Constant fatigue could be a sign of anaemia

Donatile Uyisenga is a 33-year-old mother of two and lives in Kibagabaga, a Kigali suburb. In a period of three months she developed a cocktail of symptoms ranging from shortness of breath, a fast heartbeat, dizziness, weakness and a headache, among others.

Donatile Uyisenga is a 33-year-old mother of two and lives in Kibagabaga, a Kigali suburb. In a period of three months she developed a cocktail of symptoms ranging from shortness of breath, a fast heartbeat, dizziness, weakness and a headache, among others.

She went to a nearby health facility and tested for the usual suspects; malaria, typhoid, HIV, and Brucellosis, but nothing turned positive. She left suspecting that her condition may just be a result of stress from work. Uyisenga reported back to the health facility two months later, and she was found to have anaemia, after a more comprehensive medical examination.

What is Anaemia?

Anaemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin.

Hemoglobin is a main part of red blood cells and binds oxygen. If you have too few or abnormal red blood cells, or your hemoglobin is abnormal or low, the cells in your body will not get enough oxygen.


According to Jado Maniraguha, a physician with MedPlus Clinic, certain forms of anaemia are hereditary and infants may be affected from birth.

He points out that women in the childbearing years are particularly susceptible to iron-deficiency anaemia because of the blood loss from menstruation and the increased blood supply demands during pregnancy.

Medics also say that the elderly have a greater risk of developing anaemia because of poor diet and other medical conditions.

Initially, iron deficiency anaemia can be mild and can go undiagnosed until the symptoms intensify, says Dr. Cory Couillard, who works in collaboration with WHO’s goals of disease prevention and control.

Other signs and symptoms of anaemia include cold extremities, pale skin and eyes, hairy or shiny tongue, dry brittle hair and discoloration of nails. Chronic long standing anaemia puts a burden on the heart as it has to pump more vigorously to supply oxygen to all body cells. Therefore heart failure can set in after some years.


Alfred Gatabarwa, a general practitioner with Abbey Family Clinic Remera, says anaemia is caused by three particular things, and these include blood loss, decreased or faulty red blood cell production and destruction of red blood cells.

“For instance oral contraceptive pills and intra-uterine devices used for contraception also induce chronic anaemia in women by causing excess bleeding,” he notes.

One's diet is very important in avoiding or treating anaemia. (Ivan Ngoboka)

Women also get hormonal changes in the body during the different stages of life like adolescence, pregnancy, lactation and menopause. During all these phases, demand for iron and calcium is increased. If this increased demand is not fulfilled, they tend to suffer from chronic iron deficiency anaemia, Gatabarwa adds.

He remarks that some blood is invariably lost during child birth. This also contributes to anaemia in women. The more the number of pregnancies and deliveries, the higher the chances of a woman to develop chronic anaemia.

According to Dr Rachna Pande, a specialist in internal medicine at Ruhengeri Hospital, uterine fibroids cause heavy bleeding in affected women leading to iron deficiency anaemia. Women who develop breast or cervical cancer also suffer from iron deficiency anaemia.

She mentions that women who are athletes and engage in vigorous intense physical exercise are more prone to develop iron deficiency anaemia.

“Women usually tend to be negligent about their diet. They care for the nutritional needs of the whole family but are careless about their own nutrition. This is also one of the reasons why more women suffer from anaemia,” Dr Pande says.

Maniraguha mentions that several diseases like recurrent malaria, worm infestation, chronic renal failure, among others, lead to anaemia both in men and women. He adds that alcohol, tobacco and other addictions also contribute to anaemia in women because they compromise one’s nutrition status.

“An anaemic woman can give birth to low weight babies. Severe anaemia can also impair fertility,” Maniraguha says.

Diagnosis and prevention

“How someone with anaemia will recover depends on the cause of the anaemia and how severe it is. For example, if a stomach ulcer is causing anaemia because of bleeding then the anaemia can be cured if the ulcer is treated and the bleeding stops. If anaemia is caused by kidney failure, then it will require long-term monitoring and treatment,” Gatabarwa says.

Medics say that in general, young people recover from anaemia more quickly than older people do. Younger people also tolerate symptoms of anaemia better than elderly people. Effects of anaemia in elderly people tend to be more significant because of more underlying chronic medical problems. Anaemia makes almost any medical problem worse.

“If you think you have anaemia, see your doctor who will most probably ask about your medical history and symptoms, before taking blood to run tests. These tests may include a complete blood count to look at your red blood cells and an iron test that shows how much iron is in your blood. One’s doctor may also do tests to find out what is causing anaemia,” Gatabarwa adds.

Medics say women who engage in intense physical activity are likely to become anaemic. Also, anaemic women give birth to low weight babies.


One’s doctor will probably have the patient take iron supplement pills and eat foods rich in iron to treat the ailment.

“Most people begin to feel better after a few days of taking iron pills but should not stop taking the pills even if they feel better. They need to keep taking the pills for several months to build up the iron in their bodies,” Gatabarwa says.

He, however, warns that if one thinks they have anaemia, they should never try self medication warning that it could lead to poisoning.

“You can get the most benefit from iron pills if you take them with vitamin C or drink orange juice. Do not take your iron pills with milk, caffeine, foods with high fiber, or antacids,” Gatabarwa advises.


Top 5 Foods to Improve your Hemoglobin

Red Meat: When we look at foods that can boost your hemoglobin we are looking for rich iron content. When it comes to red meat, you will find heme iron and the best part about it is that it can be easily absorbed in the intestine. But let’s not go binge on red meat, you don’t want to be down with cardiovascular disease that could result from overeating or higher fat content. As with all else, a balanced diet is the key here.


Veggies: Beetroot, palak or spinach, green peas, kidney, beans, cabbage, turnip, sweet potato and cauliflower are some vegetables that are easily available in the market. If you have access to imported veggies try out broccoli, lima beans, collards and black beans. Beetroot is the best natural remedy to boost blood count, it has the ability to regenerate iron content and activates red blood cells, supplying fresh oxygen to the blood.


Fruits — Raisins, prunes, dried figs, apricots, apples, grapes and watermelons not only get the red blood cells flowing but also improve the blood count. Citrus fruits like oranges, lime and grapefruit help to attract iron. They play a very important role in increasing blood count.

Breads, Pasta, Cereals — Check the labels on wholegrain breads, pastas, and cereals; Each pack must contain 20% or more of the daily value for iron. Whole grains offer many health benefits for which everyone must try to incorporate into their daily diets. Here’s one more reason to continue doing so, whole grain is a rich source in iron.


Nuts — Some of us like them, some don’t; but all nuts have some amount of iron in them. The king of all nuts with the highest iron content is the humble almond. One ounce of almonds every day provides 6% of iron.


Dry fruits and nuts can be purchased from any provision store in cities and towns. In fact, the good news is that almonds are the cheapest of all the other nuts and dry fruits available to us; a definite sign that Mother Nature does care.



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