What is Microcytic Hypochromic Anemia: Causes, Symptoms, Treatment, Prevention, Diagnosis

Anemia is a common medical condition, caused by reduced oxygen carrying capacity of the blood. This is secondary to inadequate quantity of red blood cells in the body, or reduced level of haemoglobin which has the ability to carry oxygen to various parts of the body. Anemia can be classified into various types based on the appearance and condition of the red blood cells in the affected individual. Microcytic hypochromic anemia is a type of anemia characterised by appearance of abnormally small sized red blood cells with poor oxygen carrying capacity as it has low concentration of haemoglobin. Microcytic hypochromic anemia is mainly caused by disruption in haemoglobin and red blood cell production in the bone marrow.

Microcytic hypochromic anemia is a common blood disorder seen among a large population. In these cases, the Mean Cell Volume or MCV of the red blood cells is below 80. The most common symptoms of this type of anemia are dizziness, tiredness, lack of energy, fatigue, decreased stamina, pale skin and other membranes.

The primary cause of microcytic hypochromic anemia is iron deficiency in the body. Iron is an essential element required by the body for producing haemoglobin. Low levels of iron in the body leads to reduced level of haemoglobin in the body, thus reducing the oxygen carrying capacity of the blood to the body. In absence of adequate amount of iron in the body, the red blood cells produced appear smaller and paler than normal red blood cells. The most common causes of microcytic hypochromic anemia are as described below:

There may be excessive and recurrent blood loss from internal bleeding due to various reasons. The most common reason for internal bleeding is ulcers, inflammatory bowel condition, haemorrhoids and other disorders in the gastrointestinal tract. Prolonged usage of aspirin and other anti-inflammatory medications can also lead to gastrointestinal bleeding over a period of time. Excessive loss of blood may also be seen in women with heavy bleeding during menstruation. In some women, excessive blood loss may be caused by uterine bleeding secondary to fibroids. Other causes include bleeding from trauma, accidents or other underlying bleeding disorders. With excessive blood loss, there is loss of iron from the body leading to anemia.

The daily requirement of iron should ideally come from diet. A daily intake of 1 mg of iron is recommended for normal functioning of the body. Following a diet deficient in iron can lead to anemia and other medical issues. It is thus advised to follow an iron rich diet. Iron rich food includes green leafy vegetables, red meat, beans, chick peas, lentils etc. The amount of iron required by the body during the growing years and the time of healing increases as compared to other times. Based on the requirement of the individual, iron supplements may be taken after consulting a physician.

Iron levels in the body may drastically reduce in the presence of certain systemic and chronic medical condition. These include presence of infections, inflammations and carcinoma. These conditions, over a period of time, can lead to disruption in the production of red blood cells and it may also cause the red blood cells to have a shorter life span. In some cases, there is disruption in normal recycling of red blood cells leading to inadequate iron levels in the body. In most of these cases, the condition begins as normocytic anemia which eventually progresses into microcytic anemia.

Lead poisoning can have serious consequences in the body including iron deficiency. In these cases, the iron level of the body does not improve even after taking iron supplements. This is a very serious condition and should be addressed at the earliest.

Treatment for microcytic hypochromic anemia depends on the underlying cause of iron loss. Based on the cause of the condition, the following treatment option is considered.

Once the cause of bleeding is determined, measures should be taken to arrest blood loss at its source. In case of gastrointestinal bleeding, specialized studies such as abdominal ultrasound, upper gastrointestinal endoscopy and CT scan of the abdomen are done to pin point the source and cause of bleeding. Affected individuals are generally referred to a gastroenterologist for further evaluation and management of the condition.

In pre-menopausal women with heavy flow, hormonal therapy (such as birth control pills) is considered. In cases of uterine fibroids and other similar conditions, surgery or radiation therapy may be considered.

In most of the cases, physicians recommend intake of iron and vitamin C supplements. Iron supplements help in replenishing the lost iron; whereas, vitamin C increases the individual’s ability to absorb iron better.

In extreme cases, predominantly when the patient is at risk of developing cardiac complications, blood transfusion may be considered.

Dietary modification is the best way to prevent any form of anemia including microcytic hypochromic anemia. It is advised to follow an iron rich diet to avoid deficiency in iron level. Besides this, increased intake of food rich in vitamin C also helps in increasing absorption of iron by the body. If the nutritional needs are not met through diet, additional iron and vitamin C supplements can be considered. However, these should be taken only after consulting an experienced physician.

The most common food that is rich in iron includes:

• Red meat such as beef, mutton, lamb, liver etc.
• Poultry products
• Dark leafy vegetables such as spinach; and pulses such as beans, red kidney beans etc.
• Dry fruits such as apricots and raisins.
• Food stuff rich in vitamin C include:
• Citrus fruits such as lemon, oranges, grapefruits etc.
• Other fruits such as strawberries
• Vegetables such as kale, red peppers, Brussels sprouts, broccoli etc.

Microcytic hypochromic anemia is common form anemia primarily caused by fall in iron level below normal acceptable level. Microcytic hypochromic anemia can be caused by multiple reasons; the most common cause being iron deficiency. It may be caused due to unhealthy lifestyle, dietary deficiency or presence of other underlying systemic condition. It is a serious health condition and hence, it is advised to follow up with an experienced physician at the earliest for early diagnosis and for determining the exact cause of the condition. Based on the underlying cause, a treatment module is planned which may include lifestyle and dietary modification.