Nutritional Anemia

Nutritional anemia refers to relative or absolute reduction in nutrients essential for hematopoiesis (iron, folate, vitamin D etc.), causing insufficient hemoglobin formation or RBC production and low hematopoietic function. It is common in infants 6 months to 2 years, pregnant or lactating women, and patients with poor nutrient absorption from GI diseases. Modern medicine divides it into microcytic and macrocytic types: the former (iron-deficiency anemia) is common in infants 6mo-1yr; the latter (megaloblastic anemia) occurs in children under 2, mainly from insufficient dietary vitamin D2/folate or insufficient gut bacterial synthesis, causing lack of RBC-maturation factors. Onset is slow; mild cases show pale/yellow-pale skin/mucosa, especially lips, gums, eyelids and nails. Severe anemia shows dizziness, generalized fatigue, irritability, anorexia; children often have malnutrition. Some have pica (eating earth, coal cinders, wall mud). Prolonged anemia can cause growth/developmental delay.

Common Symptoms

Pale lips; poor concentration; pica; pallor; anorexia; irritability; fatigue; dizziness

Causes and Pathogenesis

1. Increased iron requirement with insufficient intake: rapidly growing infants/children, menorrhagic/pregnant/lactating women need more iron; low dietary iron easily causes iron-deficiency anemia. 2. Iron malabsorption: less common. 3. Blood loss, especially chronic blood loss, is the most important cause: GI bleeding (ulcer, cancer, hookworm, esophageal varices, hemorrhoids, post-salicylate antral gastritis), menorrhagia, hemolytic anemia with hemosiderinuria/hemoglobinuria. Iron deficiency develops gradually through iron-depletion stage (stores exhausted, low serum ferritin, no anemia yet) then iron-deficiency erythropoiesis (low ferritin/serum iron, high TIBC) then iron-deficiency anemia. For megaloblastic component: (1) B12/folate intake insufficiency - B12 mainly in animal foods, folate in fresh greens/liver/kidney; delayed complementary feeding or food faddism causes deficiency. (2) Absorption/utilization disorders - chronic diarrhea, small-bowel resection, regional ileitis, intestinal TB, liver disease, acute infection, achlorhydria, vitamin C deficiency. (3) Increased requirement - premature/newborn/infant rapid growth, recurrent infection. (4) Congenital low stores - fetal B12/folate stored in liver via placenta; deficient mothers lead to low newborn stores.

Treatment

Drug therapy, supportive therapy

Preventive Measures

1. Anemic patients should avoid tea: food iron enters the GI tract as ferric hydroxide colloid; gastric acid converts ferric to ferrous for absorption; tea tannin forms insoluble iron tannate and blocks absorption. Milk and antacids also block iron absorption; avoid with iron-rich foods. 2. Treat the underlying cause of anemia; correct bleeding sources. 3. Actively prevent parasites, especially hookworm.

Department to Visit

It is recommended to visit the Hematology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.