Why Does Rheumatoid Arthritis Cause Anemia?

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Red blood cells are one of many important elements in your cardiovascular system since they carry oxygen to the cells and tissues of your body. Anemia is a common health condition associated with lack of red blood cells. It is also pretty common in people with rheumatoid arthritis (RA), why and how?

Understanding anemia in general

In general, anemia is low level of red blood cells in the bloodstream. It also means that you have low hemoglobin (lower than normal) in each your red blood cell.

In other words, it is a medical condition to describe reduced (low) amount of O2 (oxygen) carried in the bloodstream.

Red blood cell itself is produced in the bone marrow, and every day millions of red blood cells are made and released into the blood stream. The continuously supply of new red blood cells are needed to replace the old cells and keep the body functioning well!

The main important function of red blood cells is to help carry essential chemical called hemoglobin. Without hemoglobin, they cannot optimally carry oxygen from lungs since hemoglobin plays a key role to bind oxygen.

So, the body requires plenty of both red blood cells and hemoglobin. For this goal, you need to have adequate nutrients (particularly such as certain vitamins and iron) – and of course, healthy bone narrow.

Causes of anemia

When you have deficiency of certain nutrients that are required to make both red blood cells and hemoglobin, you could have anemia. One of common causes is lack of iron. This kind of anemia is often called as iron-deficiency anemia, the most common type of anemia.

In most people, a well-balanced diet should be helpful enough to cope with iron deficiency. But certain conditions may make you relatively easier to have this kind of deficiency, some of these include:

  1. Having certain conditions (for instance, coeliac disease) that trigger the poor absorption of certain nutrients (such as iron) in the body.
  2. Heavy bleeding, like in heavy menstrual bleeding in some women. This may make the amount of dietary iron they eat is not enough to cover the amount they lose with heavy bleeding every month.
  3. Some health conditions that affect the intestines (gut) and cause bleeding in the intestines that could bleed enough to trigger anemia.
  4. Following a restricted /poor diet that can increase your risk of having low dietary iron.
  5. During pregnancy, the time of when the body needs more iron than usual.


image_illustration283The best way to get to know whether or not you have anemia is with taking a blood test to measure your blood counts and analyze the amount of your hemoglobin. However, there are also some symptoms that signal the existence of this problem (though sometime anemia comes without any sign), these may include:

  1. Symptoms related to the decreased amount of O2 in the body are usually common in people with anemia – such as lethargy (poor in energy), tiredness, easier for breathless, exercise intolerance, or feeling faint.
  2. Less common signs may include appetite change /altered taste, headaches, palpitation (thumping heart), or pale skin.
  3. Various other signs may occur, depending on the cause /underlying condition behind anemia.

Anemia associated with inflammation and chronic disease (AI/ACD)

It is a kind of anemia that is commonly found in people with long term, chronic inflammatory illness or even infections – including those with chronic condition of immune system abnormality such as rheumatoid arthritis.

AI/ACD is often confused since the iron deficiency can be found in both iron-deficiency anemia and AI/ACD. Nevertheless, experts believe that the way of how this deficiency develops could be slightly different.

In the body, iron is circulating in the bloodstream for some body functions – and some are stored in the tissues of the body.

In the case of iron-deficiency anemia, the body usually has too low iron stored in the body tissues. But in people with AI/ACD, many times the body still has normal amount of iron stores but the body is very poor in using iron.

In people with inflammatory and chronic disease, there is a chance for the disease to interfere with the ability of the body in absorbing iron from diet or using iron effectively. After iron-deficiency anemia, AI /ACD may be the most common type of anemia.

AI/ACD can affect people of all ages, but it is more likely to affect older adults since they are at high risk of chronic disease. It is pretty common among hospitalized patients, too.

Why and how does rheumatoid arthritis cause anemia?

Still, symptoms related to joint disorder such as joint pain, stiffness, redness, heat, and swelling in the affected joints are the main problems in people with rheumatoid arthritis.

However, many of them also experience anemia, too. Even according to one survey, most sufferers with RA (about 60 percent) are anemic. In AI/ACD, there are some possible reasons of why and how the problem occurs:

  1. The abnormality in the function of red blood cells, especially when they lose their normal function in absorbing and using iron efficiently.
  2. The abnormality of the body to respond or use EPO (erythropoietin), a hormone produced in the kidneys. EPO is so crucial to stimulate bone marrow to work & produce red blood cells.
  3. The side effect of certain medications for inflammatory & chronic diseases.

And the similar things occur in anemia related to RA. For instance, some of treatments for RA could pose the risk of anemia, too – but overall, there can be many reasons and the following are some of them:


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