In this blog, we'll discuss fatigue related to aging and chronic disease. These are common types of anemia associated with aging but let's dig deeper to understand the causes and what you can do about fatigue related to a diagnosis of anemia of aging or anemia of chronic disease.

The terms "anemia of aging" and "anemia of chronic disease" are related but not entirely synonymous. Both types of anemia share some common characteristics, but they can have different underlying causes and contributing factors.

Anemia of Aging

"Anemia of aging," also known as anemia of the elderly, is a type of anemia that is commonly observed in older adults as they age. It is characterized by a decrease in the number of red blood cells and/or a reduction in hemoglobin levels in the blood.

Over the last few weeks, I've discussed Iron Deficiency Anemia, B12 and Folic Acid Anemia, and generalized Vitamin and Mineral Deficiency Anemia.

As a review, anemia is a medical condition characterized by a reduction in the number of red blood cells (RBCs) or a decrease in the amount of hemoglobin in the blood. Anemia results in a reduced capacity of the blood to carry oxygen, which can lead to a variety of symptoms and health problems.

Symptoms of Anemia of the Aging

Anemia of aging, like other forms of anemia, can present a range of symptoms. It's important to note that anemia of aging often has a gradual onset, and some people may adapt to the symptoms over time, attributing them to the aging process itself. However, recognizing and addressing anemia is essential for maintaining an older person's overall well-being and quality of life.

1.     Fatigue: Persistent and excessive tiredness is a hallmark symptom of anemia of aging. Individuals may feel drained and lack energy for even simple daily tasks.

2.     Weakness: Anemic individuals often experience generalized weakness, making it challenging to engage in physical activities and maintain muscle strength.

3.     Pale Skin: Anemia can lead to a paleness of the skin and mucous membranes. This paleness is a result of reduced oxygen-carrying capacity in the blood.

4.     Shortness of Breath: Anemia can cause a decreased oxygen supply to body tissues, leading to shortness of breath during physical exertion or even at rest.

5.     Dizziness and Lightheadedness: Anemic individuals may feel dizzy or lightheaded, particularly when standing up quickly. This can be due to reduced blood flow to the brain.

6.     Cold Hands and Feet: Poor circulation related to anemia can result in cold extremities.

7.     Cognitive Impairments: Anemia can affect cognitive function, leading to difficulties in concentration, memory, and overall mental sharpness.

8.     Irritability: Anemic individuals may experience mood changes, such as increased irritability or difficulty coping with stress.

9.     Heart Palpitations: Anemia can lead to a faster heart rate, which may manifest as heart palpitations or an irregular heartbeat.

10. Reduced Exercise Tolerance: Individuals with anemia may find it challenging to engage in physical activities and may tire quickly during exercise.

Onset of Anemia of Aging Symptoms

The age at which the symptoms of anemia of aging may begin can vary from person to person. While some individuals may start experiencing symptoms in their 60s or even earlier, others may not notice significant symptoms until they are in their 70s or 80s.

Causes of Anemia of the Aging

Two important considerations are overall health and well-being as well as nutritional status. These factors play a crucial role in determining when the symptoms of anemia of aging might become noticeable.

1.     Overall, Health: An individual's overall health and the presence of chronic conditions can affect when anemia symptoms become noticeable. Those with multiple chronic diseases may experience symptoms earlier.

2.     Nutritional Status, Lifestyle, and Activity Levels: Lifestyle choices and a decline in eating nutritiously can influence the age at which anemia-related symptoms are recognized. Maintaining a well-balanced and nutritious diet, rich in essential nutrients, is vital to support optimal blood cell production and may delay the onset of anemia in older individuals.

The extent to which an individual remains physically active and engaged in daily activities can influence when anemia symptoms are recognized. Proactive health monitoring is an essential component of promoting healthy aging and addressing anemia-related concerns promptly.

Other causes such as genetics and lack of quality healthcare can impact the early detection of anemia.

7 Functional Nutritional Treatments for Anemia of Aging

Functional nutrition approaches to address and prevent anemia of aging involve maintaining overall health and implementing dietary strategies that support red blood cell production and nutrient absorption.

Care should be taken to keenly evaluate for nutritional deficiency of the following vitamins and minerals:

1.     Iron-rich foods: Iron is a key component for hemoglobin production. Include iron-rich foods in your diet, such as lean red meat, poultry, seafood, beans, lentils, fortified cereals, and dark leafy greens.

2.     Vitamin B12 and Folate: Ensure you have an adequate intake of vitamin B12 and folate. These nutrients are vital for red blood cell formation. Animal products like meat, fish, and dairy are good sources of vitamin B12. Folate is found in leafy greens, citrus fruits, and fortified cereals.

3.     Vitamin C-Rich Foods: Vitamin C enhances iron absorption. Include foods like citrus fruits, strawberries, bell peppers, and broccoli in your diet to improve iron utilization.

4.     Protein: Protein is essential for overall health and supports the production of hemoglobin. Include sources of high-quality protein like lean meats, poultry, fish, eggs, and plant-based proteins like legumes and tofu.

5.     Antioxidant-Rich Foods: Antioxidants like vitamins A, C, and E can help protect red blood cells from oxidative damage. Include fruits and vegetables rich in these antioxidants in your diet.

6.     Hydration: Staying well-hydrated supports overall health and helps maintain the proper viscosity of blood, making it easier for red blood cells to circulate.

7.     Limit Inflammatory Foods: Chronic inflammation can contribute to anemia of aging. Minimize your intake of processed and inflammatory foods and focus on a diet that reduces inflammation.

It's important to tailor your dietary and lifestyle choices to your individual needs and consult with a functional nutritionist who provides personalized guidance for managing and preventing anemia of aging through functional nutritional approaches.

Testing and Diagnosis of Anemia of Aging

Testing and diagnosing anemia of aging typically involves a series of blood tests to determine the underlying causes and contributing factors. These may include vitamin and mineral deficiencies listed above but may also include a deeper understanding of the nutritional needs of the bone marrow where red blood cells are produced.

The following tests are commonly used in the diagnostic process:

1.     Complete Blood Count (CBC): A CBC is a standard blood test that provides information about various components of the blood, including the number of red blood cells, their size, and the amount of hemoglobin present. Anemia of aging often results in a decrease in red blood cell count and lower hemoglobin levels, which can be detected through a CBC.

2.     Serum Iron Studies: These tests measure the levels of iron in the blood and help assess iron status. Anemia of aging may be associated with low serum iron levels.

3.     Ferritin Test: Ferritin is a protein that stores iron in the body. Low ferritin levels can indicate iron deficiency, a common contributing factor in anemia of aging.

4.     Vitamin B12 and Folate Tests: Blood tests for vitamin B12 and folate levels help identify deficiencies in these nutrients, which can lead to anemia. Low levels of these vitamins may necessitate supplementation.

5.     Inflammatory Markers: In some cases, assessing markers of inflammation, such as C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), can help identify underlying chronic inflammation associated with anemia of aging.

6.     Renal Function Tests: Since the kidneys play a role in regulating erythropoietin, a hormone involved in red blood cell production, tests of renal function may be performed to assess kidney health.

7.     Nutritional Deficiency Testing: General B-vitamin deficiency comes to mind, especially if someone has lived a stressful life, has digestive and assimilation issues or does not eat fruit and vegetables.

Anemia of Chronic Disease (ACD)

Anemia of Chronic Disease, also known as anemia of inflammation, is a type of anemia that occurs as a secondary condition to chronic illnesses, such as inflammatory disorders, autoimmune diseases, chronic infections, and certain cancers. It is characterized by a decrease in red blood cell count and a lower concentration of hemoglobin in the blood. The defining feature of ACD is that it develops in response to chronic inflammation or underlying medical conditions.

4 Key Differences Between Anemia of Aging and Anemia of Chronic Disease

1.     Underlying Causes:

o   Anemia of Aging: This type of anemia is associated with age-related changes in the body, such as alterations in bone marrow function and changes in nutrient absorption.

Anemia of Chronic Disease: ACD is secondary to chronic illnesses or inflammatory conditions. It develops in response to the body's immune response to ongoing diseases or infections.

2.     Age of Onset:

o   Anemia of Aging: Anemia of aging is specifically related to older adults and the aging process, typically becoming more common as individuals advance in age.

o   Anemia of Chronic Disease: ACD can affect individuals of all ages and is not limited to the elderly. It occurs when chronic diseases or inflammatory conditions are present.

3.     Associated Symptoms:

o   Anemia of Aging: Symptoms of anemia of aging include fatigue, weakness, pale skin, and cognitive impairments. These symptoms may be attributed to the aging process itself.

o   Anemia of Chronic Disease: ACD is characterized by symptoms of anemia, but it often coexists with the symptoms and manifestations of the underlying chronic disease, such as joint pain in rheumatoid arthritis or fever in chronic infections.

4.     Primary Focus of Treatment:

·        Anemia of Aging: Treatment for anemia of aging primarily focuses on addressing nutritional deficiencies, optimizing nutrient intake, and promoting overall health in older adults.

·        Anemia of Chronic Disease: The primary treatment approach for ACD involves managing and treating the underlying chronic disease or inflammatory condition, which may include anti-inflammatory medications, disease-specific treatments, and symptom management.

Symptoms of Anemia of Chronic Disease

Anemia of Chronic Disease (ACD), also known as anemia of inflammation, presents with symptoms that are similar to other types of anemia, (fatigue, pallor, shortness of breath) but it is associated with underlying chronic illnesses or inflammatory conditions.

Causes of Anemia of Chronic Disease

Anemia of Chronic Disease (ACD) is caused by the chronic inflammation associated with various medical conditions and diseases. The inflammation can interfere with the normal production and lifespan of red blood cells.

With Anemia of Chronic Disease thought must be given to finding the cause of the inflammation and can include food sensitivity, underlying infections, known as silent infections and these conditions:

1.     Inflammatory Diseases: Chronic inflammatory diseases are significant triggers of ACD. Conditions such as rheumatoid arthritis, systemic lupus erythematosus, and inflammatory bowel diseases (e.g., Crohn's disease and ulcerative colitis) are examples.

2.     Chronic Infections: Persistent infections, such as tuberculosis, HIV/AIDS, and certain bacterial or viral infections, can induce chronic inflammation.

3.     Cancer: Some malignancies, particularly those associated with the release of inflammatory cytokines.

4.     Autoimmune Disorders: Autoimmune diseases like systemic lupus erythematosus, multiple sclerosis, and type 1 diabetes can lead to ACD as the immune system mistakenly targets healthy tissues, resulting in inflammation.

5.     Chronic Kidney Disease: Individuals with chronic kidney disease often experience ACD due to changes in erythropoietin production and renal anemia.

6.     Chronic Respiratory Diseases: Chronic obstructive pulmonary disease (COPD) and asthma, characterized by persistent inflammation, can lead to ACD.

7.     Inflammatory Liver Diseases: Liver diseases with chronic inflammation, such as non-alcoholic fatty liver disease (NAFLD) or hepatitis

8.     Other Chronic Inflammatory Conditions: Conditions like systemic infections, sepsis, and chronic wounds can also induce inflammation and subsequently lead to ACD.

In these medical conditions, the inflammatory response activates the release of inflammatory signaling molecules, which affect the body's normal regulation of red blood cell production. Chronic inflammation can suppress the bone marrow, leading to lower red blood cell production, more immature red cells released into the bloodstream, or a breakdown of red blood cells in the spleen. This is the process that can result in anemia. It's essential to identify and manage the underlying chronic disease or inflammation.

In Conclusion

In conclusion, Anemia of Aging and Anemia and Anemia of Chronic Disease reveals two distinct types of anemia, each with its unique characteristics, causes, and management approaches:

Anemia of Aging:

·        Related to decreased nutrient absorption, and nutritional deficiencies.

·        Often attributed to changes in bone marrow function.

·        Treatment primarily involves addressing nutrient deficiencies and optimizing overall health in older individuals.

Anemia of Chronic Disease (ACD):

·        Develop in response to chronic inflammatory diseases, autoimmune disorders, chronic infections, and certain cancers.

·        Associated with chronic inflammation, which interferes with red blood cell production and lifespan.

·        Treatment focuses on identifying and eliminating the underlying chronic inflammation responsible for ACD, often involving anti-inflammatory measures and disease-specific interventions.

Recognizing the key differences between these two types of anemia is crucial for accurate diagnosis and effective management. Anemia of Aging primarily affects older adults due to poor nutrition, depression, social isolation, and lifestyle-related factors, while ACD is a secondary anemia related to chronic diseases and inflammation. Early intervention and individualized care can help mitigate the impact of anemia on health and vitality.