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Anaemia

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Anaemia is a decrease in number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood. However, it can include decreased oxygen-binding ability of each hemoglobin molecule due to deformity or lack in numerical development as in some other types of hemoglobin deficiency.

Symptoms

Anaemia and the immune system

Whenever the body detects any form of unwanted invader, the Immune system is brought into action. Our immune system is a system of biological structures and processes that protects against disease by identifying and killing pathogens and tumour cells. It detects a wide variety of agents, from viruses to bacteria, to parasitic worms.

Our defence system is to be found not in our red blood cells but our white blood cells. Leukocytes are key to our defense – storm troopers. They are not the only defense, but they are a major part of our defences. In a sense, instead of looking at anaemia as a disease, we should be looking at it purely as a symptom - an increase in white cells is a sign our body is fighting an intruder.

The reduction in iron in the blood is the means by which the red blood cells can be reduced in order that white blood cells can predominate. The fact we feel tired and weary is inevitable, but it may also be a clever means to get us to lie down and rest and let the immune system work.

In effect, we need to stop thinking of anaemia as a disease, but think of it as a signal that the immune system is fighting something truly nasty. What sorts of nasty pathogens are proven to need this sort of immunological response?

Causes

Viral infection

There is no point in trying to limit which viruses ara capable of causing anaemia, as it is clear from a number of papers that all pathogenic viruses can do so according to the circumstances. Furthermore, viruses can attack and destroy the red blood cells, themselves.

The ability of the bone marrow (BM) to generate copious amounts of blood cells required on a daily basis depends on a highly orchestrated process of proliferation and differentiation of hematopoietic stem and progenitor cells (HSPCs). This process can be rapidly adapted under stress conditions, such as infections, to meet the specific cellular needs of the immune response and the ensuing physiological changes.
Viruses constantly pose a significant health risk and demand an adequate, balanced response from our immune system, which also affects the BM. In fact, both the virus itself and the ensuing immune response can have a tremendous impact on the hematopoietic process. …. Chronic viral infections frequently have clinical manifestations at the level of blood cell formation, and we summarize which viruses can lead to BM pathologies, like aplastic anemia, …. Regarding the underlying mechanisms, we address specific effects of acute and chronic viral infections on blood cell production. PMID: 27695457

Parasites

All pathogenic parasites, if they really get a hold and start to attack the organs in a major way, are capable of causing anaemia. All parasites. For example "Ancylostomiasis is caused when hookworms, present in large numbers, produce anemia by sucking blood from the host's intestinal walls".

Bacterial infection

All pathogenic bacteria are capable of causing anaemia and some bacteria can also destroy or damage red blood cells. The following is but one example, made more interesting because it is a specific type of anaemia - anaemia resulting from having Sickle-cell disease.

The bacterial causes of osteomyelitis were reviewed on 25 patients with sickle cell anaemia using blood culture and direct wound swab. Age range was 2 to 45 years with a median of 23 years. Klebsiella species were cultured in 45% of the blood samples. Staphylococcus aureus was responsible in 20%, Salmonella species in 8% and Streptococcus pyogenes was cultured in 4% of the samples. From direct wound swab culture, Klebsiella was responsible for 36%, Staphylococcus aureus 28% and coagulase Negative Staphylococcus 24%. Proteus species were responsible for 8% and Salmonella was cultured in 4%. PMID: 8634234

but we could have provided papers from PubMed that eventually covered all the seriously pathogenic bacteria, for example:

Objective: To assess the clinical feature and outcomes of severe aplastic anaemia (SAA) patients suffered from bacteremia…..A total of 264 cases hospitalized in our hospital between Jan 2000 and July 2011 were enrolled into this study. ….. Bloodstream infections occurred in 49 patients, …. including 38 cases with very SAA (VSAA) and 11 SAA patients. …. The most common microbiologically were Enterobacteriaceae (28.4% ), Pseudomonas aeruginosa (20.9% ) and Klebsiella pneumonia (14.9% ). Almost half (46.9% ) of these bacteria were resistant to most or all available antibacterial classes. PMID: 27719726

Fungal infection

All pathogenic fungi are capable of causing anaemia and some fungi can also destroy or damage red blood cells.

Here is a case history which shows that even very uncommon fungal infection can cause anaemia. Lasiodiplodia theobromae is normally a plant pathogen with a very wide host range. It causes rotting and dieback in plants….

Human Lasiodiplodia theobromae infection has not been reported frequently. We report the first case of invasive L. theobromae nasal and neck infection. A 66-year-old male visited our hospital with anaemia and general weakness. He showed pancytopenia, and his bone marrow examination revealed markedly decreased hematopoietic cells. The patient was presumed to have iatrogenic aplastic anaemia due to mushroom toxicity. …. During hospitalization, he complained of nasal obstruction and left neck lymph node enlargement. A mass-like lesion was observed, and a nasal mass biopsy was performed. The mass was identified as a fungal ball. … The pathologic examination indicated an invasive fungal infection, and the lymph node revealed chronic granulomatous inflammation with fungal infection. 18s rRNA sequencing revealed that the sequence shared 99 % identity with L. theobromae. …. PMID: 27650099

Toxins

Poisons in the blood stream will cause anaemia. All toxins, from insecticides, to pesticides to food additives. Drugs and toxins in high doses can also cause chemical buildup inside erythrocytes [red blood cells] causing oxidative damage to the erythrocyte cell membrane. This type of damage is usually inhibited by glutathione; however, with reduced ATP levels caused by the poisons or toxins [disrupted sugar levels] , glutathione levels are impaired, permitting oxidative erythrocyte cell lysis. The gradual loss of erythrocytes leads to anaemia. Nitrogenous compounds in the blood act as poisons causing the same sort of damage we saw above.

Headache makes one of the most common side effects of frequently pesticide application. This is to be taken care of in rural areas. Headaches have been reported with the use of ivermectin, ivermectin-diethylcarbamazine, organophosphates, and also with the fungicide maneb and copper sulfate, carbofuran, hexonal, dioxin, methomyl and its salts, as well as rare cases of poisoning with the fungicide combination of propineb and cymoxanil. Headache often occurs after long term work with pesticides and/or in laboratories. There are numerous symptoms accompanying headache in pesticide poisoning the most common being elevated body temperature, lassitude, dizziness, irritability, nausea, vomiting, epigastric pain, diarrhea, myalgia, pains in the arms and legs, sleepiness, pains in joints, irritation of eyes/face/skin, sweating. …. disturbances, tachycardia, tachypnea and other cardiac distur bances, fall of blood pressure, gastrointestinal discomforts, constipation, poor appetite, significant decrease in leukocyte count, anaemia, albuminuria, azotemia, fasciculations, miosis, blurred vision, memory disturbances and other neurologic disturbances, postural tremor, signs of cerebral function damage, bradykinesia, etc. PMID: 18710090

Nutritional deprivation

All over the Internet, in many self help books and papers you see the same old mantra being wheeled out that iron deficiency causes anaemia. Anaemia is a decrease in number of red blood cells (RBCs) or less than the normal quantity of hemoglobin in the blood.

Hemoglobin is indeed derived from iron, as such if you have low levels of iron then there is the possibility that low levels of hemoglobin may result, but iron deficiency is extremely rare. In general it is Mineral deficiency or simply imbalance as a whole that may be a problem - iron deficiency leads to anaemia, but so does copper deficiency. Overdosing on minerals however, can also cause problems.

Vitamin deficiency can also cause anaemia. Vitamin B12 deficiency can cause anaemia, for example.

Thus it is not correct to home in on any one mineral or vitamin, amino acid or fatty acid. It is nutritional deprivation that is the principal cause. Nutritional deprivation results in the body having none of the raw materials it needs to manufacture the blood and all its constituents. Furthemore, a nutritionally deprived person has a very poor immune system - the immune system needs fuel to keep it going - so deprive it of fuel and all the pathogens can have a field day and anaemia will then result from the pathogens.

Heavy metal poisoning

All heavy metals have the capability of producing anaemia, even those that in trace amounts have a biological role:

Environmental pollution has increased many folds in recent years and in some places has reached levels that are toxic to living things. Among pollutant types, toxic heavy metals and metalloids are among the chemicals that pose the highest threat to biological systems (Jjemba 2004). Unlike organic pollutants, which are biodegradable, heavy metals are not degraded into less hazardous end products (Gupta et al. 2001). Low concentrations of some heavy metals are essential for life, but some of them like Hg, As, Pb and Cd are biologically non-essential and very toxic to living organisms. Intake of Ni, Cr, Pb, Cd and Cu causes heart problems, leukemia and cancer. Even the essential metals may become toxic if they are present at a concentration above the permissible level (Puttaiah and Kiran 2008). For example, exposure to [heavy metals can] produce

gastric disorder and vomiting,
irritation of the skin and mucous membranes.,
anaemia and hypertension
cardiovascular disorders
asthma (Wiwatanadate and Liwsrisakun 2011), bronchitis/emphysema (Pope 2000), and other respiratory diseases (Dominici et al. 2006).

PMID: 27464847

Organ damage

Damage to the organs that purify or process the blood can also cause anaemia, for example:

Liver damage - Damage to the liver can result in anaemia, as the liver destroys worn out red blood cells. Blood which contains high levels of worn out red blood cells can cause anaemia as their ability to store oxygen becomes impaired

Kidney damage - the kidneys filter the blood and remove noxious substances thus any damage to the kidneys will increase the toxins in the blood and damage the red blood cells

Radiation and hypoxia

Both radiation and hypoxia can cause anaemia, and often appear to go together.

Electromagnetic fields (EMF) are associated with oxidative stress, which is in turn associated with reactive oxygen species (ROS), anemia, and hypoxia…. [Furthermore] ……..Lead contamination in the presence of an EMF exacerbates the oxidative damage to plasma proteins as well as the conformational changes in Hb. An artificial neural network can be used as a predictive tool for the oxidative danger posed to workers in industrial fields, battery manufacturing companies, and power plants. PMID: 27651951

Pharmaceuticals

The eHealthme site collects the Adverse Drug reports submitted by doctors to the FDA and SEDA in the USA. It then summarises them for ease of use. We originally provided a direct link to Anaemia listed on this site and the pharmaceuticals that can cause it, but the eHealthme website frequently reorganise the site and thus break the links. Thus in order to find out which pharmaceuticals are implicated in Anaemia

Follow the LINK to the eHealthme website
Using the ‘All conditions’ index find the appropriate entry - American spellingg is used Anemia
Now scroll down until you get to the section marked ‘Drugs that could cause ”

The list shows you all the drugs implicated in CAUSING Anaemia as well as the number of people who have made a complaint to their doctor and had their case reported by him. Note that it is up to the doctor whether he reports or not.

As of October 2016, about 100 pharmaceuticals were in this list. Some example drugs known to cause anaemia include

Gold salts used to treat rheumatoid arthritis can cause anaemia
Chemotherapy drugs like Cisplatin can cause anaemia
Antipsychotics like Zotepine
NSAIDs like phenylbutazone and aspirin in the long term can cause anaemia
ADHD drugs
Anti-inflammatory drugs can cause anaemia
Anabolic steroids
Antiviral drugs
Epilepsy and anticonvulsant drugs
ACE inhibitors
Statins - see quote below
Antibiotics
Immunosuppressants
and so on, a large number of classes of drugs can result in anaemia

"At discharge, more than 70% of the patients were prescribed aspirin, statins and nitrates. Non-cardiac comorbidities were [later] found in 56.8% of patients, with the following prevalences: anemia 18.2%; chronic obstructive pulmonary disease 11.4%; chronic renal failure 25.8%; cancer 3.0%; neurologic or psychiatric disorders 11.4%; and prostatic hyperplasia 20.5%. PMID: 21815522"

Treatments

The first line of treatment is to find the cause.

The standard approach of many doctors has been to add iron to the diet often in the form of iron supplements, but given what I have found out in the above iron supplements can produce iron overload and add more problems to the list.

Old people, for example, given iron supplements in the mistaken belief it will help their anaemia can end up with dementia.

How it works

Because hemoglobin (found inside red blood cells) normally carries oxygen from the lungs to the tissues, anaemia leads to hypoxia (lack of oxygen) in organs.

And here we have the reason for the spiritual experiences, this chain of reactions leads to hypoxia!

References and further reading

NOTE
An exceptionally important section that is pertinent to this section is that on Anaphylaxis. The reason will become clear if one follows the LINK. The description uses the work of the Nobel prize winner Dr Charles Richet

Congest Heart Fail. 2000 Nov-Dec;6(6):330-332. Pharmacotherapy in congestive heart failure: ACE inhibitors and anemia in congestive heart failure.Sica DS. Departments of Medicine and Pharmacology, Medical College of Virginia of Virginia Commonwealth University, Richmond, VA 23298. “The use of angiotensin-converting enzyme inhibitors can be accompanied by a number of adverse events, including cough, angioedema, and hyperkalemia, as well as a peculiar form of functional renal insufficiency. Other, less obvious side effects accompany ACE inhibitor use, such as a reduction in red blood cell production. ….......the suppressive effect of ACE inhibitors on red blood cell production may intensify the anemia of chronic renal failure and/or congestive heart failure. PMID: 12189339”

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