Anaemia is defined as decrease in red blood cell count or hemoglobin level. The normal haemoglobin levels are: women – 12.1 to 15.1 gm/dl; men: 13.8 to 17.2 gm/dl; children – 11 to 16 gm/dl; pregnant women – 11 to 15.1 gm/dl. Symptoms include fatigue, breathlessness, change in stool colour and signs include pallor, paraesthesia, glossitis and splenomegaly. It is vitally important to rule out all plausible causes of anaemia (including malignancy).
Medications:
Iron deficiency anaemia-
- Cap. R B Tone (Elemental iron 30 mg, Folic acid, Vit B12, Zinc) 1 capsule a day, two hours after meal AND
- Tab. Limcee (Vitamin C 500 mg) 1 tablet once a day (two hours after meal).
Macrocytic anaema-
- Cap. Meganeuron OD Plus (Methylcobalamin 1500 mcg, Pyridoxine 5 mg; Folic acid 5 mg) – one capsule once a day for 3 months.
Normocytic anaemia-
- Rule out evidence of menorrhagia or polymenorrhea
- Rule out worm infestations or malabsorption syndromes
- Rule out tuberculosis or other chronic illnesses.
- Treat any other underlying condition.
General advice:
- Advice good nutritious diet (high in green leafy vegetables, eggs, milk and red meat)
- Advice fortified foods to increase iron intake
- Avoid tea or coffee due to reduced iron absorption
- Avoid Non-Steroidal Anti-infllammatory Drugs (NSAIDs) such as Ibuprofen, Diclofenac etc.
- Reduce calcium intake if possible
Investigations:
- Complete blood count – to check haemoglobin, RBC count, PCV, MCV (raised in macrocytic anaemia).
- Peripheral smear – to look for immature or precursor red blood cells.
- Reticulocyte count – raised in hemolytic anaemia
- Iron studies – to rule out iron deficiency or iron overload.
- Vitamin B 12, RBC folate – to rule out vitamin deficiency.
Referral:
Consider referring to haematologist if patients fail to respond to treatment or presents with additional complications. Referral to gynaecologist may be needed if cases are related to reproductive system.