Normocytic anemia, like its name suggests, is a type of anemia where the patient has normal sized red blood cells but do not have a sufficient amount of them. From a laboratory point of view, the mean corpuscular volume is within the normal range but both the haemoglobin and haematocrit count is well below the normal limits. It is often seen in chronic diseases such as endocrine disorders (e.g. hypopituitarism) and like all other types of anemia, most patients with normocytic anemia are presented with non-specific or even no symptoms whatsoever. In such cases, what are the possible treatments available?
Treatments for normocytic anemia depend on the exact cause of the condition. Thus, the first step would be to correctly and timely identify the cause of the anemia. Unfortunately, physicians are often inefficient in their evaluation of this condition, either running a battery of blood tests or foregoing them all together. What they should do instead is evaluate the condition and correlate the progress of the anemia with the patient's medical history. This way, the medical profession would be able to eliminate possible causes of normocytic anemia that doesn't fit into the patient's case and therefore, proceed with the most appropriate treatment.
For normocytic anemia that is caused by acute blood loss, the first step should be to eliminate the trigger of the blood loss as much as possible. For instance, many elderly patients taking non-steroidal anti-inflammatory drugs (NSAIDs) suffer from ulcer formations in the gastric lining and/or gastric bleeding. Even common drugs such as aspirin may pose a threat. In such cases, the removal of the medication should be sufficient as treatment. Similarly, patients with mixed disorders suffering from iron, folate or vitamin B12 deficiency should have these deficiencies quickly corrected through a well balanced diet or pharmaceutical supplements.
However, patients whose normocytic anemia is caused by renal (kidney) disease, the anemia is usually associated with a lower than normal amount of erythropoietin circulating in the cardiovascular system. Erythropoietin (or more commonly known as the cycling drug EPO) is what stimulates and guides the production of red blood cells. Thus, deficiencies in erythropoietin would lead to falls in the red blood cell count. Currently, there are considerable interest and research devoted to treatments involving exogenous erythropoietin, which are administered to the patient via injections. In addition, the provision of optimal nutrition and supportive care also helps to speed up treatments.
The other cause of normocytic anemia is cancer and/or failure of the bone marrow (aplastic anemia). In such cases, normocytic anemia would be the second condition and although erythropoietin will be administered to help stimulate red blood cell production, the main focus would be to cure the primary disease cancer.
In conclusion, there are many possible causes of normocytic anemia and as a result, many treatments of this condition. Generally, a well balanced diet should be maintained to minimise the risks of developing this disease. While it is not the role of the patient to be aware of the diagnosis and treatments, they have the responsibility to recognise the signs and seek medical condition as soon as possible if they suspect they have normocytic anemia.
Kumar, P. and Clark, M. (2005) Clinical Medicine. USA: Elsevier Limited.