Anemia is when you don’t have enough red blood cells. Since red blood cells carry oxygen, you can probably guess what the symptoms of anemia might be: no energy, easily out of breath, pale and washed-out looking–in other words, long-lasting general blahs. Anemia is always due to some other condition, and this is why you need a doctor’s help to find out just why you’re anemic. Because of their periods, women will always have the most trouble with anemia. But the list of conditions causing anemia is huge, from troublesome bleeding hemorrhoids to kidney failure. Or it might be something really simple–taking too much aspirin or not getting enough vitamin B.
Self diagnosis for anemia is not a good idea, even if you’re sure you’ve got all the symptoms. See your doctor about a blood test, then come back to this WholeHealth Chicago Healing Center for a visit. We’ll be glad to help!
On the other hand, if you know right now that you’re anemic, and your doctor has said you need more iron (the most common type of anemia) or some more vitamins (the second most common), then you’ve definitely come to the right place.
What is Anemia?
Anemia is a condition in which there aren’t enough red cells in the blood or existing cells don’t have enough of an oxygen-bearing protein called hemoglobin. The result is that the body is shortchanged on oxygen, which causes weakness and fatigue. Although symptoms may be mild or even nonexistent at first, anemia can be deadly if not caught in time. Anyone who develops symptoms of anemia should see a physician immediately for a blood test to determine the reason. Treatment varies depending upon the type of anemia.
Fatigue, dizziness, weakness
Paleness, especially of the eyelids, gums, and nail beds
Heart palpitations, shortness of breath
Sores in the mouth or on the tongue, easy bruising or bleeding
Numbness and tingling in the legs or feet
What Causes Anemia?
Iron deficiency anemia is the most common type of anemia. Its usual cause is blood loss, which leaves the body short of red cells that can carry iron. Women of childbearing age, especially those with heavy menstrual periods, are vulnerable to iron-deficiency anemia. So is anyone with a condition that involves slow bleeding, such as hemorrhoids, rectal polyps, ulcers, digestive cancers, or regular use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Iron-deficiency anemia is rarely due to lack of dietary iron, since the U.S. food industry adds this mineral to a wide variety of foods.
Folic acid deficiency anemia comes from a deficiency of folic acid, which is crucial in the formation of red blood cells. Most at risk are people whose diets have a poor supply of folic acid and people who don’t absorb it efficiently, among them alcoholics, smokers, people with certain digestive disorders, infants, adolescents who are having a growth spurt, people over age 50, and pregnant or lactating women.
Pernicious anemia comes from a lack of vitamin B12, usually because of an absorption problem, since most people get enough vitamin B12 in their diet. The major exception here are the strict vegetarians (called vegans because they avoid eggs and dairy along with meat, poultry, and fish), since most of our B12 comes from animal sources. Vegetarians do not have an absorption problem regarding B12, they’re just not getting enough of it. Nutritionally oriented physicians routinely advise strict vegetarians to take a good multiple vitamin or a B complex vitamin to avoid this problem.
Chronic illnesses (such as cancer, lupus, or rheumatoid arthritis), hereditary disorders such as sickle-cell anemia, or exposure to toxic drugs, chemicals, or radiation cause other forms of anemia.
Treatment and Prevention
Don’t attempt to diagnose or treat anemia on your own. Before beginning any kind of treatment, you need to find out what kind of anemia you have. This requires a visit to your doctor, who will run tests on a sample of your blood. The results will indicate whether your anemia is due to an iron deficiency (the most common cause) or deficiencies of other nutrients.
Additional tests may be ordered at the start or during the course of treatment to pinpoint the reason for a nutrient deficiency. For example, your doctor may recommend an endoscopy (in which a lighted tube is inserted through the mouth into the esophagus) to locate the source of blood loss that is often responsible for iron deficiencies.
Once the cause of the anemia has been identified, your doctor will advise you about how to treat it. Because nutrient deficiencies are involved in most cases of anemia, supplements often have a valuable role to play. But it’s important to talk to your doctor about which supplements might be right for you. Don’t take supplements to treat anemia, especially iron supplements, without professional advice.
Be sure to take any supplements for as long as your doctor advises. It’s also important to follow any dietary changes that may be recommended. Your doctor should talk to you about any medications you may be taking, especially aspirin or other NSAID pain relievers, which can cause gastrointestinal bleeding. And once treatment is underway, you should have your blood tested on a regular basis to see how you are responding.
Because anemia can be caused by a number of different disorders that affect red blood cells, there is no single strategy for preventing it. But eating a healthy, balanced diet and taking a daily high-potency multivitamin supplement can help your body maintain a proper balance of vitamins and minerals.
How Supplements Can Help
Iron is of course the most important supplement in iron-deficiency anemia. Iron is a vital ingredient of hemoglobin. Work closely with your doctor when taking iron, since an excess can create damaging molecules called free radicals that can raise cholesterol, block arteries, and ultimately cause heart disease. (Most postmenopausal women, and men of all ages, get enough dietary iron and don’t need a supplement.) Doctors recommend taking supplements several times a day with meals and at least 8 ounces of fluid, but not with milk or antacids since these limit how well the iron is absorbed.
Vitamin C taken several times daily may help in all types of nutritional anemia because it helps the body absorb nutrients more efficiently. In one study, strict vegetarians who took vitamin C increased hemoglobin and blood iron levels significantly.
Vitamin B12 and folic acid can remedy anemia due to a deficiency of these nutrients. It’s important to take them both, because high levels of one can conceal a deficiency of the other. They also work together to increase the formation of red blood cells. Also, be sure to take them under a doctor’s supervision. Once anemia is corrected, and as long as absorption problems aren’t the cause of the anemia, a daily multivitamin may contain enough B12 and folic acid to maintain health. Some doctors believe that injected B12 is better absorbed than oral forms, but some studies suggest that B12 placed under the tongue (sublingual) works just as well. Doctors recommend the sublingual form twice a day for one month. The National Academy of Sciences now urges all seniors to take B12 supplements since people over age 50 absorb it less efficiently.
To prevent and help remedy iron-deficiency anemia, eat foods rich in iron such as red meat, dried beans, dried fruits (especially apricots), nuts, shellfish, and liver.
To prevent and help remedy folic acid deficiency anemia, eat foods rich in folic acid such as citrus fruits, spinach, asparagus, mushrooms, soybeans, wheat germ, and liver.
To prevent and help remedy pernicious anemia, eat foods rich in vitamin B12 such as shellfish, lamb, beef, cheese, fish, eggs, and liver.
When to Call a Doctor
If you have any symptoms of anemia.
If you menstruate heavily, are considering conceiving, or are pregnant.
If you are being treated for anemia. Regular blood work can confirm that the supplements you take are doing their job.
From David Edelberg, M.D. at WholeHealth Chicago: Before you take supplements for anemia, you need to find out why you are anemic. Your doctor will order blood tests to determine the cause.
Self-treatment of anemia without a professional diagnosis is a bad idea. This is because even though supplements may improve your anemia temporarily, you could be ignoring an important underlying problem.
For instance, the most common form of anemia, iron-deficiency anemia, is usually due to heavy menstrual periods. But iron-deficiency anemia can actually caused by any loss of blood, including a bleeding ulcer or even a tumor in your colon. In such cases, the anemia is simply a “red-flag” warning. And to mask this warning by self-treatment can be dangerous.
After your doctor has started treatment, be sure to have a blood test every month to make sure it is working.
How to Take the Supplements
These supplement recommendations are only to be used when the cause of your anemia has been determined, and your doctor has recommended that you take a blood-building formula (called a “hematinic”).
Begin with a daily high-potency multivitamin plus a good antioxidant complex. The multi should contain enough B vitamins to prevent the second most common anemia, a B-vitamin deficiency. (The only exception to taking B vitamins is if you’re diagnosed with pernicious anemia, caused by an inability to absorb vitamin B12.)
For iron-deficiency anemia, your doctor will recommend extra iron often combined with vitamin C to improve iron absorption. Blood-building formulas contain iron, vitamin C, and B complex.
For B-vitamin deficiency anemia. Folic acid-deficiency anemias are usually caused by several months of a bad diet; taking a good hematinic will correct this. B12-deficiency anemias (pernicious anemia) occur among strict vegetarians or older people who can’t absorb B12;often this condition requires B12 injections. A note of caution: B-vitamin deficiency anemias can be very difficult to accurately diagnose and treat. You need to be under a physician’s care for this condition.
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700, ext. 2001.
David Edelberg, MD