Nicolette: 0:01

Welcome to the Health Pulse, your go-to source for quick, actionable insights on health, wellness and diagnostics. Whether you're looking to optimize your well-being or stay informed about the latest in medical testing, we've got you covered. Join us as we break down key health topics in just minutes. Let's dive in.

Rachel: 0:25

Okay, so let's dive in. Today we're looking at anemia of chronic disease. You probably saw this pop up in some of your sources, right, and basically it's well. It's a type of anemia, so meaning you know your body's not making enough of those red blood cells and it's tied to these long-term illnesses, the ones that stick around for more than three months.

Mark: 0:47

Yeah, yeah, those chronic conditions.

Rachel: 0:49

Yeah, and they cause, like all this, inflammation in your system. You might also see it called something else.

Mark: 0:55

Oh for sure, Anemia of inflammation, or even like the full anemia of inflammation in chronic disease.

Rachel: 1:01

Exactly, so you know lots of different names for basically the same thing.

Mark: 1:05

Right and I think if your sources went into it like, the core issue here is that that inflammation is just hanging around. That's what messes with your body's ability to actually use iron the way it should.

Rachel: 1:18

OK.

Mark: 1:18

To make those red blood cells. So even if you're, you know, eating all the right things, getting enough iron in your diet, this chronic inflammation can really make things difficult.

Rachel: 1:28

Yeah, like throws a wrench in the whole system.

Mark: 1:30

Totally.

Rachel: 1:31

But the thing is it's like okay, the name sounds kind of scary yeah.

Mark: 1:36

Anemia of chronic disease. It's a mouthful.

Rachel: 1:38

It is, it is. But the good news is and I think your sources probably touched on this too most of the time it's mild.

Mark: 1:44

Yeah.

Rachel: 1:45

And the treatment isn't like going straight at the anemia itself. It's more about tackling that underlying condition that's causing all this inflammation to begin with.

Mark: 1:56

Get to the root of the problem.

Rachel: 1:57

Exactly, exactly Now, in terms of, like, who this affects. I mean, you probably saw some stats in your research demographics and stuff and basically it can affect anyone who has, well, a long-term illness, but it's most common in people 65 and older.

Mark: 2:12

Right, right, and it's pretty prevalent. I mean, we're talking about a million people in that age group just in the US alone who might be dealing with this.

Rachel: 2:19

Wow, that's a huge number, okay, so then there's the whole question of what kinds of illnesses, right, because it's not just one specific thing.

Mark: 2:27

Oh no, not at all. I'm sure your materials showed like a whole spectrum of chronic illnesses that can be tied to this anemia of chronic disease.

Rachel: 2:37

Yeah, I mean you probably saw stuff like cancer mentioned, chronic kidney disease, even heart failure, especially that congestive heart failure.

Mark: 2:45

Right, right, and then there's like a whole other category to the autoimmune diseases.

Nicolette: 2:49

Yeah.

Mark: 2:50

Where you know it's your own immune system. That's kind of going haywire.

Rachel: 2:53

Right, attacking your own body.

Mark: 2:55

Exactly.

Rachel: 2:55

So within those, like you know, if you were digging into the specifics, you probably came across some big ones.

Mark: 3:00

Oh yeah, you've got things like rheumatoid arthritis, which, as you know, is that chronic inflammation of the joints, and then there's systemic lupus erythematosus Most people just call it lupus.

Rachel: 3:11

Right.

Mark: 3:11

And that one's tough because, well, the immune system can attack lots of different parts of the body.

Rachel: 3:16

So it's not really localized.

Mark: 3:17

No, not at all.

Rachel: 3:18

Okay, what else? I feel like there were a bunch more in the research.

Mark: 3:21

Oh, there are, there are. You've got vasculitis, where it's the blood vessels themselves that are inflamed, and then sarcoidosis, which is well, it's an inflammatory disease. Usually affects the lungs and lymph glands, probably because of, you know, some kind of immune response. That's not quite right.

Rachel: 3:37

Okay, and then like inflammatory bowel disease.

Mark: 3:40

Yep, yep. That covers Crohn's disease and ulcerative colitis. Those are the ones that target the intestines.

Rachel: 3:45

Right, right and even irritable bowel syndrome. Ibs can be linked sometimes.

Mark: 3:50

Yeah, sometimes it's a pretty long list. It is it is, but it's also not just, like you said, not just those autoimmune things, it's infections too, absolutely Any kind of infection that hangs around for a while that can trigger this type of anemia and even, believe it or not, something like obesity has been linked to it. It is. And it kind of underscores how inflammation is so widespread in the body and it can impact all sorts of things you wouldn't necessarily think were connected.

Rachel: 4:16

Right right, and to give you an idea how common this is, anemia of chronic disease. I think some of your sources mentioned it's the second most common type we see.

Mark: 4:25

Yeah, right after iron deficiency.

Rachel: 4:27

Okay, so for this deep dive, what we want to do is really get into, like, what's happening under the hood. You know the actual mechanisms, what are the symptoms, how do doctors figure out what's going on based on like those lab tests? And then, of course, how do you manage it, all based on you know the research that you've done.

Mark: 4:46

Sounds good, let's get into it. Okay, so to start, let's talk about what you might actually notice if you have anemia of chronic disease. The symptoms and I think this came up in your sources they can be pretty similar to iron deficiency anemia.

Rachel: 5:02

Oh, okay.

Mark: 5:03

Which can make things a little tricky to diagnose at first and some people, especially if it's mild, they might not even realize they have it Like they won't have any symptoms, especially when they're just resting.

Rachel: 5:13

Gotcha, so it's subtle at first.

Mark: 5:15

Yeah, it can be Okay, but as it progresses or, you know, especially when you're being active, that's when things might become more obvious.

Rachel: 5:22

Okay, like what kinds of things?

Mark: 5:24

Well, we're talking about that feeling of just being completely wiped out, tired, weak, like to the point where it's actually affecting your daily life.

Rachel: 5:31

Yeah.

Mark: 5:32

And then there's shortness of breath. That can be a big one.

Rachel: 5:34

Makes sense if your blood isn't carrying enough oxygen. Exactly.

Mark: 5:38

Yeah, and visually you might see some changes too, like your skin might look paler than usual.

Rachel: 5:43

Okay.

Mark: 5:50

And some people even get like unexplained sweating, dizziness, feeling faint, even headaches.

Rachel: 5:52

It's all because the body's not getting that oxygen it needs. Right, right, okay, so let's dig into what's actually happening in the body at the cellular level that leads to all this. We talked about inflammation before, right? So any chronic disease that triggers that inflammation that's the main culprit here, absolutely and that chronic illness, it can directly mess with your red blood cells, which are, you know, essential for carrying oxygen around your system.

Mark: 6:13

Right, right. And what's interesting is how these chronic diseases can actually disrupt the normal lifespan of a red blood cell. I mean, normally, your bone marrow is busy making new ones all the time to replace the old or damaged ones. A healthy red blood cell usually lives for about 120 days.

Rachel: 6:30

Okay, a healthy red blood cell usually lives for about 120 days, Okay.

Mark: 6:33

But with a chronic disease, those red blood cells, they might die off way sooner. Or the production of new ones gets slowed down. Either way it's a problem.

Rachel: 6:42

Right, right. And isn't there something about iron recycling too? I feel like that came up in the research.

Mark: 6:47

Oh, yeah, for sure, and this is kind of a key thing to understand. Normally your body is pretty efficient at recycling iron from those old red blood cells to make new ones.

Rachel: 6:56

Okay.

Mark: 6:57

But here's the thing In anemia of chronic disease there's this type of immune cell, a macrophage, and it basically traps that recycled iron.

Rachel: 7:08

Oh, so it's like it's getting locked away somewhere, exactly.

Mark: 7:10

It's not readily available to make those fresh red blood cells. Oh, so it's like it's getting locked away somewhere. Exactly, it's not readily available to make those fresh red blood cells. And on top of that, anemia of chronic disease also affects how your cells actually process iron, like their whole metabolism is thrown off. It's complicated.

Rachel: 7:23

Yeah, it sounds like it, so that would explain why, when doctors do blood tests, sometimes the iron levels look low.

Mark: 7:29

Right.

Rachel: 7:29

Even if, like your overall, iron stores aren't actually depleted.

Mark: 7:32

Yeah, at least not at first. It's just that the iron is being held in these specific cells instead of being used to make those new red blood cells.

Rachel: 7:40

Okay, so it's kind of misleading then.

Mark: 7:42

In a way yeah.

Rachel: 7:43

Interesting. Okay, so how do doctors actually like figure out that someone has this? I mean, you mentioned blood tests. Yeah, that's usually the first step Run a bunch of blood tests to get a clear picture of what's going on with your red blood cells and your iron levels.

Mark: 8:00

Okay, so what are they looking for specifically? Well, there are a few key values. They'll definitely check your hemoglobin level. Hemoglobin that's what gives red blood cells their color and it's crucial for carrying that oxygen right normal range is usually around 12 to 17.4 grams per deciliter, but that can vary a bit, and if that number is low, they might also check your erythropoietin level. We call it EPO for short.

Rachel: 8:22

EPO. Okay, Remind me what's that again.

Mark: 8:24

EPO is a hormone that your kidneys make. It's basically the signal that tells your bone marrow hey, we need more red blood cells.

Rachel: 8:31

Oh, right, right, Okay, so they check hemoglobin, epo, what else?

Mark: 8:35

They'll also look at your serum iron level Serum is just the liquid part of your blood and this test measures well how much iron is actually floating around in it.

Nicolette: 8:43

Okay, okay.

Mark: 8:45

Normals usually between 60 and 170 micrograms per deciliter.

Rachel: 8:49

Gotcha.

Mark: 8:50

Then there's the reticulocyte count Reticulocytes, those are basically baby red blood cells. You know, the immature ones.

Rachel: 8:57

Okay.

Mark: 8:57

And if that counts low, it could mean your bone marrow is not pumping out new red blood cells fast enough.

Rachel: 9:02

So that's not a good sign.

Mark: 9:04

Not really.

Rachel: 9:05

Okay, what else do they look at?

Mark: 9:07

Oh, there's iron binding capacity too. This one's interesting. It tells us if there's too much or too little iron in your blood. Overall Normal range for adults is somewhere between 250 and 450 micrograms per deciliter.

Rachel: 9:19

Okay.

Mark: 9:19

And then, last but not least, they'll probably check your serum ferritin level. Ferritin, that's a protein that stores iron. So this test gives us a sense of, you know, your body's overall iron reserves, and those normal levels can vary a bit, anywhere from like 20 to 200 or even 500 nanograms per milliliter. You might even see slightly different ranges depending on which lab did the test.

Rachel: 9:41

Oh, okay, that makes sense. So a lot of numbers to keep track of.

Mark: 9:44

It is, it is, and sometimes you know, if they need even more information, they might do other tests, like a bone marrow biopsy.

Nicolette: 9:50

Oh, wow.

Mark: 9:50

Yeah, that lets them look directly at the iron stores in your bone marrow and the serum iron levels right there in the marrow itself.

Nicolette: 9:58

Okay.

Mark: 9:58

And if they see high iron stores but low serum iron in your blood, that can be a pretty strong sign of anemia, of chronic disease.

Rachel: 10:06

Okay, so we've got like what it is, how it's diagnosed. Now what about managing it, treating it?

Mark: 10:12

Right. So, like we touched on before, the big thing is treating that underlying disease, whatever's causing the anemia in the first place. Lots of times, if you can manage that root cause, the anemia will get better on its own, maybe even completely go away.

Rachel: 10:25

So it's not about treating the symptom, it's about treating the cause.

Mark: 10:28

Exactly Treat the cause and the symptom often takes care of itself. But and I'm sure your sources mentioned this too sometimes it's not that simple. Like if your anemia is tied to something like cancer or chronic kidney disease, then you might need other treatments specifically for the anemia.

Rachel: 10:46

Okay, that makes sense. So, alongside treating the underlying condition, are there other things they can do for the anemia itself?

Mark: 10:54

Oh yeah, there are a few things. Sometimes they'll do a blood transfusion. That's a quick fix, especially if it's severe, to boost those red blood cell numbers fast, right, but it's not a long-term solution. There could be side effects like too much iron building up or risk of infection.

Rachel: 11:09

Right, right Makes sense.

Mark: 11:10

Another option is synthetic EPO therapy. Remember EPO.

Rachel: 11:13

Yeah, the hormone that tells your body to make more red blood cells.

Mark: 11:17

Exactly, so they can give you a synthetic version of that to kickstart production, and sometimes they'll combine that with iron supplements. Oh, ok, just to make sure your body's got all the building blocks it needs to make those red blood cells.

Rachel: 11:29

Right, right, okay. So what about preventing it? Like, if someone's worried about developing this, what can they do?

Mark: 11:34

Well, that's a bit tricky Because, remember, it's tied to having a chronic illness in the first place. So you can't really prevent the anemia itself if you already have one of those conditions.

Rachel: 11:46

Okay, so it's not like there's a magic bullet, right you?

Mark: 11:47

already have one of those conditions, OK, so it's not like there's a magic bullet Right, but the general advice and I'm sure this was in your research too is just to focus on overall health, and a big part of that is diet.

Rachel: 11:57

Yeah, makes sense.

Mark: 11:58

Make sure you're getting enough lean protein, like chicken, turkey beans, things like that.

Rachel: 12:02

OK.

Mark: 12:03

And those dark leafy greens spinach, kale. Those are good too. Plus iron-fortified breads and cereals can help.

Rachel: 12:10

Right, right. And what about supplements like vitamin B12, folate, iron, all that?

Mark: 12:15

Yeah, those can definitely play a role, but and this is important you really should talk to your doctor before starting any supplement.

Rachel: 12:21

Okay.

Mark: 12:22

Because it really depends on your individual situation. You know what your underlying condition is. All that.

Rachel: 12:26

So it's not one size fits all.

Mark: 12:27

Nope, not at all.

Rachel: 12:28

Okay. So last thing, prognosis. What's the outlook for someone with anemia of chronic disease?

Mark: 12:35

Well, like we've said, the good news is that often, if you can manage that underlying chronic condition, the anemia often gets better too. Might even go away entirely.

Rachel: 12:45

That's good to hear.

Mark: 12:47

It is, and I know if you're already dealing with a long-term illness and now you've got this anemia on top of it, it can feel overwhelming, like another thing to worry about. Yeah for sure. But the good news is that most cases they're mild to moderate and those symptoms they often improve once you start treating that underlying illness.

Rachel: 13:04

Okay, that's reassuring.

Mark: 13:06

Yeah.

Rachel: 13:34

And once you've gone through treatment, it's a good idea to talk to your doctor about lifestyle changes, things you can do to maybe lower the risk of it coming back like diet tweaks the ones that involve a lot of inflammation and that inflammation. It messes with how your body uses iron and that ultimately affects how it makes healthy red blood cells. Exactly, and the biggest thing, like you said, is managing that underlying chronic condition.

Mark: 13:42

Absolutely. That's the most effective way to address the anemia.

Rachel: 13:45

Okay, this has been super helpful. I feel like I understand this so much better now.

Mark: 13:49

Glad to hear it.

Rachel: 13:50

But it also makes you think right, Like, if inflammation plays such a huge role in this type of anemia, what other health issues are being affected by inflammation that we might not even realize? It really shows you how interconnected everything in the body is.

Mark: 14:04

It really does.

Rachel: 14:05

Wow, okay. Well, that's a lot to think about. Thanks so much for breaking it all down.

Mark: 14:09

You're very welcome.

Rachel: 14:10

And to everyone listening, thanks for joining us for another deep dive. Until next time.

Nicolette: 14:19

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