia including;

Take short naps and rest where you can
Ask for help and accept offers of help when given
Keep up your fluid intake or speak to a registered dietitian for advice on dietary changes you could make.

What foods are rich sources of iron?

In the diet there are two main sources of iron, known as heme-iron (these are animal-based foods) and non-heme iron (these are plant-based foods). Animal-based sources of iron are more easily absorbed by your body, compared with plant-based sources.

Animal-based sources of iron in the diet include: Red meat such as lean beef and lamb, chicken and fish as well as eggs.⁸

Plant-based sources of iron in the diet include: green leafy vegetables, dried lentils, nuts and seeds as well as foods that have been iron-fortified (had iron added to them) such as cereals and spreads.⁸

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