But iron-deficiency anemia is only one of more than 100 varieties of the disorder, in which red blood cells are not able to carry enough oxygen to meet the body’s needs
Anemia awareness. Today, hematologists— doctors specializing in diseases affecting the blood, spleen and lymph glands—are trying to raise public awareness about this complex disorder. “Anemia isn’t a disease in itself—but a sign of an underlying health problem,” says Dr. Jae C. Chang, a UCI Medical Center hematologist. “Having too few oxygen-carrying red blood cells can be an indication of impending danger long before the cause becomes apparent. Cancer, ulcers, rheumatoid arthritis, HIV and many other diseases often make their presence known through anemia several months before a patient notices any symptoms.”
For this reason, blood tests for anemia and other blood abnormalities are an essential part of a physical exam. A test known as a complete blood count (CBC) measures several components in the blood, including the amount of oxygen-carrying hemoglobin in red blood cells. Normal hemoglobin levels are 13.5 to 16.9 for men, and 12 to 15 for women. “People with hemoglobin levels as low as 11 may feel fine,” says Chang. “But once hemoglobin levels fall to 13 for men, or 12 for women, further testing should be conducted to determine the cause of the anemia.”
Checking it out. Typically, the next step after a CBC is a microscopic examination of the patient’s blood by a hematologist. The shape, size and volume of the red blood cells can be tip-offs for dozens of diseases. If the results of this microscopic exam aren’t specific enough to confirm a diagnosis, a bone-marrow test may be conducted. “The fundamental question is whether the anemia is the result of nutritional deficiencies, blood loss due to heavy menstruation, a blood-related problem such as leukemia, or an undetected disease such as colon cancer,” explains Chang.
Treatment depends on the type of the anemia. If caused by a vitamin or mineral deficiency, the remedy may be simple—diet modification, folic acid supplements, B12 injections or iron pills. If caused by a serious disease, however, the underlying condition must be treated immediately.
“Anemia often piggybacks on major medical problems such as cancer, making the lives of these patients even more difficult,” says Chang. “With the correct treatment, however, even those with severe anemia can enjoy improved vitality.” A drug called erythropoietin is sometimes used to help restore red blood cell levels in patients with certain types of anemia. It improves the quality of life significantly for many people.
The hematologist’s role. In addition to nonmalignant blood diseases such as anemia, hematologists diagnose and treat clotting disorders such as hemophilia and malignant blood disorders such as leukemias and lymphomas.
