The Effect Of Ethanol Extract Of Corn Silk (Stigma Maydis) On Some Hematological Parameters In Plasma Of Wistar Rats Administered Paracetamol

ABSTRACT

This study was aimed at investigating the effects of ethanol extract of the corner silk (stigma maydis) on hematological parameters in wistar rats administered paracetamol. Twenty (20) rats were assigned into four groups (cages) of five rats. The weight of the rats was between 120.0 – 124.7 kg. 750 mg of paracetamol was dissolved in 30 ml of distilled water. Group one serves as the positive control, group two serves as the negative control and received 1ml of paracetamol independent dose only, group three received 1ml of paracetamol and 100mg/kg ethanol extract of corn silk, group four received 1ml of paracetamol and 150mg/kg ethanol extract of corn silk. The treatment lasted for fourteen (14) days. The HB,T.WBC,MCV, MCHand  N after treatment with paracetamol  (11.821.20, 6500.00500.00, 64.448.46, 21.402.85, and 48.800.84)was observed to have significant increase from the positive control( 11.560.79, 4200.00122.47, 43.163.42, 14.341.15, 48.201.30) respectively, while PCV, RBC, L, E(33.001.73, 5.560.52, 49.000.71, 1.000.00) was observed to have significant decrease from the positive control (37.001.41, 8.080.43, 49.200.84, 1.800.84) respectively but the MCHC and M has no significant difference. Animals administered with 100 mg/ kg(0.1g) of corn silk extract shows a significant increase in PCV, HB, T.WBC, MCV, MCH, MCHC and L level ( 39.801.10, 13.220.37, 4900.001341.64, 72.988.30, 24.242.77, 33.260.05, 48.400.89)respectively and a significant decrease in RBC, L and E(4.502.12, 48.400.89,1.400.55) from the positive control group but has no significant difference in their M. The animals administered with 150 mg/ kg(0.15g) of corn silk extract shows a significant increase in the PCV, HB, T.WBC, MCV, MCH, N( 41.601.67, 13.760.55, 4420.00576.19, 60.3712.72, 19.981.49, 48.40 0.55) and a significant decrease in the RBC, MCHC, L and E(6.900.29, 33.100.39, 49.000.00, 1.800.45) from the positive control group but has no significant difference in their Monocytes M.

CHAPTER ONE

INTRODUCTION/ LITERATURE REVIEW

INTRODUCTION

1.1. BACKGROUND OF THE STUDY

Corn silk is a common name for the shiny, thread-like, weak fibers that grow as part of ears of corn (maize); the tuft or tassel of silky fibers that protrude from the tip of the ear of corn. The ear is enclosed in modified leaves called husks. Corn silk (Zea mays) is an herbal remedy made from stigmas, the yellowish thread-like strands. The stigmas are found on the female flower of corn, a grain that is also known as maize and is a member of the grass family (Gramineae or Poaceae). The stigmas measure 4–8 in (10–20 cm) long and are collected for medicinal use before the plant is pollinated.

If fertilized, the stigmas dry and become brown. Then yellow corn kernels develop..Corn silk scientifically regarded as Maydis stigma. It is an important herb used traditionally by the Chinese, and Native Americans to treat many diseases. It is also used as traditional medicine in many parts of the world such as Turkey, United States and France.  According to Guoet al (2009); Liu et al (2011) and Wang (2011) corn silk contains flavonoids, saponin, phenols, anthocyanins, vanillic acid, steroids, vitamin B, vitamin C, vitamin K and minerals such as magnesium, calcium, zinc, phosphorus and antioxidants.

Pharmacological studies have revealed that corn silk performs several biological activities such as anti-bacterial, anti-oxidant and anti-diuretic .Fresh green corn silk is collected from the cob and dried for tea or processed into tincture. This medicine keeps the entire urinary tract clean; offering relief to chronic suffers of bladder infections.

The concentration of potassium in corn silk makes it a wonderful supplement for a variety of kidney problems.

Corn silk tea is traditionally served to children to help prevent bed wetting, also known as enuresis.. Corn silk contains phytochemicals of medical benefits such as proteins, vitamins, carbohydrates and natural sugars, fibers, mineral salts such as Ca, K, Mg, and Na salts, fixed and volatile oils, steroids such as sitosterol and stigmasterol, alkaloids, saponins, tannins, and phenolic compounds, particularly flavonoids.

Paracetamol (Acetaminophen, N-Acetyl-pAminophenol) is widely used as prescription and over thecounter (OTC) analgesic and antipyretic agent (Trumperet al.2005).Paracetamol (Acetaminophen) is one of the most popular over the counter medications that are commonly used as an anti-inflammatory and pain killer, and to relieve fever and headaches. Despite its several therapeutic benefits, it is well known that an overdose of paracetamol can lead to hepatic and renal damage. A major problem is the misuse of paracetamol through intentional or unintentional uptake of supratherapeutic doses, which may lead to hepatic and renal adverse side effects in humans and experimental animals (Guo and Nzerue 2002). Paracetamol is metabolized mainly in the liver via conjugation with glucuronic acid and sulphate, and finally excreted in urine. Paracetamol metabolism also yields a cytochrome P450-dependent highly reactive metabolite known as N-acetyl-p-benzoquinonimine (NAPQI This metabolite is able to react with glutathione (GSH) forming a non-toxic conjugate to be excreted via kidneys (Henderson et al., 2000; Manyikeet al., 2000). Critically, overdoses of paracetamol saturate these neutralization metabolic pathways thus the rate of formation of NAPQI exceeds the capacity to detoxification.

Hematology refers to the study of the numbers and morphology of the cellular elements of the blood – the red cells (erythrocytes), white cells (leucocytes), and the platelets (thrombocytes) and the use of these results in the diagnosis and monitoring of disease.Hematological studies are useful in the diagnosis of many diseases as well as investigation of the extent of damage to blood. Hematological studies are of ecological and physiological interest in helping to understand the relationship of blood characteristics to the environment and so could be useful in the selection of animals that are genetically resistant to certain diseases and environmental conditions. Haematological parameters are those parameters that are related to the blood and blood forming organs. As reported by Isaac et al., 2013, animals with good blood composition are likely to show good performance. Role in the physiological, nutrition and pathological status of an organism.

1.2. AIMS AND OBJECTIVES

AIM:

The aim of this research is to study the effect of ethanol extract of corn silk on hematological parameters in wistar rats administered paracetamol.

OBJECTIVES;

1. They objective is to evaluate the effect of the paracetamol on hematological parameters such as;Packed cell volume ( PCV), Hemoglobin concentration ( HB), Mean cell volume ( MCV), Mean corpuscular cell hemoglobin( MCH), White blood cell count (WBC), Red blood cell(RBC).
2. To evaluate the plasma concentration of specific hematological parameters on administration of corn silk in wistar rats.

1.3. SCOPE OF THE RESEARCH

The scope of this research is to evaluate the effect/plasma concentration of ethanol extract of corn silk on packed cell volume(PCV) white blood cell count( WBC), Red blood cell count (RBC), mean cell volume,mean corpuscular cell hemoglobin in wistar rats exposed to paracetamol.

1.4 JUSTIFICATION OF STUDY

In recent times, increased consumption of corn silk tea has been reported to have effects on hematological parameters. Corn silk tea has been claimed in traditional medicine practice to have many benefits to human health such as lowering blood pressure, and promote relaxation.

1.5 LITERATURE REVIEW

MAIZE

Maize (Zea mays L.) is a crop of world repute and has a remarkable adaptability in a wide range of climates, and it is more extensively distributed over the country than any other local crops Ibeawuchi et al, 2008. Maize is the world most widely grown cereal and it is ranked third among major cereal crops.

Corn (Zea mays), also called Indian corn ormaize, cereal plant of the grass family (Poaceae) and its edible grain. The domesticated crop originated in the Americas and is one of the most widely distributed of the world’s food crops. Corn is used as livestock feed, as human food, as biofuel, and as raw material in industry.

 Taxonomy

Maize is a member of the grass family Poaceae (Gramineae), a classification it shares with many other important agricultural crops, including wheat, rice, oats, sorghum, barley, and sugarcane. Based on fossil evidence, it is estimated that these major grass lineages arose from a common ancestor within the last 55–70 million years, near the end of the reign of dinosaurs. Maize is further organized in the genus Zea, a group of annual and perennial grasses native to Mexico and Central America. H. G. Wilkes (1967) laid the foundation for the current classification scheme in 1967 with the first thorough monograph on teosinte. In 1980, Hugh Iltis and John Doebley (1980) produced a system of classification that considered the probable evolutionary relationships between taxa.

Based on the morphological characteristics and geographic delineations established in these systematic treatments, five species of Zea are currently recognized:

• ZeadiploperennisIltis, Doebley& Guzman, a perennial, diploid teosinte found in very limited regions of the highlands of western Mexico
• Zeaperennis (Hitchcock) Reeves &Mangelsdorf, a perennial tetraploid teosinte, also with a very narrow distribution in the highlands of western Mexico
• Zealuxurians (Durieu&Ascherson) Bird, an annual teosinte found in the more equatorial regions of southeastern Guatemala and Honduras
• ZeanicaraguensisIltis& Benz, closely related to Zealuxuriansand found in mesic environments in Nicaragua (Iltis and Benz, 2000)
• Zea mays , a highly polymorphic, diploid annual species, including both wild teosinte and cultivated maize

Origin of Maize

In the late 1930s, Paul Mangelsdorf and his colleague Robert Reeves proposed a hypothesis known as the tripartite hypothesis (Mangelsdorf,1974;). This theory stated that maize was domesticated from some unknown wild maize, presumably a plant withstructures that resembled the modern maize ear.

Classification of corn

• Kingdom Plantae – Plants
• Subkingdom Tracheobionta – Vascular plants.
• SuperdivisionSpermatophyta – Seed plants
• Division Magnoliophyta – Flowering plants
• Class Liliopsida – Monocotyledons
• Subclass Commelinidae
• Order Cyperales
• Family Poaceae – Grass family
• Genus Zea L. – corn P
• Species Zea mays L. – corn P

Botanical Description

Corn (Zea mays Linnaeus), also known as maize, is a member of the family Poaceae or Gramineae. It is indigenous to Mesoamerica and was domesticated in Mexico some 9,000 years ago, then it spread throughout the American continents(accessed on 29 June 2011).  Now, it is widely cultivated all over the World..All parts of corn are utilized, including the silks. The flowers of corn are monoecious in which the male and female flowers are located in different inflorescences on the same stalk. The male flowers (tassel) at the top of the plant produce yellow pollen. Meanwhile, the female flowers produce Corn silk and are situated in the leaf axils. The silks are elongated stigmas which look like a tuft of hairs. The colors of the Corn silk, at first are usually light green and later turn into red, yellow or lightbrown. The function of Corn sink  is to trap the pollen for pollination.  Corn silk is harvested just beforepollination occurs and can be used in fresh or dried form. Each silk may be pollinated to produce one kernel of corn.

Corn silk (stigma maydis)

Corn silks (Stigma maydis) are elongated stigmas from the female flowers of maize which look like a tuft of hairs. It is a waste material from corn cultivation and available in abundance. The Corn silk can be 30 cm long or longer with a faintly sweetish taste. Corn silk has long been used traditionally by the Chinese and Native Americans to treat many diseases. Its potential healthcare benefits as anti-fatigue, anti-depressant, anti-diabetic, and as hypoglycemic agent have been claimed in several reports (Farsi et al., 2008). It has been used as traditional medicine in many parts of the world such as China, Turkey, United States and France. Its efficacy in the treatment of cystitis, edema, kidney stones, prostate disorder, urinary infections, bedwetting, obesity, and as diuretic has also been reported (Graseset al., 1993).

Benefits/ uses of corn silk

Traditional Use and health benefit

The traditional use of Corn Silk can be traced back to the Mayans, Incans and Native Americans, who used it to treat bladder and urinary disorders.

Bladder and Urinary Health

As a powerful diuretic and anti-inflammatory, Corn Silk increases urination, thus preventing the build up of bacteria in the urethra. It soothes inflammation in the bladder and urinary tract and coats the lining of the urethra.

A 2011 – 2012 study was conducted in Baghdad on 42 patients of both sexes with UTI’s. Manifestation of the UTI were checked clinically and included; suprapubic pain, urgency, frequency and dysuria. All of the patients were followed up after 5 days, 10 days and 20 days from starting a course of treatment with aqueous extract of Corn Silk. The study concluded: “Administration of aqueous extract of Corn Silk significantly reduce the symptoms in patient with UTI in addition to reduction in the values of pus cells, RBCs, and Crystals, without any reported side effect which indicate its efficacy and safety.”

Another study found that Corn Silk can help to prevent the formation of kidney stones and can increase the percentage of urinary stones through the urinary tracts. The study entitled “In-vitro Anti-Urolithiatic Activity of Corn Silk of Zea Mays” proved that it exhibited anti-urolithiatic activity – the dissolving or preventing the formation of calculi in the kidneys, ureters, or bladder.

The researchers found that Corn Silk was playing an important physical role in the treatment of kidney stones by increasing the contraction of smooth muscles, which led to increase the urinary output and increased the percentage the passage of urinary stones through the urinary tracts.

Type 2 Diabetes

The hypoglycaemic mechanisms of Corn Silk have been investigated by many researchers the world over. It has a long history of use in Traditional Chinese Medicine as a herbal medicine to treat diabetes.

A 2009 study, “The effects of Corn Silk on glycaemic metabolism”, concluded: “Corn Silk extract markedly reduced hyperglycemia in alloxan-induced diabetic mice. The action of corn silk extract on glycaemic metabolism is not via increasing glycogen and inhibiting gluconeogenesis but through increasing insulin level as well as recovering the injured β-cells.”

Lowers Blood Pressure

Corn Silk is rich in bioactive compounds such as flavonoids and terpenoids which are thought to contribute to the anti-hypertensive action of this herb. It also contains high amounts of potassium, a mineral that is well known for its vasoligating properties and ability to relieve tension of the blood vessels – one of the main causes of high blood pressure.

Paracetamol

Acetaminophen (ACMP) commonly referred to as paracetamol (N-acetyl-para-aminophenol) is a white crystalline solid or powder. It was first introduced as a prescription drug in the United States in 1955 and was approved by the Food and Drug Administration for sale as a nonprescription drug Administration for sale as a nonprescription drug in 1960 (Venkatesan and Deecaraman, 2014). ACMP is available as oral, rectal, and injectable formulation. ACMP is widely used because many people mistakenly believe it to be entirely harmless. However, the use of ACMP is one of the most common causes of poisoning worldwide.  ACMP poisoning can be due to ingestion of excessive repeated or too frequent doses.Severe overdose can cause terminal liver damage, and in exceptional cases, a standard dose can act in like manner and the danger can be on the increase with alcohol intake (Venkatesan and Deecaraman, 2014).

A large portion of a therapeutic dose of paracetamol is directly conjugated with glucuronic acid or sulfate. The remaining part of the dose is metabolized by the P450 system to a reactive metabolite, presumably N -acetyl- p -benzoquinone imine (NAPQI). NAPQI reacts with glutathione (GSH) spontaneously or catalyzed by GSH- S-transferases to form GSH-adduct. Thus, the earliest effect of paracetamol metabolism is a profound depletion of hepatocellular GSH (Mitchell et al., 1973), which affects both the cytosolic and the mitochondrial compartments.

Haematological Components and Their Functions

Blood which is a vital special circulatory tissue is composed of cells suspended in a fluid intercellular substance (plasma) with the major function of maintaining homeostasis. Haematological components, which consist of red blood cells, white blood cells or leucocytes, mean corpuscular volume, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration are valuable in monitoring feed toxicity especially with feed constituents that affect the blood as well as the health status of farm animals.  According to Isaac et al.(2013) red blood cell is involved in the transport of oxygen and carbon dioxide in the body. The major functions of the white blood cell and its differentials are to fight infections, defend the body by phagocytocis against invasion by foreign organisms and to produce or at least transport and distribute antibodies in immune response. Blood platelets are implicated in blood clotting. Low platelet concentration suggests that the process of clot-formation (blood clotting) will be prolonged resulting in excessive loss of blood in the case of injury. Packed Cell Volume (PCV) which is also known as haematocrit (Ht or Hct) or erythrocyte volume fraction (EVF), is the percentage (%) of red blood cells in blood (Purves et al., 2003). Haemoglobin has the physiological function of transporting oxygen to tissues of the animal for oxidation of ingested food so as to release energy for the other body functions as well as transport carbon dioxide out of the body of animals (Ugwuene, 2011; Omiyale et al., 2012;).  Chineke et al. (2006) posited that high Packed Cell Volume (PCV) reading indicated either an increase in number of Red Blood Cells (RBCs) or reduction in circulating plasma volume. Mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration indicate blood level conditions. A low level is an indication of anaemia (Aster, 2004).

Some Hematological Markers In Vivo Toxicity

Hematology parameters otherwise known as blood parameters or blood components in a layman’s language are notable features of blood and blood forming organs. These features are of great clinical important in determination of humans health status.

These parameters include;

Red blood corpuscles (RBCs)

Red blood corpuscles (erythrocytes) are enucleate cells that are packed with the oxygen-carrying protein, hemoglobin. Under normal conditions, the concentration of erythrocytes in blood is approximately3.85-5.16 million/μL in women and 4.54-5.78 million/μL in men (Junqueiraet al., 2006). A decrease in number of red cells in the blood is been associated withdevelopment of anemia.

Hemoglobin (HB)

Hemoglobin is the primary intracellular protein of the RBCs; bindsoxygen in the pulmonary artery for transport to tissues and bindstissue carbon dioxide for transport back to lungs for exhalation (Wintrobe M and Greer JP 2009). Itis synthesized in the bone marrow. The normal concentration of HB in an adult variesfrom 12.0 to 17.2 g/dL. Low levels of hemoglobin arise as a result of loss of blood (hemorrhage) or immature reticulocytes usually related to irondeficiency in the diet; or accelerated blood cell destruction, leading to anemia. Alterations in hemoglobin molecules also results in sicklecell disease.

Hematocrit (PCV)

Hematocrit represents the percentage of red blood cell volume ofwhole blood volume (called Packed Cell Volume (PCV). Factors influencing RBCs will affect the hematocrit because RBCs comprise99% of the total cells of the blood Reference values are 42-52% formales and 36-48% for females. The hematocrit is usually about 3 timesthe hemoglobin value (assuming there is no marked hypochromia). Theincreased levels of hematocrit may be as a result of hyperosmoticconditions due to high dosage levels of toxin, elevated levels of WBCs, hypoxia, chronic alcoholism, vitamin B12 deficiency and folatedeficiency. The average error in hematocrit is about 1-2%. Hematocrit is amajor determinant of blood viscosity. Increased blood viscosity alsocontributes to the development of insulin resistance (Medalie  et al., 1975).

Mean cell/corpuscular volume (MCV)

MCV is a measure of the average volume or size of a red blood cell.The reference range for MCV is 78.5-96.4 fL/red cells in adult although the reference ranges may vary depending on the individual laboratoryand patient’s age (Chhabra N 2013).  MCV is elevated or decreased inaccordance with average red cell size; low MCV indicates microcytic (small average RBC size), normal MCV indicates normocytic (normalaverage RBC size), and high MCV indicates macrocytic (large averageRBC size). Low MCV is consistent with iron deficiency, microcytic anemia and thalassaemia syndromes while values above the referencerange are found in chronic alcoholism, vitamin B12 deficiency and folate deficiency indicator (Aslinia et al., 2006)

Mean cell hemoglobin (MCH)

Mean corpuscular hemoglobin (MCH) is a calculation of theaverage amount of hemoglobin inside a single red blood cell (Chhabra N 2013). Thereference range is 27-33 pg (pictograms). Values below this range arefound in iron deficiency, thalassaemias and in some cases of anemia inchronic diseases. MCH is increased in macrocytic anemias (Kasper et al.,2005)

 Mean corpuscular hemoglobin concentration (MCHC)

Mean corpuscular hemoglobin concentration (MCHC) is acalculation of the average concentration of hemoglobin inside a singlered blood cell. The reference range is 32.6-37.7 g/dL (Chhabra N 2013). It is mainlyused in the diagnosis of iron deficiency. A low MCHC is a sensitiveindicator of iron deficiency only when it is calculated using a PCVdetermined by hematocrit method, or when it is obtained from a Technicon H1 series automated cell counter. The decreased levels MCHC values might also be an indication of abnormal hemoglobinsynthesis, failure of blood osmoregulation and plasma osmolarity (Stookey et al., 2007).

The above hematological indices especially the RBC, PCV, and Hbare associated with the total population of the red cells; MCV reflectsthe size of red blood cells while MCH and MCHC are usedmathematically to define the concentration of hemoglobin and tosuggest the restoration of oxygen carrying capacity of the blood

White blood cells ( WBCs )

White blood cells (WBCs), also called leukocytes are the cells of the immune system that are involved in protecting the body against both infectious disease and foreign invaders. White blood cells are made in the bone marrow.

Types of white blood cells are:

• They have a longer lifespan than many white blood cells and help to break down bacteria.
• They create antibodies to fight against bacteria, viruses, and other potentially harmful invaders.
• They kill and digest bacteria and fungi. They are the most numerous type of white blood cell and your first line of defense when infection strikes.
• These small cells seem to sound an alarm when infectious agents invade your blood. They secrete chemicals such as histamine, a marker of allergic disease, that help control the body’s immune response.
• They attack and kill parasites and cancer cells, and help with allergic responses.

Reference Range

The reference range for adults (males and females) is as follows:

• Total leukocytes: 4.00-11.0 x 109/L
• Neutrophils: 2.5–7.5 x 109/L
• Lymphocytes: 1.5–3.5 x 10 9/L
• Monocytes: 0.2–0.8 x 109/L
• Eosinophils: 0.04-0.4 x 10 9/L
• Basophils: 0.01-0.1 x 109/L

Interpretation

A white blood cell (WBC) count of less than 4 x 109/L indicates leukopenia.A WBC count of more than 11 x 109/L indicates leukocytosis .

Decreased WBC count, leukopenia, is seen when supply is depleted by infection or treatment such as chemotherapy or radiation therapy.

Elevated WBC, leukocytosis, is seen in response to infection, stress, inflammatory disorders (referred to as reactive leukocytosis), or abnormal production as in leukemia.

 Problems affecting white blood cells.

A number of diseases and conditions may affect white blood cell levels:

Weak immune system. This is often caused by illnesses such as HIV/AIDS or by cancer treatment. Cancer treatments such as chemotherapy or radiation therapy can destroy white blood cells and leave you at risk for infection.

Myelodysplastic syndrome. This condition causes abnormal production of blood cells. This includes white blood cells in the bone marrow.

Myeloproliferative disorder. This disorder refers to various conditions that trigger the excessive production of immature blood cells. This can result in an unhealthy balance of all types of blood cells in the bone marrow and too many or too few white blood cells in the blood.

Factors Influencing Haematological Parameters of Farm Animals

The genetic and non-genetic factors affecting haematological parameters of farm animals have been observed (Xie et al., 2013).

Genetic Factors

Breed and Genotype

In a study on haematological parameters of rabbit breeds and cross in humid tropics conducted by chineke et al. (2006) it was reported that genotype influence on PCV, WBC, MCH and ESR; RBCand MCHC values were identical in all genotypes, pointing similar cellular haemoglobin content in blood samples obtained. In a study conducted by Peters et al., (2011) on variation inhaematological parameters of Nigerian native chickens; normal-feathered birds had higher mean values compared to frizzled feather and native neck genotype.

 Non-Genetic Factors

Age and Sex

In a study conducted by Addass et al. (2012) on indigenous chickens, it was reported that age group effect was observed on PCV, RBC and WBC where the 150d age group recorded highest WBC, PCV; higher RBC value was observed for age group 90d. In a study conducted by Isaac et al. (2013) on haematological properties of different sexes of rabbits, it was observed that the males had the highest values of WBC, Neutrophil, Monocyte, lymphocyte, basophils, RBC, Hb,  MCV, MCHC and platelets while females had the highest values in MCH; there was no significant difference among the sexes.

Anaemia

Anemia is a decrease in the number of red blood cells. Anemia is a condition in which you lack enough healthy red blood cells to carry adequate oxygen to your body’s tissues.

Symptoms

Anemia signs and symptoms vary depending on the cause.

Signs and symptoms, if they do occur, might include:

• Fatigue
• Weakness
• Pale or yellowish skin
• Irregular heartbeats
• Dizziness or lightheadedness
• Chest pain
• Cold hands and feet
• Headaches
• Weakness

Causes

Anemia occurs when your blood doesn’t have enough red blood cells.

Causes of anemia

Different types of anemia have different causes. They include:

• Iron deficiency anemia. This most common type of anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can’t produce enough hemoglobin for red blood cells.
• Vitamin deficiency anemia. Besides iron, your body needs folate and vitamin B-12 to produceenough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production.
• Anemia of inflammation. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn’s disease and other acute or chronic inflammatory diseases — can interfere with the production of red blood cells.
• Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn’t produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
• Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them.
• Sickle cell anemia. It’s caused by a defective form that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.

Risk factors

These factors place one at increased risk of anemia:

A diet lacking in certain vitamins and minerals. A diet consistently low in iron, vitamin B-12 and folate increases your risk of anemia.

Intestinal disorders: Having an intestinal disorder that affects the absorption of nutrients in your small intestine — such as Crohn’s disease and celiac disease — puts you at risk of anemia.

Menstruation: In general, women who haven’t had menopause have a greater risk of iron deficiency anemia than do men and postmenopausal women. Menstruation causes the loss of red blood cells.

Pregnancy: If you’re pregnant and aren’t taking a multivitamin with folic acid and iron, you’re at an increased risk of anemia.

Chronic conditions: If you have cancer, kidney failure, diabetes or another chronic condition, you could be at risk of anemia of chronic disease. These conditions can lead to a shortage of red blood cells.

Family history: If your family has a history of an inherited anemia, such as sickle cell anemia, you also might be at increased risk of the condition.

Prevention

Many types of anemia can’t be prevented. But you can avoid iron deficiency anemia and vitamin deficiency anemias by eating a diet that includes a variety of vitamins and minerals.

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