Anaemia
Anaemia is a condition in which there is a reduction in the number of red blood cells, or a reduced amount of haemoglobin in the red blood cells. Haemoglobin is the iron containing protein in red blood cells which transports oxygen around the body. The reduced oxygen levels reflect in the symptoms of anaemia, such as fatigue.
Haemoglobin deficiency occurs when there is a reduced number of circulating red blood cells due to insufficient production; formation of abnormal red blood cells; or an increased loss of, or destruction of red blood cells.
There are several types of anaemia, the most common is iron deficiency anaemia, with about 5% of the UK population being affected. Worldwide however the proportion of people affected by iron deficiency anaemia is much higher.
In iron deficiency anaemia, loss of iron exceeds the intake, and iron stores decrease. If this occurs gradually symptoms may initially go unnoticed. In the early stages fewer red blood cells are formed though they usually appear normal. As the body tries to compensate for the reduced haemoglobin level the bone marrow produces the smaller red blood cells typical of iron deficiency anaemia.
Iron is most commonly lost through bleeding in iron deficiency anaemia. The bleeding may not be apparent such as chronic low level blood loss from a peptic ulcer, from the gums in gum disease, or as a result of chronic anti-inflammatory medication use which damages the gastrointestinal tract lining. Other possible causes of blood loss include haemorrhoids, heavy menstrual blood loss, and polyps of the colon.
Insufficient intake of iron may result in iron deficiency anaemia. This is more likely to occur when someone has reduced food intake or avoids foods rich in iron, such as red meat. Children and teenagers have a greater requirement for iron because they are growing. Pregnant women also need to have sufficient iron intake for the growing foetus.
Health conditions which affect absorption of nutrients including iron may also cause deficiencies. Coeliac disease and irritable bowel syndrome are two examples which may lead to iron deficiency anaemia.
Premenopausal women should also be aware that anaemia can actually cause heavy menstrual periods. See research below.
Symptoms of iron deficiency anaemia
Symptoms reflect inadequate oxygen levels and include fatigue, lethargy and weakness and may often be put down to having a busy or stressful lifestyle. More obvious symptoms such as dizziness when standing, shortness of breath and feeling faint are more likely to be investigated. Family members are likely to notice that the affected person appears pale.
Severe iron deficiency anaemia may result in palpitations and rapid breathing. There may be a sore mouth, tongue or gums, and cracks at the corners of the mouth. Fingernails may be brittle and become misshapen. Severe iron deficiency anaemia may also cause chest pain and even heart failure.
Some people with iron deficiency anaemia develop cravings for non-foods such as coal, paper or soil.
Treatment of iron deficiency anaemia
If iron deficiency anaemia is suspected it is vital to seek professional advice, to discover the underlying cause, rule out conditions such as coeliac disease, and/or any potential source of bleeding. Iron deficiency anaemia can be diagnosed with a simple blood test.
Severe iron deficiency anaemia is likely to require a blood transfusion. Milder cases are often treated by improving dietary intake and/or supplementation.
Dietary sources of iron
Dietary iron occurs in two forms, haem iron and non-haem iron. Haem iron is more easily absorbed and occurs in animal products, meat, fish and poultry. Non-haem iron sources include pulses, wholegrains, dried fruits and leafy green vegetables.
Iron absorption is improved if vitamin C is consumed at the same time.
However, some foods inhibit iron absorption by binding to the iron in the gut preventing its assimilation. Foods containing oxalates (beetroot, chocolate), tannins (tea), phosphates, bran and antacids should not be consumed at the same time as iron rich foods if you are trying to increase your iron intake.
Herbs traditionally used by herbalists for iron deficiency anaemia have several benefits. Bitter herbs such as gentian and dandelion root help to improve digestion and absorption generally. Herbs such as nettle leaf, yellow dock root and parsley leaf are very nutritious and contain relatively large amounts of iron and other minerals. And some herbs such as amla fruit and parsley leaf help to improve iron absorption because they are naturally high in vitamin C.
If you would like to include herbs in your treatment plan for iron deficiency anaemia please consult a qualified herbalist.
Research
A short review of malabsorption and anaemia; abstract full-text PDF
Iron deficiency, Helicobacter infection and gastritis; abstract
Effect of Iron Therapy on Platelet Function among Iron-Deficient Women with Unexplained Menorrhagia; abstract