While chronic obstructive pulmonary disease (COPD) is a significant health concern, it can often coexist with other health issues. One such issue is anemia, which occurs when the body lacks sufficient healthy red blood cells to carry enough oxygen to the tissues.
Anemia in people with COPD is typically associated with less optimistic outcomes, such as
Doctors may be able to help someone manage symptoms, but it may depend on the underlying cause of the anemia.
This article examines the relationship between anemia and COPD and why people with COPD may develop this comorbidity.
Anemia and COPD are two distinct health conditions that can significantly impact an individual’s well-being. However, they can coexist in the same person.
In anemia, a person lacks healthy levels of red blood cells, or their oxygen-carrying ability is reduced. The body then has difficulty delivering oxygen to the tissues.
COPD also affects the body’s oxygen supply as it causes changes in the lungs that affect breathing. As a result of these conditions, a person’s tissue may not get enough oxygen. This is known as hypoxia.
Anemia of chronic disease (ACD) vs. iron deficiency anemia
Another form of anemia that can occur in people with COPD is iron deficiency anemia.
With iron deficiency anemia, a person lacks the iron they need to produce hemoglobin. Hemoglobin is a protein in red blood cells that carries oxygen to the tissues.
Conversely in ACD, a person may have “normal” or even elevated amounts of iron stored in their body tissues but low levels in the blood. However, inflammation prevents the body from using stored iron to make enough healthy red blood cells, leading to anemia.
People with COPD may develop iron deficiency anemia as they have difficulty getting enough iron from their diet likely because of reduced appetite or dietary restrictions. Furthermore, some medications used to treat COPD, such as corticosteroids, can increase the risk of developing iron deficiency.
Doctors must identify the type of anemia present as it affects the necessary treatment and management of the condition.
Anemia can occur in people with COPD. However, when present, anemia may not always be due to untreated or a progressive COPD process. Sometimes COPD directly causes
A 2017 review article reported that the prevalence of anemia and COPD is highly variable, ranging from nearly 5% to 38%. The authors state that this large range is due to differences in COPD diagnosis and the definition of anemia.
It can also depend on the individual’s COPD status.
In people with stable COPD, the prevalence varies from 5.3% to 17.0% in Western populations. Stable COPD usually means that a person has mild symptoms that regular use of inhalers can manage, as opposed to having exacerbations when there is an increase in symptoms, which may require additional treatments — for example, steroids, nebulizers, or oxygen support.
But in people with acute exacerbations of COPD, meaning periods of worsening symptoms, the prevalence of anemia is higher, ranging from 18.0% to 27.7%.
Symptoms of anemia in people with COPD can
- shortness of breath
- pale skin or pale mucous membranes
Several risk factors can contribute to the development of anemia in people with COPD. These
- Chronic renal failure: Renal (or kidney) failure can cause anemia due to reduced erythropoietin production. This hormone stimulates the bone marrow to produce red blood cells.
- Hypogonadism: In hypogonadism, the gonads produce little or no hormone testosterone or estrogen. Testosterone is involved in red blood cell production.
- Nutritional deficiencies: Malnutrition is common in COPD. If a person does not consume enough iron, vitamin B12, or folic acid, it can increase the risk of anemia.
- Medications: Salicylates, corticosteroids, and nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the likelihood of developing iron deficiency anemia.
The treatment for anemia in people with COPD depends on the underlying cause.
Treatment may involve addressing nutritional deficiencies with dietary modifications or supplements to correct them. Doctors may also review the individual’s medications to see if they can prescribe alternatives that do not worsen anemia.
Additionally, it is essential to manage any comorbidities that contribute to anemia, such as renal dysfunction or hypogonadism. Effective management of these conditions can improve erythropoietin production and red blood cell production.
Anemia can occur in people with COPD, and it can significantly impact their quality of life.
Treating anemia involves addressing the underlying cause, managing comorbidities, and providing support through dietary modifications, supplements, and medications.
It is crucial to recognize the symptoms of anemia in people with COPD and to get medical attention promptly for early diagnosis and effective management.