THE doctor says I have “low blood count”; what does that mean?

Anaemia or “low blood count” is a condition where the red blood cell count or the haemoglobin of an adult is less than normal.

This value varies based on gender, less than 13.5 g/dl and 12g/dl for males and females, respectively.

There are many causes of anaemia, which are usually due to:

1. BLOOD LOSS

This occurs through bleeding, which can be from the gastrointestinal tract such as the stomach through ulcers, inflammation (gastritis) or cancers; bleeding from the reproductive system such as during the menstrual period, in childbirth or from cancer of the cervix or endometrium.

2. DECREASED OR FAULTY RED BLOOD CELL PRODUCTION

This can occur if the components of red cell production are lacking such as vitamins, minerals or hormones.

This is seen in iron deficiency anaemia which is caused by poor diet, excessive needs such as in breastfeeding or pregnancy as well as from losing blood. Vitamin deficiency anaemia and folate deficiency are seen in dietary lack such as in vegetarian diets (eating little or no meat, diseases of intestinal absorption such as in parasitic worm infestation, Crohns disease as well as problems with the bone marrow that manufactures the cells and cell lines (aplastic anaemia, thalassemia, lead exposure).

Lack of erythropoetin, the hormone produced by the kidney to generate red blood cells, occurs in chronic kidney disease, hypothyroidism, cancer, and rheumatoid arthritis.

3. DESTRUCTION OF RED BLOOD CELLS

This occurs in hemolytic anaemia where the cells burst in the early stages.

This is seen in sickle cell anaemia, thalassemia, drug, and toxin-induced hemolysis and enlarged spleen.

The blood has red cells, white cells and platelets. The function of the red cells is to deliver oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs by the carrier protein haemoglobin.

Symptoms of anaemia include:

* Chest pain

* Dizziness

* Pale skin

* Tiredness

* Weakness

* Shortness of breath and

* Fast heart beat

If any of the symptoms above are experienced the doctor will take a history and do a physical examination to delineate the cause and any complications of anaemia. Initial investigations will include doing blood tests such as the hemoglobin, hematocrit and red cell indices. Further tests would then be done based on the findings.

The treatment will be determined by the cause and is based on the assessment of the doctor.

Complications of untreated anaemia can result in heart failure, abnormal heart rhythms, poor daily functioning due to fatigue and even death. Therefore, it is important to ensure there is full evaluation of any person suspected of having anaemia.

Dr Romayne Edwards is a consultant emergency physician at the University Hospital of the West Indies and an associate lecturer at the University of the West Indies.