Anaemia: Different Types
NATIONAL JOURNAL OF HOMOEOPATHY 2001 Jul / Aug VOL III NO 4.
Compiled by
Dr Alka Rajpuria
'Calc-ph / Ferr-ph / Kali-mur / Kali-ph / Nat-m / Nat-ph / Nat-s / Sil / Alumina / Arg-met / Calc-c / Calc-ars / Manganum-acet / Graph / Lact-ac / Kali-c / Phos / Hydrastis / Cycl / Helonius / Pic-ac / Sep / Sec-cor / Alet / Sulp-ac / Zinc
Anaemia represents a clinical syndrome of an inadequate number of circulating red blood cells and an insufficient amount of hemoglobin to deliver oxygen to tissues, resulting in pallor, fatigue, shortness of breath and predisposition to cardiac complications. Various types of Anaemia and their manifestations are discussed below.
Iron Deficiency Anaemia
Hemolytic Anaemia
Aplastic Anaemia:
A reduction in the number of circulating RBCs resulting from bone marrow failure, generally accompanied by agranulocytosis and/ or thrombocytopenia.
Causes and Incidence: Etiology is unknown in half the cases; other half being induced by chemicals, drugs, viruses or radiation. It has a low incidence in population.
Disease Process: Exposure to known or unknown toxins depresses production of erythrocytes, platelets and granulocytes in the bone marrow. Common toxins include ionizing radiation, chemical agents (eg Benzene, DDT, carbon tetrachloride), and drugs (eg anti-tumor or anti-microbial agents).
Symptoms: Onset usually insidious, occurring weeks or months after exposure to toxin. Fatigue, weakness, dyspnoea and waxy pallor of the skin and mucous membranes are characteristics. Thrombocytopenia causes hemorrhages into mucous membranes, skin and optic fundi. Agranulocytosis leads to severe infection.
Potential Complications: Chronic anaemia leads to increasing hemorrhage and repeated infections, which result in death in about half of those diagnosed.
Diagnostic Tests:
Complete blood count (CBC)
Decreased RBCs (normochromic, normocytic), WBCs, and hemoglobin (Hb)
Platelet count
Decreased
Bone marrow biopsy
Hypocellular / hypoplastic; fatty, fibrous tissue
Reticulocyte count
Marked decreased
General: Removal of causative agent; bone marrow transplant if possible, blood transfusions; hemorrhage precautions.
Pernicious Anaemia A chronic, progressive anaemia characterized by the production of megaloblasts, which are enlarged red blood cells with an immature nucleus.
Causes and Incidence: Pernicious anaemia usually is caused by deficiency in or underutilization of vitamin B12.
Disease Process: The gastric mucosa develops a defect by unknown factor and atrophies. This inhibits the secretion of intrinsic factor (IF), which binds and transports dietary vitamin B12 to the ileum for absorption. The lack of IF prevents vitamin B12 from entering the body, and exiting stores of the vitamin are depleted, leading to the production of enlarged, immature RBCs.
Symptoms: Usual signs and symptoms associated with anaemia (pallor, fatigue, weakness, dyspnoea) plus symptoms that stem from the physiology changes in the gastrointestinal tract (eg glossitis, gingivitis, indigestion, epigastric pain, loss of appetite, diarrhoea, constipation, weight loss). Peripheral neurologic changes occur, with paresthesia in the hands and feet.
Potential complications: If the condition goes untreated, the neurologic changes become more profound, with involvement of the spinal cord and loss of vibratory sense, ataxia, spasticity, and disturbances in bowels and bladder function. Depression, paranoia and delirium may follow. Splenomegaly and hepatomegaly occur, as well as organ failure, neurologic degeneration, or infection, eventually causing death.
Diagnostic Tests: Peripheral blood smear - Oval macrocytes, hypersegmented neutrophils, enlarged platelets
Schilling test - Radioactive - tagged vitamin B12 is not excreted in urine.
Complete blood count - Decreased Hb, leukocytes, erythrocytes, and thrombocytes
Bone marrow aspirations - Hyperplasia; increased large-cell megaloblasts
Gastric analysis - Lack of free hydrochloric acid
General: Treatment of underlying cause of gastric atrophy, if possible; oxygen to increase arterial levels; oral hygiene; orientation if confused; safety precautions for neurologic effects; instructions about vitamin B12 replacement as a life change.
Post-Haemorrhagic Anaemia
An anaemia characterized by a decrease in hemoglobin in the blood, related to rapid, massive hemorrhage.
Causes and Incidences: Rapid blood loss may be caused by traumatic rupture or incision or erosion of a large blood vessel (ulcer, tumor). The prognosis depends on the rate and the site of the bleeding and the total blood loss.
Disease Process: With blood loss, blood volume diminishes, hemodilution occurs and oxygenation of the tissues declines.
Symptoms: The rate of blood loss determines the signs and symptoms, which may include dizziness, faintness, weakness, pallor, thirst, sweating, rapid, weak pulse, rapid respiration, and orthostatic hypotension.
Potential complication: Lack of prompt treatment or failure to control the bleeding results in shock, coma, and death.
Diagnostic Tests: CBC- RBCs, Hb and Hematocrit are deceptively high during initial period of hemorrhage because of vasoconstriction; values begin to decline within hours of the onset of bleeding if hemorrhage is not controlled.
Peripheral smear - Normocytic cells, agranulocytosis
Coagulation time - Reduced
General - Elimination of causative agent, erthrocytopheresis (RBC exchange), transfusion, oxygen therapy for hypoxemia, fluid and electrolyte management.
Homoeopathic Remedies:
Calcarea-Phosphorica
This remedy acts by supplying new blood-cells.
Pains and cramps dependent on anaemic conditions.
Waxy appearance of the skin due to anaemia.
Chlorosis, complexion waxy, greenish-white, with constant headache and ringing in ears.
Schussler gives this remedy alone for chlorosis.
"A fine constitutional remedy in old cases of cerebral anaemia where nutrition is manifestly defective." (Arndt)
"Pernicious anaemia, vertigo when getting up or on rising from sitting, eyes misty, epistaxis, point of the nose cold, pale face, sallow, yellowish, earthy, cold sweat on the face, body cold, foul taste and smell, tongue white, furred at the root most in the morning, nausea and vomit nutrition, empty, sinking sensation at the Epigastrium, watery looseness of the bowels, with urging after stools day and night, urine with flocculent sediment, menorrhagia, blood either bright-red or too dark, palpitation with anxiety, followed by trembling weakness, particularly of the calves, weariness and the greatest weakness." (Arndt)
This remedy is also useful in leukemia, or excess of white corpuscles in the blood after exhaustive disease.
Ferrum-Phosphoricum
Follows Calcarea-phos as soon as improvement of the general health sets in.
There is a want of red blood in the system.
This remedy, by its power of attracting oxygen, colors the new blood-cells and enriches them after they have been supplied by Calcarea-phos
Schussler in a letter says:
"Iron, which enters into the formation of young blood-cells, is never absent in the blood stream of the chlorotics".
Therefore I have lately abandoned iron, which I recommended in the first editions of my Therapeutics for chlorosis and other anemic conditions.
Kalium-Muriaticum:
This remedy may have to be given in anaemia, as a secondary remedy or intercurrent, if such symptoms as eczema or eruptions of the skin coexist.
Kalium-Phosphoricum
Cerebral anaemia, anemic conditions of the brain causing undue nervousness.
Poverty of the blood from influences which continually depress the mind and the nervous system
This remedy also cures the leukemia, which is induced by long continued disorders.
"Spinal anaemia, from exhausting diseases, such as diphtheria, reflex paraplegia, with aching pains aggravated by rest, but most manifest on the beginning to move about." (Arndt)
Natrium-Muriaticum
In anemic conditions, where the blood is thin and watery; in chlorotic conditions, with an almost habitual feeling of coldness in the back; chlorosis in young girls, with dead, dirty skin, frequent palpitation, oppression and anxiety in the chest, morning cough, easily fatigued and prostrated, with the characteristic tongue, etc; malarious cachexia, from ague and Quinine, sallow complexion or very pale, pressure and distension of the stomach, constipation with contraction of the anus, terrible sadness.
Natrium-Phosphoricum
Spinal anaemia, paralytic weakness of the lower extremities, with the general prostration, heaviness and sensation of fatigue, especially after a short walk or ascending steps; legs give way, so as to be unable to progress further.
Natrium-Sulphuricum
Hydranaemia, sycosis, hydrogenoid constitution of the body, depending upon dampness of the weather or dwelling in damp houses; sycosis and hydranaemia. (Lilienthal)
Silicea
Leucorrhoea instead of menses; attack of momentary blindness or obscuration of vision. Anaemia in infants, thin, delicate and puny, with tendency to rickets.
Alumina
Cold, chilly girls with inactive rectum and bladder; anaemic at puberty with pale, scanty menses and profuse leucorrhoea; marked debility.
Sadness in the morning on awaking.
Argentum-Met
Shares with the Nitricum in chlorosis.
Body shriveled, complexion sallow, dyspnoea, palpitation, prolapsus, ulercation and induration of the uterus; foul leucorrhoea.
Arsenicum-Album
A direct poison to the red corpuscles - useful in anaemias of malarial or toxic origin. Pernicious Anaemia; prostration with emaciation, oedema, anasarca, engrafted upon the well-known generalities of Arsenicum.
Calcarea-Carbonica
Anaemia of girls; diminished haemoglobin and red blood corpuscles, increased leucocytes- Chlorosis. Psoric, scorfulous, tuberculous diathesis and general symtoms of the drug.
Sad and apprehensive.
Rush of blood to the head and vertigo, on excitement, on hearing bad news, sufferings of others. Cold feet, dry cough at night, partial sweat, soreness of chest beneath right clavicles. Menses too profuse, too soon.
Calcarea-Arsenicum
A careful study of this remedy is worthwhile in anaemia and chlorosis, with the mind upon Calcarea and Arsenicum. Fleshy women at climacteric, palpitation from the slightest emotion, chilliness; haemoglobin and red-corpuscles low.
China Officinalis
Anaemia from loss of vital fluids. Women who do not make blood after haemorrhages and develop a gradually increasing anaemia with feeble circulation and Dropsy, directly following loss of blood.
Manganum-Act
Chlorosis, even Pernicious Anaemia with no history of haemorrhages but long period of scanty menses.
Headaches, irritability, sad and silent weeping mood; prefers to lie down and great relief there from.
Chininum-Arsenicum
Constantly increasing Anaemia from prolonged suppuration and haemorrhaages. Pernicious Anaemia.
Aceticum-Acidum
Anaemia from prolonged morning sickness; waxy skin, thirst.
Ferrum-Metallicum
False plethora with abnormal paleness of all mucous membranes; pale face flushing up red on emotion.
Pulsating headache; throbbing all over body; palpitation.
Anaemic murmur in the veins of the neck; chilly with hectic flush in the evening and oedema of the extremities; though weak yet relieved by moving slowly about, exhausted easily.
Complementary to Alumina in Chlorosis and to China in Anaemia from loss of blood.
Graphites
Anaemic though obese; cold, constipated; rough, herpetic skin; cracks and fissures; late, scanty, pale, watery menses: low-spirited and chilly, indoors or outdoors.
Complements Ferrum, having many symptoms in common.
Lacticum- Acidum
Anaemia with diabetes; nausea after eating; canker sores in mouth; salivation; polyuria.
Kalium-Carbonicum
Anemia with chilliness, cannot go out without becoming chilly and cold; vertigo, humming in ears, weak heart, sweat, and backache, especially with female complaints and well known modality and characteristics of Kali-carb.
Often complements Nat-mur.
Phosphorus
Anaemia in deep-seated chronic diseases in tall, slender, narrow-chested, Phthisical patients; easily catching cold; menses too early, too copious, bright red.
Chronic loose stool; great thirst for cold, refreshing drinks. Jaundice .
Ferrum-phos and Calc-phos sometimes outclass their components.
Hydrastis
Anaemia from deep-seated zymotic diseases, as cancer, etc, with faintness, prostration, atony, emaciation; yellowish-white skin.
Pulsatilla:
Chlorosis or Anaemic; after Quinine or Iron tonics; yet better in open air; fleshy and pale with late, scanty, dark and painful protracted menstruation; sad crying easily, seeks consolation; short breath, anxiety, palpitation; pain under clavicles of either or both sides; absences of thirst, weak digestion, Diarrhea.
Cyclmen-Eurapaeum
Similar to Pulsatilla, but more or less thirsty and dreads open air; physical langour in the morning.
Scarcely fit to go through the day's work, but goes on tolerably well.
Helonias-Dioica
Chlorosis or Anaemia from prolonged hemorrhages in those enervated by luxury or worn out with hard work; sleeplessness and melancholia; tired, weak, backache, females, better when attention is engaged or when doing something.
Picricum- Acidum
Extreme prostration in Pernicious Anaemia; burning pain along with the spine, worse from excitement.
Sepia-Officinalis
Similar to Pulsatilla, but differs in mental symptoms.
Sepia is irritable, often vehement; averse to household duties.
Secale-Cornutum
Progressive General Anaemia with cachexia; pale, bloodless, jaundiced; body cool but worse from warmth.
Aletris-farinosa
Tired all the time like Helonias with anaemia and relaxation etc; of female organism. "The China of the uterine organs".
Sulphuricum-Acidum
Often arouses up action of other remedies; flushes of heat; vertex; cold feet; burning of the soles; oppressions of the chest at night- must open window; weak, sinking feeling in the epigastrium at fore-noon.
Zincum-Metallicum
Too anaemic to develop an exanthema or menses; progressive general emaciation, burning along spine, twitching of muscles, general trembling; jerking of body during sleep; aggravated by wine or stimulants.
Anaemia From exhausting diseases, discharges, or hemorrhages, chi. 3, 4h.
For Simple iron deficiency anaemias, there are many excellent iron preparations:
- Ferrum 6. OD for I week, followed by Ferrum 12 OD for 1 week followed by Ferrum 30 for 1 week will produce a rapid rise in hemoglobin.(NB: If iron does good at all, it does it rapidly and it should be stopped as the improvements ceases. If there is no improvement at first, it should never be continued.)
- Nat-mur 6: with constipation, palpitation on lying low down, earthly complexion, Nat mur 6, 6h.
- Constipation very obstinate, Plumbum-acet 3, gr.ii. 8h.
- With much sickness, inability to retain any food, Petrol 3, 4h
- Especially in splenic anaemia, Rub-t, gtt x 8h
- In patients who have been heavily dosed with tonics, Puls3, 4h
- Anaemia, resulting from accidental stoppage of the menses, Puls 3 4h.
- Anaemia with excessive menstrual loss, the period coming on before its normal time, Calc-c 6, 4h.
- With marked disposition to bodily or mental exertion, and great increase of urates and phosphates in the urine, Picr-ac 3, gr ii. 8h.
- In pale, flabby children, with tendency to enlarged tonsils, Calc-phos 3, gr.v.8h.
- Chlorosis (green sickness), with mental depression, irritability, debility and increase of phosphates in urine, Helonias - 3, 4h.
- Anaemia in infants, thin and puny, with tendency to rickets, Silica 6, 8h.
- Anaemia with vomiting, acute epigastric pain and tenderness, palpitation and fainting, Arg-n 6, 1h.
Sources:
API, Farrington, Kitchulu, Comparisons in Matria Medica with Therapeutic Hints, E A Farrington.
