anaemia is the condition when there is a decreased level of haemoglobin hb in the red blood cells rbc which function by carrying oxygen to various tissues and organs while anaemia can occur due to a variety of conditions including concomitant chronic diseases such as heart and kidney diseases arthritis bowel inflammation etc malignancy hematological conditions including blood cancers and precancerous conditions breakdown of rbcs bone marrow failure hereditary diseases thalassemia sickle cell disease or infectious diseases such as tuberculosis hiv nutritional deficiency remains the most common and easily treatable cause more than two billion people word wide are affected by anaemia as per the national family health survey 5 data its prevalence is highest in india comprising 3986 of total world population of anaemia almost 59 of children 53 nonpregnant women and 50 pregnant women are affected deficiency of essential dietary elements and micronutrients such as iron vitamin b12 and folic acid gives rise to nutritional anaemia this can be due to either a lack of these substances in the diet an increased loss that cannot be compensated by diet alone or an increased unmet demand during pregnancy and lactationa large percentage of the indian population does not consume a balanced diet sufficient in iron vitamin b complexes or folic acid moreover hookworm infestation remains a real problem for developing countries which contributes to decreased absorption and increased loss of these elements chronic gastrointestinal conditions such as celiac disease and other inflammatory bowel disorders helicobacter pylori infection or gastric bypass surgeries may result in the inability to absorb these micronutrients from food deficiency anaemia also result due to increased loss which is mainly seen in women of the reproductive age group due to heavy menstrual bleed iron deficiency in the elderly age group and in men can be indicative of serious underlying conditions such as a gastrointestinal malignancy and hence should be investigated promptly and thoroughly while chronic blood loss result in iron deficiency vitamin b12 and folic acid deficiency mainly occurs when there is a dietary insufficiency particularly in vegans or due to chronic malabsorption pregnant and lactating women are particularly at risk of developing iron deficiency anaemia occurs physiologically in the initial stages of pregnancy due to increased fluid retention by the body resulting in haemodilution the requirement for iron increases over time due to the growing foetus potentiating the risk of iron deficiency frequent or multiple pregnancies coupled with insufficient dietary supplement contributes to the burden of this disease there is a much higher risk of foetal growth retardation spontaneous abortions premature birth and maternal and neonatal mortality and morbidity in women with iron deficiency during pregnancy similarly lactating mothers are also at an increased risk of developing iron deficiency due to a much higher demand during this period symptoms of nutritional deficiency anaemia generalized fatigue and weakness irritability memory impairment shortness of breath palpitation pale skin hair loss brittle nails tingling numbness of hands and feet cravings for nonfood items such as chalk ice mud