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Article reviewed by Cosimo Simeone — Scientifically written by Angeline Lee, BSc Student in Nutrition and Medical Sciences at UCL.

Introduction:

Anemia is a widespread health problem, according to the estimates derived from the Global Burden of Diseases affects the lives of nearly 1.93 billion people worldwide, approximately 25% of the world’s population (1). Anemia occurs when the body has a shortage of red blood cells or hemoglobin, the protein that carries oxygen to the body’s tissues. However, the Incidence of Anemia differs across genders, with women and young children being more susceptible to the condition than men. WHO estimates that 42% of children less than 5 years of age and 40% of pregnant women worldwide are anemic.

Symptoms:

So, this article aims to explore the reasons behind the gender disparity in Anemia incidence, along with its prevention and treatment. Indications of Anemia can take on the form of: 

  • Fatigue, 
  • Weakness, 
  • Dizziness, 
  • Pica (desire to eat unusual and nondietary substances)
  • Shortness of breath 
  • Headache 
  • Restless legs
  • Pale skin.

These symptoms can vary in severity depending on the underlying cause of Anemia. Mild Anemia may otherwise be asymptomatic. Severe anemia may present with syncope, and reduced exercise tolerance.

Diagnosis:

To summarize these are some of the tests useful to diagnose Anemia: 

  • Complete blood count (CBC): A measure of the number of red blood cells, white blood cells, and platelets in the blood. The amount of hemoglobin and the hematocrit (the amount of whole blood that is made up of red blood cells) are also measured.
  • Thyroid function tests: Includes thyroxine (T4) and thyroid-stimulating hormone level (TSH).
  • Hemoglobin electrophoresis: Evaluates the hemoglobin amino acid chains.
  • Iron profile: Includes serum iron, ferritin, and total iron-binding content (TIBC).
  • Peripheral blood smear: microscopic evaluation of red blood cell morphology. 
  • Liver function tests (LFT): these tests should include calcium, transaminases, total protein, bilirubin, albumin, and alkaline phosphatase.

Causes:

Women are more prone to anemia due to a variety of factors, including their menstrual cycle, pregnancy, and lactation. A study conducted in Kuwait found that 19.6% of women of reproductive age had anemia compared to only 12.6% of men (2). In fact, women experience menstrual bleeding each month, which can lead to a loss of iron and other nutrients. If iron levels are not adequately replenished through the diet or supplementation, anemia can occur. Women who have heavy menstrual bleeding are at a higher risk of developing anemia.

Pregnancy can also increase the risk of anemia in women. During pregnancy, the body produces more blood to support the growth and development of the fetus, which can deplete iron stores. Additionally, the developing fetus requires a significant amount of iron for proper growth and development. If the mother’s iron stores are low, the fetus may not receive an adequate supply of iron, which can lead to complications such as premature birth and low birth weight. Moreover, mothers who are lactating have an elevated risk of developing anemia. Breast milk production requires a significant number of nutrients, including iron. If a lactating mother does not consume enough iron-rich foods or supplements, she may experience a depletion of iron stores, leading to Anemia.

Other Factors?

Apart from these factors, women may also be more prone to anemia due to genetics, underlying health conditions, and poor dietary habits (2). Women with genetic conditions such as thalassemia or sickle cell disease are at a higher risk of developing Anemia. Additionally, chronic health conditions such as inflammatory bowel disease, chronic kidney disease, and cancer can lead to Anemia (4). In the United States, anemia affects approximately 5.6 million adults, with chronic kidney disease being the leading cause of anemia in this population. Furthermore, certain medications like chemotherapy and anticoagulants can also cause Anemia as a side effect. Poor dietary habits, such as a diet low in iron or a vegetarian or vegan diet that does not include enough plant-based sources of iron, has also been associated with an increase the risk of anemia in women (3).

Prevention and Treatment:

The prevention and treatment of Anemia depend vastly on its underlying cause. In cases where Anemia is caused by iron deficiency, a diet rich in iron, such as leafy greens, meat, and legumes, can help prevent anemia. Iron supplements may also be prescribed by a doctor if the Anemia is severe. In cases where anemia is caused by chronic diseases or medications, the underlying condition or medication may need to be treated or adjusted to manage the Anemia. For instance, patients with inflammatory bowel disease may need to take anti-inflammatory medications to manage the condition and improve iron absorption (4).

Conclusions:

In brief, the disparity in the incidence of Anemia across genders with women being more susceptible is due to their menstrual cycle, pregnancy, and lactation. Iron deficiency is the primary cause of Anemia in women, but genetics, underlying health conditions, and poor dietary habits can also contribute to anemia. So proper diagnosis and treatment of Anemia are essential for improving health outcomes and reducing the risk of complications in women. In fact women should ensure they are consuming a diet rich in iron or taking iron supplements as their healthcare provider recommends to prevent or manage Anemia. Prevention and treatment depend on the underlying cause of Anemia and may include a diet rich in iron, iron supplements, or treatment of the underlying condition. Regular check-ups with a GP or Nutritionist can help detect and manage Anemia early on, leading to better health outcomes. Finally, for iron supplements, we recommend visiting the supplements section of our shop, https://mundushealth.com/supplements/

REFERENCES:

  1. Kassebaum, N. J., Jasrasaria, R., Naghavi, M., Wulf, S. K., Johns, N., Lozano, R., Regan, M., Weatherall, D., Chou, D. P., Eisele, T. P., Flaxman, S. R., Pullan, R. L., Brooker, S. J., Murray, C. J., & Team, G. B. D. A. (2014). A systematic analysis of global anemia burden from 1990 to 2010. Blood, 123(5), 615–624.
  2. Alawadhi, R., Alsharafi, A. A., Almuhanadi, S., Al-Mutairi, H., Al-Lamki, Z., Alhajeri, A., & Al-Mutawa, A. (2019). Gender and age differences in anemia prevalence during the lifecycle in Kuwait. Journal of Family Medicine and Primary Care, 8(7), 2315–2321.
  3. Lee, J.-O. et al. (2014) “Prevalence and risk factors for iron deficiency anemia in the Korean population: Results of the Fifth korea national Health and Nutrition Examination survey,” Journal of Korean Medical Science, 29(2), p. 224.
  4. Ryu, S.-R. et al. (2017) “The prevalence and management of anemia in chronic kidney disease patients: Result from the Korean cohort study for outcomes in patients with chronic kidney disease (know-CKD),” Journal of Korean Medical Science, 32(2), p. 249.

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