Anemia is a medical condition in which there is low red blood cell count and low hemoglobin level. There are various forms of anemia, and macrocytic hypochromic anemia is one of them. Macrocytic hypochromic anemia is a condition in which the red blood cells are larger than their normal size with insufficient concentration of hemoglobin.
Enlarged red blood cells with low RBC count and reduced hemoglobin can lead to oxygen deficiency in every cell. This reduced oxygenation can lead to several symptoms that may be mild to severe.
Macrocytic hypochromic anemia typically occurs due to deficiency of vitamin B12 and folate. Both are essential for production and development of red blood cells. Treatment consists of vitamin B12 supplement either orally or through injections. Folic acid is taken in oral dose.
Causes Of Macrocytic Hypochromic Anemia
Normally in majority of people macrocytic hypochromic anemia is caused due to nutritional deficiency, especially deficiency of vitamin B12 and folate. Vitamin B12 deficiency can arise either due to absence of this vitamin in your diet or due to absence of intrinsic factor in the intestine. Intrinsic factor is a type of protein present in the gut. It helps the intestine to absorb vitamin B12. Absence of intrinsic factor can be hereditary. The condition arising from this is also called pernicious anemia. If you are not eating foods that contain vitamin B12 you are at risk of developing macrocytic anemia. Mostly vegans suffer from vitamin B12 deficiency. Vitamin B12 is mainly present in meat, fish, egg, milk, dairy products, and sea food.
Certain medical conditions such as Crohn’s disease, Celiac disease can cause vitamin B12 deficiency due to lack of absorption of nutrients from intestine. Macrocytic hypochromic anemia is also present in chronic alcoholism patients. Vitamin B12 deficiency resulting in macrocytic anemia can also occur as a side effect of gastrointestinal surgery.
Folate deficiency occurs due to poor intake of vegetables, overcooking habits, old age, milk fed premature babies, active liver disease, increased demand as in pregnancy, lactation. Impaired absorption due to Celiac disease and tropical sprue can also give rise of folic acid deficiency.
Signs And Symptoms Of Macrocytic Hypochromic Anemia
A person may not experience any symptoms of macrocytic hypochromic anemia until the tissue storage of vitamin B12 and folic acid are substantially exhausted. The onset of anemia is insidious. Often clinical manifestation appears after years of vitamin B12 and folate deficiency.
Signs and symptoms of macrocytic hypochromic anemia are as follows:
- Loss of appetite
- Loss of weight
- Sore tongue
- Alternating diarrhea and constipation.
- Pale skin, lips, and conjunctiva.
- Shortness of breath.
- Poor concentration.
- Giddiness, headache and drowsiness.
- Forgetfulness and irritability.
- Enlarged spleen and liver.
- Increased heart rate.
- Nails become brittle.
Diagnosis And Treatment Of Macrocytic Hyperchromic Anemia
Macrocytic hypochromic anemia is diagnosed from symptoms and confirmed with blood tests in a pathology laboratory. Further the doctor may also recommend for other tests to find if there is any problem related to liver and thyroid. These tests are also blood tests.
Treatment of macrocytic hypochromic anemia is to correct the cause and underlying pathology. In most cases the cause is nutritional deficiency. Nutritional deficiency is corrected with providing supplements and foods that are rich in vitamin B12 and folate.
- Patient must eat foods that are rich source of these vitamins. Red meat, fish, egg, milk, dairy products, shellfish etc are rich in vitamin B12. In case for vegans, they have to rely more on fortified cereals and grains.
- Patient must also consume folate rich food. Green leafy vegetables, lentils and fruits such as oranges have substantial amount of folate.
- Lastly if food intake is not sufficient to correct macrocytic hypochromic anemia, patient may have to take vitamin B12 injections.
- Patient must also stop alcohol and follow healthy lifestyle.