Anemia in the elderly can be complicated
By Roberta Cannon, RN
An estimated 35 million Americans over the age of 65 have anemia, and that figure is predicted to double in the next 25 years, according to the American Society of Hematology.
“While anemia in a younger population is often related to iron deficiency, the causes in seniors can be complicated due to underlying diseases such as diabetes, chronic kidney disease, vitamin deficiencies, nutritional issues, and medications that can affect absorption of iron,” said Sarita Bajracharya, MD, an internal medicine physician with Primary Care Internists in Hyannis.
“All of these chronic illnesses can affect your kidney’s ability to produce erythropoietin (a hormone that stimulates red blood cell production), which can lead to anemia.”
A more serious cause is cancer.
“My primary concern is cancer when an elderly patient presents with anemia,” Dr. Bajracharya said. “It is mostly cancer-related to the gastrointestinal tract. I’ve had a couple of patients who had routine bloodwork for the annual physical and were found to be severely anemic. After more testing, they were diagnosed with colon cancer in the cecum, had a partial colectomy (a surgical procedure to remove part of the colon) and are doing fine now.”
Dr. Bajracharya said other types of cancer that can cause anemia in the elderly are myelodysplastic syndromes which are a group of cancers that occur when the immature blood cells in the bone marrow don’t mature or grow into healthy cells.
Symptoms of Anemia
“The most common symptom of anemia I hear from patients is they are feeling very, very tired,” said Dr. Bajracharya. “The other two most common symptoms include shortness of breath when climbing the stairs, and palpitations.”
When patients complain of these symptoms, Dr. Bajracharya begins the cycle of testing to find the cause. She orders blood tests that include a complete blood count, that checks the cells and components of the blood which can indicate anemia, and a comprehensive metabolic panel that checks kidney and liver functions. If she needs further information, blood tests will include looking for iron, Vitamin B12, and folic acid deficiencies. If those results are normal, then she may do further testing or refer the patient to a hematologist, a physician who specializes in blood disorders.
Treatment for Anemia
Depending on the cause of the anemia, Dr. Bajracharya will make treatment recommendations.
“If it is nutritional anemia, I will recommend healthy eating that includes the three major nutritional components to prevent anemia, and those are foods that contain iron, Vitamin B12 and folic acid,” she said. “I give my patients a list of these common foods so they can take it to the grocery store when they go shopping. Green, leafy vegetables; nuts; and beans are always a good choice for folic acid and Vitamin B12. Foods rich in iron and Vitamin B12 are lean red meats, shellfish, and fish.”
When the anemia is a result of iron or Vitamin B12 deficiencies, Dr. Bajracharya can prescribe iron to take by mouth to treat the iron deficiency, or patients can receive a Vitamin B12 injection monthly at her office.
Dr. Bajracharya stressed the importance of seniors getting a yearly physical.
“I really encourage the elderly population to get a physical once a year even if they feel well,” she said. “It has happened more than once in my practice that patients have been diagnosed with colon cancer or other diseases that have been treatable because they came in for their physical.”
View Physician Profile
Originally published on Cape Cod Health News, December 3, 2024
“While anemia in a younger population is often related to iron deficiency, the causes in seniors can be complicated due to underlying diseases such as diabetes, chronic kidney disease, vitamin deficiencies, nutritional issues, and medications that can affect absorption of iron,” said Sarita Bajracharya, MD, an internal medicine physician with Primary Care Internists in Hyannis.
“All of these chronic illnesses can affect your kidney’s ability to produce erythropoietin (a hormone that stimulates red blood cell production), which can lead to anemia.”
A more serious cause is cancer.
“My primary concern is cancer when an elderly patient presents with anemia,” Dr. Bajracharya said. “It is mostly cancer-related to the gastrointestinal tract. I’ve had a couple of patients who had routine bloodwork for the annual physical and were found to be severely anemic. After more testing, they were diagnosed with colon cancer in the cecum, had a partial colectomy (a surgical procedure to remove part of the colon) and are doing fine now.”
Dr. Bajracharya said other types of cancer that can cause anemia in the elderly are myelodysplastic syndromes which are a group of cancers that occur when the immature blood cells in the bone marrow don’t mature or grow into healthy cells.
Symptoms of Anemia
“The most common symptom of anemia I hear from patients is they are feeling very, very tired,” said Dr. Bajracharya. “The other two most common symptoms include shortness of breath when climbing the stairs, and palpitations.”
When patients complain of these symptoms, Dr. Bajracharya begins the cycle of testing to find the cause. She orders blood tests that include a complete blood count, that checks the cells and components of the blood which can indicate anemia, and a comprehensive metabolic panel that checks kidney and liver functions. If she needs further information, blood tests will include looking for iron, Vitamin B12, and folic acid deficiencies. If those results are normal, then she may do further testing or refer the patient to a hematologist, a physician who specializes in blood disorders.
Treatment for Anemia
Depending on the cause of the anemia, Dr. Bajracharya will make treatment recommendations.
“If it is nutritional anemia, I will recommend healthy eating that includes the three major nutritional components to prevent anemia, and those are foods that contain iron, Vitamin B12 and folic acid,” she said. “I give my patients a list of these common foods so they can take it to the grocery store when they go shopping. Green, leafy vegetables; nuts; and beans are always a good choice for folic acid and Vitamin B12. Foods rich in iron and Vitamin B12 are lean red meats, shellfish, and fish.”
When the anemia is a result of iron or Vitamin B12 deficiencies, Dr. Bajracharya can prescribe iron to take by mouth to treat the iron deficiency, or patients can receive a Vitamin B12 injection monthly at her office.
Dr. Bajracharya stressed the importance of seniors getting a yearly physical.
“I really encourage the elderly population to get a physical once a year even if they feel well,” she said. “It has happened more than once in my practice that patients have been diagnosed with colon cancer or other diseases that have been treatable because they came in for their physical.”
View Physician Profile
Originally published on Cape Cod Health News, December 3, 2024