Hematocrit and Anaemia

Hematocrit

As you know, blood consists of two main components. The liquid component, also called plasma, is a pale yellow liquid containing clotting proteins, antibodies, etc. Inside are red blood cells that contain haemoglobin, a protein whose purpose is to transport oxygen to the body's cells.

One of the most critical laboratory blood tests, which is also a basic element of the "general blood", is the hematocrit. Hematocrit is the ratio of red blood cells per unit volume in the blood, i.e. it indicates how dense the blood is. Hematocrit is one of the leading indicators of human health since its values can show the person's hydration status, possible blood loss, the existence of anaemia and the transport of oxygen in the blood.

• men, 40%-54%

• women, 36%-48%

High hematocrit values

Transient high hematocrit values are usually due to body dehydration because, after fluid intake, it returns to normal levels. In rarer cases, the increased hematocrit is due to the increased number of erythrocytes, erythemia*, which are produced in the bone marrow, so the increase can cause a problem in the bone marrow or from a malfunction in the respiratory function since the red blood cells carry oxygen throughout the body.

The increased hematocrit may also coexist with other diseases such as, e.g. with chronic hypoxia, i.e. low blood oxygen with lung diseases as a classic example or even with neoplasms that secrete erythropoietin (it is the hormone that regulates the production of erythrocytes which is produced in the kidneys).

* Erythremia is the opposite of anaemia, i.e., the condition where there is an increased hematocrit or haemoglobin and is usually accompanied by increased white blood cells and platelets.

Low hematocrit values

They indicate a pathological condition of the body in which the blood carries far fewer red blood cells than the required amount. This results in the necessary oxygen not being transported to the body's tissues, which can cause many complications.

At this point, we should point out that anaemia is not a disease but a laboratory finding. More specifically, anaemia results from various conditions and its diagnosis have no real meaning if it is not determined by the disease that causes it, precisely the type of anaemia.

Anaemia

Categories of anaemia

Anaemia is divided into three main categories depending on the pathological cause that caused it. In more detail:

• Anaemia due to reduced production of red blood cells. This can be due to a lack of erythropoietic factors in the blood or DNA, lymphomas, and a disorder in red blood cells.

• Hemolytic anaemia due to increased destruction of erythrocytes from intra-erythrocyte or extra-erythrocyte causes. In the second case, it is autoimmune hemolytic anaemia.

• Post-hemorrhagic anaemia is caused by heavy blood loss from the respiratory, digestive or urinary system.

Types of anaemia

The types are proportional to the cause that caused it, and the most common types of anaemia are:

Iron deficiency anaemia

Iron deficiency is the most common form of anaemia due to poor nutrition and chronic blood loss caused by excessive menstruation. Also, increased needs for iron, such as in fetal growth during pregnancy and children undergoing rapid growth in childhood and adolescence, can cause iron deficiency anaemia.

Aplastic anaemia

Aplastic anaemia is a blood disorder in which the body's bone marrow does not produce enough new blood cells. This can lead to several health problems, including arrhythmias, an enlarged heart, heart failure, infections and bleeding. Aplastic anaemia is a rare but severe condition that can develop suddenly or slowly and worsen over time unless the cause is recognized and treated early.

Hemolytic anaemia

Hemolytic anaemia is when red blood cells are destroyed and removed from the blood circulation before their expected lifespan. Several diseases, conditions and factors can cause red blood cells to be destroyed. Hemolytic anaemia can lead to various health problems, including fatigue, pain, arrhythmias, an enlarged heart, and heart failure. There are many types of hemolytic anaemias, some of which are inherited and others manifest from different causes.

Thalassemia (Mediterranean anemia)

Thalassemias are inherited disorder that causes the body to produce fewer healthy red blood cells and less haemoglobin (an iron-rich protein in red blood cells). The two main types of thalassemia are α- and β-thalassemia. The most severe form of α-thalassemia is also known as a-thalassemia or hydrops fetalis. In contrast, the extreme form of β-thalassemia is known as significant thalassemia or Cooley's anaemia. Thalassemias affect men and women and are more common in people of Italian, Greek, Middle Eastern (hence the name Mediterranean anaemia), Asian and African descent. The severe forms are diagnosed in early childhood and are lifelong ailments.

Sickle cell anaemia

Sickle cell anaemia is a severe disease in which the body produces sickle "C" shaped red blood cells. Normal red blood cells are disc-shaped and move quickly through the blood vessels. Red blood cells contain haemoglobin (an iron-rich protein that gives blood its red colour and carries oxygen from the lungs to the rest of the body). Sickle cells contain abnormal haemoglobin that causes them to have a sickle shape, which does not allow them to move quickly through the blood vessels, resulting in masses sticking to the blood vessels. Sickle cell masses block blood flow in the vessels leading to the extremities and organs.

Blocked blood vessels can cause pain, severe infections and organ damage. In sickle cell disease, a lower-than-normal number of red blood cells occurs because sickle cells do not last long, usually dying after about 10 to 20 days, and the body cannot reproduce red blood cells fast enough to replace them.

Pernicious anaemia

Pernicious anaemia is a condition in which the body cannot produce healthy red blood cells because it does not have enough vitamin B12. People with pernicious anaemia cannot absorb enough vitamin B12 because they lack endogenous factors (a protein made in the stomach). However, other conditions and factors can cause vitamin B12 deficiency.

Fanconi anaemia

Fanconi anaemia, or FA, is a rare, inherited blood disorder that results in the bone marrow failing to produce blood. FA is a type of aplastic anaemia where the bone marrow is destroyed, preventing it from having enough new blood cells for the body to function normally. FA can also cause the bone marrow to make too many abnormal blood cells, leading to serious health problems like leukaemia.

The leading causes of anaemia

• Reduced production of red blood cells by the body

• Bleeding that results in the loss of red blood cells at a faster rate than their production

• The body itself destroys the red blood cells.

• Reduced intake or insufficient absorption of iron by the body

• Lack of vitamins and minerals required for the synthesis of new red blood cells

• Chronic conditions or infections, for example, chronic kidney failure or infection of a vital organ

• Damage to the function of the bone marrow and, by extension, to the production of erythrocytes

• Hereditary factors

Symptoms

One of the most critical complications of anaemia, regardless of type and category, is the body's difficulty transporting oxygen to vital organs.

This causes various complications and can also be recognized by the following symptoms:

• Overwork without long hours

• Feeling of weakness

• Weight loss and pale skin

• Headaches and dizziness

• Increased number of breaths, more than 20 per minute

• Tachycardia

Tips

Remember that a healthy lifestyle can help solve many problems as long as it is chronic and based on correct foundations and information.