Nutritional Anemias

BYU MNT 356, work in progress

Anemia

a deficiency in the size and number of RBC’s or the amount of Hgb they contain

Hypochromic

Pale color. Deficient hgb in RBC’s

Macrocytic

larger than normal RBC (nucleated). Increased MCV and MCH

Megaloblastic

presence of large immature, abnormal RBC progenitors in the bone marrow

Microcytic

smaller than normal RBC and less circulating hemoglobin

Pernicious anemia

lack of intrinsic factor

Protoporphyrin

iron containing portion of the respiratory pigments which when combined with protein form of hemoglobin or Mgb

what causes iron anemia?

how is iron anemia diagnosed?

• ferritin <30 ng/ml

• transferrin saturation <16-20%

• increased serum transferrin receptors

what are medical and nutritional interventions for iron anemia?

• 200-300mg of ferrous salts

• 1 tablet QD or QOD is adequate until ferritin stores are repleted

• 4-6 months of therapy is required to replenish iron stores

• IV iron: appropriate for malabsorption diseases or failure on oral iron

• Transfusions: only appropriate for hemoglobin < 7mg/dL

what are the causes for folate anemia?

• inadequate intake

• poor absorption or utilization

• increased requirements (growth, pregnancy)

• alcohol abuse

how is folate anemia diagnosed?

• low serum folate

• low red cell folate

• need to differentiate folate vs. B12

  • serum folate

  • RCF

  • serum B12

  • TCII

what are the medical and nutritional interventions for folate anemia?

• 1 mg folate orally QD for 2-3 weeks

what are the causes for B12 anemia?

• veganism

• most common: intrinsic factor deficiency

• malabsorption conditions

• loss of ileum

• achlorhydria: making less acid

• gastrectomy

• elderly

how is B12 anemia diagnosed?

• serum b12 and serum folate

• unsaturated b12 binding capacity

• schilling test → determines intrinsic factor deficiency

• IFAB - intrinsic factory antibody

what are the medical and nutritional interventions for B12 anemia?

• IM or subcutaneous injections

  • 500-1000 micrograms for 1-2 weeks then 100 mcg for a month

• 1 mg oral B12 day if functioning small intestine

what are the causes for protein anemia?

how is protein anemia diagnosed?

what are the medical and nutritional interventions in protein anemia?

what are the causes for B6 anemia?

how is B6 anemia diagnosed?

what are the medical and nutritional interventions for B6 anemia?

what are the causes of responsive anemia?

how is responsive anemia diagnosed?

what are the nutritional and medical interventions for responsive anemia?

what are the causes for vitamin E anemia?

how is vitamin E anemia diagnosed?

what are the medical and nutritional interventions for vitamin E anemia?

what are the causes of copper anemia?

how is copper anemia diagnosed?

what are the medical and nutritional interventions for copper anemia?

what is the cause and treatment of anemia from blood loss?

• cause: losing blood from anything like periods, gun shots, stab wounds, etc.

• treatment:

what is the cause and treatment of sickle cell anemia?

cause: genetic condition, sickle cell anemia

treatment: vegetarian diet, low iron diet, high folate