Anaemia is a still a serious problem and is present when:-
- your levels of Hb -haemoglobin (the protein that transports iron and oxygen) are low
- you have fewer healthy Red Blood Cells (RBC) that contain haemoglobin
- you have RBC that may be smaller and paler than usual
If you have low iron and fewer RBC you will be getting less oxygen to your cells which can lead to cell damage, poor mental function, low energy and even cancer.
If you also have low Ferritin then that shows that you are not storing sufficient iron in the body and this could be due to low levels of nutrients required to make healthy RBC or you may be losing too many from the body.
If you have high Ferritin in the body then it may indicate an Anaemia of chronic disease or an inflammatory response where the body is in defense mode and storing more iron and this is why Anaemia should never be treated before knowing the cause. To take an iron supplement without a diagnosis from a Doctor can be dangerous.
As a Nutritionist I am concerned as I would have thought that Anaemia should have declined with rising standards of living, more protein in our diets and better knowledge of nutrition generally but that doesn’t seem to be the case. I know personally of three people, ages from 7 to 40, on good diets, who have anaemia with low Ferritin levels that partially respond to iron supplementation but their Ferritin levels remain low. This would suggest that other factors are missing in their diet that convert the iron into the correct form for re-use and storage. I believe this could be due to missing micro-nutrients in both the food consumed and modern choices in diet that limit the intake of iron, copper and zinc and possibly Vitamin B12. Skip to the section on Treatment for iron deficiency Anaemia if you already know about anaemia in general and would like to know more about micro-nutrient deficiency.
Facts and Figures
Normal levels Hb are
Men 13.5 to 17.5 gm/dL
Women 12.0 to 15.5 gm/dL
Children 11.0 to 13 gm/dL
*30% of the World Population has iron deficiency Anaemia
* there are over 1 million deaths a year from Anaemia
* according to a recent study in The Lancet Anaemia is 3rd on the list of medical problems that cause suffering and more Years Lived with Disability(YLD) coming higher than Diabetes that is in 7th place.
So Anaemia is a serious condition and should be viewed as a symptom rather than a disease in itself.
Signs and Symptoms of possible Anaemia
- weakness or fatigue
- shortness of breath
- poor memory or cognitive skills, brain fog
- pallor ( pale skin, pale inside eyelids, pale lips)
- rapid or irregular pulse
- sore tongue
- fingernail abnormalities and pale or blue tinged nail base
- Restless leg syndrome
If you have two or more of these symptoms you should see your Doctor for a blood test.
Some of the CAUSES of Anaemia
- Diet – lack of any of the nutrients needed – Iron, B Vitamins especially Folate and B12, Vitamin A, Vitamin C, Copper and Zinc
- Medication side effect – aspirin, NSAID’s causing bleeding in your digestive tract, Chemotherapy, PPI’s or other drugs that lower gastric acidity, Calcium supplements
- Poor Absorption – not enough stomach acid, lack of Intrinsic factor in stomach, celiac disease, Inflammatory bowel diseases, hypothyroidism, eating disorders, gut parasitic worm infections, or following surgery to digestive tract.
- Blood loss – due to heavy periods, childbirth, injury, surgery, digestive tract disease.
- Inflammatory conditions – Autoimmune Disease, Thyroid disease, Malaria, Arthritis, Diabetes
- Poisoning – heavy metals – lead, Cadmium, chemicals, alcohol abuse
- Rare disorders of the blood
Treatment for iron deficiency Anaemia
Normally this will involve taking an iron supplement and there are different types – Ferrous Sulphate, Ferrous Fumarate, Ferrous Gluconate, and sometimes with additional Vitamin C to help absorption. Heme iron polypeptide can be given when the regular supplements are not tolerated or absorbed and therapy usually needs to be continued for 3-6 months to raise body levels. There are other, over the counter supplements that may also be better tolerated either because of chelation or in liquid form with co-factors like B12. In more severe cases iron can be given by injection or I/V infusion or by regular blood transfusion.
Improving the dietary intake of all the nutrients needed for recovery may mean making considerable changes to your diet. It is best to try to increase your nutrients in several ways and spread iron intake out over the whole day as the body is only capable of absorbing small amounts at a time. Up to 45 mgs a day should be tolerable by most adults. If you are vegetarian or vegan then you will need to take special care and also continue long term. The iron most easily absorbed is heme iron from meat, blood, some seafood and fish and the iron from plant sources is harder for the body to utilise. Vitamin B12 should always be supplemented if you don’t eat meat or fish.
Foods containing B12 in order of highest (48 mcg per serving) to lowest content (0.6 mcg)
Liver, Clams, fish roe, red meat, Turkey, Chicken liver, Chicken, Fortified breakfast cereals, trout, salmon, live yogurt, milk, egg.
Foods containing Folate, B9 or Folic Acid highest 185 mcg to lowest 25 mcg
Liver, fortified breakfast cereals, spinach(lightly cooked), Asparagus, baked beans, Broccoli, Avocado, enriched bread.
Foods containing Iron highest 13.2 milligrams per serving to lowest at 1 mg
Oysters, liver, Prune juice, Clams, Anchovies, Octopus, Walnuts, Chickpeas, Bran Flakes, Roast meats, Raisins, Kale, spinach, Beet greens, Coconut meat and milk, Arrowroot, Cocoa powder, green peas, leeks and egg.
Foods containing Zinc
meats – Lambs Liver, Lamb, Ostrich, Pork, Chicken Liver, chicken heart
fish – Sardines, Scallops, shrimp, squid, swordfish, snapper, Trout, Tuna, Crab, Eel, Lobster and Oysters
fruit and vegetables – Prunes, Raisins, Coconut meat and coconut milk, pumpkin seeds.
Foods containing Copper
meats – Lambs liver, Quail, Beef liver, Gelatine.
fish – Sardines, shrimp, squid, swordfish, Talipia, Trout, Tuna, Scallops, crab, Lobster, Oysters, Eel
fruit and vegetables – Prunes, Raisins, Coconut meat and milk, Dates, Garlic, Kohlrabi
Foods containing Vitamin A / Beta- Carotene
A fat soluble Vitamin therefore it needs to be consumed with fat for optimal absorption. best taken as wholefood and not supplements. In studies Beta -Carotene significantly increased iron absorption and also overcame the inhibitory effects of compounds like tannin in tea and coffee and phytates in non-heme iron, wholegrains, nuts and seeds.
Sweet Potatoes, carrots, peaches, oranges, prunes, dark leafy greens, winter squash, beets and beet greens, lettuce, dried apricots, cantaloupe, corn, bell peppers, fish, liver, red grapes and tomatoes.
HOW THESE FOODS CAN HELP IN YOUR DIET
So you can now see how prevention and treatment of Anaemia is much more complicated than you might have thought! OK we may not all be able to add Oysters, Quail or Lobster to our diet but Prune Juice, Sardines, fresh vegetables, dates, jelly (gelatine), Chocolate mousse made with cocoa powder, honey and chilled coconut cream, bone broth, Coconut and coconut milk, even picky eaters often like meatballs in tomato sauce and if you make them yourself a little mashed or ground liver can be easily hidden within. Even people who don’t like the texture of liver will often be able to eat pate. When you buy liver do try to get Organic as it is still a cheap meat. Eat plenty of fresh vegetables and vitamin C fruits and berries with each meal to help absorb the iron. Snack on dried fruit and nuts and seeds.
If you still feel that you may not be able to get all of these necessary nutrients in your diet or you are not well enough to eat properly then I would suggest that you take a daily Sizzling Mineral supplement that you can buy from Simply Naturals.
The changes to our Western diet over the last 50 years have been much greater than most people realise. It was common to eat Liver, kidney, heart, fish was cheaper and cod roe on toast or crab or sardine pastes were also common tea-time treats for children rather than just bread and jam. We also used to eat cooked dried fruits and custard, and we were given Cod liver oil and orange juice by the NHS as post war children. Now we have to cope with food that has most of the goodness processed out or fresh food that contains less minerals due to soil depletion and farming methods so we have to make more effort to get the optimum nutrition we need for health.
What factors don’t help in your diet.
Too much tea or coffee as tannin interferes with iron absorption; too much fibre as found in grains, legumes and other plant food; Dairy products; Eggs – although egg yolk contains iron there is a protein that binds to the iron inhibiting its absorption and that of any other iron in the meal by as much as 28%. Too much alcohol can also inhibit iron absorption and it is not true that Guinness or Stout contain loads of iron, the average is 0.3 mg per 100 ml of Guinness and 0.05 mg per 100 ml Stout, although they do contain helpful B Vitamins. Red wine contains more iron at 0.9 mg in 100 ml but alcohol is not a good way to get your nutrients 🙁
“Baby Boomers”and above watch out for the common prescription concoction of NAID’s (anti-inflammatory drugs) combined with drugs to protect you stomach like PPI’s. These can lead to gut damage, malnutrition from both gut damage and also low stomach acidity which makes it almost impossible for your body to break down and absorb all the nutrients you so badly need if you already have joint deterioration or arthritis. There are natural, alternative anti-inflammatories like Turmeric and Omega 3 fish oils with proven effect and no long-term damage only benefit.
I would love to hear from anyone having problems with Iron deficiency Anaemia with continuing low Ferritin levels as I believe we might be seeing a new epidemic of this problem – don’t be shy – Comments below will be answered. Or connect on my Facebook Page at https://www.facebook.com/millenniumhealth