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Here you'll find advice on how to take a more comprehensive approach toward managing your rheumatoid arthritis (RA). Keep in mind, this column is intended to advise you on how to complement your treatment, not replace it. Please consult your doctor to determine what advice may be right for you.
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Anemia & RA Part 2: Diagnosis and Treatment
Nov 4, 2009
As we discussed last week, there is a connection between RA and anemia. If you've been diagnosed with RA, your rheumatologist may conduct regular blood tests to monitor your RA and your treatments, as well as watch for signs of anemia. In this week's article, we'll go over how your rheumatologist can diagnose and treat the condition.
Diagnosing anemia
In the last article, I mentioned that anemia is the result of a low level of red blood cells or hemoglobin in the blood. To diagnose anemia, your doctor will often order a complete blood count (CBC) test that measures:
The hematocrit—the proportion of your blood that is made up of red blood cells
The amount of hemoglobin in your blood
If your body's level of red blood cells or hemoglobin is lower than expected, you are considered to have anemia. The CBC test is routinely done in most doctors' offices. It is the only sure way to know if you have anemia and how severe it is.
Treating anemia in people with RA
If diagnosed with anemia, your rheumatologist may also test your blood for substances like iron to help determine the type of anemia. If you remember from last week's article, the 2 most common types of anemia in people with RA are anemia of chronic disease (ACD) and iron-deficiency anemia (IDA), and they are treated differently.
The first principle of treating ACD associated with RA is to reduce inflammation as much as possible using primary RA therapies. This helps address the underlying cause of ACD. When iron deficiency occurs together with ACD, you may also need iron replacement. Other treatments may also be used either alone or in combination with iron supplements. For example, the doctor may prescribe drugs called erythropoiesis-stimulating agents (ESAs) that stimulate the production of red blood cells. This approach may even improve your RA symptoms
For IDA, your rheumatologist will help determine the best ways for you to increase the amount of iron in your body. He or she may prescribe an oral iron supplement for you to take every day. There are different types of iron supplements. They may be given in pill, capsule, or liquid form
Now that you know the symptoms of anemia, the most common types found in people with RA, and what you can expect in its diagnosis and treatment, you may have a few questions. I am sure your rheumatologist would welcome the opportunity to discuss anemia and RA with you. See you next week.
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