Sion Pedrog outlines some common blood disorders and asks how underwriters view different conditions
Blood is the life-maintaining fluid that circulates through the body's heart, arteries, veins and capillaries. The blood carries away waste matter and carbon dioxide and brings nourishment to every cell in the body.
A blood test is probably one of the most common investigations undertaken by a GP and can lead to a wealth of information to enable the GP and underwriter to make their assessment.
The adult human body contains approximately five litres of blood and makes up 7% to 8% of body weight. Blood is made up of about 78% water and 22% cells.
The liquid portion of the blood is termed 'plasma' and this is a clear, yellowish fluid.
The main basic constituents of the cellular portion of the blood are the red cells, white cells and platelets:
Red cells: The red cells carry oxygen from the lungs to the cells of the body and are by far the most numerous. They are manufactured in the bone marrow and millions of these cells are released into the bloodstream each day. A constant new supply of red blood cells is needed to replace old cells that break down.
White cells: The white cells form part of the immune system and help the body fight infection. They circulate in the blood so that they can be transported to an area where an infection has developed.
Platelets: The main function of the platelets is to help blood to clot by forming something called a 'platelet plug'.
The most common blood disorders which are disclosed on application forms and which financial advisers are likely to encounter include the following:
Anaemia
Anaemia means there are less red blood cells than normal and a reduced amount of oxygen is carried around in the bloodstream.
The symptoms of anaemia include tiredness, lethargy, feeling faint and becoming easily breathless. Less common symptoms include headaches, palpitations, altered taste and ringing in the ears (tinnitus).
The main causes of anaemia are:
• Pregnancy. There are times when more iron than usual is required. The amount of iron that is eaten during these times may not be enough.
• Heavy menstrual periods. The amount of iron that you eat may not be enough to replace the amount that is lost with the bleeding each month.
• Poor absorption of iron. This may occur with some gut diseases. For example Coeliac's disease (hypersensitivity of the small intestine to gluten in foods such as wheat, barley and rye, which gives rise to malabsorption) as well as Crohn's disease (a chronic inflammatory disease of the colon).
• Bleeding from the intestines. The bleeding may be slow or intermittent and blood can pass with the faeces without noticing.
• Poor diet. Your diet may not contain enough iron.
There are also other less common factors, which may lead to anaemia but, as can be seen from the above, it is important to identify the underlying cause in order that terms of cover are available.
Sometimes, the underlying cause is obvious as with pregnancy or women who have heavy menstrual periods. In these situations, no further tests may be needed and treatment with iron tablets may be advised. However, the cause of the anaemia may not be clear and further tests may need to be organised.
Leukaemia
The word leukaemia comes from the Greek for 'white blood'. Leukaemia is a cancer of the blood, which occurs when too many white cells of the blood are produced. In some cases, the patient's blood appears to be milky. Not only are there too many white blood cells, but those that are produced do not work properly. As the leukaemia cells take over, patients develop symptoms such as excessive bruising, breathlessness and can develop infections, which may be hard to shake off. This is because the blood cells, which normally control these things, can no longer do their job properly.
Leukaemia is referred to as either chronic or acute, depending on how rapidly it develops and worsens.
Treatment, once diagnosed, will depend on the patient's level of general health and fitness but may be a combination of chemotherapy, radiotherapy, steroid therapy or bone marrow transplant.
Haemophilia
The cause of haemophilia is due to a platelet or 'clotting' deficiency. Haemophilia is an inherited disorder and is a lifelong deficiency condition.
Just how easily or badly a haemophiliac bleeds will depend on the severity of the deficiency. The mildest sufferers will only have abnormal bleeding after major injury or surgery, whereas the most severely affected will have spontaneous haemorrhages, particularly into joints but also skin, muscles and organs, causing extensive tissue damage. Joint damage from intra-articular haemorrhage can cause long-term damage, while haemorrhages into the brain are particularly difficult to manage and can be fatal.
Treatment will normally consist of medication to try to raise the levels of the missing clotting factors, or they may receive facto concentrate, but the management of acute bleeding is essential if long-term health is to be sustained.
Raised cholesterol
Cholesterol is a waxy, fat-like substance found in the bloodstream. Although cholesterol is an important substance for the normal functioning of the body, when levels in the blood rise (hypercholesterolaemia), problems can occur.
A high level of cholesterol can be found to be due to various factors including family history, eating habits and alcohol consumption.
Excess cholesterol is deposited in the wall of arteries to produce areas of plaques called atheroma. These plaques narrow the blood vessels and reduce the blood supply to the tissues. This produces a range of cardiovascular diseases (disease of the heart and blood vessels), which are the most common causes of death in the western world. Conditions include include heart attack, angina, abnormal heart rhythm, stroke and even dementia.
Once a diagnosis has been made, the usual treatment is to take up regular exercise and alteration of diet to lower the amount of animal fats in the diet.
If these measures are unsuccessful or the initial cholesterol readings are too high, treatment with medication may be required.
Sion Pedrog is a senior life and disability underwriter at Scottish Equitable Protect.
