Anaemia

Anaemia means that your blood carries less haemoglobin than normal, so less oxygen reaches your tissues. It is a finding, not a final diagnosis: the important question is always why it has happened.

Most anaemia is mild and easily corrected once the cause is found. In adults, unexplained iron deficiency deserves particular attention, because slow bleeding from the stomach or bowel is a common hidden reason.

Symptoms

• Tiredness and reduced stamina
• Breathlessness on stairs or exertion
• Pale skin, pale inner eyelids
• Palpitations or a pounding pulse
• Headache, dizziness or poor concentration
• Brittle nails, hair shedding, a sore tongue or a craving for ice in iron deficiency
• Numbness, tingling or unsteady walking in vitamin B12 deficiency
• Yellow tinge to the eyes and dark urine when red cells are being destroyed

Causes and risk factors

Causes fall into three groups. Loss of blood: heavy periods, ulcers, bowel polyps or cancer, haemorrhoids, and regular use of anti-inflammatory painkillers. Reduced production: lack of iron, vitamin B12 or folate, chronic kidney disease, long-standing inflammation, thyroid underactivity, bone marrow disorders and chemotherapy. Increased destruction: inherited conditions such as thalassaemia, sickle cell disease and G6PD deficiency, or autoimmune haemolysis. Pregnancy and rapid growth in childhood raise iron needs.

How it is diagnosed

• Full blood count: Gives the haemoglobin level and red cell size. Small cells suggest iron deficiency or thalassaemia; large cells suggest B12 or folate deficiency.
• Ferritin and iron studies: Show whether iron stores are empty. Ferritin can be falsely normal during inflammation.
• B12, folate, kidney and thyroid tests: Identify common production problems.
• Reticulocyte count and haemolysis screen: Show whether the marrow is responding and whether cells are being broken down.
• Haemoglobin electrophoresis: Detects thalassaemia trait and sickle cell disorders.
• Gastroscopy and colonoscopy: Recommended for men and for women after menopause with iron deficiency, to look for a bleeding source.
• Bone marrow examination: Only when blood tests suggest a marrow disease.

Treatment options

• Oral iron: One tablet daily or on alternate days, continued for 3 months after the count is normal to refill stores. Constipation and dark stools are common.
• Intravenous iron: Used when tablets are not tolerated or absorbed, or when stores must be restored quickly, for example before surgery.
• Vitamin B12 and folate: Injections or high dose tablets for B12; tablets for folate.
• Treating the source: Managing heavy periods, healing an ulcer, removing a polyp or treating coeliac disease.
• Erythropoiesis stimulating agents: Injections used in kidney disease and some marrow conditions.
• Blood transfusion: Reserved for severe or symptomatic anaemia, or active bleeding.

When it is urgent

Call emergency services locally if you have chest pain, breathlessness at rest, fainting, a very fast heartbeat, black tarry stools or vomiting of blood. Severe anaemia and active bleeding need same day hospital care, not a flight.

Travelling to Türkiye for treatment

Anaemia itself is rarely a reason to travel: tests and iron treatment are available almost everywhere. What a visit can add is a thorough work-up in a few days when the cause has not been found, including endoscopy and a haematology opinion, or correction of anaemia with intravenous iron before a planned operation. If your haemoglobin is very low, ask a doctor whether flying is safe, since cabin air has less oxygen.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

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