An Osteopathic Approach to Anemia
With close to 2 billion people affected globally, anemia is a commonly seen condition worldwide. Diagnosed by a patient’s low hemoglobin, and then subsequently differentiated through red blood cell indices, a complete blood count should be performed on every patient presenting with the classic symptoms of anemia. Iron studies, as well as the corrected reticulocyte count and peripheral blood smears, can also be of use to further specify the exact type of anemia. Additionally, tests including colonoscopies, upper endoscopies and gynecologic procedures should be considered to identify the different underlying causes of the disease. The most common microcytic anemias include iron deficiency, thalassemia and anemia of inflammation. Deficiencies in folate and B12—also known as cobalamin—are the most common etiologies of macrocytic anemia. Treatment of each of these types of anemia is tailored to the individual patient based on the severity of their condition as well as the specific underlying cause. Osteopathically, anemia falls largely into the respiratory-circulatory model, as well as the metabolic-energy model, which can also be used to guide treatment. For a family physician, identifying symptoms, making accurate diagnoses and properly treating patients with anemia is of the utmost importance.