ANEMIAPresented by:

Amy Kelly, Karl Russell, Caleb Smith

INTRODUCTION

Pathophysiology Exercise Response Exercise Training Management & Medications Exercise Testing Exercise Programming Special Considerations Case Study Conclusion

OVERVIEW

One of the most common blood disorders in the United States

3.5 million Americans are affected

Condition of having less than normal # of rbc per cubic mm Amount of hemoglobin per in 100 ml of blood Or even the volume of packed rbc 100 ml of

blood This results in the reduction of oxygen carrying

capacity of the blood

WHAT IS THE NORMAL AMOUNT?

Men = 4.7 – 6.1 million/uL Women = 4.2 – 5.4 million/uL Children = 4.6 – 4.8 million/uL

Men = 13.8 – 15.1g/dl Women = 12.1 – 15.1g/dl Children = 11 – 16g/dl Pregnant Women = 11 – 12g/dl

Red Blood Cells

Hemoglobin

WHO IS AT RISK?

ALL age, race, and ethnic groups

Women of child bearing age are more susceptible to anemia

Individuals who have other medical conditions

Infants <2 years of age

TYPES OF ANEMIA

Aplastic Benzene Poisoning Fanconi Hemolytic Iron Deficiency Osteopetrosis Pernicious Sickle Cell Disease Thalassemia Myelodysplastic Syndrome

Types of Anemia Description Examples of Causes

Iron DeficiencyLack of iron leads to

decreased amounts of hemoglobin in turn leads to

decreased production of normal RBCs

Blood loss; diet low in iron; poor absorption of iron

Pernicious Anemia & B Vitamin Deficiency

Lack of B vitamins does not allow RBCs to grow and then

divide as they normally would during development; leads to

decreased production of normal RBCs

Lack of intrinsic factor; diet low in B vitamins; decreased

absorption of B vitamins

AplasticDecreased production of all cells produced by the bone

marrow of which RBCs are one type

Cancer therapy, exposure to toxins, autoimmune disorders,

viral infections

HemolyticRBCs survive less than the

normal 120 days in the circulation; leads to overall decreased numbers of RBCs

Inherited causes include sickle cell and thalassemia; other causes include transfusion

reaction, autoimmune disease, certain drugs

(penicillin)

Anemia of Chronic Diseases

Various conditions over the long term can cause

decreased production of RBCs

Kidney disease, diabetes, tuberculosis or HIV

MAJOR RISK FACTORS

Insufficient diets low in iron, vitamins, and minerals

Blood loss from surgery or injury

Intestinal disorder which affects nutrient absorption(Crohn’s disease or celiac disease)

Pregnancy and menstruation

Chronic or serious illnesses/infections (kidney disease, cancer, diabetes, HIV/AIDS)

Inherited

SPECIFIC MECHANISMS OF ANEMIA

Reduced RBC production Reduced serum ferritin levels Marrow damage by drugs or tumor

infiltration Failure of erythropoietin response to

anemia Abnormal RBC precursor maturation

SPECIFIC MECHANISMS OF ANEMIA

Iron, B12, folate deficiency Thalassemia Drug Toxicity Increase RBC destruction or loss Hemolytic Blood Loss

EFFECTS OF EXERCISE RESPONSE

•Resting • Low oxygen & carbon dioxide = increase in

cardiac output & breathing rate• Bohr effect

•Submaximal Exercise•Cardiac output & muscle blood flow increases faster & remains higher for time of exercise

•Peak Exercise• Low hemoglobin levels associated with

anemia can’t compensated for• Cardiac output, muscle flood flow, & oxygen

extraction• Limits energy production & performance

EFFECTS OF EXERCISE TRAINING

•Chronic anemia keeps a limit on aerobic performance

•Studies on animals • Shows that aerobic exercise endurance levels

can be superior to nonanemic sedentary individuals

•Endurance training can increase submaximal performance

•Women with iron deficiency but not yet anemic can experience a decrease in endurance capacity, this can simply be corrected by supplementation of iron.