Manor Field Blog Number 16 – Anaemia (iron deficiency)

Anaemia is the condition where you have too few Red Blood Cells in your body.

There are many different types of anaemia and I will not cover them all here; this blog is focused on a very common form – specifically the one we call, ‘iron deficiency’ as it has a potential connection with cancer.

Most people who are anaemic do not have cancer although many people who have cancer are anaemic.

There are many reasons for this.

Iron deficiency anaemia – is where for whatever reason your body is unable to maintain a healthy production or Red Blood Cells (RBC’s).

Red Blood Cells transport oxygen to our organs and keep us alive. Without them we are in trouble.

To maintain enough Red Blood Cells (which naturally die three months after being produced) you require a constant supply or iron. If you aren’t getting enough iron in your diet (quite uncommon in the UK), you can’t absorb iron (for a separate blog), or you are losing iron – the thing we worry about, you can become anaemic.

How can you lose iron?

The main route of concern tends to be through bleeding tiny amounts over time; if someone is haemorrhaging (bleeding lots) they tend to see it happening and seek help, if however, amounts that are lost are so small that people don’t notice, anaemia can occur gradually, over months; common symptoms are tiredness or breathlessness although these only tend to appear later-on.

Where does the blood go?

Most commonly, in healthy women blood is lost during their periods; this is normal, natural and not the focus of this blog.

In older people (yes, anyone older than me, or you) the causes we worry about are loss of blood from the gut; this is, the oesophagus (gullet), stomach or bowels; as, in some instances this can relate to cancer.

This is why we check Faecal Occult Bloods (using the FITT test, described in Blog 13)

Small amounts of blood can be hidden in our bowel movements and over time this can become significant.

Less commonly, tiny amounts can be lost in the urine and that is why checking urine is always important to ensure that there is nothing wrong with the bladder or kidneys.

Once anaemia is detected, a decision has to be made what to do.

You can either leave it alone and monitor – which might be the preferred option for some, although for many the best approach it to undergo tests to ensure there is no cancer; mostly cancer is not found, instead ulcers, inflammation or polyps which can all be easily treated are discovered.

If cancer is found, if early, it can also be easily treated with full recovery.

The main tests we request are endoscopies – these are miniature cameras that look inside the stomach and bowels for any of the above. Potentially, certain conditions can be treated, even cured at the time of this test.

There are many other causes of anaemia, some of which are easy to correct – lack of Vitamin B₁₂ or Folic acid, others trickier, like the anaemia associated with chronic kidney disease or long-term illness.

If the doctor says, ‘You are anaemic,’ the next sensible question is probably, ‘Why?’ or, ‘What are we going to do?’

This has been a difficult blog and I don’t know if I have managed to explain iron deficiency anaemia adequately; readers, let me know if you have questions and I will try to explain!