My 71 year old patient with breast cancer asked me if she should start taking an iron pill for her anemia. Anemia is a condition where there are less than normal red blood cells in the body. It is measured as hemoglobin with a normal range around 12-18 g/dl in most labs. Her hemoglobin was down to 9 g/dl.
Our body has three types of blood cells namely, red cells, white cells and platelets. Red cells help to carry oxygen throughout the body. White cells help in fighting infections and platelets help our blood to clot. If someone has low red cells (anemia), they can experience many symptoms including fatigue, shortness of breath, headaches, palpitations.
People can become anemic for various reasons. Some causes include congenital anemias where people are born anemic due to genetic abnormalities in blood cells, anemia due to chronic diseases, medications causing anemia, hemolytic anemia where body destroys red cells or anemia due deficiency of iron, vitamin B12 or folic acid. Our bone marrow makes all blood cells, and anemia can also occur due to diseases of the bone marrow. In the case of my patient, she became anemic due to chemotherapy treatments.
Bleeding is another common cause of anemia. This can be in the form of heavy menstrual bleeding in young women or chronic rectal bleeding from a polyp or cancer in the colon. If you have any obvious ongoing bleeding, please make sure to see your health care provider. I often see severely anemic young women with heavy menstrual periods. In such instances, iron levels in the body are very low and anemia can easily be fixed by eating foods rich in iron such lean red meat, poultry, fish, spinach, although more severe cases require taking iron pills or getting iron intravenously. Excessive bleeding must be corrected at its source.
People often start taking iron pills on their own if they know they are anemic. Contrary to popular belief, iron pills will only fix anemia that is caused by low iron in the body. Iron will not fix and can potentially be harmful if taken for anemia due to other causes. Your doctor will obtain appropriate blood tests to find out the cause of your anemia. In the case of my patient, her iron levels were in fact normal and her blood counts recovered on their own once she completed her chemotherapy.
It is important to get your blood counts checked at least once a year or more often if you are experiencing any symptoms. If low blood counts are detected your doctor may do additional tests or refer you to a hematologist to evaluate why your counts are not normal. The additional tests may include blood tests and/or urine tests. Rarely, it may involve a bone marrow biopsy which is a simple outpatient procedure performed for certain blood conditions including leukemias, lymphomas and conditions associated with bone marrow failure.
Start the new year by keeping up with your health checks. Please promptly notify your health care provider of any new symptoms. Make it a Healthy Year!
Priya Rudolph, MD,PhD
Dr. Priya Rudolph, a graduate from Yale University is an experienced hematologist/oncologist with Georgia Cancer Specialists affiliated with Northside Hospital Cancer Institute (www.gacancer.com). She has offices in Athens (ph 706-369-4478) and in Greensboro (Ph 706 454-0159). Georgia Cancer Specialists is a top 10 privately owned practice and is a national leader in advanced cancer treatment and research. Its physicians and staff offer many clinical trials and state of the art personalized care to each individual patient.