Anaemia

Anaemia is a deficiency of either haemoglobin (the carrier of oxygen) or erythrocytes (red blood cells) in circulating blood (1). This results in a reduced oxygen carrying capacity of the blood which produces a variety of health disturbances.

Iron deficiency is misunderstood because in its early stages, it is seldom recognised. This is because only its severe form shows up in routine blood tests as anemia.

Iron deficiency is the most common nutritional deficiency worldwide and the most common deficiency medically recognised. Abundant in many foods, iron remains difficult to absorb. Anaemia is rarely thought of as the basis of many common health problems; yet it affects women with progressive severity from the teen years onwards.

General Symptoms of Anaemia

Anaemia is associated with: weakness, shortness of breath, dizziness, irritability, restlessness, drowsiness, poor concentration, headaches, tinnitus (ringing in the ears), ease of fatigue, sugar cravings, palpitations, amenorrhoea (loss of menstruation), menorrhagia (heaving menstruation and/or flooding), reduced libido, brittle nails, and in severe cases, spots before the eyes and bizarre behaviour. (2)

Iron Deficiency in Children

In Australia an estimated 5% of children under the age of one are iron deficient and in very young children, iron deficiency produces irreversible intellectual impairment. Breath holding spells, blue sclera (the sclera is the white of the eye), spooning of the nails, gastrointestinal disorders, and a reduced ability to exercise all may be connected to anaemia in children.

Iron and Nutrition

Iron is abundant in many food sources, yet hard to absorb. Foods richest in iron include: egg, organ meats, red meats, poultry and fish. Diets that are rich in vitamin C increase iron absorption.

Other iron-containing foods include: fortified cereals, enriched grains, dried beans, fruit, peas and spinach. However, it is difficult to absorb iron from these foods because they are high in fibre which contains phytates (which bind minerals reducing absorption) and plant cellulose.

Inhibitors of iron absorption include: calcium, phytates, tannic acid in tea, caffeine in coffee and other beverages, caffeine in foods and medicines, phosphates and plant cellulose.

The common practice of drinking tea or coffee after meals reduces iron absorption from all foods. Avoiding caffeine for two hours before and after eating greatly reduces this interaction.

Calcium inhibits the absorption of all forms of iron as it interferes with iron transport through the gut. It is more effective to take calcium vitamin supplements with high carbohydrate meals (for example pasta).

Iron - Food Content and Absorption Chart
Food	Iron Content	Absorption Rate	Fibre Content
red meat	very high	very high	low
eggs	very high	very high	low
white meats	high	high	low
green vegetables	high	very low	high
other vegetables	variable	very low	high
whole grains	low	very low	high
refined grains	low	low	low
nuts/seeds	variable	low	high
legumes	low	very low	high

Iron Absorption Chart
Iron Saboteurs	Iron Content	Absorption Rate
caffeine/chocolate	minimal	reduces absorption
all cola drinks	minimal	reduces absorption
high fibre foods	minimal	reduces absorption
whole grain foods	minimal	reduces absorption
refined foods	minimal	neutral effect

Iron absorption is improved by vitamin C rich foods and supplements. Vitamin E and C supplementation increase the lifespan of cells because of their antioxidant properties.

Iron Deficiency

Iron deficiency is the most common cause of anaemia. It generally responds rapidly to nutritional improvements which may include supplements. Taking a multivitamin that includes; B12, Folic Acid and Vitamin C (which improve iron absorption) and Vitamin E (which helps red blood cells last longer), with an iron supplement is beneficial. The reason not to take additional iron would be the presence of active liver disease. If in doubt, you should check with your Medical practitioner.

Anaemia and Your Health

Anaemia effects your health by decreasing oxygen availability to body tissues. This has a profound effects on all aspects of health.

Our whole body, including our immune system is fuelled by oxygen. Prolonged anaemia often reduces immune strength. This may allow your health to be ravaged by conditions such as: allergies, candida, thrush, viruses, bacteria, chronic fatigue, herpes, genital warts, gynaecological problems or other chronic health problems.

The Three Stages of Iron Deficiency

Many medical experts may find the iron deficient woman difficult to diagnose. This is because iron deficiency is often identified only when it has already progressed to anaemia (stage three). In the first two stages of iron shortage there is no deficiency of haemoglobin or erythrocytes. The most common medical test for anaemia, looks for a decrease in the level of erythrocytes. This only occurs in advanced iron deficiency. This is why iron deficiency without anaemia is seldom diagnosed. Even though anaemia is generally not a life threatening problem, it can be linked to many common health concerns.

Menstrual Problems

Menstrual disturbances are often linked to iron deficiency. This is aggravated by normal monthly menstruation. Because the more blood you lose, the weaker your blood becomes. Then your clotting time increases and bleeding increases. Periods then become heavier longer and more irregular. In its extreme this problem can lead to two periods per month, or ultimately the need for a hysterectomy.

Daily Nutritional Needs

The most common blood disturbance amongst the total population is anaemia caused by deficiency of iron, B12 and folate with one third of Australians being affected. Vegetarians who don't eat eggs and dairy foods are amongst those most at risk.

Vegans (are vegetarians who do not eat animal products) often have low levels of B vitamins (especially B12) iron and essential fatty acids. To help compensate for this health-wise vegans should include three to five teaspoons of cold pressed seed oils such as olive or grape seed per day. A daily teaspoon of molasses to provide extra iron and calcium and a daily tablespoon of brewers yeast will provide extra B vitamins. This will help supply essential vitamin and fatty acid needs. It would also be an great booster for anyone who does not like taking supplements in pill form.

If you obtain your iron from animal products, a minimum of two grams of protein per kilo body weight is recommended. This means that if you weigh 55 kilos, it would be best eat at least of 110 grams of protein per day. More dietary protein is recommended if you do regular or heavy exercise.

Body Stores

A healthy body has a two-year reserve supply of iron stored in the liver. This is why nutritional lack generally exists for years before health problems occur. So, iron-rich nourishment is a general long term health enhancer.

A case study in the treatment of Anaemia

The case of Mary.

At 36 years of age Mary suffered miserably, due to her many health problems. Mary was enduring bad sleep, severe tiredness, diarrhoea, chronic back pain, intestinal wind, and two periods every month. A recent laparoscopic operation had diagnosed endometriosis. Looking at her iris (iridology) revealed congested lymphatics and very weak blood. Further evaluation showed that Mary was reacting badly to wheat, dairy foods, the 'nightshade' vegetables - potato, tomato, eggplant tobacco, monosodium glutonate and shellfish. I recommended she reduce her intake of these foods. Mary said "If I can't eat my marinara (which is pasta with tomato and seafood) and bread what is there left to live on." I said "sour dough bread".

You can eat sour dough bread as the natural fermenting of flour by natural yeast (this makes the dough rise) makes the carbohydrate much more digestible so it will absorb well. The sour dough process also inactivates the phytates in whole grains so minerals including iron are well absorbed. This nutritional factor was crucial to Mary's recovery.

I also recommended that she eat more green and orange vegetables, home made vegetable soup, rice and cold water fish. For snacks between meals, fresh fruit would provide nutrition and energy. Chips and packet snacks were fuelling her poor health.

Mary said "I'll give it all a go for a month, and see if I feel any better". Desperation and fear of the endometriosis returning had motivated her to drastically change her diet. The vitamin supplements I recommended included - a herb concentrate tablet of St. Marys Thistle, a blood tonic containing iron B vitamins herbs and minerals, and a powerful echinacea C, E, and zinc complex. At bedtime she took a magnesium potassium calcium complex and activated charcoal.

After one month Mary was sleeping much better, and her back pain had gone completely. Also, intestinal wind was no longer causing regular discomfort and embarrassment. Mary had much more energy and said " I am really starting to enjoy life for the first time in ages, so I'm going to keep going with all this". As Mary was still having two periods a month, I added homoeopathic hormone balancing formula to her supplement program which otherwise remained the same.

After two months Mary's menstrual periods were now monthly, although they were still very heavy. She was very pleased that none of the endometrial symptoms had returned. We were both truly impressed with results that her nutritional changes. Mary once again started to go out dancing and play tennis.

After three months she was sleeping well. Tiredness was only apparent if she regularly burnt the candle at both ends. Mary knew this was her body's signal to rest more. Her periods were regular with only one day being heavy.

Another year has passed and Mary has not had any endometriosis symptoms return. Her periods remain regular and without pain or other debilitating symptoms. She was so pleased with her original nutrition program and she remains fairly true to it. Mary and I still send each other Christmas cards each year.

End-notes and Recommended Reading

1. Dorlands Pocket Medical Dictionary 21st Edition
2. The Merk Manual 14th Edition
3. Novak's Text book of Gynaecology 11th edition Williams and Willkins, 1987.
4. E. Perry Good, In pursuit of happiness New View Publications 1996
5. F. Naish and J. Roberts Better Babies Random House 1996

©1998 Miriam Orwin. This article may not be reproduced in part or full without the author's written consent.