CAUSES
1.Nutritional anaemia: It is the most common type which is due to a deficiency of iron, folic acid, vitamin B 12, vitamin C are vitamin B6 (pyridoxine) in the diet.
2. Anaemia due to blood loss or excessive destruction of red blood cells.

• Injuries
• Hookworm infestation
• Excessive bleeding during menstruation
• Ulcers
• Piles
• Thalassaemia and
• Sickle cell Anaemia (genetic conditions).

3. Anaemia due to failure of bone marrow to produce red blood cells. This may be caused by drugs such as, chloramphenicol and anti-cancer drugs.
4. Anaemia is also seen in chronic conditions: Such as –

• Kidney diseases
• Rheumatoid arthritis
• Chronic infections
• Cancer

SIGNS AND SYMPTOMS
1. Headache
2. Dizziness
3. Fatigue
4. Breathlessness
5. Palpitation
6. Chest pain
7. Pallor in the inner surface of the lower eyelids, tongue and nail beds
8. Increased heart rate
9. Swelling of the ankles and feet
10. Swelling of the whole body (occasionally)
11. Changes in the appearance of the nails (Koilonychias- Spoon shaped nails)

DIAGNOSTIC TESTS
Blood test for haemoglobin is to be done. Depending upon Hb the treatment is given.

TREATMENT
1. Food
Iron is better observed from animal foods than vegetarian foods. Green leafy vegetables, cereals, egg yolk, meat and fish, milk and milk products are good sources of iron and folic acid.
Vitamin B12 is formed by micro-organisms in the soil, water and intestines of animals. (It is not present in plants). Meat, liver, fish, egg yolk, milk and milk products are good sources of vitamin B 12.
2. Drugs
Ferrous sulphate and Folic acid containing preparations (drugs) are used for treating anaemia. These drugs to be given for some more months after the Anaemia are corrected, So as to replenish the body stores of iron. So treatment should be continued for 3 to 4 months. In pregnancy, women should receive iron and folic acid from the fourth month onwards and continued during lactation period at least for the first six months.

Iron preparations are available in the form of tablets, capsules, syrups, and injections. Iron by injection is required only in cases where iron taken orally is not tolerated or cannot be observed.
The usual symptoms are:
1. Nausea
2. Vomiting
3. Diarrhoea
4. Constipation
5. Discomfort in the abdomen.
Vitamin C present in the fruits (amla, guavas, oranges and lemons), increases the absorption of iron, when taken with it.

Foods rich in iron (mg)
Cauliflower leaves, Arakeerai, Sirukeerai, Sundakai dry, Crab muscle, Mauthakkali keerai, Rice flakes, Radish leaves, Mint, Ponnaganni leaves, Bengalgram roasted, Bajra, Liver sheep, Plantain green.