Why Does Rheumatoid Arthritis Cause Anemia?

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Side effects of some medicines for rheumatoid arthritis (RA)!

Below are some treatments for RA that could contribute to cause anemia:

  1. The use of NSAIDs (a group of anti-inflammatory medicines) and corticosteroids is pretty common for people with RA. Unfortunately, they could carry the risk of hypertension (high blood pressure) and secondary iron deficiency since they could cause gastrointestinal bleeding.
  2. Other medicines that suppress the bone marrow such as methotrexate (a kind of DMARD) may also have contribution to trigger anemia in people with RA.

The systemic inflammation of RA

As well we know, the inflammation in RA is more likely to become systemic. In other words, it can affect other parts of the body, causing some complications such as eye problems, hypertension, heart diseases, lung diseases, and osteoporosis.

The inflammation triggered by the immune system abnormality in RA could affect the production of red blood cells, too! If you have RA, you are more likely to have inflamed tissues in the joint and other parts of the body, especially if your RA is out of control.

Inflamed tissues can have several effects and interfere with some body functions. Some of them may include problem of iron metabolism, the abnormality function of bone marrow, and improper use of erythropoietin. All these things can contribute to lead to deficiency of red blood cells, causing anemia.

So in general, anemia in rheumatoid arthritis could be caused by the systemic RA inflammation itself (particularly true if the inflammation is not controlled as well) or/and side effect of some treatments for RA.

Stand-alone iron deficiency anemia

While the chronic condition of RA can be a stand-alone trigger /cause of anemia (this type is called ACD or anemia of chronic disease), some sufferers can experience iron-deficiency anemia that has nothing to do with RA. And even in some cases, ACD can co-exist with iron-deficiency anemia.

Treatment options

Treating anemia related to inflammation and chronic condition is usually focused on treating the underlying illness. If your anemia is really linked to your RA, the goal of the treatment is to make sure that your RA is controlled as well.

Overall, the decision of prescribing certain medication should outweigh the risks or potential side effects of the medication. But if your doctor thinks that some medications for your RA do have a significant impact to trigger or worsen your anemia, her/she may ask you to consider switching.

The good news, there are some medications for RA that are helpful to treat anemia, too – for more advice, talk with a physician /doctor!

Citations /references:

  1. http://www.patient.co.uk/health/anaemia-leaflet
  2. http://hematologic.niddk.nih.gov/anemiachronic.aspx/
  3. http://www.anemia.org/patients/information-handouts/arthritis/

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