Symptoms

• Fatigue
• Paleness, especially of the skin, lips, and nails
• Loss of appetite

Less common symptoms of anemia include:

• Headaches
• Constipation
• Confusion
• Disorientation
• Shortness of breath
• Depression
• Memory loss
• Poor reflexes

Approach

There are several causes of anemia. Common to all is either a decreased production of red blood cells, or increased loss of red cells, or both. Increased loss can be caused by hemorrhage (e.g., menstruation, gastrointestinal bleeding) or by increased destruction, usually in the liver.

There are several different types of anemia, but the two most common are caused by nutritional deficiencies. The first is iron deficiency anemia, caused by a shortage of iron. The second is pernicious anemia, caused by a deficiency of vitamin B-12 and folic acid. Fortunately, these anemias are easily diagnosed with a routine lab test: the complete blood count (CBC).

Iron deficiency anemia is caused by a deficiency of the essential mineral iron. When the red blood cell factories in the bones are not getting enough iron, they make less hemoglobin (the iron-containing molecule that carries oxygen). When there is less hemoglobin, the blood cells are actually smaller. This is called a “microcytic” (small celled) anemia. The complete blood count (CBC) reveals smaller than normal red cells, as measured by MCV (mean corpuscular volume). Another part of the blood test is a measurement of the hemoglobin level, and in iron deficiency anemia, that, too, will be below the normal range.

Another test that can confirm iron deficiency is a serum iron test. This test can be used to diagnose iron deficiency, and to track how well replacement therapy is working.

Iron deficiency anemia is often seen in vegetarians, because vegetable-derived foods are naturally low in iron. Iron deficiency is also seen in children--or anyone--on a low quality diet. Many people these days eat fast food and junk food, which will deplete body iron stores without replacing iron or other minerals.

Women with heavy periods or abnormal uterine bleeding may also lose excessive amounts of blood, and develop an iron deficiency anemia.

Severe iron deficiency anemias should be treated with supplemental iron. Dietary sources of iron should also be increased. It is not necessary to eat meat to get iron. Some rich vegetable sources of iron are: beans, peas, soy foods (soy meal, tofu, soy milk, soybean dishes), whole grains, potatoes, sea vegetables (kelp), prunes, prune juice, nutritional yeast, blackstrap molasses, sesame seeds. Foods rich in vitamin C (most fruits and vegetables) enhance iron absorption. Cook in cast iron pots. Avoid caffeinated beverages, which deplete iron stores.

It is not a good idea to take iron preventively in the hopes of staving off iron deficiency before it happens. This is because iron is a “two edged sword,” if you will: too much iron is as bad as too little. Iron is a powerful oxidizing agent, and excess amounts in the body--over and above that which we need to make adequate hemoglobin--depletes antioxidants and places a burden of oxidative stress on the body. So only take iron if a lab test has proven that you need it.

Pernicious anemia is caused by a deficiency of vitamin B-12. This is common in older people and vegetarians.

An MCV (mean corpuscular volume or average size of red blood cell) greater than 95 suggests a folic acid and/or B-12 deficiency. To correct this, take 1-2 B-12/folic acid tablets daily. Do not take either of these essential nutrients alone, as this could exacerbate, rather than cure, the anemia.

Suggested Supplements

For iron deficiency anemia, take 2-4 iron tablets twor three times daily.

For all anemias, whey protein has been shown to stimulate the production of red blood cells.

Whey also stimulates the production of white blood cells. By enhancing bone marrow production of white blood cells, whey protein enhances immune system functioning.