PM Pediatrics
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Dr. Christina Johns
Senior Medical Advisor, PM Pediatrics

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Anemia: Ironing Out the Details

“I think he’s anemic.” (SAID CONFIDENTLY BY A PARENT RECENTLY)
“What do you mean?” (ME)
“He has no energy” (REASONABLE CONCERN, BUT NOT AUTOMATICALLY ANEMIA RELATED)

Anemia seems to be a vocabulary word that has several different casual meanings, including:

• Weak
• Pale
• Low-blood
• Low-Iron
• Small

That’s a pretty large spectrum of synonyms, everyone. Let’s take a minute and clear things up.

Anemia is strictly defined as a condition marked by deficiency or decreased RED BLOOD CELLS and therefore hemoglobin, the substance primarily responsible for transporting oxygen in the blood to all our cells and tissues. It can often result in a pale appearance to a person, but there are other causes of pallor than just anemia, so some precision is in order here.

Ok -so now that we know what it is, let’s talk about why we get it. How much time do we have? ’til 2019? Let’s get started.

 

Why does anemia happen?

Lots causes of anemia in the world—from the fairly simple “low iron” to more complex dietary deficiencies to genetic disorders like sickle cell anemia. At the end of the day there are a myriad of causes of anemia, and if you or your child have it, it warrants some figuring to understand why. Is it due to low production of red blood cells by the body or too much destruction of red blood cells? There’s no real distinct set of symptoms that occur when someone’s anemic, but rather a wide range—from absolutely NONE to pale appearance (especially lips and whites of the eyes –already pale, right: WHITES of the eyes. Kind of crazy but you know it when you see it), weakness, fatigue and malaise—all those terms we see above.

How do I know if I have anemia?

The way that anemia is diagnosed is by a simple blood test that quantifies the red blood cells (called the hematocrit) and the hemoglobin. There’s a standard range of normal and if a child is low on these numbers then we look a little deeper into the subset numbers that describe the size, shape and density of the cells. This indicates whether or not we just need to tell our patients to have a steak or two and some iron supplements, or if they need a referral to a hematology specialist for further diagnostic testing.

 

So is there any way to PREVENT anemia?

Well, sort of- depending on the type. The most common type of anemia is iron-deficiency anemia– so making sure that you and your child have a strong dietary presence of iron is important. Green leafy vegetables are a great source (and I’m not gonna begrudge anyone an occasional steak or cheeseburger). Other genetic causes have specific treatment regimens that are best handled by a hematologist.

Knowledge is power.

The big take home message here is that I want to make sure that you know exactly what anemia is and that it’s not just a general vague descriptive term that we toss around lightly. Do what you can in you and your child’s diet to make sure it’s well rounded with as much variety of vegetables and fruits as you can (no small task) and if so you shouldn’t necessarily need any kind of supplements. If you think your child seems pale or excessively tired, anemia may be the cause, but it’s certainly not a sure shot.

 

Ask your doctor about it as a possibility though, now that you’re an educated patient and parent. #nowyouknow

 

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