Tiredness: A Creeping Disorder or a Disease?

 Tiredness: A Creeping Disorder or a Disease? -Written and composed by Dr. Siddhika Singh

        Have you ever felt tired even after a full night’s sleep? Do you get breathless after climbing just a flight of stairs, or find yourself losing focus easily? These signs, often dismissed as “normal tiredness,” could be something more—something as common yet overlooked as Anemia. Anemia is a silent creeper that has millions of people in its hold. More than 65% of children and about 60% adolescent girls, more than 55% women, about 50% pregnant women and about 30% of males suffer from anemia in India. Adolescent girls and low socioeconomic classes are at the highest risk of anemia all across India. Anemia is a serious illness; it degrades our quality of life significantly with time. This quality of life is nothing else than our working capacity and overall attitude toward world around us. The most commonly found anemia is India is Iron Deficiency Anemia. Daily iron requirement varies with your age, sex, pregnancy, lactation. For men being 8mg/day, adult women being 18mg/day, pregnant women being about 27mg/day. When this iron is deficient the oxygen supply to our body is hampered, this deficiency leads to various health complications. Notable symptoms include:  

 • Fatigue

• Shortness of breath

• Weakness

• Paleness

• Dizziness

• Cold hands & feet

• Headaches

• Irregular heartbeats

• Brittle nails

• Infertility 

• miscarriage

• Inflamed or sore tongue

• Poor appetite

• Craving for ice/dirt

• Stress

• Tinnitus

• Frequent infections

• Bleeding tendencies

         Many patients often also complain of losing their vigor and will- to do thing which they earlier used to love doing. We don’t realize this but anemia affects our mood negatively- leading us to get irritable, angry. These mood changes can affect our behaviors and our relations with people around us- our partner, family, friends, colleagues. It is very often overlooked and worsened by stress, physical exertion, dehydration, poor sleep quality and lack of a stable circadian rhythm. Deficiency of iron supplements plays a role in Infertility with decreases sperm quality, motility and number in males and decreases egg quality in females, often leading to miscarriage. Little do we realize how these small things can Indirectly affect our mental health and develop into disorders like anxiety, depression, etc. According to The Lancet, about 45-50% of Indian population suffers from anxiety and depression, whose numbers are on the rise each day. According to national alliance on mental illness, about 46% of people who commit suicide have a known mental illness at the time.

        The good news is that its easily detectable. A simple CBC can let you know if you’re anemic by the RBC count and Hemoglobin. A doctor’s diagnosis will let you know which type of anemia you have. Iron deficiency anemia is usually reversible with diet modifications. Iron is a very important component of Hemoglobin; it binds with oxygen to carry it around the body. After the treatment many issues (even very mild mental issues) of patients that did not seem to be connected to anemia directly, ended up resolving. Iron is very important for our body. It is not only needed for blood cells production but also needed in mitochondria-the powerhouse of the cell to produce energy. It is needed by many enzymes (namely Cytochrome c, cytochrome oxidase, succinate dehydrogenase, cytochrome p450, ribonucleotide reductase, myeloperoxidase) in whole body that play a role in DNA replication, DNA repair, Detoxification, Antioxidant activity and Brain development especially in childhood. It is also required by our immune system to kill bacteria. It is usually due to poor diet that lacks iron- like fast-food, packaged food. The treatment is Diet modification- eating foods rich in iron naturally like dates, spinach, beetroot, raisins, jaggery, beans, lentils, red meat, poultry products, etc. To increase the iron absorption, you can take vitamin C supplements or squeeze a lemon in your food. Cooking in iron utensils is also found effective. Iron supplements are best taken under supervision of your doctor because iron toxicity has its own complications. Tea and coffee decrease iron absorption so they are best consumed after/before 1-2 hours of food intake. 

        What you do need to keep in mind is if you overlook initial symptoms, the anemia progresses to degrade your quality of life more by fatigue and breathlessness that it might get difficult to do some daily tasks.  Sometimes the self-treatment may Not work, it may be due to either a different type of anemia, or some complication in iron absorption or a different cause, in such a case it is best to seek help from your doctor. It can be due to genetic defect, an acquired defect, a malabsorption syndrome or Bone Marrow suppression which are more serious conditions. These require further screening and more in-depth analysis by a qualified doctor. If your anemia is associated with jaundice, increased infections lately or increased time for your blood to clot, after you get a cut, seek medical help immediately. Sometimes, your anemia may resolve but if other associated symptoms persist, ask your healthcare provider.

        So, Iron Deficiency anemia is a very common illness that is a factor in manifestation of several other disorders and symptoms, even infertility. It is commonly due of lack of iron intake which is easily curable with dietary modifications.