Healing Center

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Key Symptoms
 Fatigue, dizziness, weakness

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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.

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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.

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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.

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Self-Care Remedies
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.

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When to Call a Doctor