Anaemia - sickle cell

What causes sickle cell anaemia?

In sickle cell disease, haemoglobin does not work well. Haemoglobin is in your red blood cells and it carries oxygen around the body. Normal red blood cells are flexible and disc-shaped, but in sickle cell disease they can become rigid and shaped like a crescent or sickle. These cells also do not live as long as normal red blood cells. These changes means that your haemoglobin cannot carry as much oxygen.

This can cause symptoms of anaemia as your body cannot get the oxygen it needs.

How common is sickle cell anaemia?

Nearly all people with sickle cell disease have anaemia. Sometimes the anaemia can be severe and then it is life-threatening as it can cause serious problems if left untreated.

Symptoms of sickle cell anaemia can be seen at different stages of the disease. They include:

• feeling tired or having little energy (lethargy)
• feeling faint and dizzy
• looking pale, having pale skin
• being short of breath or feeling breathless
• headaches
• faster heart rate or a thumping heart (palpitations)
• cold hands or feet
• lack of concentration
• slow growth
• delayed puberty
• heart failure.

Sickle cell anaemia can get worse when you have another infection such as slapped cheek disease (parvovirus) or if you are pregnant.

The treatment for the anaemia depends on how severe it is. It can include:

• Folic acid supplements – to help the body make new red blood cells. It can be useful if you have a restricted diet such as a vegetarian or vegan diet.
• Blood transfusions – if anaemia is severe. It can help add normal red blood cells to the blood.
• Hydroxycarbamide – this medicine stops red blood cells from changing to a sickle shape. 

Anaemia caused by sickle cell disease is not the same as iron deficiency anaemia and is not caused by having too little iron in your blood. Do not take iron supplements without speaking to your doctor. Extra iron in your body can damage your organs.

How is sickle cell anaemia monitored?

Your doctor will monitor your blood levels regularly. Your blood tests can also measure how many red blood cells you have and how well they are working.

Possible complications

If anaemia is left untreated it can damage organs in your body because your blood can't get enough oxygen to them. 

Avoid infections

You are at extra risk of infections when you have sickle cell disease, so it is important to be up to date with all of your vaccinations, practice good hand cleaning hygiene and good food hygiene. If you are travelling to an area where malaria is found, it's important to take antimalarial medication as well as extra food and water precautions.

Avoid situations that can trigger a crisis

Anaemia can lead to a sickle cell crisis which can happen when sickle cells block the flow of blood causing symptoms such as pain, tiredness, jaundice, dizziness, headache and fever. Avoid triggers of a crisis which may include cold, dehydration, and tiredness.

Seek help and support

You are not alone. It is important to seek help and support for your condition. Register with a GP and see them at least once a year so they can monitor your anaemia. If you are missing school or work due to symptoms of anaemia see your GP for support.