Deficiencies in blood: Experts reveal how to deal with them

In an interview with HT Lifestyle, Dr Rakesh Gupta, Senior Consultant, Internal Medicine at Indraprastha Apollo Hospitals in New Delhi, shared, “When it comes to anemia, which is characterised by a decrease in the number of red blood cells or a deficiency in hemoglobin, treatment options depend on the underlying cause. Iron-deficiency anemia, the most common type, can be managed by increasing iron intake through dietary sources such as leafy green vegetables, beans, and fortified cereals, or through iron supplements. Other types of anemia may require different treatments, such as vitamin B12 injections or medications to stimulate red blood cell production.”

For clotting disorders, such as hemophilia or von Willebrand disease, he suggested specialised medical care. He said, “Depending on the severity of the disorder, treatment may involve infusing clotting factor concentrates or medications that enhance blood clotting. It is important for individuals with clotting disorders to take precautions to prevent injuries and bleeding episodes, such as avoiding activities that may pose a higher risk of trauma.”

Dr Rakesh Gupta added, “Low platelet count, known as thrombocytopenia, can be managed by identifying and treating the underlying cause. Treatment options may include medications that stimulate platelet production, addressing any nutritional deficiencies, or managing autoimmune conditions that affect platelet production. In severe cases, platelet transfusions may be necessary to prevent excessive bleeding. In addition to medical interventions, certain lifestyle modifications can also support the management of blood deficiencies. Regular exercise, as advised by healthcare professionals, can improve blood circulation and overall health. Avoiding tobacco and excessive alcohol consumption is important to maintain healthy blood vessels and prevent complications.”

He highlighted, “Diet plays a crucial role in dealing with blood deficiencies. Consuming a balanced diet that includes a variety of nutrient-rich foods can help improve blood health. For instance, increasing the intake of iron-rich foods, such as lean meats, legumes, and fortified grains, can benefit individuals with anemia. Including vitamin C-rich foods, like citrus fruits and bell peppers, can enhance iron absorption. Similarly, individuals with clotting disorders may need to limit foods high in vitamin K, such as leafy greens, which can interfere with blood clotting.”

Bringing her expertise to the same, Dr Sangeeta Pathak, Associate Director and Head – Transfusion Medicine at Max Super Speciality Hospital in Delhi’s Saket, simplified that Blood Deficiencies can affect any of the three main components of blood:

1. Red blood cells, which carry oxygen to the body tissues
2. White blood cells, which help fight infections
3. Platelets, which help blood to clot
4. Blood deficiency can also affect plasma.

I. Blood Disorders Affecting Red Blood Cells

According to Dr Sangeeta Pathak, blood disorders that affect red blood cells include:

• Anemia: People with anemia have low hemoglobin levels. Mild anemia often causes no symptoms. More severe anemia can cause fatigue, pale skin, and shortness of breath with exertion.
• Iron-deficiency anemia: It is a common type of anemia — a condition in which blood lacks adequate healthy red blood cells. Red blood cells carry oxygen to the body’s tissues. Low iron intake and loss of blood due to menstruation, blood loss from the GI tract because of ulcers or cancer are the most common causes of iron-deficiency anemia. Treatment includes iron pills, or rarely, blood transfusion.
• Pernicious anemia (B12 deficiency): A condition that prevents the body from absorbing enough B12 in the diet. This can be caused by a weakened stomach lining or an autoimmune condition. Besides anemia, nerve damage (neuropathy) can eventually result. High doses of B12 prevent long-term problems.
• Aplastic anemia: In people with aplastic anemia, the bone marrow does not produce enough blood cells, including red blood cells. This can be caused by a host of conditions, including hepatitis, Epstein-Barr, or HIV — to the side effect of a drug, to chemotherapy medications, to pregnancy. Medications, blood transfusions, and even a bone marrow transplant may be required to treat aplastic anemia.
• Anemia of chronic disease: People with chronic kidney disease or other chronic diseases tend to develop anemia. It does not usually require treatment. Injections of a synthetic hormone, epoetin alfa, to stimulate the production of blood cells or blood transfusions may be necessary in some people with this form of anemia.
• Autoimmune hemolytic anemia: In people with this condition, an overactive immune system destroys the body’s own red blood cells, causing anemia. Medicines that suppress the immune system, such as prednisone, may be required to stop the process
• Thalassemia: This is a genetic form of anemia that mostly affects people of Mediterranean heritage. Most people have no symptoms and require no treatment. Others may need regular blood transfusions to relieve anemia symptoms.
• Sickle cell anemia: It is a genetic disorder. In this condition, the red blood cells are sticky and stiff. They can block blood flow. Severe pain and organ damage can occur.
• Polycythemia vera: The body produces too many blood cells, from an unknown cause. The excess red blood cells usually create no problems but may cause blood clots in some people.

II. Blood Disorders Affecting White Blood Cells

Dr Sangeeta Pathak revealed that blood disorders that affect white blood cells include:

• Leukemia: A form of blood cancer in which a white blood cell becomes malignant and multiplies inside bone marrow. Leukemia may be acute (rapid and severe) or chronic (slowly progressing). Chemotherapy and/or stem cell transplantation (bone marrow transplant) can be used to treat leukemia, and may result in a cure.
• Lymphoma: A form of blood cancer that develops in the lymph system. In lymphoma, a white blood cell becomes malignant, multiplying and spreading abnormally. Hodgkin’s lymphoma and non-Hodgkin’s lymphoma are the two major groups of lymphoma. Treatment with chemotherapy and/or radiation can often extend life with lymphoma, and sometimes cure it.
• Myelodysplastic syndrome: A family of blood cancers that affect the bone marrow. Myelodysplastic syndrome often progresses very slowly, but may suddenly transform into a severe leukemia. Treatments may include blood transfusions, chemotherapy and stem cell transplant
• Multiple myeloma: A blood cancer in which a white blood cell becomes malignant. The plasma cells multiply and release damaging substances that eventually cause organ damage. Multiple myeloma has no cure, but stem cell transplant and/or chemotherapy can allow many people to live for years with the condition.

III. Blood Disorders Affecting Platelets

Dr Sangeeta Pathak explained that blood disorders that affect the platelets include:

• Thrombocytopenia: A low number of platelets in the blood; numerous conditions cause thrombocytopenia, but most do not result in abnormal bleeding.
• Idiopathic thrombocytopenic purpura: A condition causing a persistently low number of platelets in the blood, due to an unknown cause; usually, there are no symptoms, yet abnormal bruising, small red spots on the skin (petechiae), or abnormal bleeding can result.
• Thrombotic thrombocytopenic purpura: A rare blood disorder causing small blood clots to form in blood vessels throughout the body; platelets are used up in the process, causing a low platelet count.

IV. Blood Disorders Affecting Blood Plasma

Dr Sangeeta Pathak concluded that blood disorders that affect blood plasma include:

• Hemophilia: A genetic deficiency of certain proteins that help blood to clot; there are multiple forms of hemophilia, ranging in severity from mild to life-threatening.
• von Willebrand disease: von Willebrand factor is a protein in blood that helps blood to clot. In von Willebrand disease, the body either produces too little of the protein, or produces a protein that doesn’t work well.
• Deep venous thrombosis: A blood clot in a deep vein, usually in the leg; a deep venous thrombosis can dislodge and travel through the heart to the lungs, causing a pulmonary embolism.
• Disseminated intravascular coagulation (DIC): A condition that causes tiny blood clots and areas of bleeding throughout the body simultaneously; severe infections, surgery, or complications of pregnancy are conditions that can lead to DIC.