By Dr. Loretta Lanphier, ND, CN, HHP, CH

Some people describe anemia as akin to having “tired blood.” Well, I don’t know how true it is that an anemic’s blood is tired, but I know that they may very well feel tired and run-down a lot of the time. Fatigue is the hallmark symptom of anemia, but there’s a whole lot more to this common malady that can thankfully be prevented in most cases.

What is Anemia?

Anemia is a common blood disorder that is characterized by abnormally low levels of healthy red blood cells. Red blood cells are critical for delivering oxygen to tissues all over the body. A lack of available oxygen in the body leads to the main symptom of anemia, fatigue. Insufficient oxygen also puts our bodies into an unhealthy state that opens the door to many kinds of disease.

Anemia is a common condition that affects over 3 million Americans. There are more than 400 known types of anemia. It can range from so mild that you don’t even know you have it, to severe enough to be life threatening.

Red blood cells are responsible for delivering oxygen to the body. They only live for about 120 days, and are then recycled and used to create a new supply of red blood cells. Anemia occurs due to several conditions:

  • Blood loss that reduces the number of red blood cells.
  • Reduced production of red blood cells.
  • Increased destruction of red blood cells.

What Causes Anemia?

Understanding the basics of how our blood is designed will help us to better understand anemia. The blood is composed of three main components:

  • White Blood Cells: These are the cells that are part of the immune system, and are responsible for helping the body fight infection.
  • Platelets: Their main function is to help the blood clot to stop the flow after a cut or wound.
  • Red Blood Cells: Also called erythrocytes, these are the vehicles for the distribution of oxygen throughout the body. Without enough oxygenated blood, every system of the body suffers, they are not able to function properly, and they are put in a compromising position that makes them more prone to disease.

A substance called hemoglobin is the actual agent that makes it possible for the erythrocytes to transport oxygen. Hemoglobin is a protein that has a high iron content, and it also gives the blood its characteristic red color. Hemoglobin is also responsible for carrying carbon dioxide to the lungs so that it can be exhaled. This specialized protein plays a key role in keeping the body’s “engine” running smoothly. In a way, it is similar to an automobile engine. Oxygen must be present for combustion (energy), and the waste products must be expelled via the exhaust system (exhalation).

As with most health conditions, a nutritious well-balanced diet is critically important for hearty red blood cells, and is the best defense against most forms of anemia. The majority of blood cells, including erythrocytes, are manufactured by the bone marrow. This is the factory where the dead red blood cells are recycled and used along with iron and vitamins from the foods we consume to form new ones. When the system breaks down, enough hemoglobin-rich erythrocytes are not produced, and your body becomes anemic.

Among the hundreds of types of anemia, there are a handful that are the most commonly found:

  • Iron Deficiency Anemia is by far the most common form of anemia, and is found in about 20% of all women (50% of pregnant women) and only 3% of men. As the name indicates, iron deficiency anemia occurs when there are insufficient levels of iron in the body. This can be caused by not enough iron in the diet, or by blood loss that lowers the amount of iron in the body. Sometimes your body may try to compensate by producing more red blood cells, but without enough iron they are often abnormally small. Heavy bleeding or hemorrhaging does not give the body enough red blood cells to recycle to form new ones. So, if you lose blood, your iron levels drop. It is a vicious cycle, because as iron levels drop, there is less iron available for hemoglobin-rich red blood cells, which makes the iron plummet even lower. This is why anemia can be a progressive condition that may start out with no symptoms and slowly worsen to the point where signs such as fatigue become apparent. Internal bleeding, or a condition that causes chronic blood loss such as an ulcer, can lead to anemia. Women who have heavy menstrual periods are also at risk for this type of anemia. Women who are carrying a baby must make sure they get plenty of iron in their diets. The fetus growing inside them demands a lot of iron, and this may deplete the mother’s iron to problematic levels. Just think “Popeye” mom, and remember to eat your spinach! (Not canned though—fresh, raw, organic is best).
  • Vitamin Deficiency Anemias: Vitamin B12 and folate (B-complex) are also needed by the body at sufficient levels to produce enough healthy erythrocytes. Most of the time, this type of anemia is due to a poor diet that does not contain enough of these nutrients. Another less common cause is one of several intestinal disorders that result in the inability of the body to absorb nutrients properly. If a person has a specific inability to absorb vitamin B12 and becomes deficient in B12, it is referred to as “pernicious anemia.” Since the body stores B12, it may take quite a while before pernicious anemia makes itself known, up to 4 years in some folks. Again, eating a healthy balanced diet will avoid most cases of vitamin deficiency anemia.
  • Chronic Disease Anemia: Chronic anemia is a secondary form of anemia due to a side effect of another condition. Many chronic illnesses can interfere with the production of healthy red blood cells. Examples of such conditions include: Crohn’s disease, alcoholism, rheumatoid arthritis, and cancer. Kidney disease can also result in anemia due to low levels of a hormone called erythropoietin that is normally produced by the kidneys and used by the body to manufacture red blood cells. Some forms of chemotherapy used in the treatment of cancer can also bring on anemia by destroying erythropoietin.
  • Hemolytic Anemias: These types of anemia are the result of erythrocytes being killed off faster than the bone marrow can produce them. This can be caused by a variety of things including medications (some antibiotics, for one), and certain blood diseases that result in the premature death of red blood cells. Some autoimmune diseases can also mistakenly identify red blood cells as invaders to be destroyed. Jaundice (yellowing of the skin) may be a sign of hemolytic anemia. Enlargement of the spleen can also occur with this type of anemia.
  • Bone Marrow Disease Anemias: Certain diseases that are associated with bone marrow dysfunction can result in too few hemoglobin-rich red blood cells and cause anemia. Some of these conditions cause a reduction in erythrocyte production, while others can be life-threatening by completely shutting down the body’s ability to make blood. Examples of diseases that can cause bone marrow related anemia are: leukemia, myelodysplasia, multiple myeloma, and certain forms of lymphoma. Many of these are types of cancer or precancerous conditions.
  • Aplastic Anemia: This type of anemia occurs when the bone marrow is damaged or unable to produce all three forms of blood cells—red, white, and platelets. The cause of aplastic anemia is not known for sure, but it is suspected to be an autoimmune condition. Possible triggers may be lupus and other inflammatory autoimmune diseases, exposure to environmental toxins, and side effects of chemotherapy and/or radiation therapy.
  • Sickle Cell Anemia: This is an inherited form of anemia that is found almost exclusively in Africans and some Mediterranean peoples. A defective form of hemoglobin forms abnormally shaped red blood cells (sickle-shaped) that are not able to survive and function normally. This is a serious disease that results in a chronic shortage of red blood cells.

What Are the Symptoms of Anemia?

Fatigue is the number one symptom associated with all forms of anemia. Other signs may include:

  • Pale skin
  • Lack of color in the nail beds, gums, creases of the palms, or lining of the eyelids.
  • Dry, brittle nails with uncharacteristic ridges in them
  • Headaches
  • Angina pectoris (chest pain, often associated with a choking feeling that may cause anxiety
  • Shortness of breath
  • Dizziness
  • Irregular heartbeat
  • Unusual perspiration
  • Unusual thirst
  • Inflammation of the mouth or tongue (stomatitis or glossitis)
  • Insomnia
  • Cognitive problems such as memory loss or inability to concentrate
  • Sores in the rectal area
  • Tinnitus (ringing in the ears)

Pernicious anemia (B12 deficiency) has the potential to cause spinal chord damage, and should be dealt with without delay. It has some specific signs that may help to diagnose it:

  • An unusual slick feeling to the tongue
  • Difficulties with movement or balance
  • Tingling in the extremities
  • More intense cognitive issues, such as depression, memory loss, and confusion

What Can Be Done to Prevent or Treat Anemia?

Most forms of anemia, other than secondary or inherited ones, can be dramatically turned around or completely avoided by a quality diet. Many mainstream doctors will tell you that you must eat dairy products and meat to get enough iron. Some even go as far as saying that vegetarian diets are dangerous because they do not provide enough iron and lead to chronic anemia. This advice is nonsense. There are plenty of high quality sources of vegan iron. Even if you do choose to consume some dairy foods and meat, you should keep them to a minimum and focus on other sources of iron and vitamins. Some excellent foods that provide lots of iron include:

  • Broccoli
  • Spinach and other leafy green veggies
  • Whole grain rice (brown or wild)
  • Almonds
  • Dried beans
  • Dried fruits
  • Tomatoes
  • Potatoes
  • Whole grain breads and cereals

Other nutrients that often cause anemia due to deficiency are vitamin C and folic acid. Vitamin C helps to stimulate iron absorption. A good tip to remember is that fresh, raw fruits and vegetables provide the most vitamin C and folic acid (as well as many other nutrients). Fruits and veggies have a very short “shelf-life.” Light and heat are especially harmful to folic acid.

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