Anaemia of Chronic Disease

Haemoglobin is a protein which allows red blood cells to deliver oxygen from the lungs to other parts of the body. Anaemia is the shortage of either red blood cells or haemoglobin, causing an inadequate level of oxygen in the blood.

Anaemia of chronic disease (abbreviated to ACD) occurs when this condition is associated with, and caused by, a pre-existing chronic disease.

It is the most commonly-diagnosed form of anaemia among hospitalized patients.

Causes

In ACD, an underlying chronic illness alters the body’s chemical balance.

The production of red blood cells is subsequently disrupted. This gives rise to the symptoms associated with ACD.

Symptoms and diagnosis

Relative to other forms of anaemia, ACD develops slowly, and tends to be quite mild. As such, it produces few to no symptoms, with the underlying chronic condition being more symptomatic.

Although anaemia can be indicated by abnormally low levels of red blood cells and haemoglobin, there is no test to distinguish ACD from other forms of anaemia.

Treatment

Many patients regard the anaemia as simply another effect of their chronic disease, along with other symptoms and aspects of the illness.

The most appropriate method of treatment for ACD is therefore to address this underlying illness.

In severe cases, blood transfusions may be necessary.

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Vitamin B Complex [1, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19]:

Please note, this management does NOT treat the condition itself. It may mildly help in preventing some of the symptoms, and even then has insufficient evidence to back up this claim at present. Please note, this acts as a PREVENTATIVE treatment, and not necessarily symptomatic relief. Supplements should only be taken if they contain no more than 100% of the recommended daily value

Recommendation: Strongly in favor (Vitamin B may help in preventing anaemia due to its role in the production of red blood cells)

Grade of Evidence: High quality of evidence

Molybdenum (Mo, Sodium Molybdate) [1, 5, 6, 7, 8, 9]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (There is insufficient evidence to support claims that Molybdenum has any affect on the treatment of anaemia)

Grade of Evidence: very low quality of evidence

Chlorella (Green Algae, Chlorella Pyrenoidosa) [1, 2, 3, 4]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (There is insufficient evidence to support claims that Chlorella helps to treat anemia in any way)

Grade of Evidence: Very low quality of evidence

Ayurvedic Medicine (Ayuveda):

Recomendation: No recommendation (there is insufficient evidence to show that Ayurveda in any way contributes to treating Anemia of Chronic Disease)

Grade of Evidence: Very low quality of evidence

Vitamin C [20, 21, 22]:

Recomendation: No recommendation (There is insufficient evidence to support claims that vitamin c is able to treat anaemia. Although there is evidence that vitamin C enhances the absorption of iron, the efficacy in reducing anaemia/iron deficiency is not clear)

Grade of Evidence: Very low quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. Nakano, S et al. “Maternal-fetal distribution and transfer of dioxins in pregnant women in Japan, and attempts to reduce maternal transfer with Chlorella (Chlorella pyrenoidosa) supplements...” Chemosphere 2005 Dec; 61(9): 1244–55.

3. http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=retrieve&db=pubmed&list_uids=11347287&dopt=Abstract

4. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/chlorella

5. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/molybdenum

6. http://lpi.oregonstate.edu/infocenter/minerals/molybdenum/

7. Hassouneh B, Islam M, Nagel T, Pan Q, Merajver SD, Teknos TN. Tetrathiomolybdate promotes tumor necrosis and prevents distant metastases by suppressing angiogenesis in head and neck cancer. Mol Cancer Ther. 2007;6:1039-1045.

8. Cassileth B. The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies. New York, NY: W.W. Norton; 1998.

9. Nakadaira H, Endoh K, Yamamoto M, Katoh K. Distribution of selenium and molybdenum and cancer mortality in Niigata, Japan. Arch Environ Health. 1995;50:374-380.

10. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/vitamin-b-complex

11. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-folate.html

12. Butterworth RF. Thiamin. In: Shils ME, Shike M, Ross AC, Caballero B, Cousins RJ, editors. Modern Nutrition in Health and Disease, 10th ed. Baltimore: Lippincott Williams & Wilkins; 2006.

13. http://www.ncbi.nlm.nih.gov/pubmed/18220605

14. http://news.bbc.co.uk/2/hi/health/6935482.stm

15. http://www.ncbi.nlm.nih.gov/pubmed/19061687

16. Gropper, S. S, Smith, J. L., Groff, J. L. (2009). Advanced nutrition and human metabolism. Belmont, CA: Wadsworth, Cengage learning.

17. Otten, J. J., Hellwig, J. P., Meyers, L. D. (2008). Dietary reference intakes: The essential guide to nutrient requirements. Washington, DC: The National Academies Press

18. http://recipes.howstuffworks.com/vitamin-b1.htm

19. Higdon, Jane (2003). "Biotin". An evidence-based approach to vitamins and minerals. Thieme. ISBN 9781588901248.

20. http://www.ncbi.nlm.nih.gov/pubmed/10948381

21. http://www.nhlbi.nih.gov/health/health-topics/topics/anemia/treatment

22. http://www.mayoclinic.org/diseases-conditions/vitamin-deficiency-anemia/basics/definition/con-20019550