Anemia and hyperemia are changes in the function of the red blood cell system that may include either a shortage of red blood cells or an excess of red blood cells.

Anemia

Anemia is characterized by a change in the amount of hemoglobin and the number of red blood cells (erythrocytes) per unit of blood volume, e.g. in 1 mm³, usually with a decrease in the volume of the circulating mass of red blood cells and, consequently, a decrease in the hematocrit index.

Anemia Symptoms

Symptoms of anemia are generally known and depend on its cause, speed of development, i.e. growth (its gradual development is conducive to a certain adaptation of the body), and the patient’s age, and above all, on the condition of the circulatory and respiratory system. These two systems have a countervailing role in alleviating the tissue oxygen deficit caused by anemia:

1. the circulatory system – by accelerating the heart rate and thus increasing the speed of blood circulation, and thus greater use of red blood cells existing in the body,
2. respiratory system – by improving the efficiency of gas exchange in the lungs and better oxygenation of hemoglobin present in the body due to deepening and faster breathing.

The main symptoms of anemia are:

1. paleskin (sometimes with a yellowish tinge),
2. pallor of the mucous membranes of the mouth and throat as well as the conjunctiva of the eye,
3. reduced mobility, quick fatigue and the occurrence of the so-called breathlessness with even slight physical exertion (e.g. faster walking, climbing stairs),
4. a feeling of heaviness
5. apathy,
6. somnolence,
7. headachesanddizziness,
8. tinnitus_
9. sometimes spots in front of the eyes (especially in severe cases),
10. predisposition tofainting,
11. sometimes low-grade fever,
12. sometimes aching pains around the heart, similar to coronary insufficiency.

Each sudden appearance and rapid worsening of these symptoms is an indication for an urgent call to a doctor or an ambulance (risk ofhemorrhage). The above review of symptoms shows that there is no specific symptom or complex of symptoms of anemia, as most of them can be observed in many disease states of other organs.

Diagnosis of Anemia

Proper diagnosis of anemia, especially its severity, possible causes and lesions, and correct treatment can only be determined by a physician based on the information obtained from the patient and the identified physical changes supplemented with diagnostic laboratory tests (among which the peripheral blood counts and bioptical examinations are particularly useful). bone marrow).

Taking into account the degree of saturation of red blood cells with hemoglobin, anemia can be divided into:

1. hypochromatic anemia,
2. hyperpigmented anemia.

Breakdown of anemia

The simplest general classification of anemia is based on the main causes that cause it. Thus, the following are distinguished:

1. anemia caused by excessive blood loss (known as haemorrhagic anemia)
2. anemia caused by the abnormal production of red blood cells and / or hemoglobin (called deficiency and achrestic anemia),
3. anemia caused by a shortened lifetime of red blood cells or / and their excessive breakdown (so-called haemolytic anemia),
4. anemia arising from congenital or acquired (toxic substances, some preparations, ionizing radiation) atrophy of erythrocyte stem cells in the bone marrow (so-called aplastic and regenerative anemia).

Types of anemia

1.Haemorrhagic anemia

Haemorrhagic anemia is a consequence of sudden or chronic blood loss from the vascular bed as a result of external or internal hemorrhage. Due to the compensatory and adaptive mechanisms, to fill the vascular bed and restore the necessary arterial pressure and the required tissue perfusion of the body, on the one hand – after the sudden loss of more blood – extracellular fluid moves to the vascular bed, and on the other hand, the production of red blood cells is intensified.

Intensive bleeding should be consulted with a surgeon as soon as possible.

In the event of haemorrhage being stopped, the body quickly compensates for the deficiency of red blood cells, depending on the level of blood loss, expressed by the hematocrit index. The ability to restore lost blood depends on the regenerative capacity of the bone marrow and the supply of the necessary hematopoietic substances to the body.

In haemorrhagic anemia, the proper regeneration of the necessary number of red blood cells is determined by the ability to cover the increased demand for iron (Fe), necessary for the synthesis of hemoglobin (Hb). The human body uses only part of the intracorporeal iron repeatedly, incl. from broken red blood cells.

In the clinical picture, haemorrhagic anemia resembles anemia resulting from a small amount of iron, because the body lost a certain amount of it along with blood lost to the outside.

The periodic loss of blood by girls at the time of puberty is manifested in many cases by anemia, formerly known as bladder disease or virgin disease. Chronic (minor) bleeding, e.g. from ulcers in the digestive tract or the so-calledThey can also cause hemorrhoidsby depleting the body of iron to hemorrhagic anemia and iron deficiency.

A deficiency in the body of enough iron, in addition to the fact that it causes:

1. brittle nails,
2. increasedhair lossand split ends,
3. increased general irritability, and even low-grade fever and increased ESR ,
4. the maturation of red blood cells.

Domestic proceedings

Counteracting iron deficiency should primarily consist in:

• a rational, varied diet of natural food products in which there is a large amount of iron, such as egg yolks, fish, hearts, liver, various blood dishes (sausage, black head cheese), groats, legume seeds, vegetables, fruit,
• alleviating the consequences of non-acidic or acid-free gastritis by taking prescription mixtures containing, among others, hydrochloric acid or pharmaceutical preparations containing acidic substances (e.g. ascorbic acid, i.e. vitamin C), because hydrochloric acid in gastric juice is necessary for the proper absorption of iron from food products,
• increasing the supply of iron from the outside (food products or pharmaceutical preparations containing iron) during periods of increased demand (e.g. in pregnant women, breastfeeding or sudden growth) or in periods of chronic or acute blood loss (e.g. women with abundant menstruation or after gynecological hemorrhages conditioned by other factors), small, even, but chronic, bleeding from other causes, in chronic inflammation, which should be prescribed by a doctor.

Remember! Do not limit yourself to home procedures, but seek medical advice to determine the causes of iron deficiency and subsequent anemia, and to institute appropriate causal or at least symptomatic treatment. It should also be emphasized that more significant iron deficiencies in the body require systematic consumption of an iron supplement recommended by a doctor for at least several weeks or even months. Iron is absorbed from the gastrointestinal tract much better when we take preparations on an empty stomach.

2. Anemia due to inappropriate production of erythrocytes or hemoglobin.

Anemia of this type, also called anemia due to deficiency of hematopoietic factors, is a group of anemia that is based on a deficiency of factors necessary in the formation and maturation of red blood cells, such as: iron (Fe), vitamin B₁₂, folic acid, etc., or a defect the possibility of their use for the formation of red blood cells.

3. Iron deficiency anemia

The most common of all anemia, including deficiency anemia, is iron deficiency anemia, also known as hypochromic anemia, because the deficiency of a blood pigment called hemoglobin is disproportionately greater than the degree of red blood cell deficiency.

4. Vitamin B deficiencyanemia_12.

_{Vitamin B 12}deficiency anemia , also known asAddison-Biermer anemia (disease), is the second most important and common example of deficiency anemia. Vitamin B₁₂is necessary in the human body for the proper synthesis of proteins included in the newly produced red blood cells. Its correct content in the body additionally means that the red blood cells produced by the bone marrow are of the correct size, which means that their production is normoblastic._{In the case of vitamin B 12}deficiency, apart from the anemia itself, we also encounter the phenomenon of theso-called megaloblastic regeneration, appearing in the human fetal period. It is characterized by the fact that selected cells of the red cell system are larger than those normally found in the adult human body. Hence the synonymous term for this type of anemia as megaloblastic anemia.

Vitamin B₁₂deficiency may be a consequence of a reduced supply or disturbances in the biochemistry of absorption observed in the so-called acid-free, histamine-resistant gastritis. Some of the amount of vitamin B₁₂necessary for humans is normally synthesized by bacteria that make up the natural human intestinal flora, hence megaloblastic anemia, similar to the typical Addison-Biermer anemia, can be found in people with total or partial gastrectomy, chronic alcoholism and in chronic alcoholism. various types of chronicdiarrhealstates or malabsorption syndromes, as an expression of the inability to use vitamin B administered with food or synthesized in the gastrointestinal tract by microorganisms₁₂, as well as in infections with certain parasites.

There is no correct diagnosis and treatment of Addison’s and Biermer’s anemia without careful examination of peripheral blood counts, bone marrow and a closer characterization of gastric acidity.

From the above information, we can draw a practical and obvious conclusion that in the case of Addison’s and Biermer’s anemia and other megaloblastic anemia, it is unnecessary and ineffective to use other than vitamin B₁₂hematopoietic preparations, such as e.g. iron preparations, vitamin B₆, steroid hormones .

How to prevent anemia ?

_{Home prevention of vitamin B 12}deficiency anemia is:

1. prevention of acid-free gastritis,
2. elimination of parasitic infections,
3. periodic intake of vitamin B₁₂in conditions after gastrectomy and chronic diarrhea, inflammatory diseases or anatomical defects of the small intestine,
4. elimination of chronic alcoholism,
5. attention to the functional efficiency of the liver.

5. Hemolytic anemia

Haemolytic anemia is caused by excessive breakdown, i.e. a reduction in red blood cells’ survival time in the vascular bed.

The reasons for their short life span may be congenital defects in the structure of these blood cells in terms of their shape, intracellular biochemical composition, or reduced immunity of the cell membrane.

Haemolytic anemia can also be the result of temporary factors beyond the blood cells, such as bacterial venoms, called haemolysins, toxic and chemical substances, including certain medications, physical agents, or serological and immune reactions, etc., which significantly accelerate the breakdown of red blood cells. .

Characteristic for haemolytic anemia are:

1. increased levels of iron in the blood serum,
2. yellowing of the whites of the eyes
3. olive yellow skin tone.

There are many causes and types of haemolytic anemia, therefore it is impossible to establish a correct diagnosis at home. The accompanying elevated bilirubin levels and yellowing of the sclera of the eyes and skin also suggest a high probability of liver disease. Getting the diagnosis right requires a lot of painstaking diagnostic and laboratory tests. The tests of peripheral blood counts, serum iron levels only, and the picture of peripheral blood and bone marrow are usually insufficient in these cases.

Carrying out a number of different tests is necessary for the correct diagnosis of the type of disease and for the appropriate, effective treatment. Thus, the possibilities of effective home treatment to prevent the onset of this or that type of haemolytic anemia are limited. Having a precise diagnosis can in many cases – following medical recommendations – prevent possible recurrences.

6. Aplastic anemia

Aplastic anemia is a congenital or acquired loss of red blood cell stem cells in the bone marrow (bone marrow aplasia). This causes red blood cells to be abnormally produced and renewed.

Another characteristic feature is the increase in the degree of anemia despite the treatment, increased iron concentration in the blood serum and often accompanying leukopenia and a decrease in the number of platelets. As a consequence, resistance to infection decreases and there is a predisposition to ulceration on the tonsils and the oral mucosa.

Diagnosis

It should be emphasized that there is no possibility of an unequivocal and correct diagnosis of aplastic anemia without the simultaneous bioptic examination of peripheral blood, or actually trepanobioptic bone marrow. In the absence or disappearance of bone marrow stem cells, this type of anemia is very resistant to treatment.

That is why prophylaxis is very important, i.e. preventing the occurrence of bone marrow damage, even to a small extent, especially in situations where it depends on us and when we do not know whether, accidentally, in the future we do not know, further bone marrow damage will not occur. The degree of this disappearance and, consequently, the degree of severity of aplastic anemia can vary.

The reasons

Among the factors showing the effect of damaging the bone marrow are:

1. ionizing radiation, including X-rays, and of isotopic radioactive elements,
2. chemical substances, among them many agents used in chemical plant protection (pesticides), the residues of which can be consumed in our products as a result of non-compliance with the so-called waiting periods or drink it with water if it is not properly protected,
3. many preparations, including most of all commonly used anti-rheumatic and analgesic drugs,
4. sometimes as a result of an infection,
5. many other factors, still unknown.

Prevention

The knowledge of the factors detrimental to the bone marrow gives the prospects and possibilities of real and conscious prevention of aplastic anemia by:

1. avoidance of various chemical compounds unknown to the consequences of action on the human body,
2. not spontaneously, without consulting a doctor, repeated treatment with previously used preparations, so as not to increase the dose of drugs that may adversely affect the bone marrow in a short time,
3. refraining from taking the treatment recommended, for example, to friends or neighbors with a similar problem, because drugs showing effectiveness in their case may turn out to be unsuitable for others, due to the possibility of cumulative adverse effects on the bone marrow,
4. avoiding being in the vicinity of benzene vapors, gasoline and other organic solvents and quick-drying varnishes (e.g. in a carpentry workshop),
5. avoiding contact with chemical preparations intended for wood preservation (carpenters, carpenters) and pesticides used in chemical plant protection.

Hyperemia

Hyperemia is a medical condition characterized by an increase in the number of red blood cells above the norm for a given sex and age, and usually also hemoglobin per unit of blood volume (e.g. in 1 mm³).

The clinical consequence of such a situation is a large increase in the concentration of red blood cells in the circulating blood and thus its increased viscosity. For this reason, the workload of the heart as a suction and pressure pump increases significantly and there is a predisposition to the formation of intravascular blood clots, emboli and infarctions in various organs (e.g. the brain,heart,lungs, kidneys, etc.) with all the consequences of such complications for the organism. .

Types of hyperchemia

1. Tufted tufted duck

The essence of polycythemia vera, i.e.primary hypererythrocytosis(hyperaemia), is the developing hyperplasia of the red blood cell system of the bone marrow, i.e. an increase in the number of red blood cells, hemoglobin and circulating blood volume with all its consequences, e.g. increased resistance to the heart, generally increased blood pressure and venous blood and a predisposition to the formation of blood clots.

The consequence of such changes and often coexisting thromboembolic changes is:

1. conjunctival hyperemia,
2. tinnitus
3. trouble seeing
4. pain of the coronary type,
5. redness and sometimes even bruising of the face, lips and other parts of the body,
6. headaches,
7. dizziness,
8. arterial hypertension,
9. shortnessof breath at rest or exercise shortness of breath,
10. digestive tract disorders, etc.

The type and severity of these changes depends on the advancement of the disease process. Many of them may not appear at all if the patient follows the doctor’s instructions and, above all, undergoes systematic, periodic check-ups and treatment.

The type of treatment implemented depends on the period of the disease and the organ changes found – in the initial period, blood depletion is practically sufficient. Then treatment with pharmacological preparations is started that inhibit the production of red blood cells by the bone marrow. Such methods are aimed at reducing the number of red blood cells and the volume of circulating blood, thus relieving the entire body, and especially individual organs, from the above-mentioned consequences of their excess.

From a medical point of view, the cause of this type of growth remains unknown. This makes it difficult to prevent growth. However, complications in its course can be prevented.

Prevention

The prevention of complications in polycythemia vera consists of:

1. periodic monitoring of blood counts, the result of which determines the frequency of blood bleeds and the intensity of pharmacological treatment,
2. frequent blood pressure monitoring and possibly pharmacological monitoring to relieve the left ventricle and prevent vascular complications associated with hypertension (hemorrhages),
3. avoiding long-term exposure to the sun, especially sunlight on the head, so as not to create conditions conducive to hemorrhagic or thrombotic complications,
4. on leading a sparing lifestyle that does not cause additional burden, among others heart and blood vessel walls and thus prevents complications in the form of acute heart failure or vessel wall ruptures, and thus hemorrhagic complications,
5. regular use of pharmacological measures recommended by a doctor, aimed at correcting the disease, or possibly associated complications.

Secondary polycythemia (secondary hyperemia)

Secondary anemia affects the entire group of disease states, occurring as a secondary, compensatory phenomenon in chronic oxygen deficiency in the body, the common feature of which is an over-normal increase in the number of red blood cells and hemoglobin concentration.

Polycythemiacan appear in people who stay at high altitudes for a long time (e.g. in the Andes or the Himalayas). Then we are dealing with systemic hypoxia due to the reduction of oxygen pressure in the atmospheric air.

It also occurs in the course of diseases such as:

1. Chroniclung diseaseslimit gas exchange (including oxygen uptake by red blood cells),
2. Some cyanotic congenitalheart defects,
3. Tumors
4. kidney problems that may stimulate red blood cell production.

The consequences for the body and the symptoms of an increase in the number of red blood cells are similar to those described for polycythemia vera (see above). They are perhaps only less intensely expressed, as the degree of compensatory hyperplasia and red blood cell overproduction is usually less. In general, however, right ventricular failure occurs much faster, because coexisting primary changes, e.g. in the respiratory organ, intensify the increase in resistance in small (pulmonary) circulation and thus the development of the so-called Pulmonary Heart Syndrome, also known as the PulmonaryHeart.

In outpatient treatment, it is difficult to distinguish between a primary increase in red blood cells (i.e. polycythemia vera) from a secondary increase in red blood cells. Only the appropriate diagnosis (finding the causes of hyperaemia and their elimination) or limitation creates the premises for the implementation of proper causal treatment. Polycythaemia can only be treated by a doctor.

Prevention

In the prevention of both the development and complications of polycythemia, pay attention to:

1. avoiding any inflammatory changes in the respiratory system and other ailments, leading sooner or later to limiting the possibility of saturating red blood cells with oxygen (such as emphysema, pneumoconiosis, post-inflammatory or tuberculous lesions in the lungs, bronchiectasis, etc.),
2. elimination or at least a significant reduction in cigarette smoking, which significantly determines chronic bronchitis and, as a consequence, may lead to the development of chronic pulmonary heart with subsequent polycythemia,
3. early diagnostics, i.e. determining the causes of objectively diagnosed polycythemia, in order to implement the most effective treatment of disease states that may stimulate the formation of red blood cells through biochemical methods.